Pennsylvania Code › Title 55 - HUMAN SERVICES › Part III - MEDICAL ASSISTANCE MANUAL › Chapter 1181 - NURSING FACILITY CARE › Subchapter D - NURSING HOME REFORM-STATEMENT OF POLICY › APPEALS OF ADVERSE DETERMINATIONS › Appendix G

Current through Register Vol. 54, No. 28, July 13, 2024
TIMETABLE OF KEY MEDICAL ASSISTANCE RELATED
IMPLEMENTATION DATES UNDER OBRA-87, as amended, FOR
						HHS,
PROVIDER FACILITIES AND STATE AGENCIES
1988
7/1/88
Facilities:
Must provide LTC
								ombudsmen, physicians and State/Federal officials immediate access to
								residents.
7/1/88
HHS:
Issue regulation to
								define which costs can be charged to Medicaid eligible nursing facility
								residents' personal fund, and which costs are included in the Medicaid payment
								amount.
9/1/88
HHS:
Establish requirements
								for approval of nurse aide training and competency evaluation programs.
10/1/88
HHS:
Establish guidelines
								for minimum standards for state appeals process for transferred and discharged
								residents.
10/1/88
HHS:
Develop minimum
								criteria for preadmission screening and annual resident review (PASARR) for
								mentally retarded and mentally ill residents of nursing facilities.
10/1/88
HHS:
Develop criteria for
								appeals process for residents adversely affected by PASARR process.
10/1/88
HHS:
Develop criteria to
								monitor state performance in granting nursing facilities waiver of 24-hour
								licensed professional nurse provision.
10/1/88
HHS:
Publish regulation
								regarding alternative remedies (sanctions) for nursing facilities out of
								compliance.
1989
1/1/89
States:
Must have in effect
								a preadmission screening program for mentally retarded and mentally ill patient
								placement determinations.
1/1/89
States:
Establish a nurse
								aide registry.
1/1/89
States:
Must establish
								appeals process for residents adversely affected by screening and review
								process for mentally retarded and mentally ill individuals.
1/1/89
States:
Specify approved
								nurse aide training and competency evaluation programs.
1/1/89
Facilities:
Must not admit
								any mentally retarded or mentally ill individuals unless screened by
								appropriate state authority and found to need level of care provided by
								facility.
1/1/89
HHS:
Specify minimum data
								set of core elements and common definitions for use by nursing facilities in
								conducting resident assessments. Establish guidelines for utilization of data
								set.
4/1/89
States/HHS:
Enter into
								agreement regarding alternative disposition plan for review/placement of
								mentally retarded or mentally ill residents needing active treatment but not
								level of care provided by facility in which they reside (NOTE: Since HCFA
								usually requires a 90-day period to review and approve such plans, states are
								advised to submit their alternative disposition plans to HCFA by January 1,
								1989.
7/1/89
States:
Implementation and
								enforcement of standards for nursing facility administrators.
7/1/89
Facilities:
Must provide for
								nurse aid competency evaluation programs for nurse aides employed in facility
								as of July 1, 1989; and for any preparation needed to complete program by
								January 1, 1990.
10/1/89
States:
Must have appeals
								process in place for residents involuntarily transferred or discharged from
								nursing facilities on or after October 1, 1989.
10/1/89
States:
Establish
								alternative remedies (sanctions) for nursing facilities out of compliance.
10/1/89
Facilities:
Must notify
								residents of right to appeal all transfers and discharges.
1990
1/1/90
States:
Provide for review
								and reapproval of all nurse aide training and competency evaluation programs.
1/1/90
Facilities:
All nurses aides
								must have completed training and competency evaluation program if they are
								employed more than 4 months by facility.
1/1/90
HHS:
Develop, test and
								validate protocol for standard and extended survey of nursing facilities.
4/1/90
States:
Complete review of
								all mentally retarded and mentally ill residents currently residing in nursing
								facilities and determine and implement appropriate placement.
4/1/90
States:
Submit to HHS a
								state plan amendment which provides for appropriate payment adjustment to
								nursing facilities (which takes into account the cost of complying with nursing
								home reform provisions).
4/1/90
HHS:
Must designate one or
								more resident assessments which a state may specify for use by nursing
								facilities.
7/1/90
States:
Must specify
								resident assessment instrument to be used by nursing facilities.
7/1/90
States:
Must specify
								resident assessment instrument to be used by nursing facilities.
9/30/90
HHS:
Must review and
								approve/disapprove state plan amendments for payment adjustments to nursing
								facilities.
10/1/90
States:
Survey and
								Certification requirements become effective.
10/1/90
Facilities:
Must conduct
								resident assessment within 4 days for residents admitted on or after October 1,
								1990 and must begin conducting annual resident assessments.
10/1/90
Facilities:
Must provide
								24-hour/day licensed professional nursing services and full-time registered
								nurse services 7 days/week (unless waived). Distinction between SNF and ICF
								level of care eliminated.
1991
10/1/91
Facilities:
Resident
								assessment for all residents admitted to facility prior to October 1, 1990 must
								be completed.
1993
*1/1/93
HHS:
Evaluation of resident
								assessment process-report to Congress.
This section cited in 55 Pa. Code §
													1181.505 (relating to
						  discussion).