Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO: KRS 194A.050(1), 42 C.F.R. 488.433
NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires
the Secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to operate programs and fulfill the
responsibilities vested in the cabinet, qualify for the receipt of federal
funds, and cooperate with other state and federal agencies for the proper
administration of the cabinet and its programs. 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff) and 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff) pertain
to the collection and use of civil money penalties (CMP) imposed by the Centers
for Medicare and Medicaid Services (CMS) on certified long-term care facilities
(serving Medicare and Medicaid beneficiaries) that do not comply with
applicable federal health and safety laws and regulations. Except for temporary
use in the case of sudden nursing facility relocations, natural disasters, or
similar emergencies, states are required to obtain prior approval from CMS for
any new project, new grantee, or new use of federally imposed CMP funds. Upon
approval by CMS, states may direct collected CMP funds to a variety of
organizations if the funds are used in accordance with 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff) and 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff). This
administrative regulation establishes a competitive grant program to provide
funding to organizations which offer programs or services approved by CMS for
the use of CMP funds, thereby establishing the CMP Fund Grant Program.
Section 1. Definitions.
(1) "Cabinet" means the Cabinet for Health
and Family Services.
(2) "CMP"
means civil money penalties imposed by CMS on certified long-term care
facilities (serving Medicare and Medicaid beneficiaries) that do not comply
with applicable federal health and safety laws and regulations.
(3) "CMS" means the Centers for Medicare and
Medicaid Services.
(4) "Funding"
means a grant from collected CMP funds distributed by the cabinet upon approval
by CMS.
Section 2.
Funding Opportunities. Collected CMP funds may be used to support activities
that benefit Kentucky's residents of certified long-term care facilities,
including:
(1) Assistance to support and
protect residents of a certified long-term care facility that closes
(voluntarily or involuntarily) or is decertified, and may include offsetting
the costs of relocating residents to a home and community-based setting or
another facility;
(2) Projects that
support resident and family councils;
(3) Consumer involvement activities which
assure quality care in long-term care facilities; or
(4) Facility improvement initiatives approved
by CMS, which may include:
(a) Joint training
of facility staff and the cabinet's long-term care facility
surveyors;
(b) Technical assistance
for facilities implementing quality assurance programs; or
(c) The appointment of temporary management
firms.
Section
3. Prohibited Uses of CMP Funds. CMP funds shall not be approved:
(1) For a project in which a conflict of
interest exists or the appearance of a conflict of interest exists;
(2) If the applicant is currently paid by a
federal or state source to perform the same function as the proposed CMP
project or use;
(3) For capital
improvements to a long-term care facility, or to build a long-term care
facility;
(4) To pay for services
or supplies that are the responsibility of the long-term care facility,
including laundry, linen, food, heat, or staffing costs;
(5) To pay the salaries of temporary managers
who are actively managing a long-term care facility; or
(6) To recruit or provide Long-Term Care
Ombudsman certification training for staff or volunteers, or investigate and
work to resolve complaints.
Section
4. Applicants.
(1) An entity that
applies for and receives funding shall be qualified and capable of carrying out
the intended project or use described in the State Request for Approval of Use
of Civil Money Penalty Funds for Certified Nursing Homes.
(2) Entities that may qualify for funding
include:
(a) Consumer advocacy
organizations;
(b) Resident or
family councils;
(c) Professional
or state long-term care facility organizations;
(d) State Long-term Care Ombudsman
programs;
(e) Quality improvement
organizations;
(f) Private
contractors;
(g) Academic or
research institutions;
(h)
Certified long-term care facilities;
(i) State, local, or tribal governments;
or
(j) Profit or not-for-profit
organizations.
Section
5. Application Process. To apply for funding, an applicant shall:
(1) Download a copy of the application titled
State Request for Approval of Use of Civil Money Penalty Funds for Certified
Nursing Homes from the cabinet's Web site at
https://chfs.ky.gov/agencies/os/oig/dhc/Pages/cmp-funds.aspx.
and
(2) Complete and email the
application to the cabinet at the following Web address:
CMPAPPLICATION_OIG@KY.GOV.
Section
6. Review of Applications.
(1)
Upon receipt of an application, the cabinet shall review the application and
determine if the application meets the criteria for use of collected CMP funds
pursuant to:
(a) Sections 2 through 4 of this
administrative regulation; and
(b)
The application's instructions.
(2) Upon review of the application based on
the criteria for use of collected CMP funds in 42 C.F.R. 488.433, the Office of
Inspector General shall forward the application to CMS, including an initial
determination on the ability of the project to improve resident outcomes and
advance the care and services provided in certified long-term care
facilities.
Section 7.
Reporting. If an application is approved by CMS, the organization or entity
from which the application originated shall:
(1) Submit a quarterly report on the status
of the project to the CMS regional office and the cabinet;
(2) Submit a follow-up report within five (5)
calendar days of conclusion of the funded project to the CMS regional office
and the cabinet; and
(3) Submit a
final report monitoring the success of the project within six (6) months of
conclusion of the funded project to the CMS regional office and the
cabinet.
Section 8.
Denials. An application that is denied shall:
(1) Be accompanied by an explanation;
and
(2) Not be subject to an
appeal.
Section 9.
Incorporation by Reference.
(1) The Centers
for Medicare and Medicaid Services, Region IV Atlanta, "State Request for
Approval of Use of Civil Money Penalty Funds for Certified Nursing Homes", May
2013, is incorporated by reference.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Cabinet for Health and
Family Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday
through Friday, 8 a.m. to 4:30 p.m.
STATUTORY AUTHORITY: KRS 194A.050(1), 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff), 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff)