Department of Social Services › 17-311 Cost Related Reimbursement System for Long-Term Care Facilities

Regulations of Connecticut State AgenciesSec. 17-311-103. AdministrationThe administration of the arbitration proceedings shall be conducted jointly by the office of the chief court administrator and the clerk of the superior court of the judicial district wherein the state refer…

Regulations of Connecticut State AgenciesSec. 17-311-104. Rehearing procedureAny provider to which payments are made by the commissioner pursuant to Sec. 17-312 to 17-314 inclusive, which is aggrieved by any decision of the commissioner, may, within ten days after written notice …

Regulations of Connecticut State AgenciesSec. 17-311-105. Conduct of rehearingThe rehearing shall be deemed a contested case, which means a proceeding in the commissioner's disposition of matters delegated to his jurisdiction by law, in which the legal rights, duties or privilege…

Regulations of Connecticut State AgenciesSec. 17-311-106. The decision on rehearingThe commissioner shall render his decision in writing, in accordance with the contested case provisions of Chapter 54 of the General Statutes and regulations referred to above within ninety days of…

Regulations of Connecticut State AgenciesSec. 17-311-107. Commencement of arbitrationIn the event that items of aggrievement are not resolved at the rehearing to the satisfaction of both the commissioner and the provider, then said items shall be submitted to binding arbitration …

Regulations of Connecticut State AgenciesSec. 17-311-108. Institution of arbitrationProceedings for arbitration shall be instituted by filing a request for arbitration in the form of a pleading as prescribed by applicable provisions of the Connecticut Practice Book and the Connec…

Regulations of Connecticut State AgenciesSec. 17-311-109. Position paper of party requesting arbitration; filing of record; memorandum in responseThe provider requesting arbitration shall file together with its request for arbitration a memorandum setting forth its position and c…

Regulations of Connecticut State AgenciesSec. 17-311-11. Scope of proceduresThese rules govern practice and procedure before the commissioner under the applicable laws of the State of Connecticut except as otherwise provided by statute. (Effective March 17, 1983)

Regulations of Connecticut State AgenciesSec. 17-311-110. Appointment of arbitrators by the partiesEach of the parties shall file the name of the person which the provider and the commissioner has designated as the arbitrator. Each of the parties will file together with the name …

Regulations of Connecticut State AgenciesSec. 17-311-111. Appointment of arbitrator; qualificationsThe chief court administrator may appoint one or more state referees as permanent arbitrators to serve in the arbitration of disputes referred to arbitration panels in accordance wi…

Regulations of Connecticut State AgenciesSec. 17-311-112. Scope of reviewThe arbitration board shall confine itself to a review of the record. The arbitration board shall not substitute its judgment for that of the department as to the weight of the evidence on questions of fact.…

Regulations of Connecticut State AgenciesSec. 17-311-113. Oral argument; time and place; adjournmentThe arbitrators shall appoint a time and place for oral argument based on the record and notify the parties thereof and, on application of either party and for good cause shown, sh…

Regulations of Connecticut State AgenciesSec. 17-311-114. Stay of department rehearing decision pending arbitration board's review of the recordThe institution of the arbitration proceeding pursuant to these regulations shall not of itself stay enforcement of the department's reh…

Regulations of Connecticut State AgenciesSec. 17-311-115. Representation by counselEither party may be represented in the arbitration proceeding by counsel or by other authorized representatives. (Effective June 2, 1986)

Regulations of Connecticut State AgenciesSec. 17-311-116. Stenographic recordWhenever a stenographic record is requested by one or more parties, the arbitration panel will arrange for a stenographer. The total cost of the transcript shall be paid by the requesting party. (Effecti…

Regulations of Connecticut State AgenciesSec. 17-311-117. Attendance at hearingsPersons having a direct interest in the arbitration, including representatives of certified collective bargaining agents at the institution are entitled to attend and observe arbitration proceedings. …

Regulations of Connecticut State AgenciesSec. 17-311-118. Majority decisionAll decisions of the arbitrators shall be by majority vote.(Effective June 2, 1986)

Regulations of Connecticut State AgenciesSec. 17-311-119. Subsequent court proceedingsThe provisions of section 52-417 through section 52-424, inclusive, are herewith incorporated by reference as if fully set forth for the purpose of governing any judicial proceedings subsequent …

Regulations of Connecticut State AgenciesSec. 17-311-12. DefinitionsThe definitions provided by 4-166 and 17-311 G.S. shall govern the interpretation and application of these rules. In addition thereto and except as otherwise required by the context: (a) \"Commissioner\" means th…

Regulations of Connecticut State AgenciesSec. 17-311-120. Aggrieved provider's choice of remedy to contest Sec. 17-311 (b) final administrative rate rehearing decisionAs an alternative remedy to the arbitration process set forth in Sec. 17-311-107 to Sec. 17-311-119 supra, a prov…

Regulations of Connecticut State AgenciesSec. 17-311-127—17-311-159. Reserved

Regulations of Connecticut State AgenciesSec. 17-311-13. Waiver of rulesWhere good cause appears, the commissioner may permit deviation from these rules, except where precluded by statute. (Effective March 17, 1983)

Regulations of Connecticut State AgenciesSec. 17-311-14. Construction and amendmentThese rules shall be so construed by the commissioner as to secure just and expeditious determination of the issues presented hereunder. Amendments and additions to these rules may be adopted by th…

