Article 7.5. Intermediate Care Facilities’ Quality Assurance Fees of California Health And Safety Code >> Division 2. >> Chapter 2. >> Article 7.5.
For purposes of this article, the following definitions shall
(a) (1) "Gross receipts" means gross receipts paid as compensation
for services provided to residents of a designated intermediate care
(2) "Gross receipts" does not mean charitable contributions.
(3) For state and local government owned facilities, "gross
receipts" shall include any contributions from government sources or
General Fund expenditures for the care of residents of a designated
intermediate care facility.
(b) "Eligible facility" means a designated intermediate care
facility that has paid the fee as described in Section 1324.2, for a
particular state fiscal year.
(c) "Designated intermediate care facility" or "facility" means a
facility as defined in subdivision (e), (g), or (h) of Section 1250.
(a) As a condition for participation in the Medi-Cal
program, there shall be imposed each state fiscal year upon the
entire gross receipts of a designated intermediate care facility a
quality assurance fee, as calculated in accordance with subdivision
(b) The quality assurance fee to be paid pursuant to subdivision
(c) of Section 1324.4 shall be an amount determined each quarter of
the state fiscal year by multiplying the facility's gross receipts in
the preceding quarter by 6 percent. For reporting purposes, the
quality assurance fee is considered to be on a cash basis of
(a) On or before August 31 of each year, each designated
intermediate care facility subject to Section 1324.2 shall report to
the department, in a prescribed form, the facility's gross receipts
for the preceding state fiscal year.
(b) On or before the last day of each calendar quarter, each
designated intermediate care facility shall file a report with the
department, in a prescribed form, showing the facility's gross
receipts for the preceding quarter.
(c) A newly licensed care facility, as defined by the department,
shall be exempt from the requirements of subdivision (a) for its year
of operation, but shall complete all requirements of subdivision (b)
for any portion of the quarter in which it commences operations.
(d) The quality assurance fee, as calculated pursuant to
subdivision (b) of Section 1324.2, shall be paid to the department on
or before the last day of the quarter following the quarter for
which the fee is imposed.
(e) The payment of the quality assurance fee a designated
intermediate care facility shall be reported as an allowable cost for
Medi-Cal reimbursement purposes.
(f) The department shall make retrospective adjustments, as
necessary, to the amounts calculated pursuant to subdivision (b) of
Section 1324.2 in order to assure that the facility's aggregate
quality assurance fee for any particular state fiscal year does not
exceed 6 percent of the facility's aggregate annual gross receipts
for that year.
(a) The Director of Health Services, or his or her
designee, shall administer this article.
(b) The director may adopt regulations as are necessary to
implement this article. These regulations may be adopted as emergency
regulations in accordance with the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
For purposes of this article, the adoption of regulations shall be
deemed an emergency and necessary for the immediate preservation of
the public peace, health and safety, or general welfare. The
regulations shall include, but not be limited to, any regulations
necessary for either of the following purposes:
(1) The administration of this article, including the proper
imposition and collection of the quality assurance fee.
(2) The development of any forms necessary to obtain required
information from facilities subject to the quality assurance fee.
(c) As an alternative to subdivision (b), and notwithstanding
Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3
of Title 2 of the Government Code, the director may implement this
article by means of a provider bulletin, or other similar
instructions, without taking regulatory action.
(a) The quality assurance fee assessed and collected
pursuant to this article shall be deposited in the General Fund.
(b) Notwithstanding subdivision (a), commencing August 1, 2013,
the quality assurance fee assessed and collected pursuant to this
article shall be deposited in the Long-Term Care Quality Assurance
Fund established pursuant to Section 1324.9.
(a) The Long-Term Care Quality Assurance Fund is hereby
created in the State Treasury. Moneys in the fund shall be available,
upon appropriation by the Legislature, for expenditure by the State
Department of Health Care Services for the purposes of this article
and Article 7.6 (commencing with Section 1324.20). Notwithstanding
Section 16305.7 of the Government Code, the fund shall contain all
interest and dividends earned on moneys in the fund.
(b) Notwithstanding any other law, beginning August 1, 2013, all
revenues received by the State Department of Health Care Services
categorized by the State Department of Health Care Services as
long-term care quality assurance fees shall be deposited into the
Long-Term Care Quality Assurance Fund. Revenue that shall be
deposited into this fund shall include quality assurance fees imposed
pursuant to this article and quality assurance fees imposed pursuant
to Article 7.6 (commencing with Section 1324.20).
(c) Notwithstanding any other law, the Controller may use the
funds in the Long-Term Care Quality Assurance Fund for cashflow loans
to the General Fund as provided in Sections 16310 and 16381 of the
In addition to the rate of payment that an eligible
facility would otherwise receive for intermediate care facility
services provided to Medi-Cal beneficiaries, an eligible facility
shall receive quarterly supplemental Medi-Cal reimbursement, in an
amount determined by the department.
The supplemental Medi-Cal reimbursement provided by this section
shall be paid to support the facility's quality improvement efforts
and shall be distributed under a payment methodology based on
intermediate care services provided to Medi-Cal patients at the
eligible facility, either on a per diem basis, or on any other
federally permissible basis.
(a) (1) The department shall seek approval from the
federal Centers for Medicare and Medicaid Services for the
implementation of this article.
(2) If after seeking federal approval, federal approval is not
obtained, this article shall not be implemented.
(3) The Director of Health Services may alter the methodology
specified in this article to the extent necessary to meet the
requirements of federal law or regulations, or to obtain federal
(b) If there is a final judicial determination by any court of
appellate jurisdiction or a final determination by the Administrator
of the federal Center for Medicare and Medicaid Services that the
supplemental reimbursement provided by this article shall be made to
any facility not described in this article, this article shall
immediately become inoperative.
In implementing this article, the department may utilize
the services of the Medi-Cal fiscal intermediary through a change
order to the fiscal intermediary contract to administer this program,
consistent with the requirements of Sections 14104.6, 14104.7,
14104.8, and 14104.9 of the Welfare and Institutions Code.