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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY GREENLEAF, WASHINGTON, ERICKSON, O'PAKE, EARLL, BROWNE AND WONDERLING, FEBRUARY 20, 2009 |
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| REFERRED TO PUBLIC HEALTH AND WELFARE, FEBRUARY 20, 2009 |
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| AN ACT |
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1 | Exempting continuing care retirement communities from the |
2 | medical assistance bed approval process and allowing nursing |
3 | facilities operated by continuing care retirement communities |
4 | to obtain medical assistance certified beds under limited |
5 | terms and conditions. |
6 | The General Assembly of the Commonwealth of Pennsylvania |
7 | hereby enacts as follows: |
8 | Section 1. Short title. |
9 | This act shall be known and may be cited as the Continuing |
10 | Care Retirement Community Act. |
11 | Section 2. Definitions. |
12 | The following words and phrases when used in this act shall |
13 | have the meanings given to them in this section unless the |
14 | context clearly indicates otherwise: |
15 | "CCRC." A continuing care retirement community licensed by |
16 | the Insurance Department. |
17 | "Department." The Department of Public Welfare of the |
18 | Commonwealth. |
19 | Section 3. Continuing care retirement community exemption. |
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1 | A licensed nursing facility operated by a licensed CCRC shall |
2 | be exempt from the requirements under 55 Pa. Code §§ 1187.21(2) |
3 | (relating to nursing facility participation requirements) and |
4 | 1187.21a (relating to nursing facility exception requests-- |
5 | statement of policy) under the following conditions: |
6 | (1) The CCRC has admitted more than 400 residents under |
7 | a continuing care agreement. |
8 | (2) The nursing facility is part of the CCRC campus. |
9 | Section 4. Certified and noncertified nursing facilities on |
10 | CCRC campus. |
11 | Where a licensed nursing facility is part of the continuum of |
12 | care of a CCRC and regardless of whether the nursing facility |
13 | currently has beds certified by the medical assistance program, |
14 | the nursing facility shall have a limited number of beds |
15 | certified by medical assistance through an application to the |
16 | department pursuant to the following requirements: |
17 | (1) One or more residents admitted under a continuing |
18 | care agreement spend down their resources, including any |
19 | funds which may be or may become available, as a full or |
20 | partial refund of any entrance fee payments, in order to |
21 | become eligible for medical assistance. |
22 | (2) The beds will be used to provide nursing care and to |
23 | maintain on the CCRC campus residents who have spent down |
24 | their resources in order to become eligible for medical |
25 | assistance. |
26 | (3) The number of beds certified by the medical |
27 | assistance program may not be greater than 15%, rounded to |
28 | the nearest whole number, of the current licensed beds of the |
29 | CCRC's nursing facility. |
30 | Section 5. Applications for nursing facility beds certified by |
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1 | the medical assistance program. |
2 | (a) Required information.--The application for a bed |
3 | certified by the medical assistance program must include |
4 | documentation that the person for whom the bed is requested was |
5 | initially admitted to the CCRC under the terms of a continuing |
6 | care agreement. |
7 | (b) Limitation.--All applications for beds certified by the |
8 | medical assistance program which satisfy subsection (a) shall be |
9 | granted by the department subject to the spend-down medical |
10 | assistance bed limitation as specified in section 4(3) and the |
11 | notice requirements specified in section 7. |
12 | (c) Agreement.--The nursing facility of the CCRC shall sign |
13 | a limited enrollment provider agreement. |
14 | Section 6. Nursing facility medical assistance reimbursement. |
15 | The nursing facility of the CCRC shall be eligible for and |
16 | shall receive reimbursement under the medical assistance program |
17 | as a participating provider effective on the date the medical |
18 | assistance eligible resident meets medical assistance |
19 | eligibility requirements. |
20 | Section 7. Department notification. |
21 | The nursing facility of the CCRC must notify the department |
22 | within 30 days upon the death or permanent transfer or discharge |
23 | of the medical assistance eligible resident from the nursing |
24 | facility. Failure of the nursing facility to notify the |
25 | department of these events within 30 days may be used as a basis |
26 | to deny future applications for certified medical assistance |
27 | beds. |
28 | Section 8. Effective date. |
29 | This act shall take effect in 60 days. |
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