<?xml version='1.0' encoding='utf-8'?>
<chapter num="20" heading="Nursing Facility Quality Assessment" title_num="10" subtitle_num="01">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <paragraph num="A.">
      <text>This chapter applies to the collection by the Maryland Department of Health of a quality assessment, pursuant to Health-General Article, §19-310.1, Annotated Code of Maryland, to be paid on a quarterly basis by nursing facilities subject to the assessment.</text>
    </paragraph>
    <paragraph num="B.">
      <text>All amounts collected under this chapter shall be distributed to a special fund to be used by the Department only to fund reimbursements to nursing facilities under the Medicaid program.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Assessment” means the quality assessment paid on a quarterly basis by each nursing facility subject to this chapter, determined by the Department for each facility based upon an amount per non-Medicare day of service for the previous quarter of the State fiscal year.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Department” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Medicaid” means the Medical Assistance Program in the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Nursing Facility.</text>
        <paragraph num="(a)">
          <text>“Nursing facility”, for purposes of this chapter, means a nursing facility, as defined in Health-General Article, §19-301, Annotated Code of Maryland, that has 45 or more beds, and operates in the State.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Nursing facility” does not include a continuing care retirement community that has obtained a certificate of registration to provide continuing care under Human Services Article, Title 10, Subtitle 4, Annotated Code of Maryland.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Collection of Nursing Facility Quality Assessment.">
    <paragraph num="A.">
      <text>On or before the 60th day after each quarter of the State fiscal year, each nursing facility subject to the quality assessment shall pay the specified amount into a bank account established under the authority of the State Treasurer.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Late Charge.</text>
      <paragraph num="(1)">
        <text>Payments not postmarked on or before the 60th day after each quarter are subject to an interest amount equal to the State of Maryland General Fund investment portfolio interest rate in effect at the time the payment is due.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The late charge is a one-time imposition for each quarterly delinquent payment and shall equal the applicable interest rate multiplied by the quality assessment amount that is unpaid on the payment due date.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The amount of each facility's quarterly quality assessment shall equal the product of:</text>
      <paragraph num="(1)">
        <text>The per diem assessment amount, as annually calculated by and provided to the facility by the Department; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The number of non-Medicare days of care provided by the facility during the previous quarter of the State fiscal year.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>With each quarterly quality assessment payment, each nursing facility paying the quality assessment shall report, on a form provided by the Department, the nursing facility's total number of patient days and non-Medicare patient days for that quarter.</text>
    </paragraph>
    <paragraph num="E.">
      <text>Effective July 1, 2012, the aggregated annual assessment collected under this chapter may not exceed 6 percent of the operating revenue for all nursing facilities subject to this assessment.</text>
    </paragraph>
    <paragraph num="F.">
      <text>The Department shall pursue collection and referral of unpaid quality assessments in accordance with the timetables and agency collection standards set forth in COMAR 17.01.01.04.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health-General Article, §19-310.1, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: October 6, 2008 (35:20 Md. R. 1774)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03E amended effective December 27, 2010 (37:26 Md. R. 1786); November 28, 2011 (38:24 Md. R. 1501); February 18, 2013 (40:3 Md. R. 217)</annotation>
  </annotations>
</chapter>