Regulations of Connecticut State AgenciesSec. 17-311-15. Computation of timeComputation of any period of time referred to in these rules begins with the first day following that on which the act which initiates such period of time occurs and ends on the last day of the period so …

Regulations of Connecticut State AgenciesSec. 17-311-16. Extensions of timeAt the discretion of the commissioner for good cause shown, any time limit prescribed or allowed by these rules may be extended. All requests for extensions shall be made before the expiration of the perio…

Regulations of Connecticut State AgenciesSec. 17-311-160. Maximun allowable charges to self-pay patients(a) Effective July 1, 1980, and annually thereafter, the Commissioner of Income Maintenance (hereinafter referred to as Commissioner) shall authorize the maximum allowable char…

Regulations of Connecticut State AgenciesSec. 17-311-161. Self-pay charges for routine servicesSelf-pay charges for routine services shall be established for each facility individually and for each level of care provided by such facility in accordance with the following method: (…

Regulations of Connecticut State AgenciesSec. 17-311-162. Self-pay charges for ancillary services(a) Ancillary services means those charges to patients which are directly identifiable as customary medical services rendered to individual patients, and furnished at the direction of…

Regulations of Connecticut State AgenciesSec. 17-311-163. Unauthorized charges to self-pay patients(a) Any facility which is found by the commissioner to have overcharged its self-pay patients, is issued a demand by the commissioner pursuant to subsection (c), and fails to rectif…

Regulations of Connecticut State AgenciesSec. 17-311-164. Field audit and other rate adjustments(a) Every facility for which self-pay charges are established may be audited as deemed necessary by the commissioner. Therefore, each facility shall maintain all supporting expenditure…

Regulations of Connecticut State AgenciesSec. 17-311-165. Hearings(a) Prior to the setting of the self-pay charges on July 1 each year, the Commissioner shall hold public hearings at various locations around the state after first giving notice as provided hereinafter. The Commiss…

Regulations of Connecticut State AgenciesSec. 17-311-166. Notification and hearings(a) The commissioner shall send a notice by mail to each facility, informing the facility of the commissioner's decision with respect to the self-pay charges approved, and the percentage of increas…

Regulations of Connecticut State AgenciesSec. 17-311-167. Requests for increases in self-pay charges(a) In the event of any unforeseen or material change in circumstances, a facility may submit an application for an increase in the self-pay charges established by the commissioner…

Regulations of Connecticut State AgenciesSec. 17-311-168. Requirements for filing annual reports(a) All facilities having 10 or more beds must file the annual report utilized by the commissioner of income maintenance in determining rates pursuant to section 17-314 of the general …

Regulations of Connecticut State AgenciesSec. 17-311-169. Self-pay charges for newly constructed or acquired facilities(a) Self-pay charges for newly constructed or acquired facilities shall be established in accordance with section 17-311-161 on the basis of the State rates for …

Regulations of Connecticut State AgenciesSec. 17-311-17. Effect of filing, public records(a) The filing with the commissioner of any application, request for advisory ruling, petition, or request of any nature whatsoever shall not relieve any person of the obligation to comply wi…

Regulations of Connecticut State AgenciesSec. 17-311-170—17-311-199. Reserved

Regulations of Connecticut State AgenciesSec. 17-311-18. Consolidation of proceedingsProceedings involving related questions of law or fact may be consolidated by the commissioner. (Effective March 17, 1983)

Regulations of Connecticut State AgenciesSec. 17-311-19. Rules of conductWhere applicable, the canons of professional ethics and the canons of judicial ethics adopted and approved by the judges of the Superior Court govern the conduct of the Commissioner; the state employees serv…

Regulations of Connecticut State AgenciesSec. 17-311-2. FunctionsThe commissioner has the duty of establishing annually the cost of services for which payment is to be made to facilities receiving appropriations granted by the General Assembly as set forth in 17-312 G.S. through …

Regulations of Connecticut State AgenciesSec. 17-311-20. Ex parte communicationUnless required for the disposition of matters ex parte authorized by law, the commissioner shall not communicate directly or indirectly with any party or intervenor concerning any issue of fact or law…

Regulations of Connecticut State AgenciesSec. 17-311-200. DefinitionsFor purposes of the enforcement of Section 19a-533 of the General Statutes of Connecticut, and as implemented by Sections 17-311-200 through 17-311-209 of the Regulations of Connecticut State Agencies, the follo…

Regulations of Connecticut State AgenciesSec. 17-311-201. Prohibition of discrimination against indigent applicantsA nursing home which receives payment from the state for rendering care to indigent persons shall be prohibited from discriminating against indigent persons who appl…

Regulations of Connecticut State AgenciesSec. 17-311-202. Admission in order of application of all applicantsA nursing home which receives payment from the state for rendering care to indigent persons shall admit all applicants for admission to such facility (i.e. indigents, Self…

Regulations of Connecticut State AgenciesSec. 17-311-203. Provision of receiptsEach nursing home shall provide a receipt to all applicants for admission as defined supra. Nursing homes shall ask all applicants whether they desire to receive a receipt and be placed on the dated li…

Regulations of Connecticut State AgenciesSec. 17-311-204. Maintenance of dated list of applicationsWhen a person indicates a desire to be admitted into a nursing home, his name shall be placed immediately on the facility's dated list of applications. Such dated list of applicatio…

Regulations of Connecticut State AgenciesSec. 17-311-205. Mailing of written application to persons on dated list of applications(a) Within two (2) business days after such initial contact, the facility shall mail its written application form to such person or his representative.…