reglab/statecodes huggingface dataset:
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-71 - Venue

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Fair hearings
			 for applicants or recipients shall be held in the social and rehabilitation
			 services' administrative area in which the applicant or recipient resides
			 unless another site has been designated by the hearing officer or the hearing
			 is conducted pursuant to the provisions of K.A.R. 30-7-72.
(b) Fair hearings for other appellants shall
			 be held in Topeka, Kansas unless another site has been designated by the
			 hearing officer or the hearing is conducted pursuant to the provisions of
			 K.A.R. 30-7-72. The effective date of this regulation shall be July 1, 1989.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-72 - Telephone hearings

Current through Register Vol. 43, No. 28, July 11, 2024
The hearing officer may conduct the fair hearing or any
				prehearing by telephone or other electronic means if each participant in the
				hearing or prehearing has an opportunity to participate in the entire
				proceeding while the proceeding is taking place. A party may be granted a face
				to face hearing or prehearing if good cause can be shown that a fair and
				impartial hearing or prehearing could not be conducted by telephone or other
				electronic means. The effective date of this regulation shall be July 1, 1989.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-73 - Summary reversals

Current through Register Vol. 43, No. 28, July 11, 2024
The hearing officer may, without notice or hearing, summarily
				reverse the agency's decision or action in the matter if it is clear from the
				agency's summary that the agency's decision or action was incorrect. The
				effective date of this regulation shall be July 1, 1989.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-74 - Independent medical, psychiatric and psychological examinations

Current through Register Vol. 43, No. 28, July 11, 2024
When the hearing involves medical, psychiatric or psychological
				issues, the hearing officer may order on the hearing officer's own motion that
				an independent medical, psychiatric or psychological assessment other than that
				of the person or persons involved in making the original decision shall be
				obtained at agency expense and made part of the record if the hearing officer
				considers it necessary. If a party requests the independent assessment, that
				party shall pay the costs incurred in obtaining the assessment. If the party
				requesting the assessment signs a poverty affidavit, the independent medical,
				psychiatric or psychological assessment shall be performed at agency expense.
				The effective date of this regulation shall be July 1, 1989.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-75 - Agency's summary

Current through Register Vol. 43, No. 28, July 11, 2024
Within 15 days after notification of the request for fair
				hearing the agency shall furnish the appellant and the administrative hearings
				section with a summary setting forth the following information:
(a) Name and address of the appellant;
(b) a summary statement concerning
			 why the appellant is filing a request for a fair hearing;
(c) a brief chronological summary of the
			 agency's action in relationship to the appellant's request for a fair hearing;
(d) a statement of the basis of
			 the agency's decision;
(e) a
			 citation of the applicable policies relied upon by the agency;
(f) a copy of the notice which notified
			 appellant of the decision in question;
(g) applicable correspondence; and
(h) the name and title of the person or
			 persons who will represent the agency at the hearing. The effective date of
			 this regulation shall be July 1, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-76 - Transcripts

Current through Register Vol. 43, No. 28, July 11, 2024
(a) A transcript of
			 the hearing may be prepared if requested by an appellant, the agency, the
			 hearing officer, the state appeals committee or the secretary. The party
			 requesting the transcript or review of the hearing officer's decision shall pay
			 any costs associated in obtaining a transcript.
(b) If an appellant requests a transcript,
			 the agency shall pay the costs of transcribing the recording if the appellant
			 signs a poverty affidavit.
(c) If
			 a transcript is prepared, the reporter shall sign the following certification
			 on all copies: "This is to certify that _____
Name of Hearing Officer conducted a hearing on the application
				of __________ in
Name of Appellant county, state of Kansas, on
Date
at _____ and that the foregoing is a true and correct
				transcript of the record of the hearing."
Signature of Reporter
The effective date of this regulation shall be January 2, 1992.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-77 - Rehearing

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Any party,
			 within 15 days after service of the hearing officer's decision, may file a
			 petition for rehearing with the administrative hearings section, stating the
			 specific grounds upon which the rehearing of the hearing officer's decision is
			 requested.
(b) A rehearing may be
			 granted to either party on all or part of the issues when it appears that the
			 rights of the party are substantially affected because:
(1) Of an erroneous ruling of the hearing
			 officer;
(2) the decision in whole
			 or in part is contrary to the evidence; or
(3) of newly discovered evidence which the
			 moving party could not with reasonable diligence have discovered or produced at
			 the hearing.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-78 - State appeals committee

