{"data":{"id":"us-ok/okla.-stat.-tit.-56-56-2002","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 56, § 56-2002","heading":"Nursing Facilities Quality of Care Fee","body":"A. For the purpose of providing quality care enhancements, the\n\nOklahoma Health Care Authority is authorized to and shall assess a\n\nNursing Facilities Quality of Care Fee pursuant to this section upon\n\neach nursing facility licensed in this state. Facilities operated\n\nby the Oklahoma Department of Veterans Affairs shall be exempt from\n\nthis fee. Quality of care enhancements include, but are not limited\n\nto, the purposes specified in this section.\n\nB. As a basis for determining the Nursing Facilities Quality of\n\nCare Fee assessed upon each licensed nursing facility, the Authority\n\nshall calculate a uniform per-patient day rate. The rate shall be\n\ncalculated by dividing six percent (6%) of the total annual patient\n\ngross receipts of all licensed nursing facilities in this state by\n\nthe total number of patient days for all licensed nursing facilities\n\nin this state. The result shall be the per-patient day rate.\n\nBeginning July 15, 2004, the Nursing Facilities Quality of Care Fee\n\nshall not be increased unless specifically authorized by the\n\nLegislature.\n\nC. Pursuant to any approved Medicaid waiver and pursuant to\n\nsubsection N of this section, the Nursing Facilities Quality of Care\n\nFee shall not exceed the amount or rate allowed by federal law for\n\nnursing home licensed bed days.\n\nD. The Nursing Facilities Quality of Care Fee owed by a\n\nlicensed nursing facility shall be calculated by the Authority by\n\nadding the daily patient census of a licensed nursing facility, as\n\nreported by the facility for each day of the month, and by\n\nmultiplying the ensuing figure by the per-patient day rate\n\ndetermined pursuant to the provisions of subsection B of this\n\nsection.\n\nE. Each licensed nursing facility which is assessed the Nursing\n\nFacilities Quality of Care Fee shall be required to file a report on\n\na monthly basis with the Authority detailing the daily patient\n\ncensus and patient gross receipts at such time and in such manner as\n\nrequired by the Authority.\n\nF. 1. The Nursing Facilities Quality of Care Fee for a\n\nlicensed nursing facility for the period beginning October 1, 2000,\n\nshall be determined using the daily patient census and annual\n\npatient gross receipts figures reported to the Authority for the\n\ncalendar year 1999 upon forms supplied by the Authority.\n\n2. Annually the Nursing Facilities Quality of Care Fee shall be\n\ndetermined by:\n\na. using the daily patient census and patient gross\n\nreceipts reports received by the Authority for the\n\nmost recent available twelve (12) months, and\n\nb. annualizing those figures.\n\nEach year thereafter, the annualization of the Nursing\n\nFacilities Quality of Care Fee specified in this paragraph shall be\n\nsubject to the limitation in subsection B of this section unless the\n\nprovision of subsection C of this section is met.\n\nG. The payment of the Nursing Facilities Quality of Care Fee by\n\nlicensed nursing facilities shall be an allowable cost for Medicaid\n\nreimbursement purposes.\n\nH. 1. There is hereby created in the State Treasury a\n\nrevolving fund to be designated the “Nursing Facility Quality of\n\nCare Fund”.\n\n2. The fund shall be a continuing fund, not subject to fiscal\n\nyear limitations, and shall consist of:\n\na. all monies received by the Authority pursuant to this\n\nsection and otherwise specified or authorized by law,\n\nb. monies received by the Authority due to federal\n\nfinancial participation pursuant to Title XIX of the\n\nSocial Security Act, and\n\nc. interest attributable to investment of money in the\n\nfund.\n\n3. All monies accruing to the credit of the fund are hereby\n\nappropriated and shall be budgeted and expended by the Authority\n\nfor:\n\na. reimbursement of the additional costs paid to\n\nMedicaid-certified nursing facilities for purposes\n\nspecified by Sections 1-1925.2 and 5022.2 of Title 63\n\nof the Oklahoma Statutes,\n\nb. reimbursement of the Medicaid rate increases for\ng to the credit of the fund are hereby\n\nappropriated and shall be budgeted and expended by the Authority\n\nfor:\n\na. reimbursement of the additional costs paid to\n\nMedicaid-certified nursing facilities for purposes\n\nspecified by Sections 1-1925.2 and 5022.2 of Title 63\n\nof the Oklahoma Statutes,\n\nb. reimbursement of the Medicaid rate increases