Chapter 514 - Nursing Facility Services - DHHR - State of West ...

CHAPTER 514 – COVERED SERVICES, LIMITATIONS, AND EXCLUSIONS FORNURSING FACILITY SERVICESTABLE OF CONTENTSTOPICPAGE NO.Introduction ................................................................................................................................. 7514.1 Definitions .................................................................................................................. 7514.2 Provider Participation Requirements ........................................................................ 11514.2.1 State Licensure ........................................................................................................ 11514.2.2 Provider Enrollment ................................................................................................. 11514.2.3 Nursing Facility Provider Agreement ........................................................................ 11514.2.4 Enforcement ............................................................................................................ 12514.2.5 Ownership ............................................................................................................... 12514.2.6 Change of Ownership .............................................................................................. 13514.2.7 Bed Configuration .................................................................................................... 15514.2.8 Noncompliance of Nursing Facilities ........................................................................ 16514.3 Provider Certification ............................................................................................... 17514.3.1 Denial of Payment for New Admission (DPNA)........................................................ 17514.3.2 Civil Money Penalty (CMP) ...................................................................................... 18514.3.3 Temporary Management/Administrator .................................................................... 18514.4 Standards for Nursing Facilities ............................................................................... 18514.4.1 Employment Restrictions ......................................................................................... 19514.4.2 Staffing Requirements ............................................................................................. 20514.4.3 General Staffing Information .................................................................................... 20514.4.4 General Administration ............................................................................................ 21514.4.5 Governing Body and Management .......................................................................... 21514.4.6 Physical Environment Requirements ....................................................................... 21514.4.7 Administrative Policies ............................................................................................. 22514.4.8 Emergency/Disaster Preparedness Procedure ........................................................ 22514.4.9 Resident Rights ....................................................................................................... 23514.4.10 Hospital Transfer Agreement ................................................................................... 23Department of Health and Human Resources Chapter 514: Nursing Facility Services Page 1January 1, 2013DISCLAIMER: This manual does not address all the complexities of Medicaid policies and procedures,and must be supplemented with all State and Federal Laws and Regulations.