Bill > A3902

Introduced Session

This bill requires nursing homes certified to participate in the Medicaid program with an overall rating on the CMS Five-Star Quality Rating System of one star to develop and implement a corrective action plan to improve the nursing home's rating as a condition of receiving reimbursement under the Medicaid program. A nursing home with a one star rating will submit a corrective action plan to the Department of Human Services, providing a description of the action steps to be taken by the nursing home over a six-month period to resolve quality issues indicated by the nursing home's domain ratings within the CMS federal Quality Rating System. The plan, at a minimum, will include steps that would improve the nursing home's overall rating to a minimum of two stars after the implementation of the plan. The department, in cooperation with the Department of Health, will review the plan. The nursing home will immediately commence implementing the plan upon written approval by the department. Any plan that is not approved will be returned to the nursing home by the department with a written explanation of the plan's deficiencies. The nursing home will resubmit an updated corrective action plan to the department for review within 30 days of receipt of this notification. Within 60 days of the completion of the nursing home's approved corrective action plan and every 60 days thereafter, the facility will submit a report to the department documenting the execution of the plan, as well as the outcomes of the action steps. The department, in cooperation with the Department of Health, will evaluate the facility's report and determine the facility's compliance in implementing the plan as approved by the department. At the Commissioner of Human Services' discretion, a nursing home determined to be non-compliant with the implementation of the facility's plan may be provided additional time to fulfill the action steps outlined in the plan. A nursing home with a one star rating determined by the Commissioner of Human Services to be non-compliant with any provisions of this bill will be ineligible to receive reimbursement under the Medicaid program, provided that reimbursement for services will continue until all Medicaid beneficiaries residing at the facility have been relocated. The nursing home will be responsible for informing Medicaid residents, in writing, of the facility's non-compliance with this bill and for providing the department with a patient-centered discharge plan for current Medicaid residents within 30 days of the receipt of the department's written determination of non-compliance. The department will include information on an appeals process, to be established by the Commissioner of Human Services, in the written documentation provided to non-compliant nursing homes.

AI Summary

Committee Categories

Tennille McCoy (D)*,  Bill Moen (D)*, 

Introduced, Referred to Assembly Aging and Human Services Committee (on 02/27/2024)

Official Document