reglab/statecodes huggingface dataset:
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-2 - Application And Enforcement

Current through Register Vol. XLI, No. 28, July 12, 2024
These procedural rules apply to the Board. The enforcement of
				  these rules is vested with the chairperson of the Board.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Authority. --
				The Health Care Cost Review Authority created under section five, article
				twenty-nine-b, chapter sixteen of the Code.
3.2. Board. -- The members of the governing
				body of the Health Care Cost Review Authority appointed by the Governor in
				accordance with section five, article twenty-nine-b, chapter sixteen of the
				Code.
3.3. Chairperson. -- The
				Board member appointed by the Governor under section five, article
				twenty-nine-b, chapter sixteen of the Code to serve as chairman of the Health
				Care Cost Review Authority.
3.4.
				Decision. -- Any determination, action, vote or final disposition of a motion,
				proposal, resolution, order or measure on which a vote of the Board is required
				at any meeting at which a quorum is present.
3.5. Meeting. -- The convening of the Board
				for which a quorum is required in order to make a decision or to deliberate
				toward a decision on any matter, but such term does not include (a) any meeting
				for the purpose of making an adjudicatory decision in any quasi-judicial
				administrative proceeding, or (b) any on-site inspection of any hospital or
				program.
3.6. Quorum. -- A simple
				majority of the constituent membership of the Board.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-4 - Meetings

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. Meetings of
				the Board may be called by the chairperson, and the chairperson shall call a
				meeting upon the written request of two (2) Board members.
4.2. The chairperson shall notify Board
				members in writing at least seven (7) days in advance of a meeting setting
				forth the time and place of such meeting and the matters to be considered,
				except that such notice is not required if the time, the place and matters for
				consideration have been fixed in a meeting where all the members are
				present.
4.3. The chairperson shall
				notify the public and the news media by filing with the office of the Secretary
				of State a public notice of the meeting at least seven (7) days in advance. The
				public notice shall contain the time, the place and the matters to be
				considered.
4.4. The provisions of
				this section shall not apply in the event of an emergency requiring immediate
				official action by the Board.
4.5.
				Special meetings may be continued to a set time and place on the following
				workday by a majority vote of the Board members present and voting.
4.6. Special meetings may be canceled by the
				chairperson if no Board member objects.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-5 - Proceeding To Be Open; Exceptions; Executive Session Permitted

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. All meetings
				of the Board shall be open to the public, except an executive session closed to
				the public may be held during a regular, special or emergency meeting, after
				the presiding officer has identified the authorization under section four,
				article nine-a, chapter six of the Code for the holding of such executive
				session and has presented it to the Board and to the general public, but no
				decision shall be made in such executive session.
5.2. An executive session may be held only
				upon a majority affirmative vote of the Board members present for the following
				(as from section four, article nine-a, chapter six of the Code):
(a) Matters of war, threatened attack from a
				foreign power, civil insurrection or riot; or
(b) The appointment, employment, retirement,
				promotion, demotion, disciplining, resignation, discharge, dismissal or
				compensation of any public officer or employee, or other personnel matters, or
				for the purpose of conducting a hearing on a complaint against a public officer
				or employee, unless such public officer or employee requests an open meeting;
				or
(c) The issuance, effecting,
				denial, suspension or revocation of a license, certificate or registration
				under the laws of this State or any political subdivision, unless the person
				seeking such license, certificate or registration or whose license, certificate
				or registration was denied, suspended or revoked requests an open meeting;
				or
(d) The physical or mental
				health of any person, unless such person requests an open meeting; or
(e) Matters which, if discussed in public,
				would be likely to affect adversely the reputation of any person; or
(f) The development of security personnel or
				devices; or
(g) Matters involving
				or affecting the purchase, sale or lease of property, advance construction
				planning, the investment of public funds or other matters involving competition
				which, if made public, might adversely affect the financial or other interest
				of the state or any political subdivision.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-6 - Minutes

