S*251 Session 107 (1987-1988)
S*0251(Rat #0260, Act #0184 of 1987) General Bill, By Leatherman
A Bill to amend the Code of Laws of South Carolina, 1976, by adding Article 2
to Chapter 7 of Title 44 so as to enact the "Nursing Home Licensing Act of
1987"; to amend Section 44-7-130, relating to the State Hospital Construction
and Franchising Act, so as to substitute nursing homes for nursing care and
intermediate facilities within the definitions of "hospital" and "health care
facility"; and to amend Section 44-7-320, relating to the franchising
application required by a health care facility, so as to provide that if a
certificate of need has been issued with special conditions or restrictions
attached, the Department may remove these conditions or restrictions without
requiring a new franchising application; and to amend Chapter 6, Title 44,
relating to the State Health and Human Services Finance Commission, by adding
Section 44-6-220 so as to require all applications for admission to a nursing
home to contain a notice signed by the applicant which states the eligibility
qualifications for Medicaid-sponsored long-term care services.-amended title
01/15/87 Senate Introduced and read first time SJ-162
01/15/87 Senate Referred to Committee on Medical Affairs SJ-162
04/01/87 Senate Committee report: Favorable with amendment
Medical Affairs SJ-1112
04/08/87 Senate Amended SJ-1212
04/08/87 Senate Read second time SJ-1214
04/08/87 Senate Ordered to third reading with notice of
amendments SJ-1214
04/21/87 Senate Special order SJ-1406
04/29/87 Senate Amended SJ-1581
04/29/87 Senate Read third time and sent to House SJ-1581
04/30/87 House Introduced and read first time HJ-2356
04/30/87 House Referred to Committee on Medical, Military,
Public and Municipal Affairs HJ-2357
05/27/87 House Committee report: Favorable with amendment
Medical, Military, Public and Municipal Affairs
HJ-3228
06/02/87 House Amended HJ-3410
06/02/87 House Read second time HJ-3411
06/02/87 House Unanimous consent for third reading on next
legislative day HJ-3411
06/03/87 House Read third time HJ-3562
06/03/87 House Returned HJ-3562
06/03/87 Senate Concurred in House amendment and enrolled SJ-2684
06/25/87 Ratified R 260
07/01/87 Signed By Governor
07/09/87 Act No. 184
07/13/87 Sec. 1,2,3,5 eff. 7/1/88 Sec. 4 eff. 7/1/87
07/13/87 Copies available
(A184, R260, S251)
AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING ARTICLE 2
TO CHAPTER 7 OF TITLE 44 SO AS TO ENACT THE "NURSING HOME LICENSING ACT OF
1987"; TO AMEND SECTION 44-7-130, RELATING TO THE STATE HOSPITAL
CONSTRUCTION AND FRANCHISING ACT, SO AS TO SUBSTITUTE NURSING HOMES FOR NURSING
CARE AND INTERMEDIATE FACILITIES WITHIN THE DEFINITIONS OF "HOSPITAL"
AND "HEALTH CARE FACILITY"; AND TO AMEND SECTION 44-7-320, RELATING TO
THE FRANCHISING APPLICATION REQUIRED BY A HEALTH CARE FACILITY, SO AS TO PROVIDE
THAT IF A CERTIFICATE OF NEED HAS BEEN ISSUED WITH SPECIAL CONDITIONS OR
RESTRICTIONS ATTACHED, THE DEPARTMENT MAY REMOVE THESE CONDITIONS OR RESTRICTIONS
WITHOUT REQUIRING A NEW FRANCHISING APPLICATION; AND TO AMEND CHAPTER 6, TITLE
44, RELATING TO THE STATE HEALTH AND HUMAN SERVICES FINANCE COMMISSION, BY ADDING
SECTION 44-6-220 SO AS TO REQUIRE ALL APPLICATIONS FOR ADMISSION TO A NURSING
HOME TO CONTAIN A NOTICE SIGNED BY THE APPLICANT WHICH STATES THE ELIGIBILITY
QUALIFICATIONS FOR MEDICAID-SPONSORED LONG-TERM CARE SERVICES.
Be it enacted by the General Assembly of the State of South Carolina:
Medicaid nursing home permits
SECTION 1. Chapter 7 of Title 44 of the 1976 Code is amended by adding:
"Article 2
Medicaid Nursing Home Permits
Section 44-7-80. For the purposes of this article:
(1) 'Nursing home' means a facility with an organized nursing staff to
maintain and operate organized facilities and services to accommodate two or more
unrelated persons over a period exceeding twenty-four hours, which is operated
either in connection with a hospital or as a freestanding facility for the
express or implied purpose of providing intermediate or skilled nursing care for
persons who are not in need of hospital care.
(2) 'Medicaid nursing home permit' means a permit to serve Medicaid patients
in an appropriately certified nursing home.
(3) 'Medicaid patient' means a person who is eligible for Medicaid (Title XIX)
sponsored long-term care services.
