Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-96 - Wage equity funding › Section 388-96-910 - Safety net assessment

Current through Register Vol. 24-14, July 15, 2024
(1)Chapter 7,
				Laws of 2011 1st sp. sess. (the act) imposes a safety net assessment (SNA) on
				nonexempt nursing facilities in Washington. Each year, under section 16 of the
				act, the department of social and health services (the department) may adjust
				the amount(s) of the SNA to be paid for the next state fiscal year (SFY),
				beginning July 1. If necessary, the department may further adjust the amount(s)
				of the SNA at other times during the SFY. Although subject to change as
				necessary and as permitted under the act, the expectation is that each year the
				SNA will be imposed at two different levels: a higher level for most nonexempt
				facilities, and a significantly lower level for facilities that have either a
				high medicaid census on the prior year's cost report or a high number of
				licensed beds. For SFY 2012, those thresholds were thirty-two thousand medicaid
				resident days, and two hundred and three licensed beds. Those thresholds may
				change, as necessary and permitted under the act. Beginning July 1, 2012 the
				department will submit any adjustments to the SNA amount(s), along with the
				data supporting the adjustments, to the Washington health care association and
				the aging services of Washington for review and comment at least sixty calendar
				days prior to implementation of the adjusted assessment amounts. These
				submissions may be made electronically. If necessary to comply with the
				sixty-day notice requirement and still make the adjustment effective as of July
				1, or another effective date, these notices may be made on a provisional, or
				potential, basis or bases.
(2) The
				status of each nursing facility under the act will be determined based on the
				facility's characteristics as of July 1 of each SFY, but using the information
				on resident days from the prior calendar year's cost report. For example, a
				facility's status for the SNA for SFY 2014 (beginning July 1, 2013) would be
				based on the resident day information from the 2012 cost report. The status of
				facilities will not be altered thereafter during the SFY. Facilities that
				become licensed throughout the SFY will be subject to the SNA as of the date of
				their licensing. The office of rates management (ORM) of the aging and
				disability services administration (ADSA) of the department will inform each
				nursing facility of its status under the act. A facility wishing to contest its
				status under the act as determined by ORM may seek review of the determination
				under WAC
				388-96-904.
(3) An add-on to each nonexempt facility's
				medicaid daily rate will be paid to reimburse the facility for the SNA it owes
				in relation to residents whose care is funded by medicaid.
(4) The SNA is assessed and payable on a
				monthly basis. The SNA must be reported on a form supplied by ORM. The SNA owed
				for each month, and the reporting form for that month, must be mailed to the
				department and postmarked no later than the twentieth day of the following
				month. Payments of the SNA are subject to an interest penalty of one percent
				per month for any payment which is delinquent for any portion of a month. This
				interest penalty is in addition to any civil fine or other enforcement action
				that the department may seek as authorized by section 20 of the act. In
				addition to the remedies specifically listed in section 20 of the act, the
				department may also offset such delinquent SNA payments and related penalties
				and/or fines against the facility's medical assistance reimbursement
				payments.
(5) The department has
				applied for, and received a waiver related to the SNA from the federal centers
				for medicare and medicaid services (CMS). After issuance, such a waiver is
				subject to ongoing review for continued compliance. In the ongoing review
				process, it may be necessary for the department to modify the levels of the
				SNA, the standard(s) for designating facilities that pay the SNA at each level,
				and/or the categories of fully exempt facilities described in Sec. 17 of the
				act. In that case, each facility may: be obligated to pay the SNA or pay a
				different amount of the SNA; be reimbursed for SNA amounts previously paid; or
				be obligated to repay any SNA add-on it has received, all retroactive to the
				effective date of the modification contained in the waiver as approved by
				CMS.
Statutory Authority: 2011 1st sp.s. c 7 and chapter 74.48
					 RCW. 12-04-004, § 388-96-910, filed 1/23/12, effective
					 2/23/12.