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. The Board
				shall provide for the preparation of written minutes of all its meetings. All
				such minutes shall be available to the public within a reasonable time after
				the meeting and shall include the following information:
(a) The date, time and place of the
				meeting;
(b) The name of each Board
				member present or absent;
(c) All
				motions, proposals, resolutions, orders, ordinances and measures proposed, the
				name of the person proposing the same and their disposition;
(d) The results of all votes and, upon
				request of a member, the vote of each member, by name.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-7 - Majority Vote Required; Vote By Proxy Prohibited

Current through Register Vol. XLI, No. 28, July 12, 2024
The vote of a majority of all members present at any meeting
				  of the Board shall be necessary to take any action. Proxy voting is
				  prohibited.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-01 - Procedural Rules For Meetings Of The Health Care Cost Review Council › Section 65-1-8 - Records Of The Board - Public

Current through Register Vol. XLI, No. 28, July 12, 2024
Records of the Board are public records that may be inspected
				  in accordance with section three, article one, chapter twenty-nine-b of the
				  Code and copied at a charge of twenty-five cents ($.25) per
				  page.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This
				legislative rule establishes general standards and procedures for the licensure
				of medical adult day care centers as a special type of ambulatory health care
				center. The W. Va. Code is available in public libraries and on the
				Legislature's web page,
http://www.legis.state.wv.us/
.
1.2. Authority. -- W. Va. Code
				§§16-5B; 16-1-4(k)
1.3.
				Filing Date. -- June 4, 2009.
1.4.
				Effective Date. -- July 1, 2009.
1.5. Repeal and Replace Former Rule. -- This
				rule repeals and replaces Division of Health rule, Licensure of Medical Adult
				Day Care Centers 64CSR2, effective July 12, 1985.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-2 - Application and Enforcement

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1.
				Application. This rule applies to any individual person, association,
				partnership, corporation, whether for profit or not, local governmental unit or
				any division, department, board or agency thereof which shall establish,
				maintain or operate a medical adult day care center. A day care program
				maintained and operated by a nursing home, hospital or other licensed health
				care facility shall comply with this rule. Compliance with the standards in
				this rule shall be evaluated independently from compliance with other licensure
				standards and sharing of staff, space, physical facilities and equipment or
				other may be permitted only if the requirements of each applicable rule are
				satisfied in full.
2.2. Exceptions.
2.2.a. This rule shall not apply to three to
				eight hour service programs carried out by a behavioral health center licensed
				under Licensure of Behavioral Health Centers, West Virginia Department of
				Health Legislative Rules, Series 11, 1984, unless the behavioral health center
				program routinely offers medical treatment services in addition to those
				behavioral health services within the scope of that rule.
2.2.b. This rule shall not apply to day care
				programs for adults which are primarily social and recreational in nature, but
				which may occasionally offer medical screening clinics.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Abuse. - The
				infliction or threat to inflict injury, unreasonable confinement, misuse of
				physical or chemical restraints, intimidation, or punishment with resulting
				physical harm, pain, or mental anguish, including the following:
3.1.a. Mental Abuse. - Includes, but is not
				limited to, humiliation, harassment, threats of punishment or
				deprivation;
3.1.b. Physical Abuse.
				- Includes, but is not limited to, hitting, slapping, pinching, kicking or, use
				of controlling behavior through corporal punishment;
3.1.c. Sexual Abuse. - Includes, but is not
				limited to, harassment, coercion, or assault of a sexual nature; and
3.1.d. Verbal Abuse. - Includes, but is not
				limited to, the use of oral, written or gestured language in communicating with
				a participant or used within the participant's hearing regardless of the
				participant's age, ability to comprehend or disability that contains
				disparaging and derogatory terms.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-4 - State Administrative Procedures

