Bill Text: NJ A2179 | 2012-2013 | Regular Session | Introduced
Bill Title: Requires all assisted living facilities set aside at least 10% of beds for Medicaid-eligible persons and accept at least 5% Medicaid direct admission.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2012-02-02 - Introduced, Referred to Assembly Health and Senior Services Committee [A2179 Detail]
Download: New_Jersey-2012-A2179-Introduced.html
Sponsored by:
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
SYNOPSIS
Requires all assisted living facilities set aside at least 10% of beds for Medicaid-eligible persons and accept at least 5% Medicaid direct admission.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning admissions to assisted living facilities and amending P.L.2001, c.234.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2001, c.234 (C.26:2H-12.16) is amended to read as follows:
1. a. For the purposes of this act, "Medicaid" means the program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and "Medicaid-eligible" means that a person is determined to meet the financial and clinical eligibility standards for medical assistance under the State Medicaid program and is approved by the Department of Health and Senior Services for participation in a federally approved 1915(c) waiver program that provides assisted living services.
b. A [new] facility that is licensed to operate an assisted living residence or comprehensive personal care home [after the effective date of this act] shall reserve a minimum of 10% of its total [bed compliment] licensed beds for use by Medicaid-eligible persons. [The 10% utilization by Medicaid-eligible persons] At least 5% of licensed beds shall be utilized by direct admission of Medicaid-eligible persons, and the remainder shall be met through Medicaid conversion of persons who enter the [assisted living residence or comprehensive personal care home] facility as private paying persons and subsequently become eligible for Medicaid[, or through direct admission of Medicaid-eligible persons]. An assisted living residence or comprehensive personal care home shall achieve this 10% utilization within three years of the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill) or, in the case of a facility newly licensed on or after the effective date of P.L. , c. (C. ) within three years of licensure to operate [and]. The facility shall maintain this level of utilization thereafter.
c. [Existing assisted living residences and comprehensive personal care homes that add additional assisted living beds shall be required, as a condition of licensure approval, to maintain 10% of the additional beds for Medicaid-eligible persons through Medicaid conversion of persons who enter the assisted living residence or comprehensive personal care home as private paying persons and subsequently become eligible for Medicaid, or through direct admission of Medicaid-eligible persons. If the total number of additional beds is less than 10, at least one of the additional beds shall be reserved for a Medicaid-eligible person.] (Deleted by amendment, P.L. , c. ) (pending before the Legislature as this bill)
d. A resident of an assisted living residence or comprehensive personal care home who entered the facility as a private paying person and subsequently becomes Medicaid-eligible, shall not be discharged from the facility because the resident has become Medicaid-eligible.
e. (1) An assisted living residence or comprehensive personal care home shall provide a resident, or the resident's guardian, family member, or other designated responsible person, as applicable, with written notice of an involuntary discharge from the facility at least 30 days in advance of the discharge, in accordance with the provisions of N.J.A.C.8:36-5.14. The notice shall include the telephone number of the Office of the Ombudsman for the Institutionalized Elderly.
(2) The facility shall transmit a copy of the notice to the Office of the Ombudsman for the Institutionalized Elderly at the same time it provides the notice to the resident or other responsible person.
(cf: P.L.2001, c.234, s.1)
2. Section 2 of P.L.2001, c.234 (C.26:2H-12.17) is amended to read as follows:
2. a. The Commissioner of Health and Senior Services may waive the 10% utilization requirement or the 5% Medicaid-eligible direct admission requirement, or reduce the required percentage by regulation for specific regions of the State or Statewide if he determines that sufficient numbers of assisted living beds are available in the State to meet the needs of Medicaid-eligible persons within the limits of the federal waiver to provide assisted living services through the Medicaid program.
b. The commissioner may waive the 10% utilization requirement or the 5% Medicaid-eligible direct admission requirement, or reduce the required percentage for a specific facility, if the owner or operator of the facility requests such a waiver and demonstrates to the satisfaction of the commissioner that the requirement presents a hardship to the facility. The commissioner shall establish, by regulation, criteria for granting a waiver pursuant to this subsection, and the form and manner for submitting a request for a waiver.
(cf: P.L.2001, c.234, s.2)
3. This act shall take effect on the 60th day after enactment.
STATEMENT
This bill provides that each assisted living and comprehensive personal care home in the State shall reserve a minimum of 10% of its total licensed beds for use by Medicaid-eligible persons to ensure that sufficient numbers beds are available to Medicaid-eligible persons, including persons who are eligible for Medicaid upon admission to a facility or enter a facility as private paying patients but exhaust their assets and subsequently qualify for Medicaid.
The bill provides that each assisted living and comprehensive personal care home in the State shall reserve a minimum of 10% of its total licensed beds for use by Medicaid-eligible persons. At least 5% of licensed beds shall be utilized by direct admission of Medicaid-eligible persons, and the remainder of the 10% requirement shall be met through Medicaid conversion of persons who enter the facility as private paying persons and subsequently become eligible for Medicaid.
The bill requires that a facility shall achieve this 10% utilization within three years of the effective date of the bill or, in the case of a facility newly licensed on or after the effective date, within three years of licensure to operate. The facility shall maintain this level of utilization thereafter.
A resident of an assisted living residence or comprehensive personal care home who entered the facility as a private paying person and subsequently becomes Medicaid-eligible, shall not be discharged from the facility because the resident has become Medicaid-eligible.
An assisted living residence or comprehensive personal care home shall provide a resident, or the resident's guardian, family member, or other designated responsible person, as applicable, with written notice of an involuntary discharge from the facility at least 30 days in advance of the discharge. The notice shall include the telephone number of the Office of the Ombudsman for the Institutionalized Elderly, and a copy of the notice shall be transmitted to the Ombudsman at the same time it is provided to the resident or other responsible person.
The Commissioner of Health and Senior Services may waive the 5% Medicaid-eligible direct admission requirement, by regulation, for specific regions of the State or Statewide if the commissioner determines that sufficient numbers of assisted living beds are available in the State to meet the needs of Medicaid-eligible persons within the limits of the federal waiver to provide assisted living services through the Medicaid program. The law currently provides that the commissioner may waive the 10% utilization requirement or reduce the required percentage, by regulation, for these reasons.
The commissioner is also authorized to waive the 10% utilization or the 5% Medicaid-eligible direct admission requirement, or reduce the required percentage, for a specific facility, if the owner or operator of the facility requests such a waiver and demonstrates to the satisfaction of the commissioner that the requirement presents a hardship to the facility. The commissioner shall establish, by regulation, criteria for granting a waiver, and the form and manner for submitting a request for a waiver.
