Current through Register Vol. 54, No. 12, March 23, 2024
(a) Upon consideration of the information
specified in §
1187.174 (relating to information
and data relevant to bed requests), the Department may approve a bed transfer
request only if the following are satisfied:
(1) The bed transfer request contains the
information required under §
1187.172(a)
(relating to contents and submission of bed requests).
(2) The receiving provider agrees to achieve
and maintain an MA day-one admission rate that is equal to or greater than the
surrendering provider's MA day-one admission rate or another MA day-one
admission rate as may be agreed to by the Department.
(3) The change in the bed complements of the
receiving and surrendering providers will maintain or improve access to
medically necessary nursing facility services for MA recipients.
(4) Neither provider will receive an increase
in reimbursement as a result of a change in its peer group if the bed transfer
request is approved.
(5) If the
proposed bed transfer will result in a change in peer group assignments under
this chapter for the surrendering or receiving provider, the change will not
have a negative effect on the MA Program, on MA recipients or on other
facilities which are members of the affected peer group.
(6) Approval of the bed transfer request will
not result in increased costs to the MA Program.
(7) None of the circumstances specified in
§ 1187.172(a)(4) applies.
(8)
Both the surrendering provider and the receiving provider agree that the new or
additional beds at the receiving provider shall be licensed, MA-certified and
available for immediate occupancy before the surrendering provider decertifies
and closes a bed.
(b)
The Department may deny a bed transfer request even if the conditions specified
in subsection (a) are satisfied if the Department determines one of the
following:
(1) Approval of the request would
negatively affect the Department's goal to rebalance the Commonwealth's
publicly-funded long-term living system to create a fuller array of service
options for MA recipients.
(2)
There are alternatives to the transfer of beds, such as an increase in home and
community-based services, that would be less costly, more efficient or more
appropriate in assuring that long-term living care and services will be
provided under the MA Program in a manner consistent with applicable Federal
and State law.
(c)
Approval of a bed transfer request is not a determination that additional
MA-certified beds are needed to maintain or improve MA recipients' access to
medically necessary services in the primary service area or county in which the
receiving provider is located.
This section cited in 55 Pa. Code §
1187.172 (relating to contents and
submission of bed requests).
