906 Ky. Admin. Regs. 1:200
Current through Register Vol. 51, No. 5, November 1, 2024
Section 906 KAR 1:200 - Use of Civil Money Penalty Funds collected from certified Long-term Care facilitiesRELATES TO: KRS 194A.050(1), 42 C.F.R. 488.433
NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires the Secretary of the Cabinet for Health and Family Services to promulgate administrative regulations necessary to operate programs and fulfill the responsibilities vested in the cabinet, qualify for the receipt of federal funds, and cooperate with other state and federal agencies for the proper administration of the cabinet and its programs. 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff) and 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff) pertain to the collection and use of civil money penalties (CMP) imposed by the Centers for Medicare and Medicaid Services (CMS) on certified long-term care facilities (serving Medicare and Medicaid beneficiaries) that do not comply with applicable federal health and safety laws and regulations. Except for temporary use in the case of sudden nursing facility relocations, natural disasters, or similar emergencies, states are required to obtain prior approval from CMS for any new project, new grantee, or new use of federally imposed CMP funds. Upon approval by CMS, states may direct collected CMP funds to a variety of organizations if the funds are used in accordance with 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff) and 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff). This administrative regulation establishes a competitive grant program to provide funding to organizations which offer programs or services approved by CMS for the use of CMP funds, thereby establishing the CMP Fund Grant Program.
Section 1. Definitions. (1) "Cabinet" means the Cabinet for Health and Family Services.(2) "CMP" means civil money penalties imposed by CMS on certified long-term care facilities (serving Medicare and Medicaid beneficiaries) that do not comply with applicable federal health and safety laws and regulations.(3) "CMS" means the Centers for Medicare and Medicaid Services.(4) "Funding" means a grant from collected CMP funds distributed by the cabinet upon approval by CMS.Section 2. Funding Opportunities. Collected CMP funds may be used to support activities that benefit Kentucky's residents of certified long-term care facilities, including:(1) Assistance to support and protect residents of a certified long-term care facility that closes (voluntarily or involuntarily) or is decertified, and may include offsetting the costs of relocating residents to a home and community-based setting or another facility;(2) Projects that support resident and family councils;(3) Consumer involvement activities which assure quality care in long-term care facilities; or(4) Facility improvement initiatives approved by CMS, which may include:(a) Joint training of facility staff and the cabinet's long-term care facility surveyors;(b) Technical assistance for facilities implementing quality assurance programs; or(c) The appointment of temporary management firms.Section 3. Prohibited Uses of CMP Funds. CMP funds shall not be approved: (1) For a project in which a conflict of interest exists or the appearance of a conflict of interest exists;(2) If the applicant is currently paid by a federal or state source to perform the same function as the proposed CMP project or use;(3) For capital improvements to a long-term care facility, or to build a long-term care facility;(4) To pay for services or supplies that are the responsibility of the long-term care facility, including laundry, linen, food, heat, or staffing costs;(5) To pay the salaries of temporary managers who are actively managing a long-term care facility; or(6) To recruit or provide Long-Term Care Ombudsman certification training for staff or volunteers, or investigate and work to resolve complaints.Section 4. Applicants.(1) An entity that applies for and receives funding shall be qualified and capable of carrying out the intended project or use described in the State Request for Approval of Use of Civil Money Penalty Funds for Certified Nursing Homes.(2) Entities that may qualify for funding include:(a) Consumer advocacy organizations;(b) Resident or family councils;(c) Professional or state long-term care facility organizations;(d) State Long-term Care Ombudsman programs;(e) Quality improvement organizations;(g) Academic or research institutions;(h) Certified long-term care facilities;(i) State, local, or tribal governments; or(j) Profit or not-for-profit organizations.Section 5. Application Process. To apply for funding, an applicant shall: (2) Complete and email the application to the cabinet at the following Web address: CMPAPPLICATION_OIG@KY.GOV.Section 6. Review of Applications. (1) Upon receipt of an application, the cabinet shall review the application and determine if the application meets the criteria for use of collected CMP funds pursuant to: (a) Sections 2 through 4 of this administrative regulation; and(b) The application's instructions.(2) Upon review of the application based on the criteria for use of collected CMP funds in 42 C.F.R. 488.433, the Office of Inspector General shall forward the application to CMS, including an initial determination on the ability of the project to improve resident outcomes and advance the care and services provided in certified long-term care facilities.Section 7. Reporting. If an application is approved by CMS, the organization or entity from which the application originated shall: (1) Submit a quarterly report on the status of the project to the CMS regional office and the cabinet;(2) Submit a follow-up report within five (5) calendar days of conclusion of the funded project to the CMS regional office and the cabinet; and(3) Submit a final report monitoring the success of the project within six (6) months of conclusion of the funded project to the CMS regional office and the cabinet.Section 8. Denials. An application that is denied shall: (1) Be accompanied by an explanation; and(2) Not be subject to an appeal.Section 9. Incorporation by Reference.(1) The Centers for Medicare and Medicaid Services, Region IV Atlanta, "State Request for Approval of Use of Civil Money Penalty Funds for Certified Nursing Homes", May 2013, is incorporated by reference.(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Cabinet for Health and Family Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.40 Ky.R. 209; 548; eff. 9-18-2013; 44 Ky.R. 2454; 45 Ky.R. 42; eff. 7-18-2018.STATUTORY AUTHORITY: KRS 194A.050(1), 42 U.S.C. 1395i-3(h)(2)(B)(ii)(IV)(ff), 42 U.S.C. 1396r(h)(3)(C)(ii)(IV)(ff)