reglab/statecodes huggingface dataset:
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-15 - CALCULATION OF OVERPAYMENTS OR UNDERPAYMENTS

Current through 2024-29, July 17, 2024
15.1 Whenever a provider submits a cost
				report for audit that shows the facility was overpaid, the provider shall
				submit a check for one hundred percent (100%) of the overpayment with the cost
				report in order for the cost report to be accepted for audit.
15.2 If, at the time the audit is completed,
				DHHS, Division of Audit, determines that the Department has underpaid a
				facility, the Department will pay the amount due and forward the result to the
				facility within thirty (30) days.
If the DHHS, Division of Audit, determines that the
				  Department has overpaid a facility, DHHS, Division of Audit, will so notify the
				  facility. Facilities will pay the total overpayment within ninety days of
				  notice of the overpayment or request the Department to reduce facility payments
				  during the balance of its fiscal year by the amount of its overpayment.
				  Facilities that do not notify the Department of the method by which they intend
				  to repay the overpayment will, beginning ninety (90) days after their receipt
				  of the notice of overpayment, have their subsequent payments from the
				  Department reduced by the amount of overpayment.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-16 - EFFECTIVE DATE

Current through 2024-29, July 17, 2024
These Principles apply to reimbursement for room and board
				  costs in residential care facilities beginning with dates of service on or
				  after July 1, 2001.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-18 - COST FINDING AND COST REPORTING

Current through 2024-29, July 17, 2024
18.1
Cost Report Periods
Facilities are required to submit annual cost reports, as
				  prescribed herein, to the State of Maine, DHHS, Division of Audit, 11 State
				  House Station, Augusta, Maine 04333-0011. Cost reports shall be based on the
				  fiscal year of the facility.
18.2
Accounting Principles
Allowable costs shown in all cost reports described herein
				  shall be on the basis of generally accepted accounting principles, except that
				  facilities are allowed to file on the accrual, cash, or modified cash method of
				  accounting. All new facilities are required to file on the Accrual basis. Once
				  a facility has established an accounting method used in filing its annual cost
				  report, that accounting method cannot be changed without the approval of the
				  DHHS, Division of Audit. The provider must pay all year-end accruals within six
				  (6) months after the end of the year in which the amounts are accrued. If the
				  accruals are not paid within such time, these amounts will be deducted from
				  allowable costs incurred in the first audit conducted following that six (6)
				  month period.
18.3
Cost Finding
Total allowable costs shall be divided by the actual bed
				  days to determine the cost per bed day. When facilities provide more than one
				  level of care, including both nursing facility and residential care, total
				  allowable costs shall be allocated to each level based on the occupancy data
				  reported for each level and the following statistical bases:
18.3.1
Capital Costs
: Square
				feet serviced to the extent the costs benefit both levels of care. In the event
				the cost benefits only one level of care, it will be directly costed to the
				level of care having the benefit of the cost.
18.3.2
Plant Operation and
				Maintenance
: Square feet serviced.
18.3.3
Housekeeping
: Lesser of
				actual direct cost or allocation based on square feet serviced.
18.3.4
Laundry
: Pounds or
				resident days.
18.3.5
Dietary
: Number of meals served.
18.3.6
General and Administrative,
				Financial and Other Expenses
: Total accumulated allowable costs for each
				level of care, not including general and administrative and financial
				expense.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-19 - ADEQUACY AND TIMELINESS OF FILING

Current through 2024-29, July 17, 2024
19.1 The cost
				report and financial statements for each facility shall be filed not later than
				five (5) months after the fiscal year end of the provider. When a provider
				fails to file an acceptable cost report by the due date, DHHS, Division of
				Audit, may send the provider a notice by certified mail, return receipt
				requested, advising the provider that all payments are suspended on receipt of
				the notice until an acceptable cost report is filed. Reimbursement will then be
				reinstated at the full rate from that time forward, but reimbursement for the
				suspension period shall be at the deficiency rate as stated in Section 34.8.
19.2 The DHHS, Division of Audit,
				may reject any filing that does not comply with these Principles. In such case,
				the report shall be deemed not filed, until refiled and in compliance. No
				extension of time will be granted, other than those defined under the
				regulations stated in the
Medicare Provider Reimbursement
				Manual
(HIM-15).
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-20 - FIXED/CAPITAL COSTS