for\n\nintermediate care facilities for individuals with\n\nintellectual disabilities (ICFs/IID),\n\nc. nonemergency transportation services for Medicaid-\n\neligible nursing home clients,\n\nd. eyeglass and denture services for Medicaid-eligible\n\nnursing home clients,\n\ne. fifteen ombudsmen employed by the Office of the\n\nAttorney General,\n\nf. ten additional nursing facility inspectors employed by\n\nthe State Department of Health,\n\ng. pharmacy and other Medicaid services to qualified\n\nMedicare beneficiaries whose incomes are at or below\n\none hundred percent (100%) of the federal poverty\n\nlevel; provided however, pharmacy benefits authorized\n\nfor such qualified Medicare beneficiaries shall be\n\nsuspended if the federal government subsequently\n\nextends pharmacy benefits to this population,\n\nh. costs incurred by the Authority in the administration\n\nof the provisions of this section and any programs\n\ncreated pursuant to this section,\n\ni. durable medical equipment and supplies services for\n\nMedicaid-eligible elderly adults, and\n\nj. personal needs allowance increases for residents of\n\nnursing homes and Intermediate Care Facilities for\n\nIndividuals with Intellectual Disabilities (ICFs/IID)\n\nfrom Thirty Dollars ($30.00) to Fifty Dollars ($50.00)\n\nper month per resident.\n\n4. Expenditures from the fund shall be made upon warrants\n\nissued by the State Treasurer against claims filed as prescribed by\n\nlaw with the Director of the Office of Management and Enterprise\n\nServices for approval and payment.\n\n5. The fund and the programs specified in this section funded\n\nby revenues collected from the Nursing Facilities Quality of Care\n\nFee pursuant to this section are exempt from budgetary cuts,\n\nreductions, or eliminations.\n\n6. The Medicaid rate increases for intermediate care facilities\n\nfor individuals with intellectual disabilities (ICFs/IID) shall not\n\nexceed the net Medicaid rate increase for nursing facilities\n\nincluding, but not limited to, the Medicaid rate increase for which\n\nMedicaid-certified nursing facilities are eligible due to the\n\nNursing Facilities Quality of Care Fee less the portion of that\n\nincrease attributable to treating the Nursing Facilities Quality of\n\nCare Fee as an allowable cost.\n\n7. The reimbursement rate for nursing facilities shall be made\n\nin accordance with Oklahoma’s Medicaid reimbursement rate\n\nmethodology and the provisions of this section.\n\n8. No nursing facility shall be guaranteed, expressly or\n\notherwise, that any additional costs reimbursed to the facility will\n\nequal or exceed the amount of the Nursing Facilities Quality of Care\n\nFee paid by the nursing facility.\n\nI. 1. In the event that federal financial participation\n\npursuant to Title XIX of the Social Security Act is not available to\n\nthe Oklahoma Medicaid program, for purposes of matching expenditures\n\nfrom the Nursing Facility Quality of Care Fund at the approved\n\nfederal medical assistance percentage for the applicable fiscal\n\nyear, the Nursing Facilities Quality of Care Fee shall be null and\n\nvoid as of the date of the nonavailability of such federal funding,\n\nthrough and during any period of nonavailability.\n\n2. In the event of an invalidation of this section by any court\n\nof last resort under circumstances not covered in subsection J of\n\nthis section, the Nursing Facilities Quality of Care Fee shall be\n\nnull and void as of the effective date of that invalidation.\n\n3. In the event that the Nursing Facilities Quality of Care Fee\n\nis determined to be null and void for any of the reasons enumerated\nlity.\n\n2. In the event of an invalidation of this section by any court\n\nof last resort under circumstances not covered in subsection J of\n\nthis section, the Nursing Facilities Quality of Care Fee shall be\n\nnull and void as of the effective date of that invalidation.\n\n3. In the event that the Nursing Facilities Quality of Care Fee\n\nis determined to be null and void for any of the reasons enumerated\n\nin this subsection, any Nursing Facilities Quality of Care Fee\n\nassessed and collected for any periods after such invalidation shall\n\nbe returned in full within sixty (60) days by the Authority to the\n\nnursing facility from which it was collected.