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. General Licensing Provisions.
4.1.a. Before establishing, maintaining,
				offering, operating or advertising a medical adult day care center a person
				shall obtain a license authorizing the operation from the Secretary.
4.1.b. Each new applicant must be at least
				twenty-one years of age and must provide at least two letters of reference from
				reputable citizens with whom he or she is personally acquainted and who certify
				to his or her character and qualifications. If the applicant is an association,
				corporation or governmental unit, evidence shall be submitted to its members
				and the persons in charge.
4.1.c. A
				license is valid only for the person or organization and for the center named
				in the application and on the license, and is not transferable. After a license
				is issued, if there is any change in the name of the licensee or the name of
				the medical adult day care center, the licensee shall notify the Secretary
				immediately and no later than within fifteen (15) days.
4.1.d. If the licensee owns more than one
				medical adult day care center, each center shall have a separate
				license.
4.1.e. The words 'clinic,"
				'hospital," "residence" or any other words that suggest a type of facility
				other than a medical adult day care center may not be used in the name or the
				advertising of the center.
4.1.f.
				The licensee is responsible for compliance with this rule, the terms of the
				medical adult day care center's license, W. Va. Code §
										16-5B-1
				et seq., and other relevant federal, state, and local laws and agency policies
				and procedures.
4.1.g. The
				Secretary may issue an initial or a renewal license for a period not to exceed
				one year, unless if an applicant submits an application for renewal of a
				license currently in effect in accordance with this rule and W. Va. Code §
										16-5B-1
				et seq., together with the required fee. The license shall continue in effect
				until:
4.1.g.1. The thirtieth of June
				following the date of issuance unless continued pursuant to this rule and W.
				Va. Code §16-5B- et seq.;
4.1.g.2. The date of a revocation or
				suspension of the license pursuant to this rule and W. Va. Code §
											16-5B-1
				et seq., or
4.1.g.3. The date of
				issuance of a new license, whichever date occurs first.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-5 - Site Location, New Construction, Additions, Renovations and Alterations

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. The
				requirements of this section apply in total to all proposed medical adult day
				care facilities.
5.2. For new
				construction, additions, renovations, or alterations to existing centers, and
				before construction begins on a proposed center, the applicant shall submit a
				complete set of drawings and specifications for the architectural, structural,
				and mechanical work as follows:
5.2.a. An
				architect or engineer registered in West Virginia shall prepare, sign and seal
				the submitted set of construction drawings and specifications and submit one
				set of these documents to the Secretary and one set to the state fire marshal
				for approval. The registered architect or engineer shall also inspect the new
				center or the additions and renovations during the construction
				phase.
5.2.b. Unless substantial
				construction is started within one year of the date of approval of final
				drawings, the architect, engineer or applicant, whichever is applicable, shall
				obtain a written statement from the Secretary that the plan approval for
				construction is still valid and in compliance with this rule.
5.2.c. The Secretary shall inspect sites for
				all proposed centers and sites of additions or renovations to existing centers,
				prior to the applicant starting site development or initiating construction.
				Sites shall:
5.2.c.1. Have adequate drainage
				to divert surface water and be located in an area above the one hundred (100)
				year flood plain;
5.2.c.2. Have a
				water supply that is safe and sized to meet all center needs. Water supplies
				shall be installed, constructed, maintained, operated and monitored in
				compliance with Division of Health rules, Water Supply Regulations, 64CSR3,
				Water Well Regulations, 64CSR19, and Cross-Connection and Backflow Prevention
				Regulations, 64CSR15, as applicable; and
5.2.c.3. Have precautions to assure the
				participants' safety, if located near railroads, freight yards, traffic
				arteries or airports.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-6 - Administrative Requirements

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1.
				General Administrative Requirements.
6.1.a.
				The licensee shall establish regular hours of operation of not less than four
				(4) hours per day and not more than fourteen (14) hours per day, a minimum of
				five (5) days per week. The center's hours of operation shall be during times
				that encompass a normal work week for participant's caregivers.
6.1.b. The licensee shall develop and adopt
				written policies and procedures that are consistent with this rule and specific
				to the medical adult day care center, governing the care and safety of
				participants, and all other policies and procedures required by this
				rule.
6.1.c. The licensee shall
				review all policies and procedures at least annually and shall sign and date
				the policies and procedures at the time of adoption, modification, and
				review.
6.1.d. The licensee shall
				have a copy of the policies and procedures available for review on request by
				employees, participants and the general public.
6.1.e. The licensee shall have a participant
				bill of rights, and rules of participation governing participant behavior and
				responsibilities, that are both in writing and consistent with this
				rule.
6.1.f. Unless otherwise
				approved in writing by the Secretary, a licensee shall not rent, lease or use
				any part of the center for any purpose other than the operation of a medical
				adult day care center.
6.1.g. Any
				individual, including an employee, or his or her spouse having a financial
				interest in the center shall not serve as a participant's legal
				representative.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-7 - Participant Rights

