Wash. Admin. Code ch. 388-96 – Nursing Facility Medicaid Payment System | Midpage

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Washington Administrative Code (WAC)

Chapter 96

Wash. Admin. Code ch. 388-96

Nursing Facility Medicaid Payment System

SOCIAL AND HEALTH SERVICES, DEPARTMENT OF

388-96-010Definitions 388-96-011Conditions of participation 388-96-012Public disclosure 388-96-020Prospective cost-related payment 388-96-022Due dates for cost reports 388-96-026New contractors 388-96-099Completing cost reports and maintaining records 388-96-102Requirements for retention of records by the contractor 388-96-105Retention of cost reports and resident assessment information by the department 388-96-107Requests for extensions 388-96-108Failure to submit final reports 388-96-117Certification requirement 388-96-119Reports—False information 388-96-122Amendments to reports 388-96-205Purposes of department audits—Examination—Incomplete or incorrect reports—Contractor's duties—Access to facility—Fines—Adverse rate actions 388-96-208Reconciliation of medicaid resident days to billed days and medicaid payments—Payments due—Accrued interest—Withholding funds 388-96-211Proposed settlement report—Payment refunds—Overpayments—Determination of unused rate funds—Total and component payment rates 388-96-217Civil fines 388-96-218Proposed, preliminary, and final settlements 388-96-310Interest on other excess payments 388-96-366Facility records and handling of resident moneys 388-96-369The nursing facility shall maintain a subsidiary ledger with an account for each resident for whom the facility holds money 388-96-372The nursing facility may maintain a petty cash fund originating from resident personal funds of an amount reasonable and necessary for the size of the facility and the needs of the residents 388-96-375Resident personal funds control/disbursement 388-96-378Resident personal funds availability 388-96-381Procedure for refunding resident personal funds 388-96-384Liquidation or transfer of resident personal funds 388-96-499Principles of allowable costs 388-96-502Secondary and overhead costs 388-96-505Offset of miscellaneous revenues 388-96-525Education and training 388-96-528Payments to related organizations—Limits—Documentation 388-96-530What will be allowable compensation for owners, relatives, licensed administrator, assistant administrator, and/or administrator-in-training?388-96-532Does the contractor have to maintain time records?388-96-535Management agreements, management fees, and central office services 388-96-536Does the department limit the allowable compensation for an owner or relative of an owner?388-96-542Home office or central office 388-96-554Equipment 388-96-556Initial cost of operation 388-96-560Land 388-96-580Operating leases of office equipment 388-96-585Unallowable costs 388-96-704Prospective payment rates 388-96-705Payment for services after settlement 388-96-710Prospective payment rate for new contractors 388-96-713Rate determination 388-96-718Public process for determination of rates 388-96-723Comparison of the statewide weighted average payment rate for all nursing facilities with the weighted average payment rate identified in the Biennial Appropriations Act 388-96-724Advance notice—Nursing facility component rate reduction taken under RCW 74.46.421 388-96-725RCW 74.46.421 rate reduction—A nursing facility's rates 388-96-726RCW 74.46.421 nursing facility component rates below the statewide weighted average payment rate identified in the Biennial Appropriations Act 388-96-730Methodology for reducing a nursing facility's medicaid payment rate in order to reduce the statewide weighted average nursing facility medicaid payment rate to equal or be less than the weighted average payment rate identified in the Biennial Appropriations Act 388-96-731Nursing facilities' rate reductions pursuant to RCW 74.46.421 388-96-738What default case mix group and weight must the department use for case mix grouping when there is no minimum data set resident assessment for a nursing facility resident?388-96-739How will the department determine which resident assessments are medicaid resident assessments?388-96-757Payment for veterans' homes 388-96-758Add-on for low-wage workers 388-96-759Standards for low-wage worker add-on 388-96-760Upper limits to the payment rate 388-96-766Notification 388-96-771Receivership 388-96-777Add-ons to the prospective rate—Initiated by the department 388-96-781Exceptional care rate add-on—Covered medicaid residents 388-96-782Exceptional direct care—Payment 388-96-785Supplemental payments 388-96-802Billing/payment 388-96-803Notification of participation—Responsibility to collect—Reporting medicaid recipient's changes in income/resources—Rate payment in full for services 388-96-805Suspension of payments 388-96-808Change of ownership—Assignment of department's contract 388-96-809Change of ownership—Final reports—Settlement securities 388-96-901Disputes 388-96-904Administrative review—Adjudicative proceeding 388-96-905Case mix accuracy review of MDS nursing facility resident assessments 388-96-906Section captions 388-96-910Safety net assessment 388-96-915Capital component—Square footage 388-96-916Capital component—Facility age 388-96-917Direct care—County wage information 388-96-918Wage equity funding