As part of the Patient Protection and Affordable Care Act (the Affordable Care Act), new federal regulations have been released which detail who is to be notified when a skilled nursing facility (SNF) or nursing facility (NF) closes, and specifies required timeframes. An administrator who fails to comply with the requirements will be subject to a civil monetary penalty. The requirements are in addition to the Minnesota specific facility closure requirements. Key components of the federal regulations include:

• Require the administrator of the facility to provide written notification prior to impending closure to the Secretary of Health and Human Services (per the 1864 Mission & Priorities document, CMS will be designating the state survey agency to act on the Secretary’s behalf). The administrator is also required to notify the state Medicaid agency, the state long-term care ombudsman, residents of the facility, and the legal representatives of the residents or other responsible parties regarding the transfer and adequate relocation of the residents specified in the plan for the SNF or NF closure.

• Require the administrator to give notice 60 days prior to the date of closure; or in the case of a facility where the Secretary or the state Medicaid agency terminates the facility’s participation in the Medicare and/or Medicaid programs, not later than the date that the Secretary determines appropriate.

• Ensure that the facility does not admit any new residents on or after the date on which such written notification is submitted.

• Ensure that the plan provides for the transfer and adequate relocation of the residents of the facility by a date that would be specified by the state prior to closure, including assurances that the residents would be transferred to the most appropriate facility or other setting in terms of quality, services, and location, taking into consideration the needs, choice, and best interests of each resident.

• Ensure that the facility must have in place policies and procedures to ensure that the administrator’s duties and responsibilities involve providing the appropriate notices in the event of a facility closure.

• Ensure that when the state Medicaid agency or CMS terminates a facility’s provider agreement, the state survey agency will arrange for the safe and orderly transfer of all Medicare and Medicaid residents to another facility.

• Require that any individual who is or was the administrator of a facility and fails or failed to comply with the requirements in the rule will be subject to civil monetary penalty (CMP) as follows: A minimum of $500 for the first offense; a minimum of $1,500 for the second offense; and a minimum of $3,000 for the third and subsequent offenses.

• Require that an administrator could be subject to higher amounts of CMPs (not to exceed ($100,000) based on criteria that CMS will identify in interpretative guidelines.

Read the S&C letter.
Read the regulations in the Federal Register.

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org