Current through Register Vol. 43, No. 28, July 11, 2024
(a) The secretary
			 may appoint one or more state appeals committees to review the decisions or
			 orders of hearing officers.
(b)
			 The committees shall consist of three impartial persons.
(c) Decisions of the committee shall be by
			 majority vote.
(d) The record, as
			 defined in
			 K.S.A.
			 77-532, shall be the basis for the state
			 appeals committee review. The effective date of this regulation shall be
			 January 2, 1992.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-79 - Motions

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Motions, unless
			 made during a hearing, shall:
(1) Be in
			 writing; and
(2) state with
			 particularity their bases.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-100 - Definition of intentional TAF or GA program violation

Current through Register Vol. 43, No. 28, July 11, 2024
(a) An "intentional
			 program violation" means any action taken by an individual to establish or
			 maintain a family's eligibility for temporary assistance for families (TAF) or
			 general assistance (GA), or to obtain an increase in or to maintain the amount
			 of the family's TAF or GA grant, when that action constitutes either of the
			 following:
(1) an intentionally false or
			 misleading statement, misrepresentation, concealment, or withholding of facts;
			 or
(2) an act intended to mislead,
			 misrepresent, conceal, withhold facts, or propound a falsity.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-101 - Administrative hearings section, hearing officer

Current through Register Vol. 43, No. 28, July 11, 2024
The disqualification hearing program shall be administered by
				the administrative hearings section of the agency. The effective date of this
				regulation shall be July 31, 1992.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-102 - Disqualification hearings

Current through Register Vol. 43, No. 28, July 11, 2024
(a) An individual's
			 fair hearing may be consolidated with a disqualification hearing by the agency
			 when the circumstances surrounding the hearings are the same or related,
			 provided that the individual receives prior notice of the consolidation. Either
			 the hearing officer for the fair hearing or the hearing officer for the
			 disqualification hearing may be assigned by the agency to preside at a
			 consolidated hearing.
(b) The
			 hearing officer shall:
(1) administer oaths
			 and affirmations;
(2) consider all
			 relevant issues;
(3) request,
			 receive and make part of the record all evidence necessary to decide the issues
			 raised;
(4) conduct the hearing in
			 a manner consistent with due process;
(5) advise the accused individual that the
			 individual may refuse to answer questions during the hearing; and
(6) render a final decision that will resolve
			 the issues in dispute.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-103 - Waiver of the administrative disqualification hearing

Current through Register Vol. 43, No. 28, July 11, 2024
(a) An individual
			 shall be allowed by the agency to waive the right to appear at an
			 administrative disqualification hearing.
(b) When the individual waives the right to
			 appear at a disqualification hearing, the individual shall be disqualified and
			 shall be subject to appropriate reduction of assistance regardless of whether
			 the individual admits or denies the charges. A written notice shall be sent by
			 the agency informing the individual of the period of disqualification, which
			 shall begin not later than the first day of the second month which follows the
			 date of notice, and the amount of payment the household will receive during the
			 disqualification period.
(c) This
			 regulation shall take effect on and after July 1, 1996.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 7 - APPEALS, FAIR HEARINGS AND TAF/GA DISQUALIFICATION HEARINGS › Section 30-7-104 - Court actions on consent agreements

Current through Register Vol. 43, No. 28, July 11, 2024
(a) An accused
			 individual shall be allowed by the agency to sign a written agreement confirmed
			 by a court of competent jurisdiction in which the individual admits committing
			 an intentional program violation.
(b) The written agreement shall include the
			 following:
(1) a statement that the
			 individual understands the consequences of signing the agreement;
(2) a statement that the caretaker relative
			 must also sign the agreement if the accused is not the caretaker relative; and
(3) a statement that signing the
			 agreement will result in a reduction in payment for the appropriate period.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-1b - Nursing facility program providers

Current through Register Vol. 43, No. 28, July 11, 2024
(a) The nursing
			 facility program providers shall include the following types of care
			 facilities:
(1) Nursing facilities; and
(2) nursing facilities for mental
			 health, which shall have been operating in accordance with a provider agreement
			 with the agency on June 30, 1994.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-1c - Provider agreement

