[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR51.30]

[Page 821-822]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 51--PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES--Table 
of Contents
 
   Subpart B--Obtaining Per Diem for Nursing Home Care in State Homes
 
Sec. 51.30  Recognition and certification.

    (a)(1) The Under Secretary for Health will make the determination 
regarding recognition and the initial determination regarding 
certification, after receipt of a tentative determination from the 
director of the VA medical center of jurisdiction regarding whether, 
based on a VA survey, the facility and facility management meet or do 
not meet the standards of subpart D of this part. The Under Secretary 
for Health will notify the official in charge of the facility, the State 
official authorized to oversee operations of the State home, the VA 
Network Director (10N 1-22), Chief Network Officer (10N), and the Chief 
Consultant, Geriatrics and Extended Care Strategic Healthcare Group 
(114) of the action taken.
    (2) For each facility recognized as a State home, the director of 
the VA medical center of jurisdiction will certify annually whether the 
facility and facility management meet, provisionally meet, or do not 
meet the standards of subpart D of this part (this certification should 
be made every 12 months during the recognition anniversary month or 
during a month agreed upon by the VA medical care center director and 
officials of the State home facility). A provisional certification will 
be issued by the director only upon a determination that the facility or 
facility management does not meet one or more of the standards in 
subpart D, that the deficiencies do not jeopardize the health or safety 
of the residents, and that the facility management and the director have 
agreed to a plan of correction to remedy the deficiencies in a specified 
amount of time (not more time than the VA medical center of jurisdiction 
director determines is reasonable for correcting the specific 
deficiencies). The director of the VA medical center of jurisdiction 
will notify the official in charge of the facility, the State official 
authorized to oversee the operations of the State home, the VA Network 
Director (10N 1-22), Chief Network Officer (10N) and the Chief 
Consultant, Geriatrics and Extended Care Strategic Healthcare Group 
(114) of the certification, provisional certification, or 
noncertification.
    (b) Once a facility has achieved recognition, the recognition will 
remain in effect unless the State requests that the recognition be 
withdrawn or the Under Secretary for Health makes a final decision that 
the facility or facility management does not meet the standards of 
subpart D. Recognition of

[[Page 822]]

a facility will apply only to the facility as it exists at the time of 
recognition; any annex, branch, enlargement, expansion, or relocation 
must be separately recognized.
    (c) Both during the application process for recognition and after 
the Under Secretary for Health has recognized a facility, VA may survey 
the facility as necessary to determine if the facility and facility 
management comply with the provisions of this part. Generally, VA will 
provide advance notice to the State before a survey occurs; however, 
surveys may be conducted without notice. A survey, as necessary, will 
cover all parts of the facility, and include a review and audit of all 
records of the facility that have a bearing on compliance with any of 
the requirements of this part (including any reports from State or local 
entities). For purposes of a survey, at the request of the director of 
the VA medical center of jurisdiction, the State home facility 
management must submit to the director a completed VA Form 10-3567, 
Staffing Profile, set forth at Sec. 58.10 of this chapter. The director 
of the VA medical center of jurisdiction will designate the VA officials 
to survey the facility. These officials may include physicians; nurses; 
pharmacists; dietitians; rehabilitation therapists; social workers; 
representatives from health administration, engineering, environmental 
management systems, and fiscal officers.
    (d) If the director of the VA medical center of jurisdiction 
determines that the State home facility or facility management does not 
meet the standards of this part, the director will notify the State home 
facility in writing of the standards not met. The director will send a 
copy of this notice to the State official authorized to oversee 
operations of the facility, the VA Network Director (10N 1-22), the 
Chief Network Officer (10N), and the Chief Consultant, Geriatrics and 
Extended Care Strategic Healthcare Group (114). The letter will include 
the reasons for the decision and indicate that the State has the right 
to appeal the decision.
    (e) The State must submit the appeal to the Under Secretary for 
Health in writing, within 30 days of receipt of the notice of failure to 
meet the standards. In its appeal, the State must explain why the 
determination is inaccurate or incomplete and provide any new and 
relevant information not previously considered. Any appeal that does not 
identify a reason for disagreement will be returned to the sender 
without further consideration.
    (f) After reviewing the matter, including any relevant supporting 
documentation, the Under Secretary for Health will issue a written 
determination that affirms or reverses the previous determination. If 
the Under Secretary for Health decides that the facility does not meet 
the standards of subpart D of this part, the Under Secretary for Health 
will withdraw recognition and stop paying per diem for care provided on 
and after the date of the decision. The decision of Under Secretary for 
Health will constitute a final VA decision. The Under Secretary for 
Health will send a copy of this decision to the State home facility and 
to the State official authorized to oversee the operations of the State 
home.
    (g) In the event that a VA survey team or other VA medical center 
staff identifies any condition that poses an immediate threat to public 
or patient safety or other information indicating the existence of such 
a threat, the director of VA medical center of jurisdiction will 
immediately report this to the VA Network Director (10N 1-22), Chief 
Network Officer (10N), Chief Consultant, Geriatrics and Extended Care 
Strategic Healthcare Group (114) and State official authorized to 
oversee operations of the State home.

(Authority: 38 U.S.C. 101, 501, 1710, 1741-1743)