30:4D-7ll.3 Nursing facility, reimbursement, traumatic brain injury, NJ FamilyCare beneficiary, single-occupancy room.
316 words·~1 min read·
/nj/title-30/chapter-4d/30-4d-7ll-3·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
3. a. The division shall reimburse a nursing facility for services provided to a NJ FamilyCare beneficiary residing in a single-occupancy room at an enhanced per diem reimbursement rate equal to 150 percent of the nursing facility's base per diem reimbursement rate, provided that, on any date after the effective date of this act, the nursing facility voluntarily delicensed beds in order to establish the single-occupancy room in which the beneficiary resides.
b. Reimbursements received under this section by a nursing facility that are in excess of the facility's base per diem reimbursement rate shall be utilized by the facility for the following purposes:
(1)renovation costs to convert multiple-occupancy rooms to single-occupancy rooms;
(2)establishment and implementation of infection control policies and infrastructure, particularly for any remaining multiple-occupancy rooms; and
(3)compensation for revenue losses due to the facility's decreased census.
c. Issuance of the enhanced reimbursement per diem rate established in subsection a. of this section shall be contingent upon the following:
(1)The nursing facility submits a proposed plan to, and receives approval from, the Department of Human Services and the Department of Health regarding the voluntary delicensing of beds. The plan shall include a description of the facility's use of reimbursement payments received under this section in excess of the facility's base rate; and
(2)The nursing facility is in compliance with all applicable State and federal laws and regulations concerning licensure, patient safety, and quality of care.
d. The Commissioners of Human Services and Health shall establish a method and manner for nursing facilities to submit plans, as required under paragraph
(1)of subsection c. of this section. The evaluation of a nursing facility's plan shall include metrics for ensuring that the voluntary delicensing of beds at a nursing facility does not negatively affect the ability of the NJ FamilyCare program to provide nursing facility services to enrollees.
L.2023, c.181, s.3.