Current through 2024-29, July 17, 2024
All allowable room and board costs not specified for
				  inclusion in the fixed cost category pursuant to these rules shall be included
				  in the routine cost component subject to the limitations set forth in
				  Principles 30 and 31.
20.1
				Fixed/Capital Costs include:
20.1.1
				Depreciation on buildings, fixed equipment, land improvements, furnishings,
				moveable equipment, and amortization of leasehold improvements. The minimum
				dollar limitation on furnishings and moveable equipment that must be
				depreciated and treated as a fixed cost is three hundred dollars
				($300).
20.1.2 Interest expense
				attributed to debt associated with the acquisition or improvement of buildings,
				moveable equipment, furnishings, fixed equipment and land
				improvements.
20.1.3 Real estate
				taxes.
20.1.4 Fire insurance
				premiums.
20.1.5 In cases where
				facilities are rented from an unrelated party, the actual costs of ownership
				attributable to items in Sections 20.1.1, 20.1.2, 20.1.3 and 20.1.4 will be
				compared to the lease payments allowed under Principle 20.3.7(b). Except as
				provided in subparagraph 20.3.7(a)(3), return on equity is not included as a
				cost of ownership in the comparison.
20.1.6 Administrative allowance.
20.1.7 The cost of Workers' Compensation
				Insurance (less the portion covered by MaineCare under Chapter III, Section 97,
				Appendix C or F of the MBM.
20.1.8
				Water and sewer fees.
20.1.9
				Amortization.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-21 - WORKERS' COMPENSATION

Current through 2024-29, July 17, 2024
Workers' Compensation insurance premiums to cover staff who
				  provide room and board services, paid to an admitted carrier, applicable fees,
				  assessments and premiums paid to an authorized and fully funded trust, and
				  premiums paid to an individual self-insured program approved by the State of
				  Maine, are fixed/capital costs. Capital contributions are not an allowable
				  cost. The Department will require the facility to be a prudent and cost
				  conscious buyer of Workers' Compensation insurance. In those instances where
				  the Department finds that a facility pays more than the going rate or does not
				  try to minimize costs, in the absence of clear justification, the Department
				  may exclude excess costs in determining allowable costs under these Principles.
				  That portion of any Workers' Compensation insurance premium paid for the
				  benefit of the administrator of the facility shall be allowed as part of the
				  total cost of the premium and shall not be deducted in lieu of the
				  administrative allowance.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-22 - WATER AND SEWER FEES

Current through 2024-29, July 17, 2024
Fees assessed for water and sewer usage, as well as
				  connection costs that are assessed by a municipality, are allowable fixed
				  costs.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-23 - AMORTIZATION

Current through 2024-29, July 17, 2024
23.1
General
.Prior to admitting
				members, certain costs are incurred, which are referred to as start-up costs.
				These costs must be capitalized as deferred charges and amortized over a period
				of sixty (60) consecutive months, beginning with the first month members are
				admitted. Start-up costs include, for example, routine and direct service
				salaries, pay roll payrolltaxestaxes and fringe benefits, heat, gas,
				electricity, taxes, insurance, mortgage and other interest, employee training
				costs, repairs and maintenance, housekeeping, and any other allowable costs
				incident to the start-up period.
23.2 Costs that are properly identifiable as
				organization costs, or which may be capitalized as construction costs must be
				appropriately classified as such and excluded from start-up costs.
23.2.1 Legal fees paid for organizational
				expenses are to be amortized over a sixty (60) month period.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-31 - OTHER ALLOWABLE ROUTINE COSTS