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. General
				Rights.
7.1.a. The licensee shall post in a
				conspicuous place the medical adult day care center's license, a copy of the
				participants' rights, the participant's responsibilities, and the phone numbers
				for the abuse hotline and the office of the licensing agency.
7.1.b. If a legal representative has been
				appointed for, or designated by, any participant as having the authority to
				exercise one (1) or more of the participants' rights for the participant, the
				licensee shall permit the legal representative to exercise the authority. If
				the legal representative exercises the authority for a participant, it shall be
				in a manner consistent with applicable federal and state laws. The licensee
				shall keep a copy of the document granting legal authority to a legal
				representative in the participant's record.
7.1.c. Nothing in this rule shall in any way
				be construed to diminish or deprive any individual of his or her rights under
				federal and state laws.
7.1.d. A
				participant has the right to be free from restraint, interference, coercion,
				discrimination or reprisal from the licensee in exercising his or her
				rights.
7.1.e. A participant has
				the right to be free from discriminatory practices related to admission or
				services on the grounds of race, religion, national origin, age, gender, sexual
				orientation or disability.
7.1.f. A
				participant has the right to view the results of inspections and complaint
				investigations conducted by the licensing agency. The licensee shall make
				available, in a place accessible to participants, the deficiencies cited during
				the most recent survey, any complaint investigation conducted within the
				preceding twelve (12) months, and the center's plan of correction.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-8 - Participant Services

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1.
				Admission and Discharge.
8.1.a. The licensee
				shall not admit to the medical adult day care center individuals requiring
				ongoing or extensive nursing care and shall not admit or retain individuals
				requiring a level of service that the center is not licensed to provide or does
				not provide.
8.1.b. The licensee
				shall seek immediate treatment for a participant or may refuse to admit or
				retain a participant if there is reason to believe that the participant may
				suffer serious harm, or is likely to cause serious harm to himself, herself or
				to others, if appropriate interventions are not provided in a timely
				manner.
8.1.c. If a participant has
				care needs that exceed the level of care for which the center is licensed or
				can provide, the licensee shall inform the participant, or his or her legal
				representative, of the need for discharge from the center.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-9 - Activities

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1. The licensee
				shall provide an activity program designed to promote the highest level
				possible in all dimensions of life including physical, psychological, social,
				and spiritual, for each participant and shall consider individual differences
				in age, health status, sensory deficits, ethnicity, religious affiliation,
				values, needs, interests, abilities, and skills by providing opportunities for
				a variety of types and levels of involvement.
9.2. The activity director shall complete an
				assessment of each participant within fourteen (14) attendance days of
				admission to determine the participant's needs, capabilities, and interests and
				develop an individualized activity plan for the participant based on the
				results of this assessment. The activity director shall review participant
				activity needs at least quarterly and update the activity assessment as
				needed.
9.3. The center shall have
				a written plan for the center's activity and recreation program that shall
				include a variety of activities as appropriate to meet the individual needs of
				participants including but not limited to:
9.3.a. Social and interpersonal activities
				that provide opportunities for enjoyment and development of social
				relationships;
9.3.b. Diversional
				and recreational activities designed to emphasize individual accomplishment,
				provide diversion and aid in adjustment to long-term rehabilitation;
9.3.c. Opportunities for participation in
				volunteer service activities;
9.3.d. Intellectual activities designed to
				provide mental stimulation, learning and foster creativity;
9.3.e. Physical activities and exercise to
				promote physical functioning, mobility, strength and endurance;
9.3.f. Individual and group
				activities;
9.3.g. Activities
				appropriate for participants with Alzheimer's disease or a related dementia;
				and,
9.3.h. Rest periods in
				accordance with participant needs.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-10 - Dietary Services

