§ 131D-4.2. Adult care homes; family care homes; annual cost reports; exemptions; enforcement. - North Carolina Statutes

§ 131D‑4.2.  Adult carehomes; family care homes; annual cost reports; exemptions; enforcement.

(a)        Except for familycare homes, adult care homes with a licensed capacity of seven to twenty beds,which are licensed pursuant to this Chapter, to Chapter 122C of the GeneralStatutes, and to Chapter 131E of the General Statutes, shall submit auditedreports of actual costs to the Department at least every two years inaccordance with rules adopted by the Department under G.S. 143B‑10. Foryears in which an audited report of actual costs is not required, an annualcost report shall be submitted to the Department in accordance with rulesadopted by the Department under G.S. 143B‑10. Adult care homes licensedunder Chapter 131D of the General Statutes that have special care units shallinclude in reports required under this subsection cost reports specific to thespecial care unit and shall not average special care costs with other costs ofthe adult care home.

(b)        Except for familycare homes, adult care homes with a licensed capacity of twenty‑one bedsor more, which are licensed pursuant to this Chapter, to Chapter 122C of theGeneral Statutes, and to Chapter 131E of the General Statutes, shall submitannual audited reports of actual costs to the Department of Health and HumanServices, in accordance with rules adopted by the Department under G.S. 143B‑10.Adult care homes licensed under Chapter 131D of the General Statutes that havespecial care units shall include in the reports required under this subsectioncost reports specific to the special care unit and shall not average specialcare costs with other costs of the adult care home.

(c)        Repealed by SessionLaws 1999‑334, s. 3.1.

(d)        Facilities that donot receive State/County Special Assistance or Medicaid personal care areexempt from the reporting requirements of this section.

(e)        Except as otherwiseprovided in this subsection, the annual reporting period for facilitieslicensed pursuant to this Chapter or Chapter 131E of the General Statutes shallbe October 1 through September 30, with the annual report due by the followingDecember 31, unless the Department determines there is good cause for delay.The annual report for combination facilities and free‑standing adult carehome facilities owned and operated by a hospital shall be due 15 days after thehospital's Medicare cost report is due. The annual report for combinationfacilities not owned and operated by a hospital shall be due 15 days after thenursing facility's Medicaid cost report is due. The annual reporting period forfacilities licensed pursuant to Chapter 122C of the General Statutes shall beJuly 1 through June 30, with the annual report due by the following December31, unless the Department determines there is good cause for delay. Under this subsection,good cause is an action that is uncontrollable by the provider. If theDepartment finds good cause for delay, it may extend the deadline for filing areport for up to an additional 30 days.

(f)         The Departmentshall have the authority to conduct audits and review audits submitted pursuantto subsections (a), (b), and (c) above.

(g)        The Departmentshall suspend admissions to facilities that fail to submit annual reports byDecember 31, or by the date established by the Department when good cause fordelay is found pursuant to G.S. 131D‑4.2(e). Suspension of admissionsshall remain in effect until reports are submitted or licenses are suspended orrevoked under subdivision (2) of this subsection. The Department may takeeither or both of the following actions to enforce compliance by a facilitywith this section, or to punish noncompliance:

(1)        Seek a court orderto enforce compliance;

(2)        Suspend or revokethe facility's license, subject to the provisions of Chapter 150B of theGeneral Statutes.

(h)        The reportdocumentation shall be used to adjust the adult care home rate annually, anadjustment that is in addition to the annual standard adjustment for inflationas determined by the Office of State Budget and Management. Rates for familycare homes shall be based on market rate data. The Secretary of Health andHuman Services shall adopt rules for the rate‑setting methodology andaudited cost reports in accordance with G.S. 143B‑10. (1995, c. 449, s. 3; c. 535,s. 10; 1997‑73, ss. 1, 2; 1997‑443, s. 11A.118(a); 1998‑212,s. 12.1A; 1999‑334, ss. 3.1, 3.2; 2000‑140, s. 93.1(a); 2001‑157,s. 1; 2001‑424, s. 12.2(b).)