42 U.S.C. § 1396r-3 : US Code - Section 1396R-3: Correction and reduction plans for intermediate care facilities for mentally retarded

Search 42 U.S.C. § 1396r-3 : US Code - Section 1396R-3: Correction and reduction plans for intermediate care facilities for mentally retarded

(a) Written plans to remedy substantial deficiencies; time for
submission
If the Secretary finds that an intermediate care facility for the
mentally retarded has substantial deficiencies which do not pose an
immediate threat to the health and safety of residents (including
failure to provide active treatment), the State may elect, subject
to the limitations in this section, to -
(1) submit, within the number of days specified by the
Secretary in regulations which apply to submission of compliance
plans with respect to deficiencies of such type, a written plan
of correction which details the extent of the facility's current
compliance with the standards promulgated by the Secretary,
including all deficiencies identified during a validation survey,
and which provides for a timetable for completion of necessary
steps to correct all staffing deficiencies within 6 months, and a
timetable for rectifying all physical plant deficiencies within 6
months; or
(2) submit, within a time period consisting of the number of
days specified for submissions under paragraph (1) plus 35 days,
a written plan for permanently reducing the number of certified
beds, within a maximum of 36 months, in order to permit any
noncomplying buildings (or distinct parts thereof) to be vacated
and any staffing deficiencies to be corrected (hereinafter in
this section referred to as a "reduction plan").
(b) Conditions for approval of reduction plans
As conditions of approval of any reduction plan submitted
pursuant to subsection (a)(2) of this section, the State must -
(1) provide for a hearing to be held at the affected facility
at least 35 days prior to submission of the reduction plan, with
reasonable notice thereof to the staff and residents of the
facility, responsible members of the residents' families, and the
general public;
(2) demonstrate that the State has successfully provided home
and community services similar to the services proposed to be
provided under the reduction plan for similar individuals
eligible for medical assistance; and
(3) provide assurances that the requirements of subsection (c)
of this section shall be met with respect to the reduction plan.
(c) Contents of reduction plan
The reduction plan must -
(1) identify the number and service needs of existing facility
residents to be provided home or community services and the
timetable for providing such services, in 6 month intervals,
within the 36-month period;
(2) describe the methods to be used to select such residents
for home and community services and to develop the alternative
home and community services to meet their needs effectively;
(3) describe the necessary safeguards that will be applied to
protect the health and welfare of the former residents of the
facility who are to receive home or community services, including
adequate standards for consumer and provider participation and
assurances that applicable State licensure and applicable State
and Federal certification requirements will be met in providing
such home or community services;
(4) provide that residents of the affected facility who are
eligible for medical assistance while in the facility shall, at
their option, be placed in another setting (or another part of
the affected facility) so as to retain their eligibility for
medical assistance;
(5) specify the actions which will be taken to protect the
health and safety of, and to provide active treatment for, the
residents who remain in the affected facility while the reduction
plan is in effect;
(6) provide that the ratio of qualified staff to residents at
the affected facility (or the part thereof) which is subject to
the reduction plan will be the higher of -
(A) the ratio which the Secretary determines is necessary in
order to assure the health and safety of the residents of such
facility (or part thereof); or
(B) the ratio which was in effect at the time that the
finding of substantial deficiencies (referred to in subsection
(a) of this section) was made; and
(7) provide for the protection of the interests of employees
affected by actions under the reduction plan, including -
(A) arrangements to preserve employee rights and benefits;
(B) training and retraining of such employees where
necessary;
(C) redeployment of such employees to community settings
under the reduction plan; and
(D) making maximum efforts to guarantee the employment of
such employees (but this requirement shall not be construed to
guarantee the employment of any employee).
(d) Notice and comment; approval of more than 15 reduction plans in
any fiscal year; corrections costing $2,000,000 or more
(1) The Secretary must provide for a period of not less than 30
days after the submission of a reduction plan by a State, during
which comments on such reduction plan may be submitted to the
Secretary, before the Secretary approves or disapproves such
reduction plan.
(2) If the Secretary approves more than 15 reduction plans under
this section in any fiscal year, any reduction plans approved in
addition to the first 15 such plans approved, must be for a
facility (or part thereof) for which the costs of correcting the
substantial deficiencies (referred to in subsection (a) of this
section) are $2,000,000 or greater (as demonstrated by the State to
the satisfaction of the Secretary).
(e) Termination of provider agreements; disallowance of percentage
amounts for purposes of Federal financial participation
(1) If the Secretary, at the conclusion of the 6-month plan of
correction described in subsection (a)(1) of this section,
determines that the State has substantially failed to correct the
deficiencies described in subsection (a) of this section, the
Secretary may terminate the facility's provider agreement in
accordance with the provisions of section 1396i(b) of this title.
(2) In the case of a reduction plan described in subsection
(a)(2) of this section, if the Secretary determines, at the
conclusion of the initial 6-month period or any 6-month interval
thereafter, that the State has substantially failed to meet the
requirements of subsection (c) of this section, the Secretary shall
-
(A) terminate the facility's provider agreement in accordance
with the provisions of section 1396i(b) of this title; or
(B) if the State has failed to meet such requirements despite
good faith efforts, disallow, for purposes of Federal financial
participation, an amount equal to 5 percent of the cost of care
for all eligible individuals in the facility for each month for
which the State fails to meet such requirements.
(f) Applicability of section limited to plans approved by January
1, 1990
The provisions of this section shall apply only to plans of
correction and reduction plans approved by the Secretary by January
1, 1990.