Current through Register Vol. 43, No. 39, September 26, 2024
(a) The nursing
facility program providers shall include the following types of care
facilities:
(1) Nursing facilities; and
(2) nursing facilities for mental
health, which shall have been operating in accordance with a provider agreement
with the agency on June 30, 1994.
(b) Each provider shall meet the following
requirements with regard to any change in the structure of the business
entities involved in the ownership, operation, or management of the nursing
facility:
(1) The current provider or
prospective provider shall notify the agency in writing by certified mail of a
proposed change of providers at least 60 days in advance of the closing
transaction date. If the current or prospective provider fails to submit a
timely notification, the new provider shall assume responsibility for any
overpayment made to the previous provider before the transfer. Failure to
submit timely notification shall not release the previous provider from
responsibility for the overpayment.
(2) Before the dissolution of the provider
business entity or a transaction involving a change of ownership of the nursing
facility or the change of lessee of the nursing facility, the provider shall
notify the agency in writing at least 60 days before the change. If the
provider fails to submit a timely notification, the new provider shall assume
responsibility for any overpayment made to the previous provider before the
transfer. Failure to submit timely notification shall not release the previous
provider from responsibility for the overpayment. Other overpayment recovery
terms may be expressly agreed to in writing by the secretary.
(3) The provider shall submit an application
to be a provider of services to the agency for any addition or substitution to
a partnership or any change of provider resulting in a completely new
partnership. An application shall not be required when a partnership is
dissolved and at least one member of the partnership remains as the provider of
services.
(4) If a sole proprietor
that is not incorporated under applicable state law transfers title and
property to another party, a change of ownership shall have occurred. The new
owner shall submit an application to be a provider of services to the agency.
(5) Each consolidation of two or
more unrelated corporations that creates a new corporate entity through an
arm's-length transaction shall constitute a change of provider. The new
corporate entity resulting from the consolidation shall submit an application
to be a provider of services to the agency.
(6) Each change or creation of a new lessee
acting as a provider of services shall constitute a change of provider. The new
lessee shall submit an application to be a provider of services to the agency.
(7) Each provider shall submit
documentation of any other change in the ownership or corporate structure of
the business entities involved in the ownership, operation, or management of
the nursing facility.
(c) Only a change in or creation of a
provider of service through a bona fide transaction shall be recognized as
resulting in a new provider. The following situations shall not be recognized
as resulting in a change of provider, and the facility shall be treated as an
ongoing entity:
(1) A transfer of
participating provider corporate stock;
(2) a merger of one or more corporations with
the participating provider corporation surviving;
(3) the purchase of the facility by the
lessee;
(4) the change or creation
of a sublessee acting as the provider of services;
(5) the creation of a new lessee that is
related to the old owner of the facility;
(6) the creation of a new lessee acting as
the provider of services that is related to the old lessee;
(7) the change or creation of a management
firm acting as the provider of services; and
(8) the takeover of the lessee's operations
by an owner of the facility.
(d) Each new provider shall be subject to a
certification survey by the state licensing agency. If certified, the period of
certification shall be established by the state licensing agency.
(e) This regulation shall be effective on and
after May 1, 2005.