General Appropriations Bill H. 4700 for the fiscal year beginning July 1, 1998
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5 SECTION 45
6
7 TO AMEND SECTION 44-6-400, AS AMENDED, OF THE 1976 CODE, RELATING TO DEFINITIONS CONCERNING
8 INTERMEDIATE SANCTIONS FOR THE MEDICAID CERTIFIED NURSING HOME ACT, SO AS TO REVISE CERTAIN
9 DEFINITIONS; TO AMEND SECTION 44-6-420, AS AMENDED, RELATING TO SANCTIONS AGAINST NURSING HOMES
10 FOR VIOLATIONS OF MEDICAID PROGRAM REQUIREMENTS, SO AS TO REQUIRE THE DEPARTMENT OF HEALTH
11 AND HUMAN SERVICES TO COORDINATE ENFORCEMENT WITH THE FEDERAL AUTHORITIES FOR NURSING HOMES
12 CERTIFIED UNDER BOTH MEDICARE AND MEDICAID AND TO TAKE ACTIONS COMMENSURATE WITH FEDERAL
13 ACTIONS WHEN THE NURSING HOME IS ONLY CERTIFIED UNDER MEDICAID; TO AMEND SECTION 44-6-470, AS
14 AMENDED, RELATING TO FINES FOR VIOLATIONS AND USE OF FINES COLLECTED, SO AS TO DELETE SPECIFIC
15 FINE AMOUNTS AND FURTHER PROVIDE FOR THE USE OF CIVIL MONETARY PENALTIES COLLECTED; TO AMEND
16 SECTION 44-6-540 RELATING TO THE AUTHORITY OF THE DEPARTMENT TO PROMULGATE REGULATIONS, SO AS
17 TO PROVIDE THAT SUCH REGULATIONS SHALL ENSURE COMPLIANCE WITH THE REQUIREMENTS FOR
18 PARTICIPATION IN THE MEDICAID PROGRAM; AND TO REPEAL SECTIONS 44-6-410, 44-6-430, 44-6-440, 44-6-450,
19 44-6-460, 44-6-480, 44-6-490, 44-6-500, 44-6-510, AND 44-6-520, ALL RELATING TO SANCTIONS AND ENFORCEMENT
20 PROCEDURES FOR VIOLATIONS OF MEDICAID PROGRAM REQUIREMENTS.
21
22 A. Section 44-6-400, as amended, of the 1976 Code, as last amended by Act 181 of 1993, is further amended to read:
23
24 "Section 44-6-400. As used in this article:
25 (1) Department' means the Department of Health and Environmental Control Health and Human Services.
26 (2) Nursing home' means a facility subject to licensure as a nursing home by the department Department of Health and Environmental
27 Control and subject to the permit provisions of under Article 2, Chapter 7 of Title 44 and which has been certified for participation in the
28 Medicaid program, or which has been dually certified for participation in the Medicaid and Medicare programs.
29 (3) Ombudsman' means the State Ombudsman established under Chapter 38 of Title 43.
30 (4)(3) Resident' means a person who resides or resided in a nursing home during a period of an alleged violation.
31 (4) Survey agency' means the South Carolina Department of Health and Environmental Control or any other agency designated to conduct
32 compliance surveys of nursing facilities participating in the Title XIX (Medicaid) program."
33
34 B. Section 44-6-420 of the 1976 Code, as last amended by Act 181 of 1993, is further amended to read:
PART II PAGE 566
1 "Section 44-6-420. When the Department of Health and Human Services department is notified by the survey agency that a nursing home
2 is in violation of one or more of the requirements for participation in the Medicaid program, it, based on the severity of the violation as set forth
3 by regulation, may take enforcement action as follows:
4 (1) deny payment under the Medicaid program if the nursing home is dually certified for participation in both the Medicare and Medicaid
5 programs, the department shall coordinate any enforcement action with federal authorities and shall defer to the actions of these federal
6 authorities to the extent required by federal statute or regulation;
7 (2) assess and collect monetary penalties set forth in Section 44-6-470 if the nursing home is only certified for participation in the Medicaid
8 program and is not certified for participation in the Medicare program, the department may take any enforcement action authorized under federal
9 statute or regulation that would have been available for use by federal authorities if the nursing home had been dually certified;
10 (3) appoint temporary management in accordance with the provisions of this article. The department of Health and Human Services may
11 promulgate regulations to assure prompt compliance with the requirements for participation in the Medicaid program and shall monitor a
12 nursing home that repeats violations.
13 Any enforcement actions taken solely by the department under item (2) must be proportionate to the scope and severity of the violations
14 and also shall take into account the factors considered by federal authorities in similar enforcement actions. Dually certified nursing homes
15 and nursing homes only certified for participation in the Medicaid program must be subjected to comparable enforcement actions for comparable
16 violations."
17
18 C. Section 44-6-470 of the 1976 Code, as last amended by Act 181 of 1993, is further amended to read:
19
20 "Section 44-6-470. A nursing home found to be in violation of one of the requirements for participation in the Medicaid program may
21 be fined up to twenty-five hundred dollars a day by the Department of Health and Human Services. A nursing home that repeats violations may
22 be fined up to five thousand dollars a day. All fines are assessed and collected with interest from the date of notification of the deficiencies until
23 the date they are corrected. The amount of the fines must be proportionate to the severity of the violation as set forth by regulation of the
24 Department of Health and Human Services.
25 Funds collected by the Department of Health and Human Services as a result of the imposition of the fines must be used to protect the health
26 and property of the patients in the affected nursing home, including the relocation of patients to other nursing homes. A receiver appointed by
27 the court to temporarily manage an affected nursing home, may use the funds for the cost of relocating patients to other nursing homes, if
28 necessary, and for maintenance of operation of the nursing home pending correction of the deficiencies. He may also reimburse patients for
29 personal funds that may have been lost as a result of the violations.
30 Any use of funds collected by the department as a result of the imposition of civil monetary penalties or other enforcement actions must
31 be for a purpose related to the protection of the health and property of residents of nursing homes that participate in the Medicaid program.
32 These funds may be used for the cost of relocating residents to other nursing homes, if necessary, and also may be used to reimburse residents
33 for personal funds lost as a result of violations of the requirements for participation in the Medicaid program by the nursing home. In addition,
34 these funds may be used for other costs directly associated with enforcement or corrective measures at facilities found to be out of compliance
PART II PAGE 567
1 with the requirements for participation in the Medicaid program or for any other purpose that enhances or improves the health and quality of
2 life for residents. These requirements for the use of funds collected also apply to funds received by the department that are collected as the result
3 of enforcement actions directed by federal authorities."
4
5 D. Section 44-6-540 of the 1976 Code, as added by Act 449 of 1990, is amended to read:
6
7 "Section 44-6-540. The commission department is authorized to promulgate regulations, pursuant to the Administrative Procedures Act,
8 to administer this article and to ensure compliance with the requirements for participation in the Medicaid program."
9
10 E. Sections 44-6-410, 44-6-430, 44-6-440, 44-6-450, 44-6-460, 44-6-480, 44-6-490, 44-6-500, 44-6-510, and 44-6-520 of the 1976 Code
11 are repealed.
12