Current through Register Vol. 43, No. 28, July 11, 2024
(a) As a
			 prerequisite for participation in the medicaid/medikan program as a nursing
			 facility provider, the owner of the real and personal property used to provide
			 the nursing facility services or the lessee of such real and personal property
			 shall enter into a provider agreement with the agency on forms prescribed by
			 the secretary.
(b) Only parties
			 signing a provider agreement shall have rights to enforcement of the agreement.
			 The effective date of this regulation shall be January 1, 1994.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-1d - Inadequate care

Current through Register Vol. 43, No. 28, July 11, 2024
(a) If the agency
			 determines that inadequate care is being provided to a recipient or that a
			 recipient's rights are being violated, payment to the nursing facility may be
			 terminated or suspended.
(b) If
			 the agency determines that a nursing facility has not corrected deficiencies
			 that significantly and adversely affect the health, safety, nutrition, or
			 sanitation of the nursing facility residents, payments for new admissions shall
			 be denied and future payments for all recipients shall be withheld until the
			 agency determines that the deficiencies have been corrected.
(c) This regulation shall be effective on and
			 after May 1, 2005.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-1f - Private pay wings

Current through Register Vol. 43, No. 28, July 11, 2024
As a prerequisite for participation in the medicaid/medikan
				program, a nursing facility shall not develop private pay wings or segregate
				medicaid/medikan residents to separate areas of the nursing facility. The
				effective date of this regulation shall be January 30, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-6 - Admission procedure

Current through Register Vol. 43, No. 28, July 11, 2024
(a) The physical,
			 emotional, social, and cognitive status of each individual, including any
			 individual from out of state, who is seeking admission to a nursing facility or
			 a nursing facility for mental health providing care under title XIX of the
			 federal social security act shall be assessed to determine the need for care
			 and the appropriateness of services in accordance with
			 K.S.A.
			 39-968 and amendments thereto.
(b) Nursing facility services and nursing
			 facility for mental health services shall be provided pursuant to title IV,
			 subtitle C, part 2, pp. 190-230, of the federal omnibus budget reconciliation
			 act of 1987, effective October 1, 1990, which is adopted by reference in K.A.R.
			 30-10-2. Each resident shall receive a comprehensive medical evaluation and an
			 explicit recommendation by the physician concerning the level of care needed.
(c) A nursing facility shall not
			 require a private-paying resident to remain in a private-pay status for any
			 period of time after the resident becomes eligible for medicaid/medikan.
(d) This regulation shall be
			 effective on and after July 1, 2002.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-7 - Screening, evaluation, reevaluation, and referral for nursing facilities

Current through Register Vol. 43, No. 28, July 11, 2024
(a) In accordance
			 with K.S.A. 39-968 and amendments
			 thereto, each individual seeking admission to a nursing facility or nursing
			 facility for mental health providing care under title XIX of the federal social
			 security act, or seeking referral to home-and community-based services (HCBS),
			 shall receive a preadmission assessment, evaluation, and referral to all
			 available community resources, including nursing facilities, before admission.
(b) Each individual choosing to
			 enter a nursing facility following a preadmission assessment identifying no
			 need for nursing facility placement shall do so as a private-paying resident.
			 Medicaid/medikan shall not participate in the cost of care unless and until a
			 preadmission assessment determines that there is a need for nursing facility
			 placement.
(c) Continued
			 eligibility for services at a nursing facility shall be based on each
			 resident's level of care needs as determined through quarterly reassessments.
			 When the reassessment indicates that the resident's level of care needs no
			 longer meet level of care criteria, the resident shall be considered to be in
			 "resident status review." Payment for services shall continue until the
			 authorized case manager indicates that more appropriate and less intensive
			 services are available that meet the resident's health, safety, and social
			 needs.
(d) Each individual
			 admitted to a nursing facility for mental health shall be evaluated at least
			 annually upon the anniversary of admission, and at any other time there may
			 have been a significant change in the resident's mental condition. This
			 evaluation shall be made under the supervision of a qualified mental health
			 professional employed by a participating community mental health center, as
			 defined in
			 K.S.A.
			 59-2946 and amendments thereto, using the
			 screening tool that may be designated by the secretary, to determine whether it
			 is appropriate for that individual to remain in a nursing facility for mental
			 health. Any state-funded individual for whom it is determined that remaining in
			 the facility is inappropriate may be required to have prepared a plan for that
			 individual's transfer to appropriate care.
(e) This regulation shall be effective on and
			 after May 1, 2002.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-11 - Personal needs fund