Current through 2024-29, July 17, 2024
31.1
Purchase Discounts and Allowances, and Refunds of Expenses
31.1.1(a) Discounts and allowances received
				on purchases of goods or services are reductions of the costs to which they
				relate. Similarly, refunds of previous expense payments are reductions of the
				related expense.
31.1.2(b)
Reduction of Costs
.All discounts, allowances, and refunds of
				expenses are reductions in the cost of goods or services purchased and are not
				income. When they are received in the same accounting period in which the
				purchases were made or expenses were incurred, they will reduce the comparable
				purchases or expenses in the period. However, when they are received in a later
				accounting period, they will reduce the comparable purchases or expenses in the
				period in which they are received.
31.1.3(c)
Application
31.1.3(c)(1) Purchase discounts have been
				classified as cash, trade, or quantity discounts. Cash discounts are reductions
				granted for the settlement of debts before they are due. Trade discounts are
				reductions from list prices granted to a class of customers before
				consideration of credit terms. Quantity discounts are reductions from list
				prices granted because of the size of individual or aggregate purchase
				transactions. Whatever the classification of purchase discounts, like treatment
				in reducing allowable costs is required.
31.1.3(c)(2) All discounts, allowances, and
				rebates received from purchases of goods or services and refunds of previous
				expense payments are clearly reductions in costs and must be reflected in the
				determination of allowable costs. This treatment is equitable and is generally
				followed by other governmental programs and third-party payment organizations
				that pay on the basis of cost.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-32 - INDIRECT COST ALLOCATION

Current through 2024-29, July 17, 2024
Indirect costs are those that are incurred for common or
				  joint objectives, and are not considered direct costs. They shall be pooled and
				  distributed to the individual services or programs benefiting there from. The
				  over all objective of the indirect cost allocation process is to provide a
				  reasonable and comparable distribution of the indirect costs of an agency with
				  multiple programs to its various activities or cost objectives. Allowable
				  indirect costs shall be allocated to the following rate components: routine
				  costs and fixed/capital costs. The distribution of indirect costs shall be in
				  compliance with generally accepted accounting methods and shall have been
				  approved by the DHHS, Division of Audit.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-33 - PROGRAM ALLOWANCE

Current through 2024-29, July 17, 2024
Facilities enrolled as a MaineCare Provider and have a
				  MaineCare Provider/Supplier Agreement, and who are paid under Chapters II and
				  III, Section 97, Appendices C or F, shall receive a program allowance from
				  MaineCare that allows the Department to receive Federal matching funds for
				  certain unspecified routine costs that also support the provision of
				  MaineCare-covered services. Routine services costs will be offset by the amount
				  of the MaineCare program allowance multiplied by the total resident days. The
				  program allowance will be set at a minimum of ten percent (10%) or at a maximum
				  determined at the discretion of the Commissioner of the applicable agency
				  providing the State share of MaineCare reimbursement, depending on the extent
				  of funds available. The maximum reimbursement amount allowed including the
				  program allowance will not be greater than the total room and board
				  costs.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-35 - CIVIL MONETARY PENALTIES

Current through 2024-29, July 17, 2024
In the event the Department issues civil monetary penalties
				  against a provider, in accordance with
				  22 M.R.S.A.
				  §7941
et seq
., the
				  Department may collect these amounts in accordance with the same procedures for
				  recovering overpayments, as described in Section 34.6.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-36 - TERMINATION UNDER TITLE XIX

Current through 2024-29, July 17, 2024
Termination of participation in the MaineCare Program shall
				  result in the provider being terminated simultaneously from financial
				  participation in room and board payments under these
				  Principles.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-38 - Hearings

Current through 2024-29, July 17, 2024
38.1 Appeals to decisions made under Section
				37 shall be made to the
				Administrative Hearings Unit of the Department of Health and Human Services.
				The request must be made in writing within thirty (30) days of the initial
				denial, to the:
Office of Administrative Hearings
Department of Health and Human Services,
11 State House Station
Augusta, Maine 04333-0011
Hearings will be held on an expedited basis and a written
				  decision will be rendered within thirty (30) days of receipt of the request.
				  The Office of Administrative Hearings will arrange the date, time, and place of
				  the hearing, and shall designate a presiding officer. The individual requesting
				  the hearing will be given at least twenty (20) days advance notice of the
				  hearing date. The hearing shall be held in conformity with the
Maine
				  Administrative Procedure Act
,
				  5 MRSA §8001
et seq
. and the Department's
Administrative Hearings
				  Manual
.The presiding officer shall issue a written decision and
				  findings of fact or, pursuant to provisions of the
Administrative
				  Hearings Manual
, issue a written recommendation to the Commissioner of
				  the Department of Health and Human Services who will make the final
				  decision.
38.2 When a
				medical assessment by a medical authority other than the one involved in the
				decision under question is requested by the hearings officer or the member and
				considered necessary by the hearings officer, it will be obtained at the
				Department's expense and forwarded to all parties involved, allowing all
				parties to comment.
38.3 The
				decision(s), rendered by the hearing authority, in the name of DHHS, will be
				binding upon the Department, unless the Commissioner directs the hearing
				officer to make a proposed decision reversing final decision-making authority
				to him or herself.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 116 - REGULATIONS GOVERNING THE FILING AND REVIEWING OF PROVIDER AGREEMENT APPLICATIONS FOR BOARDING CARE FACILITIES ON A FLAT RATE OF REIMBURSEMENT › Section 144-116-A - Purpose and Findings

