Cal. Code Regs. Tit. 22, § 51215 - Skilled Nursing Facilities
(a) A skilled nursing facility, as defined in
section 51121, shall:
(1) Be licensed by the Department of Health
Services unless exempt under state laws from licensure. (facilities which are
licensed by the Department of Health Services as hospitals may also provide
skilled nursing facility services if they meet all of the requirements of this
section.
(2) Be certified to
participate in the Medi-Cal program as a provider of skilled nursing facility
services by being in compliance with the Medicare and Medicaid requirements of
Titles XVIII and XIX of the Social Security Act and regulations promulgated
pursuant thereto.
(3) Execute a
provider participation agreement with the Department of Health Services for
participation in the Medi-Cal program. Facilities participating in both the
Medicare and Medicaid programs shall be subject to the same terms and
conditions, and be coterminous with the period of approval of eligibility,
specified by the United States Department of Health and Human Services pursuant
to title XVIII of the Social Security Act. Upon notification that a provider
participation agreement with a facility under title XVIII of the Act has been
terminated, the Department may take appropriate action to deny or terminate the
facility's participation under Medi-Cal. A facility whose agreement under title
XVIII has been canceled or otherwise terminated shall not be issued another
provider participation agreement until the reasons which caused the
cancellation or termination have been removed and a reasonable assurance
provided the survey agency that they will not recur.
(4) Assure that Medi-Cal beneficiaries in the
facility are visited by their attending physicians in accordance with section
51335(f) of this
chapter.
(5) Notify the Medi-Cal
consultant's office within 48 hours of all discharges and deaths of Medi-Cal
beneficiaries in that facility.
(b) Notwithstanding the provisions of
subsection (a) of this regulation, eligibility for participation in the program
shall be conditional on compliance with Welfare and Institutions Code section
14105.5.
(c) Notwithstanding any other provisions of
these regulations, those sanitaria or skilled nursing facilities operated by,
or listed and certified by the First Church of Christ Scientist, Boston,
Massachusetts, shall be eligible for participation in this program, provided
they conform to housing, fire protection, safety and sanitation requirements of
the local communities where they are located.Execute a provider participation
agreement with the Department of Health Services for participation in the
Medi-Cal program. Facilities
Notes
2. Amendment filed 1-18-74; effective thirtieth day thereafter (Register 74, No. 3).
3. Repealer and new section filed 7-16-75 as an emergency; effective upon filing (Register 75, No. 29).
4. Certificate of Compliance filed 11-12-75 (Register 75, No. 46).
5. Amendment filed 6-22-87; operative 7-22-87 (Register 87, No. 27).
6. Amendment filed 10-1-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted to OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 10-1-90 order including amendment of subsection (a)(2) transmitted to OAL 1-29-91, filed 2-28-91 (Register 91, No. 13).
Note: Authority cited: Sections 14105 and 14124.5, Welfare and Institutions Code; and Section 13, Chapter 502; Statutes of 1990. Reference: Sections 14110 and 14132, Welfare and Institutions Code.
2. Amendment filed 1-18-74; effective thirtieth day thereafter (Register 74, No. 3).
3. Repealer and new section filed 7-16-75 as an emergency; effective upon filing (Register 75, No. 29).
4. Certificate of Compliance filed 11-12-75 (Register 75, No. 46).
5. Amendment filed 6-22-87; operative 7-22-87 (Register 87, No. 27).
6. Amendment filed 10-1-90 as an emergency; operative 10-1-90 (Register 90, No. 45). A Certificate of Compliance must be transmitted to OAL by 1-29-91 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 10-1-90 order including amendment of subsection (a)(2) transmitted to OAL 1-29-91, filed 2-28-91 (Register 91, No. 13).
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