Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter D - NURSING HOME REFORM-STATEMENT OF POLICY
APPEALS OF ADVERSE DETERMINATIONS
Appendix G
Universal Citation: 55 PA Code ยง G
Current through Register Vol. 54, No. 44, November 2, 2024
TIMETABLE OF KEY MEDICAL ASSISTANCE RELATED
IMPLEMENTATION DATES UNDER OBRA-87, as amended, FOR HHS,
PROVIDER FACILITIES AND STATE AGENCIES
| 1988 | ||
| 7/1/88 | Facilities: | Must provide LTC ombudsmen, physicians and State/Federal officials immediate access to residents. |
| 7/1/88 | HHS: | Issue regulation to define which costs can be charged to Medicaid eligible nursing facility residents' personal fund, and which costs are included in the Medicaid payment amount. |
| 9/1/88 | HHS: | Establish requirements for approval of nurse aide training and competency evaluation programs. |
| 10/1/88 | HHS: | Establish guidelines for minimum standards for state appeals process for transferred and discharged residents. |
| 10/1/88 | HHS: | Develop minimum criteria for preadmission screening and annual resident review (PASARR) for mentally retarded and mentally ill residents of nursing facilities. |
| 10/1/88 | HHS: | Develop criteria for appeals process for residents adversely affected by PASARR process. |
| 10/1/88 | HHS: | Develop criteria to monitor state performance in granting nursing facilities waiver of 24-hour licensed professional nurse provision. |
| 10/1/88 | HHS: | Publish regulation regarding alternative remedies (sanctions) for nursing facilities out of compliance. |
| 1989 | ||
| 1/1/89 | States: | Must have in effect a preadmission screening program for mentally retarded and mentally ill patient placement determinations. |
| 1/1/89 | States: | Establish a nurse aide registry. |
| 1/1/89 | States: | Must establish appeals process for residents adversely affected by screening and review process for mentally retarded and mentally ill individuals. |
| 1/1/89 | States: | Specify approved nurse aide training and competency evaluation programs. |
| 1/1/89 | Facilities: | Must not admit any mentally retarded or mentally ill individuals unless screened by appropriate state authority and found to need level of care provided by facility. |
| 1/1/89 | HHS: | Specify minimum data set of core elements and common definitions for use by nursing facilities in conducting resident assessments. Establish guidelines for utilization of data set. |
| 4/1/89 | States/HHS: | Enter into agreement regarding alternative disposition plan for review/placement of mentally retarded or mentally ill residents needing active treatment but not level of care provided by facility in which they reside (NOTE: Since HCFA usually requires a 90-day period to review and approve such plans, states are advised to submit their alternative disposition plans to HCFA by January 1, 1989. |
| 7/1/89 | States: | Implementation and enforcement of standards for nursing facility administrators. |
| 7/1/89 | Facilities: | Must provide for nurse aid competency evaluation programs for nurse aides employed in facility as of July 1, 1989; and for any preparation needed to complete program by January 1, 1990. |
| 10/1/89 | States: | Must have appeals process in place for residents involuntarily transferred or discharged from nursing facilities on or after October 1, 1989. |
| 10/1/89 | States: | Establish alternative remedies (sanctions) for nursing facilities out of compliance. |
| 10/1/89 | Facilities: | Must notify residents of right to appeal all transfers and discharges. |
| 1990 | ||
| 1/1/90 | States: | Provide for review and reapproval of all nurse aide training and competency evaluation programs. |
| 1/1/90 | Facilities: | All nurses aides must have completed training and competency evaluation program if they are employed more than 4 months by facility. |
| 1/1/90 | HHS: | Develop, test and validate protocol for standard and extended survey of nursing facilities. |
| 4/1/90 | States: | Complete review of all mentally retarded and mentally ill residents currently residing in nursing facilities and determine and implement appropriate placement. |
| 4/1/90 | States: | Submit to HHS a state plan amendment which provides for appropriate payment adjustment to nursing facilities (which takes into account the cost of complying with nursing home reform provisions). |
| 4/1/90 | HHS: | Must designate one or more resident assessments which a state may specify for use by nursing facilities. |
| 7/1/90 | States: | Must specify resident assessment instrument to be used by nursing facilities. |
| 7/1/90 | States: | Must specify resident assessment instrument to be used by nursing facilities. |
| 9/30/90 | HHS: | Must review and approve/disapprove state plan amendments for payment adjustments to nursing facilities. |
| 10/1/90 | States: | Survey and Certification requirements become effective. |
| 10/1/90 | Facilities: | Must conduct resident assessment within 4 days for residents admitted on or after October 1, 1990 and must begin conducting annual resident assessments. |
| 10/1/90 | Facilities: | Must provide 24-hour/day licensed professional nursing services and full-time registered nurse services 7 days/week (unless waived). Distinction between SNF and ICF level of care eliminated. |
| 1991 | ||
| 10/1/91 | Facilities: | Resident assessment for all residents admitted to facility prior to October 1, 1990 must be completed. |
| 1993 | ||
| *1/1/93 | HHS: | Evaluation of resident assessment process-report to Congress. |
This section cited in 55 Pa. Code § 1181.505 (relating to discussion).
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