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A BILL to amend the Code of Virginia by adding sections numbered
32.1-125.02
and
32.1-125.03
, relating to nursing facilities; related party rent disclosures; incentive payment reduction; penalty.
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding sections numbered
32.1-125.02
and
32.1-125.03
as follows:
§
32.1-125.02
. Nursing
facility
rent or
lease payment disclosures
; penalty
.
A. As used in this section:
"Related party" means an entity or individual
that, directly or indirectly, owns, controls, is owned or controlled by, or is under common ownership o
r common control with a nursing facility, including any affiliate of the nursing facility, as determined by the Department of Medical Assistance Services
(DMAS)
.
"Related party rent expense" means the total annual amount
a
facility reports on cost reports filed with
DMAS
designated for rent or lease payments for land, bui
l
dings, and fixed equipment
,
in addition to any
other
payments required under the lease or rental agreement
,
to the extent such payments are made
to a related party recipient
.
B.
Any
nursing
facility
that is (i) licensed
under this chapter
, (ii)
enrolled as a Medicaid provider
, and (iii)
pays rent or lease paymen
ts
shall
publicly disclose
:
1. The
name of the
individual or entity rent or lease payments are
paid
to
;
2. W
hether the individual or entity rent or leas
e payments are paid to is a related party, and if so a description of that relation
ship
;
3.
Certain
terms of the rent or lease
agreement as
specified
by
DMAS
; and
4.
T
he
related
party rent expense for
the most recently completed fiscal year.
C
.
Disclosures
required under this section shall
be
posted in a manner that is publicly and easily accessible on the nursing facility's website. If the nursing facility does not
have a website, the disclosure shall be posted on the website of the operator or management company with a
dedicated webpage clearly labeled for each facility.
D.
Disclosures required under this section shall be updated on an annual basis within 120 days
of
the end of the most recent fiscal year, as well as within 30 days of any change in (i) ownership of the facility,
(ii)
operator or management company
, or (iii) lease terms. Such disclosures shall remain publicly available for at least five years from the date
they are
initially posted.
E
.
Nothing in this section shall be construe
d to require the Department or
DMAS
to host, collect, store, or publish the information required to be disclosed.
F
.
Failure to
comply with
the
disclosure requirements under this section shall constitute a violation of licensure requirements for nursing facilities and may subject the facility to enforcement action by the Department
.
As a condition of licensure renewal, each nursing facility shall furnish to the Department the URL of the disclosures required under this secti
on, as well as an attestation that such disclosures are complete and current.
G
. Notwithstanding
any other penalty proscribed under this section,
a
knowingly false attestation or disclosure
is unlawful and shall be punishable as a Class 3 misdemeanor.
§
32.1-125.03
. Nursing facility
incentive payment
reduction
.
A.
In administering any quality-based or value-based
incentive payment
for nursing facilities under the state plan for medical assistance, the Department of Medical Assistance Services
(DMAS)
shall
reduce such incentive payments for any nursing facility that incurs excessive rent or lease expenses as outlined in this section.
B.
DMAS shall establish a fair rental value
benchmark
for each nursing facility receiving incentive payments, and any related
party rent expense
, as defined in § 32.1
-125.02,
that exceeds 125 percent of the fair rental value
benchmark
shall be deducted from the total incentive payments otherwise payable to the nursing facility.
C. For purposes of calculating related
party rent expense, the fair rental value benchmark, and any excess related
party rent
expense
under this section, DMAS shall use the same reporti
ng period, and shall align the calculation to the
nursing
facility's cost report
ing
period used for the applicable incentive payment year, as determined by DMAS.
D.
DMAS shall provide
written
notice
of any reduction in incentive payments made pursuant to this section, including
the methodology and calculation
used
to determine such reduction.
After receiving such notice, a nursing facility may appeal the decisio
n in a process established by DMAS.
As part of the appeal process, DMAS may grant a waiver to all or part of the reduction
upon a showing that lease terms reflect fair market value due to documented capital improvements, unusual market conditions, or other good cause.
E. Nothing in this section shall be const
rued to
permit
DMAS to reduce
base Medicaid reimbursement rates.
2. That the Department of Health and Department of Medical Assistance Services shall promulgate regulations to implement the provisions of this act. As part of such regulations, the Department of Medical Assistance Services shall (i) determine the level of common ownership or control necessary to qualify an individual or entity as a related party; (ii) specify the terms of a lease or rental agreement required to be disclosed; (iii) set accessibility standards for required disclosures to ensure ease of access to the public; and (iv) establish a methodology for calculating the fair rental value benchmark for nursing facilities.