Current through 2024-29, July 17, 2024
The 110th Legislature has appropriated funds sufficient to
				  support an additional 60 boarding care beds statewide in homes on a flat rate
				  of reimbursement. The purpose of these regulations is to establish an orderly
				  and appropriate system for the selection of boarding home operators to develop
				  these 60 beds.
Successful applicants will be awarded a provider agreement to
				  authorize acceptance of State-assisted residents at a rate of reimbursement
				  authorized by the Legislature of $355 per resident per month. In addition to
				  the requirements of these regulations the successful applicant will be required
				  to meet all regulations governing licensure of boarding care facilities in
				  order to receive a license.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 116 - REGULATIONS GOVERNING THE FILING AND REVIEWING OF PROVIDER AGREEMENT APPLICATIONS FOR BOARDING CARE FACILITIES ON A FLAT RATE OF REIMBURSEMENT › Section 144-116-B - Priority Areas

Current through 2024-29, July 17, 2024
The Department will accept applications for boarding care
				  provider agreements from applicants residing in fifteen areas of Maine. The
				  areas were selected on the basis of current availability of long-term care
				  beds. All areas identified below have fewer than the mean number of long-term
				  care beds for the State as a whole. Long-term care beds include boarding care
				  (BC), adult foster care (AFC), and intermediate care (ICF) beds. Bed
				  availability was determined according to the following formula:
(3 x #BC beds) + (2 x #AFC beds) + (# of ICF
				  beds)/Population/1000 65+
The Department reserves the right to allocate any or all or
				  the 60 beds to any of the priority areas based on the quality of applications
				  received.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 116 - REGULATIONS GOVERNING THE FILING AND REVIEWING OF PROVIDER AGREEMENT APPLICATIONS FOR BOARDING CARE FACILITIES ON A FLAT RATE OF REIMBURSEMENT › Section 144-116-C - Application Process

Current through 2024-29, July 17, 2024
1. In order to be
				considered eligible for any of the 60 beds, applicants must file an application
				with the Manager of the Boarding Home Program.
2. All completed applications will be grouped
				according to service area and reviewed competitively with all other
				applications for that area. Applications which do not contain all required
				information will not be considered.
3. Special applications have been developed
				for this purpose and must be used by all applicants. They may be obtained from
				the Manager of the Boarding Home Program, Bureau of Medical Services,
				Department of Human Services, 221 State Street, Station #11 Augusta, Maine
				04333.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 116 - REGULATIONS GOVERNING THE FILING AND REVIEWING OF PROVIDER AGREEMENT APPLICATIONS FOR BOARDING CARE FACILITIES ON A FLAT RATE OF REIMBURSEMENT › Section 144-116-D - Criteria for Reviewing Provider Agreement Applications

Current through 2024-29, July 17, 2024
1. Applicants must demonstrate in the
				application that they have the ability to provide quality boarding
				care.
2. Applicants must
				demonstrate financial feasibility by comparing estimated resources to
				expenditures.
3. Applicants must
				demonstrate the availability of community resources and how they will access
				them.
4. Applicants must
				demonstrate a willingness to participate in a joint plan of care for the
				residents if one is developed by outside agencies.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-2 - Obtaining a License

Current through 2024-29, July 17, 2024
2.1
Requirements.
Adult Day Services is a group program designed to
				meet the needs of adults who, through an assessment and service plan, are
				determined to need therapeutic activities and services of socialization,
				supervision, support services, assistance with activities of daily living
				and/or health monitoring.
2.1.1 No person or
				entity shall operate an Adult Day Services Program of more than two (2)
				consumers without a license from the Department in force, authorizing such
				operation.
2.1.2 The person or
				entity applying for the license shall be responsible for complying with Maine
				Statutes and regulations adopted pursuant thereto.
2.1.3 Reimbursement shall not be accepted by
				any person for rendering Adult Day Services for more than two (2) persons who
				are not blood relatives without such person having first secured a license
				authorizing such operation in accordance with these regulations.
2.1.4 The license is valid only for the named
				licensee(s).
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-4 - Administration

