| (A) A nursing facility's written request for a review must
be made to the DHS Director of Medical Quality Assurance, Office of Programs,
within 10 calendar days after the facility receives notification of its eligibility.
Facility performance data are posted on the DHS QRS website, which is updated
monthly. Providers have the opportunity to see their performance results on
the DHS QRS website during the entire service period. A facility's request
for a review must contain specific documentation supporting its contention
that factual or calculation errors were made which, if corrected, would result
in the facility qualifying for performance-based add-on payment or receiving
performance-based add-on payment in a corrected amount.
(B) The review is:
(i) limited to allegations of factual or calculation errors;
(ii) limited to a review of documentation submitted by the
nursing facility or used by DHS or its designee in making its original determination;
and
(iii) not conducted as an adversary hearing.
(C) DHS or its designee conducts the review as quickly as possible
and makes its decision before disbursing the entire performance-based add-on
fund.
(v) Performance-based add-on payment payee. The performance-based
add-on will be paid to the provider of record at the time that the payment
is made.
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