Current through Register Vol. XLI, No. 28, July 12, 2024
10.1. The
				licensee shall provide meals that are in substantial compliance with current
				Recommended Dietary Allowances of the Food and Nutrition Board of National
				Academy of Sciences, National Research Council, or as specified in this rule,
				except as ordered by a physician.
10.2. The licensee shall ensure that each
				participant is provided freshly prepared meals and snacks:
10.2.a. Each meal shall be equivalent to at
				least one third of the recommended daily dietary allowance as established by
				the Food and Nutrition Board of the National Academy of Sciences, National
				Research Council;
10.2.b.
				Participants attending four (4) hours or less shall be provided one (1)
				meal;
10.2.c. Participants
				attending the center five (5) to eight (8) hours per day shall be provided one
				(1) hot meal and two (2) snacks daily;
10.2.d. Participants attending the center
				more than eight (8) hours per day shall be provided two (2) hot meals and two
				(2) snacks daily;
10.2.e. Meals
				shall meet participant requirements for special diets, participant's needs and
				choices, as identified in his or her needs assessment.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-11 - Transportation

Current through Register Vol. XLI, No. 28, July 12, 2024
11.1. If the center
				provides transportation, all vehicles used for the transportation of
				participants shall be maintained in good operating condition in accordance with
				all applicable local, state and federal requirements.
11.2. There shall be sufficient staff present
				to ensure the safety of participants being transported by program
				vehicles.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-12 - Fire Safety and Emergency Operations

Current through Register Vol. XLI, No. 28, July 12, 2024
12.1. Fire Safety.
12.1.a. The licensee shall provide evidence
				of compliance with applicable rules of the state fire commission. The state
				fire marshal's and Secretary's written approval are required for any variation
				from compliance with the fire code.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-13 - Physical Facilities

Current through Register Vol. XLI, No. 28, July 12, 2024
13.1.
				Physical Facilities and Equipment.
13.1.a. The
				licensee of a medical adult day care center built, renovated or altered after
				the effective date of this rule shall maintain the center in accordance with
				the requirements of Subsection 5 of this rule.
13.1.b. The licensee shall maintain the
				building, grounds and equipment in a clean, safe and sanitary condition at all
				times.
13.1.c. The licensee shall
				provide storage facilities that prevent contamination of food and supplies
				intended for human consumption.
13.1.d. The licensee shall store only those
				articles necessary for the operation and maintenance of the center on the
				premises.
13.1.e. The licensee
				shall establish and conduct a program of preventive maintenance for all
				equipment as recommended by the manufacturer.
13.1.f. The licensee shall keep the center
				free of insects, rodents and vermin.
13.1.g. Any method of extermination of
				insects, rodents and vermin used by the licensee in the center shall not create
				a fire or health hazard.
13.1.h.
				The center shall have a heating system capable of maintaining a temperature in
				all rooms used by participants of at least seventy-two degrees Fahrenheit
				(72°F).
13.1.i. The center
				shall have cooling devices or a system so that inside temperatures do not
				exceed eighty degrees Fahrenheit (80°F). Acceptable cooling devices
				include, but are not limited to, air conditioners, electric fans and heat
				pumps.
13.1.j. The staff call
				system shall be maintained operational at all times.
13.1.k. The Secretary may require the
				licensee to provide alarm systems for participant safety if a participant
				exhibits potentially harmful behaviors such as wandering from the
				center.
13.1.l. The center shall
				have space for the storage of linens, maintenance and housekeeping supplies,
				and equipment.
13.1.m. The center
				shall provide a storage area for individualized storage of participant clothing
				and personal belongings.
13.1.n.
				The center shall assure that oxygen being stored, handled or delivered for
				participant use complies with the safety requirements as specified by the
				National Fire Protection Association (NFPAA) 99.
13.1.o. The licensee shall ensure that every
				closet door latch can be readily opened from inside in case of
				emergency.
13.1.p. The licensee
				shall ensure that windows have curtains, shades, or blinds that may be opened
				and closed and are kept clean and in good repair.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-14 - Penalties, License Restrictions and Revocations