Current through Register Vol. 43, No. 28, July 11, 2024
(a) At the time of
			 admission, each nursing facility provider shall furnish each resident and the
			 resident's representative, if any, with a written statement that meets the
			 following requirements:
(1) Lists all
			 services provided by the provider, distinguishing between those services
			 included in the provider's per diem rate and those services not included in the
			 provider's per diem rate that can be charged to the resident's personal needs
			 fund;
(2) states that there is no
			 obligation for the resident to deposit funds with the provider;
(3) describes each resident's right to select
			 one of the following alternatives for managing the personal needs fund:
(A) The resident or the resident's legal
			 guardian, if any, may receive, retain, and manage the resident's personal needs
			 fund;
(B) the resident may apply
			 to the social security administration to have a representative payee designated
			 for federal or state benefits to which the resident may be entitled; or
(C) except when paragraph (B) of
			 this subsection applies, the resident may designate, in writing, another person
			 to act for the purpose of managing the resident's personal needs fund;
(4) states that any
			 charge for management of a resident's personal needs fund is included in the
			 provider's per diem rate;
(5)
			 states that any late fees, interest, or finance charges shall not be charged to
			 the resident's personal needs fund for late payment of the resident liability;
(6) states that the provider is
			 required to accept a resident's personal needs fund to hold, safeguard, and
			 provide an accounting for it, upon the written authorization of the resident or
			 representative, or upon appointment of the provider as the resident's
			 representative payee; and
(7)
			 states that, if the resident becomes incapable of managing the personal needs
			 fund and does not have a representative, the provider shall be required to
			 arrange for the management of the resident's personal funds as provided in
			 subsection (j).
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-20 - Payment of claims

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Payment to
			 participating providers. Each participating provider shall be paid, at least
			 monthly, a per diem rate for nursing facility services, excluding resident
			 liability, rendered to eligible residents if all of the following conditions
			 are met:
(1) The agency is billed on the
			 paper claim form or electronic claim submission furnished by the contractor
			 serving as the fiscal agent for the medicaid/medikan program.
(2) The paper claim form or electronic claim
			 submission is verified by the administrator of the facility or a designated key
			 staff member.
(3) The claim is
			 filed no more than 12 months after the time the services were rendered pursuant
			 to K.S.A.
			 39-708a, and amendments thereto.
(4) The claim does not include services for
			 the date of discharge.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-21 - Reserve days

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Payment shall
			 be available for nursing facility residents, excluding those on planned
			 temporary stays, for days for which it is necessary to reserve a bed in a
			 nursing facility (NF) or nursing facility for mental health (NF-MH) when the
			 resident is absent for any of the following reasons:
(1) Admission to a hospital for acute
			 conditions;
(2) therapeutically
			 indicated home visits with relatives and friends; or
(3) participation in any state-approved
			 therapeutic or rehabilitative program.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-23c - Revenues

Current through Register Vol. 43, No. 28, July 11, 2024
A statement of revenue shall be required as part of the cost
				report forms.
(a) Revenue shall be
			 reported in accordance with general accounting rules as recorded in the
			 accounting records of the facility and as required in the detailed revenue
			 schedule in the uniform cost report.
(b) The cost of non-covered services provided
			 to residents shall be deducted from the related expense item. The net expense
			 shall not be less than zero.
(c)
			 Revenue received for a service that is not related to resident care shall be
			 used to offset the cost of providing that service, if the cost incurred cannot
			 be determined or is not furnished to the agency by the provider. The cost
			 report line item which includes the non-resident related costs shall not be
			 less than zero. Miscellaneous revenue with insufficient explanation in the cost
			 report shall be offset.
(d)
			 Expense recoveries credited to expense accounts shall not be reclassified as
			 revenue to increase the costs reported in order to qualify for a higher rate.
			 The effective date of this regulation shall be November 2, 1992.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-24 - Compensation of owners, related parties, and administrators