\n\nJ. 1. If any provision of this section or the application\n\nthereof shall be adjudged to be invalid by any court of last resort,\n\nsuch judgment shall not affect, impair or invalidate the provisions\n\nof the section, but shall be confined in its operation to the\n\nprovision thereof directly involved in the controversy in which such\n\njudgment was rendered. The applicability of such provision to other\n\npersons or circumstances shall not be affected thereby.\n\n2. This subsection shall not apply to any judgment that affects\n\nthe rate of the Nursing Facilities Quality of Care Fee, its\n\napplicability to all licensed nursing homes in the state, the usage\n\nof the fee for the purposes prescribed in this section, or the\n\nability of the Authority to obtain full federal participation to\n\nmatch its expenditures of the proceeds of the fee.\n\nK. The Authority shall promulgate rules for the implementation\n\nand enforcement of the Nursing Facilities Quality of Care Fee\n\nestablished by this section.\n\nL. The Authority shall provide for administrative penalties in\n\nthe event nursing facilities fail to:\n\n1. Submit the Quality of Care Fee;\n\n2. Submit the fee in a timely manner;\n\n3. Submit reports as required by this section; or\n\n4. Submit reports timely.\n\nM. As used in this section:\n\n1. “Nursing facility” means any home, establishment or\n\ninstitution, or any portion thereof, licensed by the State\n\nDepartment of Health as defined in Section 1-1902 of Title 63 of the\n\nOklahoma Statutes;\n\n2. “Medicaid” means the medical assistance program established\n\nin Title XIX of the federal Social Security Act and administered in\n\nthis state by the Authority;\n\n3. “Patient gross revenues” means gross revenues received in\n\ncompensation for services provided to residents of nursing\n\nfacilities including, but not limited to, client participation. The\n\nterm “patient gross revenues” shall not include amounts received by\n\nnursing facilities as charitable contributions; and\n\n4. “Additional costs paid to Medicaid-certified nursing\n\nfacilities under Oklahoma’s Medicaid reimbursement methodology”\n\nmeans both state and federal Medicaid expenditures including, but\n\nnot limited to, funds in excess of the aggregate amounts that would\n\notherwise have been paid to Medicaid-certified nursing facilities\n\nunder the Medicaid reimbursement methodology which have been updated\n\nfor inflationary, economic, and regulatory trends and which are in\n\neffect immediately prior to the inception of the Nursing Facilities\n\nQuality of Care Fee.\n\nN. 1. As per any approved federal Medicaid waiver, the\n\nassessment rate subject to the provision of subsection C of this\n\nsection is to remain the same as those rates that were in effect\n\nprior to January 1, 2012, for all state-licensed continuum of care\n\nfacilities.\n\n2. Any facilities that made application to the State Department\n\nof Health to become a licensed continuum of care facility no later\n\nthan January 1, 2012, shall be assessed at the same rate as those\n\nfacilities assessed pursuant to paragraph 1 of this subsection;\n\nprovided, that any facility making the application shall receive the\n\nlicense on or before September 1, 2012. Any facility that fails to\n\nreceive such license from the State Department of Health by\nt\n\nof Health to become a licensed continuum of care facility no later\n\nthan January 1, 2012, shall be assessed at the same rate as those\n\nfacilities assessed pursuant to paragraph 1 of this subsection;\n\nprovided, that any facility making the application shall receive the\n\nlicense on or before September 1, 2012. Any facility that fails to\n\nreceive such license from the State Department of Health by\n\nSeptember 1, 2012, shall be assessed at the rate established by\n\nsubsection C of this section subsequent to September 1, 2012.\n\nO. If any provision of this section, or the application\n\nthereof, is determined by any controlling federal agency, or any\n\ncourt of last resort to prevent the state from obtaining federal\n\nfinancial participation in the state’s Medicaid program, such\n\nprovision shall be deemed null and void as of the date of the\n\nnonavailability of such federal funding and through and during any\n\nperiod of nonavailability. All other provisions of the bill shall\n\nremain valid and enforceable.","path":["OK Code","Title 56"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os56.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"7425e9f3a2dba0de68f066701b37796723619fb7a525c34c29c83e8aa5819728","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-56-56-200.6","next":"us-ok/okla.-stat.-tit.-56-56-2004"},"notice":"GroundRules: Original legal text. Not legal advice."}