Nursing Facility Requirements for Licensure and Medicaid Certification Handbook
- Subchapter A, Basis and Scope
- Subchapter B, Definitions
- Subchapter C, Nursing Facility Licensure Application Process
- §19.201
- Criteria for Licensing
- §19.202
- Building Approval
- §19.204
- Application Requirements
- §19.205
- Probationary License
- §19.206
- Increase in Capacity
- §19.208
- Renewal Procedures and Qualifications
- §19.209
- Exclusion from Licensure
- §19.210
- Change of Ownership License
- §19.211
- Relocation
- §19.212
- Time Periods for Processing License Applications
- §19.214
- Criteria for Denying a License or Renewal of a License
- §19.215
- Opportunity to Show Compliance
- §19.216
- License Fees
- §19.218
- Method of Payment
- §19.219
- Plan Review Fees
- Subchapter D, Facility Construction
- §19.300
- General Requirements
- §19.301
- Applicable Codes and Standards
- §19.302
- Waivers
- §19.303
- Emergency Power
- §19.304
- Space and Equipment
- §19.305
- Resident Rooms
- §19.306
- Toilet Facilities
- §19.307
- Resident Call System
- §19.308
- Dining and Resident Activities
- §19.309
- Other Environmental Conditions
- §19.310
- Site and Grounds
- §19.311
- Fire Service and Access
- §19.312
- Means of Egress
- §19.313
- Interior Finishes - Walls, Ceilings, and Floors
- §19.314
- Fire Alarms, Detection Systems, and Sprinkler Systems
- §19.315
- Portable Fire Extinguishers
- §19.316
- Subdivision of Building Spaces — Smoke Barriers
- §19.317
- Elevators and Escalators
- §19.318
- Other Rooms and Areas
- §19.319
- Provisions for Persons with Disabilities
- §19.320
- Lighting and Illumination
- §19.321
- Heating, Ventilating, and Air-conditioning Systems (HVAC)
- §19.322
- Plumbing
- §19.323
- Housekeeping Services
- §19.324
- Pest Control
- §19.325
- Linen
- §19.326
- Safety Operations
- §19.330
- Construction and Initial Survey of Completed Construction
- §19.331
- Construction Standards for Additions, Remodeling, and New Nursing Facilities
- §19.332
- Location and Site
- §19.333
- General Considerations
- §19.334
- Architectural Space Planning and Utilization
- §19.335
- Exit Provisions
- §19.336
- Smoke Compartmentation (Subdivision of Building Spaces)
- §19.337
- Fire Protection Systems
- §19.338
- Hazardous Areas
- §19.339
- Structural Requirements
- §19.340
- Mechanical Requirements
- §19.341
- Electrical Requirements
- §19.342
- Miscellaneous Details
- §19.343
- Elevators
- §19.344
- Plans, Approvals, and Construction Procedures
- Subchapter E, Resident Rights
- §19.401
- Introduction
- §19.402
- Exercise of Rights
- §19.403
- Notice of Rights and Services
- §19.404
- Protection of Resident Funds
- §19.405
- Additional Requirements for Trust Funds in Medicaid-Certified Facilities
- §19.406
- Free Choice
- §19.407
- Privacy and Confidentiality
- §19.408
- Grievances
- §19.409
- Examination of Survey Results
- §19.410
- Refunds in Medicaid-Certified Facilities
- §19.411
- Work
- §19.412
- §19.413
- Access and Visitation Rights
- §19.414
- Telephone
- §19.415
- Postmortem Procedures
- §19.416
- Personal Property
- §19.417
- Married Couples
- §19.418
- Self-Administration of Drugs
- §19.419
- Advance Directives
- §19.420
- Documentation for the Delegation of Long-Term Care Resident's Rights
- §19.421
- Refusal of Certain Transfers in Medicaid-Certified Facilities
- §19.422
- Authorized Electronic Monitoring (AEM)
- §19.423
- Model Drug Testing Policy
- Subchapter F, Admission, Transfer, and Discharge Rights In Medicaid-Certified Facilities
- §19.501
- Admissions Policy for Medicaid-Certified Facilities
- §19.502
- Transfer and Discharge in Medicaid-Certified Facilities
- §19.503
- Notice of Bed-Hold Policy and Readmission in Medicaid-Certified Facilities
- §19.504
- Equal Access to Quality Care in Medicaid-Certified Facilities
- §19.505
- Discharge Planning in Medicaid-Certified Facilities
- Subchapter G, Resident Behavior and Facility Practice
- Subchapter H, Quality of Life
- Subchapter I, Resident Assessment
- Subchapter J, Quality of Care
- Subchapter K, Nursing Services
- Subchapter L, Dietary Services
- §19.1101
- Dietary Service
- §19.1102
- Staffing
- §19.1103
- Sufficient Staffing
- §19.1104
- Dietary Consultant Requirements
- §19.1107
- Menus and Nutritional Adequacy
- §19.1108
- Food
- §19.1109
- Food Intake
- §19.1110
- Frequency of Meals
- §19.1111
- Sanitary Conditions
- §19.1113
- Paid Feeding Assistants
- §19.1115
- Requirements for Training of Paid Feeding Assistants
- Subchapter M, Physician Services
- §19.1201
- Physician Services
- §19.1202
- Physician Visits
- §19.1203
- Frequency of Physician Visits
- §19.1204
- Availability of Physician for Emergency Care
- §19.1205
- Physician Delegation of Tasks
- §19.1206
- Physician Signatures
- §19.1207
- Prescription of Psychoactive Medication
- §19.1208
- Physicians' Reporting Communicable Diseases
- §19.1210
- Certification and Recertification Requirements in Medicaid-Certified Facilities
