26B-3-310. Purpose — Medicaid certification of nursing care facilities.
(1)
The Legislature finds:
Terms Used In Utah Code 26B-3-310
Certified program: means a nursing care facility program with Medicaid certification. See Utah Code 26B-3-301
Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
Intellectual disability: means a significant, subaverage general intellectual functioning that:Utah Code 68-3-12.5
Medicaid certification: means the right of a nursing care facility, as a provider of a nursing care facility program, to receive Medicaid reimbursement for a specified number of beds within the facility. See Utah Code 26B-3-301
Medicaid program: means the state program for medical assistance for persons who are eligible under the state plan adopted pursuant to Title XIX of the federal Social Security Act. See Utah Code 26B-3-101
Nursing care facility: means the following facilities licensed by the department under 2:
(i)
skilled nursing facilities;
(ii)
intermediate care facilities; and
(iii)
an intermediate care facility for people with an intellectual disability. See Utah Code 26B-3-301
Physical facility: means the buildings or other physical structures where a nursing care facility program is operated. See Utah Code 26B-3-301
State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(a)
that an oversupply of nursing care facilities in the state adversely affects the state Medicaid program and the health of the people in the state;
(b)
it is in the best interest of the state to prohibit nursing care facilities from receiving Medicaid certification, except as provided by Sections 26B-3-311 through 26B-3-313; and
(c)
it is in the best interest of the state to encourage aging nursing care facilities with Medicaid certification to renovate the nursing care facilities’ physical facilities so that the quality of life and clinical services for Medicaid residents are preserved.
(2)
Medicaid reimbursement of nursing care facility programs is limited to:
(a)
the number of nursing care facility programs with Medicaid certification as of May 9, 2016; and
(b)
additional nursing care facility programs approved for Medicaid certification under the provisions of Subsections 26B-3-311(5) and (7).
process initial applications for Medicaid certification or execute provider agreements with nursing care facility programs; or
(ii)
reinstate Medicaid certification for a nursing care facility whose certification expired or was terminated by action of the federal or state government; or
(b)
execute a Medicaid provider agreement with a certified program that moves to a different physical facility, except as authorized by Subsection 26B-3-311(3).
(4)
Notwithstanding Section 26B-3-311, beginning May 4, 2021, the division may not approve a new or additional bed in an intermediate care facility for individuals with an intellectual disability for Medicaid certification, unless certification of the bed by the division does not increase the total number in the state of Medicaid-certified beds in intermediate care facilities for individuals with an intellectual disability.
Renumbered and Amended by Chapter 306, 2023 General Session