Current through 2024-29, July 17, 2024
4.1
Administrator Requirements.
4.1.1
Qualifications.
The
				administrator of an Adult Day Services Program shall have management and
				supervisory experience in a social or health service setting or comparable
				technical or human service training or experience, with demonstrated competence
				and experience in a health or human service setting. The administrator shall
				perform his/her duties in compliance with all applicable laws and regulations
				and consistent with the standard of conduct that a reasonable and prudent
				person would observe in the same situation. The administrator shall be at least
				twenty-one (21) years of age.
4.1.2
Determination of Qualification.
A determination of qualification
				shall require the applicant and proposed administrator to demonstrate their
				willingness and ability to operate and manage an Adult Day Services Program
				with mature judgment, compassionate regard for the best interests of the
				consumers and consistent compliance with these regulations and all relevant
				laws. In making this determination, the Department shall consider each of the
				following factors to the extent that they are relevant to the proposed program,
				ownership interest and/or employment: The applicant/licensee and administrator,
				as part of the license application process, shall consent to the release of all
				information that may be reviewed in this Section.
4.1.2.1 . Record and reputation for honest
				and lawful conduct in business and personal affairs. The provider shall
				authorize the Department to review the records of professional licensing boards
				or registers, any criminal record, child protective record or adult protective
				record necessary to determine compliance with these rules;
4.1.2.2 . Experience in the field of health
				care, social services or areas related to the provision of Adult Day Services
				programs;
4.1.2.3 . Conduct which
				demonstrates an understanding of, and compliance with, consumer
				rights;
4.1.2.4 . Information which
				relates to the ability, willingness or disposition towards compliance with all
				applicable laws and regulations;
4.1.2.5 . Any information reasonably related
				to the ability to provide knowledgeable, safe and quality services to the
				consumer
4.1.2.6 Management and
				supervisory experience, including the capacity to manage the financial
				operations and staff of the program.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-5 - Staff Qualifications

Current through 2024-29, July 17, 2024
5.1
Personnel
				Policies.
The program shall have policies that address all personnel
				practices including job descriptions, orientation, training and
				evaluation.
5.2
Staff
				Qualifications.
The program must employ, on a full time, part time or
				consulting basis, those persons necessary to carry out the provisions of these
				regulations. Preference shall be given to staff that have a minimum of one (1)
				year of training or experience in social or health care services. An Adult Day
				Services Program that is co-located in a licensed Nursing or Assisted Living
				Facility shall schedule staff with distinct hours that are assigned to the
				Adult Day Services Program.
5.2.1 Any person
				working in the program who is not a consumer must demonstrate the following:
5.2.1.1 Conduct which demonstrates an
				understanding of, and compliance with, consumers' rights;
5.2.1.2 The ability and willingness to comply
				with all applicable laws and regulations;
5.2.1.3 The ability to provide safe and
				compassionate services; and
5.2.1.4
				A history of honest and lawful conduct.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-6 - Environmental Safety

Current through 2024-29, July 17, 2024
6.1
Environment and Safety.
Any Adult Day Services Program must comply
				with State and local health, fire, safety, building and sanitation laws,
				ordinances or codes.
6.2 No license
				to operate an Adult Day Services Program shall be issued or re-issued until the
				program site has passed inspection by the State Fire Marshal Office and a
				written report signed by the State Fire Marshal has been provided to the
				Department.
6.3
Fire Safety
				Plan.
Each program must have a fire safety plan. This plan and any
				changes in it are to be developed in conjunction with and approved by local or
				State fire authorities. The plan shall be posted conspicuously in the program
				area and shall include:
6.3.1 Fire safety
				measures to be taken;
6.3.2
				Location of emergency exits;
6.3.3
				Evacuation procedures;
6.3.4 The
				telephone numbers of police, fire, ambulance, physicians or other individuals
				to contact in an emergency;
6.3.5
				The number and placement of smoke detectors.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-8 - Assessments, Service Plans and Consumer Records