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Non-working
			 owners and related parties. Remunerations paid to non-working owners or other
			 related parties, as defined in K.A.R. 30-10-1a, shall not be considered an
			 allowable cost regardless of the name assigned to the transfer or accrual or
			 the type of provider entity making the payment. Each payment shall be
			 separately identified and reported as owner compensation in the
			 non-reimbursable and non-resident-related expense section of the cost report.
(b) Services related to resident
			 care.
(1) If owners with five percent or more
			 ownership interest or related parties actually perform a necessary function
			 directly contributing to resident care, a reasonable amount shall be allowed
			 for such resident care activity. The reasonable amount allowed shall be the
			 lesser of the following:
(A) The reasonable
			 cost that would have been incurred to pay a non-owner employee to perform the
			 resident-related services actually performed by owners or other related
			 parties, limited by a schedule of salaries and wages based on the state civil
			 service salary schedule in effect when the cost report is processed until the
			 subsequent cost report is filed; or
(B) the amount of cash and other assets
			 actually withdrawn by the owner or related parties.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-28 - Resident days

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Calculation of
			 resident days.
(1) "Resident day" shall have
			 the meaning set forth in K.A.R. 30-10-1a.
(2) If both admission and discharge occur on
			 the same day, that day shall be considered to be a day of admission and shall
			 count as one resident day.
(3) If
			 the provider does not make refunds on behalf of a resident for unused days in
			 case of death or discharge, and if the bed is available and actually used by
			 another resident, these unused days shall not be counted as a resident day.
(4) Any bed days paid for by the
			 resident, or any other party on behalf of the resident, before an admission
			 date shall not be counted as a resident day.
(5) The total resident days for the cost
			 report period shall be precise and documented; an estimate of the days of care
			 provided shall not be acceptable.
(6) In order to facilitate accurate and
			 uniform reporting of resident days, the accumulated method format set forth in
			 data specifications in diskettes furnished by the agency shall be used for all
			 residents beginning January 1, 1999. The monthly reporting, using the diskette,
			 shall be submitted to the agency as supportive documentation for the resident
			 days shown on the cost report forms and shall be submitted at the time the cost
			 report and required documents are submitted to the agency. Monthly census
			 summaries shall include reporting for nursing facility or nursing
			 facility-mental health, other residential days with shared nursing facility or
			 nursing facility-mental health costs, and day care hours. Each provider shall
			 keep these monthly records for each resident, whether a Kansas medical
			 assistance program recipient or a non-recipient. If the provider fails to keep
			 accurate records of resident days in accordance with the accumulated method
			 format, the assumed occupancy rate shall be 100 percent.
(7) The provider shall report the total
			 number of Kansas medical assistance program resident days in addition to the
			 total resident days on the uniform cost report form.
(8) The provider shall report the total
			 number of other residential days with shared nursing facility or nursing
			 facility-mental health costs on the uniform cost report form.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-201 - Intermediate care facilities for mentally retarded

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Change of
			 provider.
(1) The current provider or
			 prospective provider shall notify the agency of a proposed change of providers
			 at least 60 days in advance of the closing transaction date. Failure to submit
			 a timely notification shall result in the new provider assuming responsibility
			 for any overpayment made to the previous provider before the transfer. This
			 shall not release the previous provider of responsibility for such overpayment.
(2) Before the dissolution of the
			 business entity, the change of ownership of the business entity, or the sale,
			 exchange or gift of 5% or more of the depreciable assets of the business
			 entity, the agency shall be notified in writing concerning the change at least
			 60 days before the change. Failure to submit a timely notification shall result
			 in the new provider assuming responsibility for any overpayment made to the
			 previous provider before the transfer. This shall not release the previous
			 provider of responsibility for such overpayment. The secretary may expressly
			 agree in writing to other overpayment recovery terms.
(3) Any partnership that is dissolved shall
			 not require a new provider agreement if at least one member of the original
			 partnership remains as the provider of services. Any addition or substitution
			 to a partnership or any change of provider resulting in a completely new
			 partnership shall require that an application to be a provider of services be
			 submitted to the agency.
(4) If a
			 sole proprietor not incorporated under applicable state law transfers title and
			 property to another party, a change of ownership shall have occurred. An
			 application to be a provider of services shall be submitted to the agency.
(5) Transfer of participating
			 provider corporate stock shall not in itself constitute a change of provider.
			 Similarly, a merger of one or more corporations with the participating provider
			 corporation surviving shall not constitute a change of provider. A
			 consolidation of two or more corporations which creates a new corporate entity
			 shall constitute a change of provider and an application to be a provider of
			 services shall be submitted to the agency.
(6) The change of or a creation of a new
			 lessee, acting as a provider of services, shall constitute a change of
			 provider. An application to be a provider of services shall be submitted to the
			 agency. If the lessee of the facility purchases the facility, the purchase
			 shall not constitute a change in provider.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-202 - ICF-MR provider agreement