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1. The Secretary may suspend or revoke a
				medical adult day care center license according to the provision of Chapter 16,
				Article 5B, Section 6 or the West Virginia Code.
14.2. The Secretary may refuse to grant a
				license or may revoke a license if he or she determines that there has been
				subterfuge or other dishonest action in applying for an initial or renewal
				license.
14.3. When the Secretary
				takes action pursuant to the suspension or revocation of a license issued under
				this rule, he or she shall comply with the requirements and procedures
				specified by Chapter 16, Article 5B, Section 6 of the West Virginia
				Code.
14.4. Anyone who violates the
				provisions of W. Va. Code §
									16-5B-1
				et seq. and this rule is subject to the penalties provided in W. Va. Code
				§
									16-5B-11.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-02 - Freeze On Hospital Rates And Granting Of Temp Rate Increases › Section 64-2-15 - Administrative Due Process

Current through Register Vol. XLI, No. 28, July 12, 2024
15.1.
				Administrative due process and remedies for actions taken pursuant to this rule
				or W. Va. Code
				16-5B-1
				et seq. are as provided by this rule, by applicable statutes, and in the West
				Virginia Division of Health Procedural Rules, Rules of Procedure for Contested
				Case Hearings and Declaratory Rulings, 64CSR1.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope - This
				procedural rule sets the procedure to be used to ascertain appropriate
				projections of gross revenues for hospitals, to set the amount of net revenue
				over expenditures that is appropriate for the effective operation of each
				hospital and to set rate schedules for each hospital. The procedural rule also
				sets forth time periods for the submission of applications by hospitals
				pertaining to rate schedules, increases therein, and for subsequent actions on
				the applications including hearings in contested cases. This rule also provides
				for emergency rate increases and rate increases at or below the rate of
				inflation for the hospital industry. This procedural rule supplements the
				Health Care Cost Review Authority Act, West Virginia Code, section one, article
				twenty-nine-b, chapter sixteen et seq., and the West Virginia Administrative
				Procedures Act, West Virginia Code, section one, article one, chapter
				twenty-nine-a et seq., and must be read in conjunction with those
				Acts.
1.2. Authority - West
				Virginia Code § 16-29B-8, §§ 29A-2-9, 15 and §
				29B-1-3.
1.3. Filing Date - August
				17, 1987.
1.4. Effective Date -
				September 17, 1987.
1.5. Repeal of
				Former Rule - This procedural rule repeals West Virginia Procedural Rule
				"Health Care Cost Review Authority, Chapter 16-29B, Series III, Procedural
				Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of
				Net Revenue Over Expenditures For Hospitals And Setting Schedules Of Rates For
				Hospitals (1984)", filed August 13, 1984.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in this rule, all terms have the same meaning as
				  provided in the definition section of the Health Care Cost Review Authority
				  Act, West Virginia Code, section three, article twenty-nine-b, chapter sixteen.
				  Definitions of additional terms are set forth below and whenever those terms
				  are used, the following definitions apply, except where the context may
				  expressly otherwise require.
2.1.
				"Act" means the West Virginia Health Care Cost Review Authority Act, West
				Virginia Code, article twenty-nine-b, chapter sixteen.
2.2. "Authority" means the West Virginia
				Health Care Cost Review Authority, an autonomous division within the State
				Department of Health.
2.3. "Gross
				Revenue" means a hospital's gross patient revenue plus all operating and
				nonoperating revenues from whatever source.
2.4. "Hospital" means:
2.4.1. A facility subject to licensure as
				such under the provisions of West Virginia Code, article five-b, chapter
				sixteen; or
2.4.2. Any acute care
				facility operated by the state government which is primarily engaged in
				providing to inpatients, by or under the supervision of physicians, diagnostic
				and therapeutic services for medical diagnosis, treatment and care of injured,
				disabled or sick persons; but, in either event, does not include state mental
				health facilities, facilities primarily engaged in rendering psychiatric
				diagnosis, treatment and care or state long-term care facilities.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-3 - Revenues paid by and rates set for federal medicare and medicaid programs

Current through Register Vol. XLI, No. 28, July 12, 2024
Until such time as agreements are entered into by the board
				  with the Secretary of the United States Department of Health and Human Services
				  so that department and affected state agencies allow reimbursement to hospitals
				  subject to the provisions of this Act in accordance with rates approved by the
				  board for services provided for by that department, nothing in this rule shall
				  be interpreted or construed so as to allow the board to affect revenues paid by
				  or rates set for the Federal Medicare and Medicaid programs. Rather, until such
				  agreements are entered into, the board shall set rates of payments only for
				  other payors.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-7 - Failure to comply with rules

