101 CMR 512.03 - Facility Groups

(1) Nursing facility user fee payment liability will vary by facility group. The two groups of facilities for purposes of 101 CMR 512.00 are defined in 101 CMR 512.03(1)(a) and (b):

(a) Group I: All facilities that do not meet the criteria for group II, and;

(b) Group II: Any nursing facility meeting one or more of the following criteria:

1. a non-profit continuing care retirement community or non-profit residential care facility;

2. a non-profit facility that provides at least 39,000 annual Medicaid bed days, as determined by EOHHS; or

3. a facility with a Medicaid utilization rate of 87% or higher, as determined by EOHHS.

(2) New facilities that come into operation subsequent to the effective date of EOHHS's approved waiver under 42 CFR 433.68(e)(2), or facilities otherwise not included in the approved waiver application, will be considered Group I facilities until EOHHS determines the facility's group eligibility. Facilities that undergo a change in status that alters their group eligibility subsequent to January 1, 2023, will remain in their original group until EOHHS determines eligibility. If the determination of eligibility for a new facility or a facility's change in status would result in noncompliance with EOHHS's approved federal waiver, the facility will remain in its current group until such time as EOHHS is able to amend its approved waiver.

Notes

101 CMR 512.03

Adopted by Mass Register Issue 1329, eff. 12/30/2016. Amended by Mass Register Issue 1487, eff. 1/1/2023 (EMERGENCY). Amended by Mass Register Issue 1491, eff. 3/17/2023.