Current through Register Vol. 43, No. 28, July 11, 2024
As a prerequisite for participation in the medicaid/medikan
				program as an ICF-MR provider, the owner or lessee shall enter into a provider
				agreement with the agency on forms prescribed by the secretary. The effective
				date of this regulation shall be January 30, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-203 - ICF-MR inadequate care

Current through Register Vol. 43, No. 28, July 11, 2024
(a) When the agency
			 determines that inadequate care is being provided to a client, payment to the
			 ICF-MR for the client may be terminated.
(b) When the agency receives confirmation
			 from the Kansas department of health and environment that an ICF-MR has not
			 corrected deficiencies which significantly and adversely affect the health,
			 safety, nutrition or sanitation of ICF-MR clients, payments for new admissions
			 shall be denied and future payments for all clients shall be withheld until
			 confirmation that the deficiencies have been corrected. The effective date of
			 this regulation shall be January 30, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-204 - ICF-MR standards for participation; intermediate care facility for the mentally retarded or clients with related conditions

Current through Register Vol. 43, No. 28, July 11, 2024
As a prerequisite for participation in the medicaid/medikan
				program as a provider of intermediate care facility services for the mentally
				retarded or clients with related conditions, each ICF-MR shall:
(a) Meet the requirements of 42 CFR 442,
			 subparts A, B, C and E, effective October 3, 1988, which is adopted by
			 reference, and 42 CFR 483, subpart D, effective October 3, 1988, which is
			 adopted by reference; and
(b) be
			 certified for participation in the program by the Kansas department of health
			 and environment. The effective date of this regulation shall be January 30,
			 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-205 - ICF-MR admission procedure

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Admission
			 procedure for ICF's-MR shall be pursuant to
			 42 CFR
			 483.440, effective October 3, 1988, which is
			 adopted by reference.
(b) An
			 ICF-MR shall not require a private-paying client to remain in a private-pay
			 status for any period of time after the client becomes eligible for
			 medicaid/medikan.
(c) Each client
			 shall be screened and found eligible for services before the client is admitted
			 in the medicaid/medikan program. The effective date of this regulation shall be
			 January 30, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-206 - ICF-MR certification and recertification by physicians

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Certification.
			 At the time of admission to an ICF-MR or at the time any ICF-MR client applies
			 for medical assistance under the medicaid/medikan program, a physician or
			 physician extender shall certify that the services must be given on an
			 inpatient basis. Services shall be furnished under a plan established by the
			 physician or physician extender before authorization of payment. Before
			 reimbursement is approved, a screening team designated by the secretary shall
			 review the physician's or physician extender's certification and shall certify
			 that services in an ICF-MR are the most appropriate services available for the
			 individual. The certification of need shall become part of the individual's
			 medical record. The date of certification shall be the date the case is
			 approved for payment and the certification is signed.
(b) Recertification.
(1) Each ICF-MR shall be responsible for
			 obtaining a physician's or physician extender's recertification for each
			 client.
(2) The recertification
			 shall be included in the client's medical record. Recertification statements
			 may be entered on or included with forms, notes, or other records a physician
			 or physician extender normally signs in caring for a client. The statement
			 shall be authenticated by the actual date and signature of the physician or
			 physician extender.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-207 - ICF-MR inspection of care and utilization review

Current through Register Vol. 43, No. 28, July 11, 2024
(a) The inspection
			 of care team from the Kansas department of health and environment shall conduct
			 an inspection of care and utilization review of each medicaid/medikan client in
			 all intermediate care facilities for the mentally retarded certified to
			 participate in the medicaid/medikan program.
(b) Each ICF-MR shall cooperate with
			 authorized representatives of the agency and the department of health and human
			 services in the discharge of their duties regarding all aspects of the
			 inspection of care and utilization review.
(c) Any ICF-MR where the utilization review
			 team finds inappropriately placed clients shall be responsible for providing
			 transportation for the clients to a more appropriate placement facility. The
			 effective date of this regulation shall be October 1, 1991.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-208 - ICF-MR personal needs fund