Current through Register Vol. XLI, No. 28, July 12, 2024
Failure by a hospital or an interested party to comply with
				  any of the requirements of these rules shall subject the hospital or the
				  interested party to sanctions including the possibility of denial of all
				  requested relief in an appropriate case. Failure by a hospital or an interested
				  party to comply with the time limits set forth in this rule may also, in the
				  discretion of the board, cause the time limits to be extended and the failing
				  party shall be deemed to have waived the time periods set forth in the Act and
				  these rules or the board may impose another appropriate
				  sanction.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-8 - Health Care Facility Financial Disclosure Act

Current through Register Vol. XLI, No. 28, July 12, 2024
Before any application for a rate increase, including
				  requests for automatic rate of inflation increases, will be accepted for
				  review, the hospital must be in compliance with the Health Care Facility
				  Financial Disclosure Act, West Virginia Code, § 16-5F-1 et seq. Failure to
				  be in such compliance shall cause the board to refuse to accept the application
				  or request and to reject it.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-9 - Additional information

Current through Register Vol. XLI, No. 28, July 12, 2024
Should the board require additional information from a
				  hospital or an interested party, then, in the discretion of the board, the
				  various time limits imposed by this rule shall be tolled until the information
				  is received by the board.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-10 - Time periods

Current through Register Vol. XLI, No. 28, July 12, 2024
10.1. In
				each instance in this rule where a time period is stated, the period is
				intended to be a maximum period. In the event a given task is completed sooner
				than the stated period by the Authority, the board, a hospital or an interested
				party, then the next time period, if any, shall begin to elapse upon the actual
				completion date.
10.2. Calculation
				of time periods - Whenever in this rule the date by which some action is
				directed to be taken or accomplished would fall on a Saturday, Sunday or a
				state holiday, then the time for taking or accomplishing the action shall be
				extended to the next day which is not a Saturday, Sunday or a state
				holiday.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-11 - Decisions and records available

Current through Register Vol. XLI, No. 28, July 12, 2024
Decisions and records of the Authority may be inspected in
				  accordance with West Virginia Code, section three, article one, chapter
				  twenty-nine-b and may be copied at a charge of twenty-five cents ($.25) per
				  page.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-12 - Compliance reports

Current through Register Vol. XLI, No. 28, July 12, 2024
When there is reason to believe that a hospital is exceeding
				  its revenue limits, the board may require compliance reports from a hospital
				  midway and three-quarters of the way through the hospital's fiscal year. The
				  information requested for the compliance report shall be listed on forms to be
				  provided by the board.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-03 - Procedural Rules For The Projecting Of Gross Revenues For Hospitals, Setting The Amount Of Net Revenues Over Expenditures For Hospitals And Settings › Section 65-03-13 - Severability

