Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1187 - NURSING FACILITY SERVICES
Subchapter L - NURSING FACILITY PARTICIPATION REQUIREMENTS AND REVIEW PROCESS
BED REQUESTS
Section 1187.172 - Contents and submission of bed requests
Universal Citation: 55 PA Code ยง 1187.172
Current through Register Vol. 54, No. 44, November 2, 2024
(a) Required contents. An applicant's bed request must contain the following information:
(1)
Ownership information.
(i) The applicant shall provide the name and
address of each person who is any of the following:
(A) The applicant and a description of the
applicant's involvement in the proposed project.
(B) The legal entity of the subject
facility.
(C) An owner of the
subject facility.
(D) A related
party involved in the proposed project and a description of the related party's
involvement with the project.
(ii) For each person identified, the
applicant shall specify whether:
(A) The
person is a spouse, parent, child or sibling of another person
identified.
(B) During the 3-year
period preceding the bed request, the person is or was an owner of a nursing
facility, whether or not located in this Commonwealth, and, if so, the name and
address of each of the nursing facilities.
(2)
Project overview.
(i) The applicant shall provide an overview
of the proposed project which includes a description of the population and
primary service area the applicant intends to serve.
(ii) The applicant shall include a narrative
and supporting documentation addressing each criterion in §§
1187.175 and
1187.176 (relating to criteria for
the approval of bed transfer requests; and criteria for the approval of bed
requests other than bed transfer requests), as applicable, and indexed to the
criterion being addressed.
(3)
Financial information.
(i) The applicant shall provide a feasibility
or market study and financial projections prepared for the project that
identify the following:
(A) Project
costs.
(B) Sources of project
funds.
(C) Projected revenue
sources by payor type.
(D) Specific
assumptions used and expected occupancy rates by payor
type.
(ii) The applicant
shall provide independent audited or reviewed financial statements of the
subject facility for the most recent year prior to the fiscal year in which the
bed request is filed. If the financial statements are not available for the
subject facility, the applicant shall provide independent audited or reviewed
financial statements of the legal entity or parent corporation of the subject
facility for the most recent year prior to the fiscal year in which the bed
request is filed.
(4)
Compliance history. For each person identified in the
ownership information section of the bed request as specified under paragraph
(1), an applicant shall specify whether or not any of the following applies,
and, if so, the applicant shall attach copies of all documents relating to the
applicable action, including notices, orders or sanction letters received from
the Federal Centers for Medicare and Medicaid Services or any state Medicaid,
survey or licensing agency:
(i) The person is
currently precluded or, at any time during the 3-year period preceding the bed
request, was precluded from participating in the Medicare Program or any State
Medicaid Program.
(ii) The person
is or, at any time during the 3-year period preceding the date of the bed
request, was a party to, or the owner of a party to a corporate integrity
agreement with the Department or the Federal government.
(iii) The person owned, operated or managed a
nursing facility, including the subject facility, and, at any time during the
3-year period preceding the date of the bed request, one of the following
applies:
(A) The facility was precluded from
participating in the Medicare Program or any State Medicaid Program.
(B) The facility had its license to operate
revoked or suspended.
(C) The
facility was subject to the imposition of civil monetary penalties, sanctions
or remedies under State or Federal law for resident rights
violations.
(D) The facility was
subject to the imposition of remedies based on the failure to meet applicable
Medicare and Medicaid Program participation requirements, and the facility's
deficiencies were graded as immediate jeopardy to resident health and
safety.
(E) The facility was
designated a special focus facility by the Federal Centers for Medicare and
Medicaid Services, indicating a poor performing facility.
(5)
Certification and
authority.
(i) A bed request shall
be signed by the applicant.
(ii)
The applicant shall certify that the representations made and the information
provided in the bed request are true and correct to the best of the applicant's
knowledge, information and belief.
(iii) If the applicant is a person other than
the legal entity of the subject facility, the applicant shall certify that the
applicant is authorized to submit the bed request on behalf of the legal entity
and that the legal entity has reviewed and approved the contents of the bed
request.
(b) Optional information. In addition to the required content specified under subsection (a), an applicant may include in its bed request whatever information the applicant feels is relevant to or supports its bed request.
(c) Submission. An applicant shall submit an original and two copies of its bed request to the Department.
This section cited in 55 Pa. Code § 1187.174 (relating to information and data relevant to bed requests); 55 Pa. Code § 1187.175 (relating to criteria for the approval of bed transfer requests); and 55 Pa. Code § 1187.176 (relating to criteria for the approval of bed requests other than bed transfer requests).
Disclaimer: These regulations may not be the most recent version. Pennsylvania may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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