Current through Register Vol. 43, No. 28, July 11, 2024
(a) At the time of
			 admission, ICF-MR providers shall furnish that client and the representative
			 with a written statement that:
(1) Lists all
			 services provided by the provider, distinguishing between those services
			 included in the provider's per diem rate and those services not included in the
			 provider's basic rate, that can be charged to the client's personal needs fund;
(2) states that there is no
			 obligation for the client to deposit funds with the provider;
(3) describes the client's rights to select
			 one of the following alternatives for managing the personal needs fund:
(A) The client may receive, retain and manage
			 the client's personal needs fund or have this done by a legal guardian, if any;
(B) the client may apply to the
			 social security administration to have a representative payee designated for
			 purposes of federal or state benefits to which the client may be entitled;
(C) except when paragraph (B) of
			 this subsection applies, the client may designate, in writing, another person
			 to act for the purpose of managing the client's personal needs fund;
(4) states that any charge for
			 these services is included in the provider's per diem rate;
(5) states that the provider is required to
			 accept a client's personal needs fund to hold, safeguard, and provide an
			 accounting, upon the written authorization of the client or representative, or
			 upon appointment of the provider as a client's representative payee; and
(6) states that, if, in the
			 opinion of the professional interdisciplinary team, the client becomes
			 incapable of managing the personal needs fund and does not have a
			 representative, the provider is required to arrange for the management of the
			 client's personal funds as provided in K.A.R. 30-10-208(j).
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-209 - ICF-MR prospective reimbursement

Current through Register Vol. 43, No. 28, July 11, 2024
Providers participating in the medicaid/medikan program shall
				be reimbursed for ICF-MR services through rates that are reasonable and
				adequate to meet the client-related costs which must be incurred by efficiently
				and economically operated facilities in order to provide care and services in
				conformity with applicable state and federal laws, regulations, and quality and
				safety standards. Because even efficiently and economically operated facilities
				may incur some excess or inefficient costs, in this prospective payment system
				the identification of efficiently and economically operated facilities by the
				procedures and limitations of this article shall be an aggregate determination.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-211 - ICF-MR financial data

Current through Register Vol. 43, No. 28, July 11, 2024
(a) General. The
			 per diem rate or rates for providers participating in the medicaid/medikan
			 program shall be based on an audit or desk review of the costs reported to
			 provide client care in each facility. The basis for conducting these audits or
			 reviews shall be the ICF-MR financial and statistical report MH&RS-2004.
			 Each provider shall maintain sufficient financial records and statistical data
			 for proper determination of reasonable and adequate rates. Standardized
			 definitions, accounting, statistics, and reporting practices which are widely
			 accepted in the ICF-MR and related fields shall be followed, except to the
			 extent that they may conflict with or be superseded by state or federal
			 medicaid requirements. Changes in these practices and systems shall not be
			 required in order to determine reasonable and adequate rates.
(b) Pursuant to K.A.R. 30-10-213, ICF-MR
			 financial and statistical reports, MH&RS-2004, (cost reports) shall be
			 required from providers on an annual basis.
(c) Adequate cost data and cost findings.
			 Each provider shall provide adequate cost data on the cost report. This cost
			 data shall be in accordance with state and federal medicaid requirements and
			 general accounting principles, shall be based on the accrual basis of
			 accounting, and may include a current use value of the provider's fixed assets
			 used in client care. Estimates of costs shall not be allowable except on
			 projected cost reports submitted pursuant to K.A.R. 30-10-213.
(d) Recordkeeping requirements.
(1) Each provider shall furnish any
			 information to the agency that may be necessary:
(A) To assure proper payment by the program
			 pursuant to paragraph (2);
(B) to
			 substantiate claims for program payments; and
(C) to complete determinations of program
			 overpayments.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-212 - ICF-MR extra care

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Additional
			 reimbursement for direct services shall be available to ICF's-MR for
			 medicaid/medikan clients in need of extra care. Failure to obtain prior
			 authorization shall negate reimbursement for this service.
(b) Extra care shall be considered a covered
			 service within the scope of the program unless the request for prior
			 authorization is denied. Reimbursement for this service shall be contingent on
			 approval by the agency.
(c) The
			 additional reimbursement for extra care shall be shown as a provider adjustment
			 on the individual line item of benefit on the ICF-MR financial and statistical
			 report. Extra care costs shall not be included as a component when calculating
			 the final rate for the facility. The effective date of this regulation shall be
			 April 1, 1992.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-213 - ICF-MR cost reports