Current through 2024-29, July 17, 2024
8.1
Comprehensive Assessment.
Each consumer attending the program shall have a comprehensive written
				assessment. The assessment shall commence no later than the first day of
				program participation and shall be completed within thirty (30) calendar
				days.
8.2 If the provider does not
				use the Department approved assessment tool, the assessment shall include at a
				minimum:
8.2.1 Identification and background
				information.
8.2.1.1 . Individual's name,
				address and Social Security number;
8.2.1.2 . Age, date of birth;
8.2.1.3 . Gender;
8.2.1.4 Marital status;
8.2.1.5 . Living arrangements;
8.2.1.6 Responsible party and emergency
				contacts;
8.2.1.7 Advanced
				directives;
8.2.1.8 Previous
				occupation(s), special interests and hobbies;
8.2.1.9 Primary language spoken;
8.2.1.10 Primary care physician's name,
				address and telephone number.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 117 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF ADULT DAY SERVICES PROGRAMS › Section 144-117-9 - Adult Day Services Programs

Current through 2024-29, July 17, 2024
9.1
Adult Day
				Services Programs
.
Adult Day Services Programs
				include a Social Adult Day Services Program and an Adult Day Health Services
				Program, which are differentiated by the intensity and scope of service
				delivery. Each program shall comply with all the general licensing standards as
				well as the program specific requirements outlined herein. A provider may be
				licensed for more than one (1) program, as long as the record keeping is
				distinct.
9.2
Therapeutic
				Activities.
Therapeutic activity is the emphasis and focus of Adult Day
				Service Programs. The plan for therapeutic activity should be an integral part
				of the overall service plan, promoting a consumer's optimal functioning.
				Activities should be meaningful, have a purpose, be voluntary, and reflect
				positively the consumer's sense of self. Activities shall be varied to meet the
				needs of consumers, as reflected in the service plan, providing a structure of
				daily activities combined with the ability of staff to adapt activities to meet
				the needs of the consumer group and provide individual programming, if
				necessary. The therapeutic activities program should provide quieting and
				stimulating activities at varied times of the day, activities that are age
				appropriate, activities that provide opportunities for physical fitness, for
				creative self expression and exploration of interests, for stimulation of
				recent and long term memory and for consumers to participate in community
				outings and/or events.
9.3
Social Adult Day Services Program.
A Social Adult Day Services
				Program is designed to meet the social and supportive service needs of
				individuals attending the program.
This may include socialization, supervision, supportive
				  services and/or limited assistance with activities of daily living
				  (ADLs).
9.3.1
Required
				Services
. A Social Adult Day Services provider shall provide the
				following services:
9.3.1.1
				Supervision;
9.3.1.2 Social,
				leisure, physical, therapeutic and/or educational activities appropriate to the
				consumer's ability and interest;
9.3.1.3 Assistance with ADLs;
9.3.1.4 A morning and afternoon
				refreshment.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 1 - DECLARATION OF INTENT AND FUNCTIONS OF ICF/MR

Current through 2024-29, July 17, 2024
Intermediate Care Facilities for Persons with Mental
				  Retardation (ICFs/MR) are homes. They provide persons with mental retardation
				  an opportunity for personal development and growth. If created in concert with
				  the intent of these regulations, these homes afford individuals privacy,
				  dignity, comfort, sanitation, a home-like environment and above all, provide a
				  dynamic, healthy and purposeful life for them.
09/01/07
It is the intent of the Maine Department of Health and Human
				  Services (DHHS) to establish and to promote the development and utilization of
				  resources to ensure effective health and habilitation services for persons with
				  mental retardation and related conditions who require an environment which
				  adheres to the concepts of "Active Treatment," "Normalization" and/or "Social
				  Role Valorization".
09/01/07
Intermediate Care Facilities for Persons with Mental
				  Retardation are subject to licensure by these rules, which establish standards
				  for the physical facility, maintenance and conduct of client care and
				  habilitation, so as to meet the needs of those living in the homes.
09/01/07
The goal of ICF/MR services is to provide a habilitation
				  program, which will enhance each person's ability to cope with his/her
				  environment and create a reasonable expectation of progress toward the goal of
				  community living in the least restrictive and most normal living conditions
				  possible.
09/01/07
In accordance with Chapter 52, Resolve,
To Require
				  the Department of Health and Human Services to Amend Rules Regarding Licensing
				  of Intermediate Care Facilities for Mental Retardation,
DHHS has
				  revised these regulations to eliminate State licensing requirements that are
				  duplicative of the Federal Title XIX requirements, or no longer essential. DHHS
				  has adopted the Medicaid or Title XIX requirements for purposes of State
				  licensure, and by reference has incorporated the Conditions of Participation
				  for Intermediate Care Facilities for the Mentally Retarded (42 Code of Federal
				  Regulations, Subpart I, Sections § 483.10-483.40 ). DHHS has consulted
				  with consumers, providers, advocates and regulators prior to revising these
				  rules.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 2 - DEFINITIONS

