| (D) An acceptable Annual Staffing and Compensation
Report for the reporting period was received by HHSC Rate Analysis
at least 30 days prior to the date distribution of available reinvestment
funds was determined.
(E) The Medicaid contract that was in effect for the
facility during the reinvestment reporting period is still in effect
as an active contract when reinvestment is determined or, in cases
where a change of ownership has occurred, HHSC or its designee has
approved a Successor Liability Agreement between the contract in effect
during the reinvestment reporting period and the contract in effect
when reinvestment is determined.
(2) Distribution of available reinvestment funds. Available
funds are distributed as described below.
(A) HHSC determines units of service provided during
the most recent completed reporting period by each qualifying facility
achieving, with unadjusted LVN-equivalent minutes as determined in
subsection (m)(1) of this section, each enhancement option above the
enhancement option awarded to the facility during the reporting period
and multiplies this number by the rate add-on associated with that
enhancement in effect during the reporting period.
(B) HHSC compares the sum of the products from subparagraph
(A) of this paragraph to funds available for reinvestment.
(i) If the product is less than or equal to available
funds, all achieved enhancements for qualifying facilities are retroactively
awarded for the reporting period.
(ii) If the product is greater than available funds,
retroactive enhancements are granted beginning with the lowest level
of enhancement and granting each successive level of enhancement until
achieved enhancements are granted within available funds.
(3) All retroactive enhancements are subject to spending
requirements detailed in subsection (o) of this section. Revenue from
retroactive enhancements is not eligible for mitigation of spending
recoupment as described in subsection (p) of this section.
(4) Retroactively awarded enhancements do not qualify
as pre-existing enhancements for enrollment purposes.
(5) Notification of reinvested enhancements. Qualifying
facilities are notified in a manner determined by HHSC, as to the
award of reinvested enhancements.
(dd) Disclaimer. Nothing in these rules should be construed
as preventing facilities from adding direct care staff in addition
to those funded by the enhanced direct care staff rate.
(ee) Notification of lack of available funds. If HHSC
determines that funds are not available to continue participation
for facilities from which it has not received an acceptable request
to modify their enrollment by the last day of an enrollment period
as per subsection (d) of this section or to fund carry-over enhancements
as per subsection (j)(3) of this section, HHSC will notify providers
in a manner determined by HHSC that such funds are not available.
|
| Source Note: The provisions of this §355.308 adopted to be effective May 1, 2000, 25 TexReg 3517; amended to be effective January 1, 2001, 25 TexReg 12641; amended to be effective December 1, 2001, 26 TexReg 9565; amended to be effective January 7, 2003, 28 TexReg 59; amended to be effective May 29, 2003, 28 TexReg 4097; amended to be effective September 1, 2003, 28 TexReg 7306; amended to be effective June 6, 2004, 29 TexReg 5594; amended to be effective January 9, 2005, 29 TexReg 12128; amended to be effective August 21, 2008, 33 TexReg 6569; amended to be effective November 8, 2009, 34 TexReg 7594; amended to beeffective September 1, 2011, 36 TexReg 3706; amended to be effective April 1, 2012, 37 TexReg 2068; amended to be effective November 25, 2012, 37 TexReg 9086; amended to be effective January 1, 2015, 39 TexReg 9193; amended to be effective July 1, 2017, 42 TexReg 3267 |