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Historical cost
			 data.
(1) For cost reporting purposes, each
			 provider shall submit the ICF-MR financial and statistical report in accordance
			 with the instructions included in this regulation. The report shall cover a
			 consecutive 12-month period of operations. The 12-month period shall coincide
			 with the fiscal year used for federal income tax or other financial reporting
			 purposes. The same 12-month period shall be used by providers related through
			 common ownership, common interests or common control. A non-owner operator of a
			 facility must have a signed provider agreement to be considered a provider for
			 the purpose of this paragraph. A working trial balance, as defined in K.A.R.
			 30-10-200, and a detailed depreciation schedule shall be submitted with the
			 cost report.
(2) If a provider has
			 more than one facility, the provider shall allocate central office costs to
			 each facility consistently, based on generally accepted accounting principles,
			 including any facilities being paid rates from projected cost data.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-214 - ICF-MR rates of reimbursement

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Rates for
			 ICF's-MR.
(1) The determination of per diem
			 rates shall be made, at least annually by the secretary, on the basis of the
			 cost information supplied by the provider, and retained for cost auditing. The
			 cost information for each provider shall be compared with limits established
			 based on the level of care needs of clients to determine the allowable per diem
			 cost.
(2) Ownership allowance
			 shall be determined as follows:
(A) All
			 ICF's-MR initially certified to participate in the medicaid/medikan program
			 prior to July 1, 1991 shall be held to the established ownership allowance.
(B) All ICF's-MR certified on or
			 after July 1, 1991 shall be subject to an absolute cap on ownership costs.
(3) Per diem rates for
			 the following cost centers shall be limited by absolute caps.
(A) The cost center limits shall be based on
			 facility size and level of care. The cost centers and limiting factors shall
			 be:
(i) Direct service based on facility size
			 and level of care. Direct service consists of the room and board and health
			 care cost centers in the ICF-MR financial and statistical report;
(ii) administration based on facility size;
			 and
(iii) plant operating based on
			 total allowable costs;
(B) The absolute caps shall be reviewed at
			 least annually for reasonableness based on the reimbursement model and the
			 allowable historical costs. The absolute caps shall be approved by the
			 secretary or a designated official.
(4) To establish a per diem rate for each
			 provider by facility size and level of care, a factor for inflation may be
			 added to the allowable per diem cost. The per diem rate shall be based on the
			 lower of the actual allowable cost or the absolute cost center limits. A
			 detailed listing of the computation of the rate shall be provided to each
			 provider. The effective date of the rate for existing facilities shall be in
			 accordance with subsection (a) of K.A.R. 30-10-215.
Kansas Administrative Regulations › Agency 30 - KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES › Article 10 - ADULT CARE HOME PROGRAM › Section 30-10-215 - ICF-MR rates; effective dates

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Effective date
			 of per diem rates for existing facilities. The effective date of a new rate
			 that is based on information and data in the ICF/MR cost report shall be the
			 first day of the third calendar month following the month the complete cost
			 report is received by the agency.
(b) Effective date of the per diem rate for a
			 new provider. The effective date of the per diem rate for a new provider, as
			 set forth in subsection (c) of K.A.R. 30-10-214, shall be the date of
			 certification by the department of health and environment pursuant to
			 42 CFR section
			 442.13, effective October 3, 1988, which is
			 adopted by reference. The interim rate determined from an approved projected
			 cost report filed by the provider shall be established with the fiscal agent by
			 the first day of the third month after the receipt of a complete and workable
			 cost report. The effective date of the final rate, determined after audit of
			 the historical cost report filed for the projection period, shall be the date
			 of certification by the department of health and environment.
(c) Effective date of the per diem rate for a
			 new provider resulting from a change in provider.
(1) The effective date of the per diem rate
			 for a change in provider, as set forth in K.A.R. 30-10-215, shall be the date
			 of certification by the department of health and environment. The effective
			 date of the final rate, determined after audit of the historical cost report
			 filed for the projection period, shall be the date of certification by the
			 department of health and environment.
(2) The effective date of the projected and
			 final rate for a new provider, as set forth in K.A.R. 30-10-214, shall be the
			 later of the date of the receipt of the ICF-MR financial and statistical report
			 or the date the new construction is certified.