Current through 2024-29, July 17, 2024
The following terms shall have the meanings specified:
09/01/07
1. Abuse - The
				willful, reckless or negligent infliction of injury, unreasonable confinement,
				intimidation or cruel punishment with resulting physical harm or pain or mental
				anguish; sexual abuse or exploitation; or the willful deprivation of essential
				needs. A person may commit abuse by willfully, recklessly or negligently
				inflicting injury by responding to the actions of a client, if the person's
				response was excessive or unwarranted under the circumstances. Intimidation,
				for purposes of this definition, shall include verbal interaction between a
				person and a client receiving care that is either intended to inflict mental
				anguish or could reasonably be expected to inflict mental anguish upon the
				person subjected to such verbal interaction.
a. Willful conduct, for purposes of this
				definition, means intentional or knowing conduct.
b. Reckless conduct, for purposes of this
				definition, means a conscious disregard of a substantial and unjustifiable
				risk.
c. Negligent conduct, for
				purposes of this definition, means a failure to exercise that degree of care
				which a reasonable person would exercise in the same situation.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.A - Requirements of Licensure

Current through 2024-29, July 17, 2024
3.A.1. Requirements
a. No person shall operate an ICF/MR without
				  a license from the Department in force, authorizing such operation.
b. Reimbursement shall not be accepted, by
				  any person, for rendering intermediate care for the mentally retarded for even
				  one person not a relative within the third degree of kinship, without such
				  person having first secured a license in force, authorizing such operation in
				  accordance with these regulations.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.B - Application Procedure

Current through 2024-29, July 17, 2024
3.B.1. Filing of
				  Application
Any person desiring a license to operate an ICF/MR shall,
					 prior to the commencement of such operation, file an application containing the
					 information required in this section with the Department. Application on behalf
					 of a corporation, association, or government unit shall be made by any two
					 officers thereof or by its managing agency and by any general partner of a
					 partnership. All applicants shall submit satisfactory evidence of their ability
					 to comply with the minimum standards of Chapter 405 of Title 22 M.R.S.A., and
					 all rules and regulations adopted thereunder. Such application shall be on a
					 form approved by the Department.
3.B.2. Contents of Application
a. The name or address by which the ICF/MR is
				  to be legally known and the name under which it will be doing
				  business;
b. The address and
				  telephone number of the premises which are to constitute the location of the
				  ICF/MR, together with a description of all structures and buildings forming a
				  part thereof, and the name of the owner or owners of the premises;
				  and
c. The full name and address of
				  each person having a direct or indirect ownership interest of ten percent (10%)
				  or more in such ICF/MR. Additionally, in case the ICF/MR is organized as a
				  corporation, the full name and address of each officer and director of the
				  corporation; and if the ICF/MR is organized as a partnership, the full name and
				  address of each partner;
d. The
				  name, home address, home telephone number, e-mail address and office telephone
				  number of the individual designated by the applicant as the administrator of
				  the facility.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.D - Issuance of License

Current through 2024-29, July 17, 2024
Each license issued by the Department shall specify:
3.D.1. The name and/or the address of
				  the facility; 3. D. 2. The name of the administrator;
3.D.3. Whether the facility is ICF/MR Nursing
				  or Group;
3.D.4. The maximum
				  allowable number of clients;
09/01/07
3.D.5. Any
				  waivers that have been granted; and
3.D.6. An expiration
				  date.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.E - Number of Clients

Current through 2024-29, July 17, 2024
The ICF/MR shall not admit clients beyond:
a. Its licensed capacity; or
b. Its capability to provide adequate
				  programming.
09/01/07
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.F - Facility Sites/Community Integration