- Subchapter N, Rehabilitative Services
- Subchapter O, Dental Services
- Subchapter P, Pharmacy Services
- Subchapter Q, Infection Control
- Subchapter R, Physical Plant and Environment
- Subchapter T, Administration
- §19.1901
- Administration
- §19.1902
- Governing Body
- §19.1903
- Required Training of Nurse Aides
- §19.1904
- Proficiency of Nurse Aides
- §19.1905
- Staff Qualifications
- §19.1906
- Use of Outside Resources
- §19.1907
- Medical Director
- §19.1908
- Laboratory Services
- §19.1909
- Radiology and Other Diagnostic Services
- §19.1910
- Clinical Records
- §19.1911
- Contents of the Clinical Record
- §19.1912
- Additional Clinical Record Service Requirements
- §19.1913
- Clinical Records Service Supervisor
- §19.1914
- Disaster and Emergency Preparedness
- §19.1915
- Transfer Agreement
- §19.1916
- Respite Care
- §19.1917
- Quality Assessment and Assurance
- §19.1918
- Disclosure of Ownership
- §19.1919
- Right to Possession
- §19.1920
- Operating Policies and Procedures
- §19.1921
- General Requirements for a Nursing Facility
- §19.1922
- Resident Care Policies
- §19.1923
- Incident or Accident Reporting
- §19.1924
- Financial Records
- §19.1925
- Financial Condition
- §19.1926
- Medicaid Hospice Services
- §19.1928
- Volunteer Program
- §19.1929
- Staff Development
- §19.1930
- Blood and Blood Products
- §19.1934
- Educational Requirements for Persons under Age 22
- Subchapter U, Inspections, Surveys, and Visits
- §19.2002
- Procedural Requirements - Licensure Inspections and Surveys
- §19.2004
- Determinations and Actions Pursuant to Inspections
- §19.2006
- Reporting Incidents and Complaints
- §19.2008
- Investigations of Incidents and Complaints
- §19.2009
- Hearings on Complaints of Resident Neglect and Abuse, and Misappropriation of Resident Property in Medicaid-Certified Facilities
- §19.2010
- General Provisions
- §19.2011
- Procedures for Inspection of Public Records
- Subchapter V, Enforcement
- §19.2103
- Warning Letter
- §19.2104
- Suspension of a License
- §19.2106
- Revocation of a License
- §19.2108
- Emergency Suspension and Closing Order
- §19.2110
- Referral to the Attorney General
- §19.2111
- Suspension of Admissions
- §19.2112
- Administrative Penalties
- §19.2114
- Right to Correct
- §19.2115
- Amelioration of Violation
- §19.2116
- Involuntary Appointment of a Trustee
- §19.2118
- Appointment of a Trustee by Agreement
- §19.2119
- Open Hearing
- §19.2120
- Definitions Pertaining to Medicaid Remedies
- §19.2121
- General Provisions
- §19.2129
- Interest on Civil Money Penalties
- §19.2144
- Procedures Following Termination of the Provider Agreement
- §19.2146
- Termination of Provider Agreement on the Basis of the Imposition of Enforcement Actions Three Times Within an Accountability Period
- §19.2147
- Informal Dispute Resolution
- §19.2148
- Arbitration
- §19.2149
- Exclusions
- §19.2150
- Fraud Referral
- §19.2151
- Construction
- Subchapter W, Certification of Facilities for Care of Persons with Alzheimer's Disease and Related Disorders
- Subchapter X, Requirements Form Medicaid-Certified Facilities
- §19.2301
- Conditions for Participation as a Medicaid-Certified Facility
- §19.2302
- Requirements for a Contracted Medicaid Facility
- §19.2304
- Contract Requirements
- §19.2306
- Effective Dates of Provider Contracts
- §19.2308
- Change of Ownership
- §19.2310
- Nursing Facility Ceases to Participate
- §19.2312
- Surety Bonds or Letters of Credit
- §19.2314
- Financial Audits
- §19.2316
- Collection of Applied Income
- §19.2318
- Computation of Daily Reimbursement Rate for Recipients with Applied Income
- §19.2320
- Medical Transportation
- §19.2322
- Medicaid Bed Allocation Requirements
- §19.2324
- Selection and Contracting Procedures for Adding Medicaid Beds in High-Occupancy Areas
- §19.2326
- Medicaid Swing Bed Program for Rural Hospitals
- Subchapter Y, Medical Review and Re-Evaluation
- Subchapter Z, Preadmission Screening and Resident Review (PASARR)
- Subchapter AA, Vendor Payment
- §19.2601
- Vendor Payment (Items and Services Included)
- §19.2602
- Additional Charges (Items and Services Excluded from Vendor Payment)
- §19.2603
- Therapeutic Home Visits Away from the Facility
- §19.2604
- Vendor Payment Information
- §19.2605
- Effective Date of Vendor Coverage
- §19.2606
- Supplementation of Vendor Payments
- §19.2607
- Penalties for Supplementation
- §19.2608
- Limitations on Provider Charges
- §19.2609
- Payment of Claims
- §19.2610
- Medicare Part A Skilled Nursing Facility Deductible and Coinsurance Payment
- §19.2611
- Retroactive Vendor Payment
- §19.2612
- Quality Incentive Payment
- §19.2613
- Augmentative Communication Device Systems
- §19.2614
- Customized Power Wheelchairs
- §19.2615
- Resident Transaction Notices
Chapter 19
Division 1,
Enforcement Generally
Division 2,
Licensing Remedies
Division 3,
Remedies in Medicaid-Certified Facilities