(4) 'Medicaid patient day' means a day of nursing home care for which a
nursing home receives Medicaid reimbursement.
(5) 'Department' means the Department of Health and Environmental Control.
Section 44-7-82. No nursing home may provide care to Medicaid patients without
first obtaining a permit in the manner provided in this article.
Section 44-7-84. (A) In the annual appropriations act, the General Assembly
shall establish the maximum number of Medicaid patient days for which the
department is authorized to issue Medicaid nursing home permits.
(B) Based on a method the department develops for determining the need for
nursing home care for Medicaid patients in each area of the State, the department
shall determine the distribution of Medicaid patient days for which Medicaid
nursing home permits can be issued. The department shall promulgate by
regulation the method and criteria it will use to choose among competing
applications if there are applications for more Medicaid patient days than
allocated to an area of the State. These criteria shall give preference to
nursing homes seeking to renew their Medicaid nursing home permits. The number
of Medicaid patient days allocated to a nursing home must not be decreased from
the previous year's allocation unless requested by the nursing home. However,
if the maximum number of Medicaid patient days authorized by the General Assembly
is decreased, the nursing home may be required to absorb a proportionate decrease
in its Medicaid patient days' allocation.
(C) Within sixty days of the effective date of the annual appropriations act,
all nursing homes desiring to serve Medicaid patients must apply to the
department for a Medicaid nursing home permit. The application must state the
specific number of Medicaid patient days the nursing home will provide.
Section 44-7-88. Nursing home patients may not be involuntarily discharged or
transferred due to their Medicaid status. If no Medicaid patients are waiting
for admission to the nursing home, or if for some other reason a nursing home
anticipates the possibility that the home cannot satisfy the Medicaid nursing
home permit requirements, the home may request a waiver of the permit
requirements from the department.
Section 44-7-90. (A) Based on reports from the State Health and Human
Services Finance Commission, the department shall determine each nursing home's
compliance with its Medicaid nursing home permit. Violations of this article
include:
(1) a nursing home exceeding by more than ten percent the number of Medicaid
patient days stated in its permit;
(2) a nursing home failing to provide at least ten percent fewer days than
the number stated in its permit;
(3) the provisions of any Medicaid patient days by a home without a Medicaid
nursing home permit.
(B) Each Medicaid patient day above or below the allowable range is considered
a separate violation. The department may levy a fine not to exceed the average
rate per Medicaid patient day times each violation. Appeals from this action
must comply with the appropriate provisions of Chapter 23 of Title 1."
Definition - hospital
SECTION 2. Item (4) of Section 44-7-130 of the 1976 Code is amended to read:
"(4) 'Hospital' includes public health centers and general, tuberculosis,
mental, chronic disease, and other types of hospital and related facilities such
as outpatient facilities, nursing homes, state health laboratories, nurses'
training facilities,
facilities for persons with developmental disabilities (formerly facilities for
the mentally retarded), community mental health centers, including facilities for
alcoholics and narcotic addicts, and residential care facilities providing care
for nonambulatory persons."
Definition - health care facility
SECTION 3. Item (9) of Section 44-7-130 of the 1976 Code is amended to read:
"(9) 'Health care facility' includes hospitals, psychiatric hospitals,
tuberculosis hospitals, nursing homes, kidney disease treatment centers,
including freestanding hemodialysis centers, ambulatory surgical facilities,
rehabilitation facilities, health maintenance organizations except as exempted
by regulation, and any other project for which certificate of need review is
required under the federal act."
Department may remove conditions or restrictions
SECTION 4. Section 44-7-320 of the 1976 Code is amended by adding the following
paragraph:
"If a certificate of need has been issued with special conditions or
restrictions attached, the department may permanently remove these conditions or
restrictions or waive them on an annual basis without requiring a new franchising
application."
Applications must contain notice
SECTION 5. Chapter 6 of Title 44 of the 1976 Code is amended by adding:
"Section 44-6-220. All applications for admission to a nursing home must
contain a notice, to be signed by the applicant, stating:
'Eligibility for Medicaid-sponsored long-term care services is based on income
and medical necessity. To qualify for assistance through the Medicaid program,
a nursing home patient must need intermediate or skilled nursing care as
determined through an assessment conducted by Medicaid program staff. The fact
that a patient has already been admitted to a nursing home is not considered in
this determination. It is possible that a patient could exhaust all other means
of paying for nursing home care and meet Medicaid income criteria but still be
denied assistance due to the lack of medical necessity.
It is recommended that all persons seeking admission to a nursing home be
assessed by the Medicaid program prior to admission. This assessment will
provide information about the level of care needed and the viability of community
services as an alternative to admission. The commission may charge a fee, not
to exceed the cost of the assessment, to persons not eligible for
Medicaid-sponsored long-term care services.'"
Time effective
SECTION 6. Sections 1, 2, 3, and 5 of this act take effect July 1, 1988.
Section 4 of this act takes effect July 1, 1987. |