State Budget and Payment for Expenses

7213.8 - State Budget and Payment for Expenses (Rev. 118, Issued: 06-12-14, Effective: 01-01-12, Implementation: 01-01-12) Costs incurred by the State survey agency for conducting Independent IDRs are eligible for federal funding using standard cost allocation principles. If the State has a State law or regulation that obliges the State to offer an Independent IDR, or specifies the manner in which an Independent IDR is to be provided, or who must provide the Independent IDR, then the State must use the existing cost allocation methodology and proportions in place for the State’s surveys of Skilled Nursing Facilities (SNF)/Nursing Facilities (NF), with costs allocated between Medicare, Medicaid, and State-only sources, as appropriate. In all other cases, the costs should be allocated between Medicare and Medicaid using the existing cost allocation methodology and proportions in place for the State’s surveys of Skilled Nursing Facilities (SNF)/Nursing Facilities (NF), but adjusted for the absence of a State-only share (that is, there would not need to be State-only funds beyond the requirement for State match for the Medicaid portion). States may not charge facilities for the Independent IDR process required under 42 C.F.R. §488.431. For deficiencies that are the basis for a CMP which is not collected and placed in escrow under §488.431(b), or for deficiencies that lead to the imposition of another remedy that is not a CMP, a State is not required to provide Independent IDR. In situations where the Independent IDR process is not required but is provided by the State directly at its option, the State may choose to charge a facility a user fee for those processes.