New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 49A - NURSING FACILITY PATIENT CARE RATIO REQUIREMENTS
Subchapter 3 - REBATE AND AUDIT REQUIREMENTS
Section 10:49A-3.2 - Audits of a facility
Universal Citation: NJ Admin Code 10:49A-3.2
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The Department will provide 30 days' advance notice of its intent to conduct an audit of a facility, either by Department staff or by authorized representatives of the Department.
1. All
audits will include an entrance conference at which the scope of the audit will
be presented and an exit conference at which the audit findings will be
discussed.
2. The Department will
share its preliminary audit findings with the facility, which will then have 30
days to respond to such findings. The Department may extend, for good cause,
the time for a facility to submit such a response.
3. If the facility does not dispute the
preliminary findings, the audit findings will become final. Alternatively, if
the facility responds to the preliminary findings, the Department will review
and consider such response and finalize the audit findings.
4. The Department will send the facility a
copy of the final audit findings, including any recommendations the facility
must implement as a result of the audit findings. A plan of corrective actions
must be submitted to the Department within 90 days of the issuance of the final
report.
5. If the Department
determines, as the result of an audit, that a facility has failed to pay
rebates it is obligated to pay pursuant to this chapter, the Department may
order the facility to pay those rebates in accordance with this
chapter.
6. If another entity
conducts an audit of a facility's PCR reporting and rebate obligations, the
Department may, in the exercise of its discretion, accept the findings of that
audit if the Department determines the following:
i. The entity's audit reports on the validity
of the data regarding expenses and revenue that the facility reported to the
Department, including the appropriateness of the allocations of expenses used
in such reporting; and
ii. The
entity submits final audit reports to the Department within 30 days of
finalization.
7. If the
Department accepts an audit conducted by another entity, and if the facility
makes additional rebate payments as a result of the audit, then the Department
shall accept those payments as satisfying the facility's obligation to pay
rebates pursuant to this chapter.
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