S.C. Code Regs. § § 61-95.103

Current through Register Vol. 48, 12, December 27, 2024

Section 61-95.103 - PENALTIES

A. The Department shall request quarterly reports from the State Health and Human Services Finance Commission, indicating the number of Medicaid patient days for which Medicaid reimbursement was received by each nursing home. Based on these reports, the Department will determine each nursing home's compliance with its Medicaid nursing home permit.

B. Nursing homes shall be subject to a penalty for violating these regulations. Violations include:

(1) a nursing home exceeding by more than ten (10) percent the number of Medicaid patient days stated in its permit;

(2) a nursing home failing to provide at least ninety (90) percent of the number of Medicaid patient days stated in its permit;

(3) the provision of any Medicaid patient days by a nursing home without a Medicaid nursing home permit.

C. Each Medicaid patient day above or below the allowable range is considered to be a separate violation. The Department may levy a fine not to exceed the facility's average rate per Medicaid patient day times each violation.

S.C. Code Regs. § 61-95.103