20 CAR § 400-1106 – Reports on resident room classifications and assignment of bed licenses

(a) Purpose. This section specifies the required and optional reports by a Medicaid-certified skilled nursing facility to document the classification of each resident room and the assignment of the facility’s total number of bed licenses.
(b) Total number of bed licenses. For purposes of this section, a facility’s total number of bed licenses is the total number of bed licenses approved (permitted) by the Health Services Permit Agency for the facility, excluding bed licenses designated by the Health Services Permit Agency as beds in transition and bed licenses specifically approved for a new facility that is under construction or not yet Medicaid-certified.
(c) Occupancy status does not affect reports and floor plans. The status of a resident room as fully or partially occupied, unoccupied, or reserved under a bed-hold does not affect the classification of the resident room, assignment of total bed licenses, reporting, or floor plans under this subpart.
(d) Required annual report. Annually, by November 1, each Medicaid-certified skilled nursing facility shall prepare and submit a report documenting the classification of each resident room and the assignment of the facility’s total number of bed licenses as of July 1 of the same year according to the Health Services Permit Agency.
(e) Events requiring a report.
1. (1) A Medicaid-certified skilled nursing facility must prepare and submit a new or updated report whenever any of the following events affecting the facility occur:
  1. (A)
(i) The Department of Human Services approves a change of ownership of the facility.
1. (ii) The report is the responsibility of the new owner or owners;
  1. (B) A newly constructed facility receives Medicaid certification and begins operations;
  2. (C) An expansion or major renovation of an existing Medicaid-certified skilled nursing facility is completed, resulting in new or renovated resident rooms and bathroom facilities; or
  3. (D) An existing noncertified or Medicare-only certified skilled nursing facility becomes Medicaid-certified.
2. (2) Each report required under subdivision (e)(1) of this section:
  1. (A) Must document the classification of each resident room and the assignment of the facility’s total number of bed licenses in effect following the completion or conclusion of the applicable event; and
  2. (B) Is due within sixty (60) days after the completion or conclusion of the event.
3. (3)
  1. (A) An event-based report is not required if, since the last annual report, the facility’s ownership, Medicaid certification status, total number of bed licenses, classification of resident rooms, and assignment of bed licenses have not changed.
  2. (B) In this case, within sixty (60) days of the event, the facility must notify the department in writing why an event-based report is not required.
(f) Optional report.
1. (1) In any calendar quarter in the interim between annual reports, a Medicaid-certified skilled nursing facility may prepare and submit a report in the event of changes to the facility’s physical configuration, such as changes in the:
  1. (A) Number and class of resident rooms;
  2. (B) Availability of private and en suite bathrooms;
  3. (C) Conversion of Class C resident rooms to Class A or Class B rooms;
  4. (D) Total number of bed licenses; and
  5. (E) Assigning bed licenses to Class A, Class B, or Class C.
2. (2) An optional report should address changes that became effective during the preceding calendar quarter and be submitted to the department within thirty (30) days of that quarter’s end.
(g) Report form, instructions, and attestation.
1. (1) Each report submitted to the department must:
  1. (A) Use the form and follow the form instructions issued by the Division of Provider Services and Quality Assurance;
  2. (B) Include an up-to-date simplified annotated floor plan as specified in 20 CAR § 400-1105; and
  3. (C) Include signed attestations by the facility administrator and registered architect that the report and accompanying annotated floor plan are accurate and complete.
2. (2) The Division of Medical Services and the Division of Provider Services and Quality Assurance will coordinate to ensure that the department’s form and instructions are written consistent with this subpart and efficiently provide the information to meet the Division of Medical Services and the Division of Provider Services and Quality Assurance’s respective purposes described in 20 CAR § 400-1101(b).