Sec. 17b-357. (Formerly Sec. 17-134v). Nursing facility: Compliance with federal law. Summary order. Temporary manager. Remedies. Regulations. Penalties. Hearing.
Sec. 17b-357. (Formerly Sec. 17-134v). Nursing facility: Compliance with federal law. Summary order. Temporary manager. Remedies. Regulations. Penalties.
Hearing. (a) For purposes of this section and sections 17b-358 to 17b-360, inclusive,
a "nursing facility" means a chronic and convalescent home or a rest home with nursing
supervision as defined in section 19a-521, which participates in the Medicaid program
through a provider agreement with the Department of Social Services.
(b) If the Department of Public Health finds, through the results of a survey, that a
nursing facility is not in compliance with one or more of the requirements of Subsections
(b), (c) and (d) of 42 USC 1396r and that such noncompliance poses an immediate and
serious threat to patient health or safety, the Department of Public Health shall issue a
statement of charges to the facility and shall file a copy of the charges with the Department of Social Services with a request for a summary order from the Department of
Social Services. The summary order which the Department of Social Services may issue
shall include termination of the facility's participation in Medicaid or appointment of
a temporary manager to oversee the operation of the facility and may include transfer
of patients to other participating facilities; denial of payment under Medicaid for new
admissions; imposition of a directed plan of correction of the facility's deficiencies;
imposition of civil monetary penalties; or imposition of other remedies authorized by
regulations adopted by the Department of Social Services in accordance with chapter 54.
(c) If the Department of Public Health finds, through the results of a survey, that a
nursing facility is not in compliance with one or more of the requirements of Subsections
(b), (c) and (d) of 42 USC 1396r but that such noncompliance does not pose an immediate
and obvious threat to patient health or safety, the Department of Public Health shall
issue a statement of charges to the facility and shall file a copy of the charges with the
Department of Social Services with a request for an order imposing one or more alternative remedies under this subsection. If the Department of Social Services finds, based
on a statement of charges filed by the Department of Public Health, that a nursing facility
is not in compliance with one or more of the requirements of Subsections (b), (c) and
(d) of 42 USC 1396r, but does not issue a summary order, it may impose one or more
of the following alternative remedies: Termination of the facility's participation in Medicaid; appointment of a temporary manager to oversee the operation of the facility;
transfer of patients to other participating facilities; denial of payment under Medicaid for
new admissions; imposition of a directed plan of correction of the facility's deficiencies;
imposition of civil monetary penalties; or imposition of other remedies authorized by
regulations adopted by the Department of Social Services in accordance with chapter
54. The civil monetary penalties imposed may be in the range of three thousand two
hundred fifty dollars to ten thousand dollars per day for each day the facility is found
to be out of compliance with one or more requirements of Subsections (b), (c) and (d)
of 42 USC 1396r if the failure to comply with such requirements is found to constitute
an immediate and serious threat to resident health or safety, or in the range of two
hundred dollars to three thousand dollars per day for each day the facility is found to
be out of compliance with a requirement of Subsections (b), (c) and (d) of 42 USC 1396r
that is found not to constitute an immediate and serious threat to resident health or safety.
The exact civil monetary penalty will be set depending on such factors as the existence
of repeat deficiencies or uncorrected deficiencies and the overall compliance history of
the provider. The remedies available to the Department of Social Services for violations
of the requirements of Subsections (b), (c) and (d) of 42 USC 1396r are cumulative and
are in addition to the remedies available to the Department of Public Health under chapter
368v for violations of state licensure requirements. Any penalties collected by the Department of Social Services pursuant to this section shall be deposited in a special fund
under the control of the Department of Social Services, which fund shall be utilized, in
the discretion of the department, for the protection of the health or property of residents
of nursing facilities found to be deficient, including payment for the costs of relocating
residents, payment for the maintenance of operation of a facility pending correction of
deficiencies or closure, and reimbursement of residents for personal funds lost. The
deficient nursing facility shall be obligated to reimburse the Department of Social Services for any moneys expended by the department at the facility from the fund established
pursuant to this section.
(d) The facility may request a hearing in accordance with the provisions of chapter
54 from the Department of Social Services within ten days of the issuance of the statement of charges or the summary order, as the case may be. If the facility does not request
a hearing within ten days and no summary order has been issued, the Department of
Social Services shall automatically adopt the Department of Public Health's findings
and shall issue an order incorporating one or more of the remedies authorized by subsection (c) of this section. If the facility timely requests a hearing or the Department of
Social Services issues a summary order, the Department of Social Services shall issue
a notice of hearing. At such hearing the facility shall be given the opportunity to present
evidence and cross-examine witnesses. The Department of Social Services shall issue
a decision based on the administrative record and may, if it finds the facility not in
compliance with one or more of the requirements of Subsections (b), (c) and (d) of 42
USC 1396r, order any of the remedies specified in this section. The Department of Social
Services may impose any of the alternative remedies, except for a civil monetary penalty,
during the pendency of any proceedings conducted pursuant to this subsection. In such
cases, the Department of Social Services must provide the facility the opportunity to
discuss the Department of Public Health's findings at an informal conference prior to
the imposition of any remedy. The requirement of an informal conference does not apply
to summary order proceedings.
(P.A. 89-348, S. 6, 10; P.A. 93-262, S. 1, 87; 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58.)
History: P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner
and department of income maintenance, effective July 1, 1993; P.A. 93-381 replaced department of health services with
department of public health and addiction services, effective July 1, 1993; Sec. 17-134v transferred to Sec. 17b-357 in
1995; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner
and Department of Public Health, effective July 1, 1995.