Current through Register Vol. 48, No. 9, September 27, 2024
A. Based upon the
maximum number of Medicaid patient days authorized by the General Assembly in
the annual appropriations act and the number of Medicaid patient days requested
by the nursing homes, the Department will allocate the Medicaid nursing home
permits as follows:
1. The first year that
permits are issued, priority will be given to facilities (in existence, under
construction, or issued a Certificate of Need) for beds that have been
previously approved and/or certified to participate in the Medicaid program.
The initial allocation will be for no more than the maximum number of patient
days which can be provided in the beds previously approved and/or certified for
Medicaid participation. Should there be more Medicaid patient days requested
than Medicaid patient days authorized by the General Assembly, the number of
Medicaid patient days allocated to each nursing home in its Medicaid nursing
home permit shall be decreased by the same percentage as the percent reduction
required to equal the authorized Medicaid patient days.
2. In following years, priority will be given
to facilities to renew permits authorizing up to the same number of Medicaid
patient days as allocated in the permit for the preceding year. Should the
maximum number of Medicaid patient days authorized by the General Assembly be
decreased from the previous year, the number of Medicaid patient days allocated
to each nursing home in its Medicaid nursing home permit shall be decreased by
the same percentage as the percent reduction in the number of patient days
authorized by the General Assembly.
3. If there are still Medicaid patient days
remaining to be allocated after priority is given in accordance with the above
paragraphs, the Medicaid patient days will be allocated to licensed nursing
homes by county based on the Medicaid county priority list published in the
South Carolina Medical Facilities Plan in effect at the time the allocation is
being made.
4. The Department shall
not approve additional Medicaid patient days for beds which exceed the general
long-term care bed need shown for a county in the Medical Facilities Plan
unless all other licensed facilities which could provide Medicaid patient days
in counties where a general long-term bed need is shown have been accounted for
in the allocation of Medicaid patient days.
B. Should there be competing applications
within a particular county for Medicaid patient days under Section106A. (3).
above, the Department may make a partial allocation of Medicaid patient days to
more than one facility or a full allocation to a single facility, if, in the
best judgment of the Department, such allocation will better serve the needs of
the Medicaid population.
C. The
number of Medicaid patient days allocated to a nursing home will not be
decreased from the previous year's allocation, unless either:
(1) the nursing home requests a lesser
allocation; or
(2) the maximum
number of Medicaid patient days in the appropriations act is
decreased.
