Section 75-02-07.1-04 - Participation requirementA facility may not receive aid to vulnerable aged, blind, and disabled individuals assistance payments unless it complies with all provisions of this section.
1. A facility shall have an effective provider agreement with the department.2. A facility may charge to hold a bed for a period in excess of the periods covered under subsection 2 or 3 of section 75-02-07.1-05 if: a. The resident, or a person acting on behalf of the resident, has requested the bed be held and the facility informs the person making the request, at the time of the request, of the amount of the charge; andb. For an eligible beneficiary, the payment comes from sources other than from the beneficiary's monthly income.3. A facility may not violate any resident rights as set forth in North Dakota Century Code section 50-10.2-02. Collection and use by a facility of financial information of any applicant pursuant to a screening process does not raise an inference that the facility is using that information for any purpose prohibited by North Dakota Century Code section 50-10.2-02 or this section.4. A facility may not require any vendor of medical care, who is paid by medical assistance under a separate fee schedule, to pay any portion of the vendor's fee to the facility except as payment for the fair market value of renting or leasing space or equipment of the facility or purchasing support services, if those agreements are disclosed to the department.5. A facility shall file on behalf of each resident or assist each resident in filing requests for any third-party benefits to which the resident may be entitled.6. If a facility does not comply with this section, the department, if extreme hardship to the residents would otherwise result, may continue to make medical assistance and aid to vulnerable aged, blind, and disabled individuals program payments to the facility for a period not to exceed ninety days from the date of mailing a written notice of a violation of this section. The facility may seek reconsideration of or appeal the department's action.7. A facility may charge a higher rate for a private room used by an eligible beneficiary if: a. The private room is not necessary to meet the eligible beneficiary's care needs;b. The eligible beneficiary, or a person acting on behalf of the eligible beneficiary, has requested the private room;c. The facility informs the individual making the request, at the time of the request, of the amount of payment and that the payment must come from sources other than the eligible beneficiary's monthly income;d. The payment does not exceed the amount charged to private-pay individuals for use of a private room; ande. Appropriate semiprivate accommodations are available at the time the first charges for a private room apply.N.D. Admin Code 75-02-07.1-04
Effective July 1, 1996; amended effective July 1, 2001; October 1, 2011.Amended by Administrative Rules Supplement 2023-391, January 2024, effective 1/1/2024.General Authority: NDCC 50-06-16, 50-24.5-02(3)
Law Implemented: NDCC 50-24.5-02(3)