Current through 2024-29, July 17, 2024
09/01/07 3.F.1. The ICF/MR must be operated in accordance
					 with the principles of normalization and social role valorization.
09/01/07 3.F.2. The following guidelines govern the
					 location and structure of ICF/MR facilities.
a. Based on behavioral and physical needs of
				  clients, the facility must be located within reasonable driving time of:
09/01/07
1. Day or
				  external program locations;
2.
				  Hospital and other professional services; and
3. Shopping and recreational
				  resources.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.G - New Construction

Current through 2024-29, July 17, 2024
No new construction may be commenced before application is
					 made for a Certificate of Need from the Department.
09/01/07 3.G.1. An application for approval of new
					 construction must be submitted on forms required by the Department.
09/01/07 3.G.2. Commencement of construction shall not
					 occur until the Department issues a Certificate of Need or formally notifies
					 the facility that such a Certificate is not required.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.H - Changes Requiring Prior Written Approval

Current through 2024-29, July 17, 2024
09/01/07 The following changes require prior written
					 approval by the Department
09/01/07 3.H.1. Alterations which affect:
a. The structural integrity of the
				  building;
b. Fire safety;
c. The primary functioning and/or operation
				  of the facility or the number of beds for which the facility is licensed or
				  relocation of beds.
No significant change shall be made in a licensed facility,
					 its physical plant operation, or services of a degree or character which
					 affects continuing licensability, without prior approval of the
					 Department.
09/01/07 3.H.2. Change in Ownership of Facility
a. No license is assigned or
				  transferable.
b. At least thirty
				  (30) days advance written notice must
09/01/07 be given to the Department prior to the transfer
					 of ownership.
c. Each
				  application for a license from a new owner must be accompanied by a statement
				  from the previous owner or his/her duly authorized representative concerning
				  the change of ownership, a copy of the purchase and sale agreement, or other
				  validating document.
d. Upon
				  receipt of a completed application and fee, the Department shall issue a
				  temporary license to the new owner of an occupied facility for a period not to
				  exceed ninety (90) days, pending compliance by the new owner with the
				  requirements for initial licensure.
09/01/07
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.I - Change of Administrator

Current through 2024-29, July 17, 2024
09/01/07 A change of administrator must be reported to the
					 Department in writing at least thirty (30) days prior to the change taking
					 effect. In emergency situations, the Department must be notified
					 immediately.
The name of the new administrator, his/her qualifications,
					 facility address, home and office telephone number and e-mail address must be
					 included. A new license shall be issued within thirty (30) days upon payment of
					 a $25.00 fee, pending approval of the new administrator.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.J - Waiver Provisions

Current through 2024-29, July 17, 2024
09/01/07 3.J.1. Fire Protection Waiver
a. The Department may waive specific
				  provisions of the Life Safety Code (the Code) for as long as it considers
				  appropriate, if:
1. The waiver would not
				  adversely affect the health and safety of the client's residing in the
				  facility; and
2. Rigid application
				  of specific provisions would result in unreasonable hardship for the
				  ICF/MR.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.K - Waiver Procedures

Current through 2024-29, July 17, 2024
09/01/07 3.K.1. The facility must apply in writing to the
					 Department for a waiver. The application shall contain a justification for the
					 request and state the specific provisions of the regulations for which a waiver
					 is being requested.
09/01/07 3.K.2. No waiver may extend beyond the term of the
					 license and a new waiver shall be required when the license of the facility is
					 renewed.
09/01/07 3.K.3. The Department may request additional
					 information before making a decision on an application for a waiver.
09/01/07 3.K.4. No waiver or waivers shall be granted if
					 there would be an adverse effect to the health or safety of the individuals
					 residing in the facility.
09/01/07 3.K.5. The facility shall be notified in writing
					 when a waiver is granted or denied. In the event of an approval, the waiver
					 shall be noted on the license.
Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 118 - REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF INTERMEDIATE CARE FACILITIES FOR PERSONS WITH MENTAL RETARDATION › Chapter 3 - LICENSURE › Section 144-118-3.L - Availability of License in the Facility

Current through 2024-29, July 17, 2024
The license, with noted waivers if applicable, must be made
					 available to anyone upon request.
09/01/07