§ 40-8-19.1 - Nursing facility financial oversight.
SECTION 40-8-19.1
§ 40-8-19.1 Nursing facility financialoversight. – (a) On an annual basis, every licensed nursing facility participating in themedical assistance program shall file a financial statement or other financialinformation acceptable to the department with its annual cost report (BM-64)for the time period covered by the cost report that would provide sufficientinformation for the department to assess the facility's financial status.
(b) The department shall, by regulation:
(1) Develop, in consultation with the department of health,criteria for the financial statements or financial information to be submittedin lieu of the financial statement as required in subsection 40-8-19.1(a);
(2) Develop criteria for reviewing the financial statement orfinancial information submitted and assessing the financial status offacilities to determine if they have sufficient resources to meet operationaland financial expenses and to comply with resident care and facility standards;and
(3) Establish a set of indicators or criteria that wouldindicate if a facility's financial status is marginal of if a facility ishaving severe financial difficulties. These criteria shall include, but not belimited to:
(i) Significant operating losses for two (2) successive years;
(ii) Frequent requests for advance on Medicaid reimbursements;
(iii) Unfavorable working capital ratios of assets toliabilities;
(iv) High proportion of accounts receivable more than ninety(90) days old;
(v) Increasing accounts payable, unpaid taxes and/or payrollrelated costs;
(vi) Minimal or decreasing equity and/or reserves;
(vii) High levels of debt and high borrowing costs.
(c) Whenever a facility's financial status is determined tobe marginal or to have severe financial difficulties, the department shallnotify the director of the department of health.
(d) Special rate appeal pursuant to § 23-17-12.7.The department shall file a state plan amendment with the U.S. Department ofHealth and Human Services to modify the principles of reimbursement for nursingfacilities, to be effective on October 1, 2005, or as soon thereafter as isauthorized by an approved state plan amendment, to assign a special prospectiveappeal rate for any facility for which, pursuant to § 23-17-12.6, thedepartment of health has appointed an independent quality monitor; thedepartment of health has required to engage an independent quality consultantor temporary manager; and/or the department of health pursuant to §23-17-12.7 has been required to develop and implement a plan of correction andremediation to address concerns regarding resident care and coincidentfinancial solvency. The special prospective appeal rate shall be assigned for aduration of not less than six (6) months, shall be based upon the additionalcost of the independent quality monitor, independent quality consultant ortemporary manager, as the case may be, or the approved spending plan set forthin the plan of correction and remediation, and subject to review of costreport, and subsequent extension at the discretion of the department, at six(6) month intervals for a maximum of eighteen (18) months thereafter. Incalculating the prospective per diem, the department shall disregard the costcenter ceilings for the direct labor and other operating expense cost centers.The department shall recoup any funds specified in the spending plan that havenot been expended.