(1) The Alabama Medicaid Agency will not limit participation to any nursing facility that desires to provide services to ventilator-dependent or qualified tracheostomy residents unless the following conditions exist:
- (a) Termination of the nursing facility’s Medicaid certification is imminent; or
- (b) The nursing facility is a Special Focus Facility, under review by CMS, the Alabama Department of Public Health or the Alabama Medicaid Agency.
- (c) The nursing facility does not meet the requirements established by the Department of Public Health and the Medicaid Agency to serve residents who are ventilator-dependent or in need of qualified tracheostomy services.
- (2) The Medicaid Agency will not pay for changes to the physical plant in order for the nursing facility to provide services for ventilator-dependent or qualified tracheostomy residents.
Author: Marilyn F. Chappelle, Director, Long Term Division
Statutory Authority: State Plan; Title XIX, Social Security Act; and 42 CFR Section 401, et seq., Section 483.75.
History: New Rule: Filed December 12, 2011; effective January 16, 2012.