Current through Register Vol. XLI, No. 28, July 12, 2024
If any provisions of this rule or the application thereof to
				  any person or circumstance shall be held invalid, such invalidity shall not
				  affect the provisions or applications of this rule which can be given effect
				  without the invalid provisions or application and to this end the provisions of
				  this rule are declared to be severable.
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West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-04 - Legislative Rules To Implement Utilization Review And Quality Assurance Program - Phase 1 › Section 65-4-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These rules set forth initial requirements for the implementation of the
				utilization review and quality assurance program mandated by West Virginia Code
				section twenty-three, article twenty-nine-b, chapter sixteen. The requirements
				include specified time periods for the filing of information and descriptions
				of what must be filed. Also included is a description of a peer review
				organization. These rules supplement the Health Care Cost Review Authority Act,
				West Virginia Code section one, article twenty-nine-b, chapter sixteen et seq.,
				as amended, and the West Virginia Administrative Procedures Act, West Virginia
				Code section one, article one, chapter twenty-nine-a et seq., as amended, and
				must be read in conjunction with those Acts.
1.2. Authority. -- W. Va. Code '16-29B-8(a)(1)
				and 23, '29A-2-9 and 15, and '29B-1-3.
1.3. Filing Date. -- May 20, 1985.
1.4. Effective Date. -- May 20,
				1985.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-04 - Legislative Rules To Implement Utilization Review And Quality Assurance Program - Phase 1 › Section 65-4-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in these rules, all terms have the same meaning as
				  provided in the definition section of the Health Care Cost Review Authority
				  Act, West Virginia Code section three, article twenty-nine-b, chapter sixteen.
				  Definitions of additional terms are set forth below and whenever those terms
				  are used in these rules the following definitions apply, unless a different
				  meaning clearly appears from the context.
2.1. "Act" means the West Virginia Health
				Care Cost Review Authority Act, West Virginia Code section one, article
				twenty-nine-b, chapter sixteen et seq., as amended.
2.2. "Authority" means the West Virginia
				Health Care Cost Review Authority, an autonomous division within the State
				Department of Health, established pursuant to West Virginia Code, section five,
				article twenty-nine-b, chapter sixteen.
2.3. "Contractor" means the person or persons
				who enter into agreements with the Authority for the performance of duties
				required by the Authority's utilization review and quality assurance
				program.
2.4. "Person" means a
				natural person, a corporation, association, or other legal entity.
2.5. "Program" means the Authority's
				utilization review and quality assurance program required by Section 23 of the
				Act.
2.6. "UB-82" means Uniform
				Bill-82.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-04 - Legislative Rules To Implement Utilization Review And Quality Assurance Program - Phase 1 › Section 65-4-3 - Professional Review Organization

Current through Register Vol. XLI, No. 28, July 12, 2024
In order to carry out its duties under the Act for the
				  establishment of a utilization review and quality assurance program, the
				  Authority must have available to it qualified medical and surgical expertise
				  and the requisite data storage and handling capabilities. Accordingly, the
				  Authority will, from time to time, enter into a contract or contracts with a
				  person or persons to collect patient information, to process that information,
				  and to compile reports from that information in formats to be determined by the
				  Authority.
3.1. West Virginia Medical
				Institute, Inc. -- The initial contractor shall be the West Virginia Medical
				Institute, Inc., a West Virginia corporation, whose principle place of business
				is located in Charleston, West Virginia. The West Virginia Medical Institute,
				Inc., is presently the holder of the contract with the Health Care Financing
				Administration of the United States Department of Health and Human Services to
				operate a peer review organization for the federal Medicare program in the
				State of West Virginia.
3.2.
				Subsequent contractors. -- The Authority may in the future either contract with
				the West Virginia Medical Institute, Inc., or with one or more other persons
				for the performance of subsequent programs under the terms of these
				rules.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-04 - Legislative Rules To Implement Utilization Review And Quality Assurance Program - Phase 1 › Section 65-4-4 - Patient Data

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. Hospitals.
				-- Each hospital covered by the Act must submit one (1) complete copy of the
				UB-82 data for each and every one of its inpatients. To the extent that a
				particular hospital must already submit a complete copy of UB-82 data for one
				or more classes of patients (e.g., Medicare or Medicaid) to the contractor,
				then such submissions need not be duplicated and the previously required
				submission will suffice.
4.2. Data
				format. -- The UB-82 data must be submitted to the contractor on Industry
				Standard 1600 BPI tape or upon Wang format tape or upon similar computer tape
				format. Hard copies of the UB-82 data are not to be submitted to the contractor
				unless the hospital does not itself have access to one (1) of the above noted
				computer tape formats and unless the hospital first notifies the
				contractor.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-04 - Legislative Rules To Implement Utilization Review And Quality Assurance Program - Phase 1 › Section 65-4-5 - Patient Confidentiality

Current through Register Vol. XLI, No. 28, July 12, 2024
The contractor and its officers, employees, agents as well as
				  the Authority, and its officers, employees, agents, shall maintain the
				  confidentiality of all personal medical information personally identifiable to
				  a purchaser. The hospitals shall submit and the contractor shall collect such
				  confidential data from the hospitals from the UB-82 forms and provide it to the
				  Authority as provided for in its agreement with the
				  Authority.