Listing of Items Excluded from Universal Settlement Due Sun., March 1

With the State agreeing to proceed with the Universal Settlement of rate appeals and litigation with the nursing home sector, the process has moved to the next steps, which include obtaining CMS approval and entering into a settlement agreement between the State and each owner.

In addition to executing an actual settlement agreement with the State, the Universal Settlement also includes reaching an agreement with the State on a list of those matters (lawsuits and rate appeals) that are excluded from the settlement. If a pending rate appeal or lawsuit is determined to be excluded, it will be deemed not part of the Universal Settlement and will be permitted to proceed. In contrast, if a pending rate appeal or lawsuit is not excluded, it will be deemed settled and discontinued as part of the Universal Settlement.  For example, although capital rate appeals for periods after Jan. 1, 2012 are categorically excluded from the settlement, the Department of Health (DOH) is requesting that homes list all of these appeals on the exclusion form. 

The form to submit exclusions along with a memo providing information on the various categories of excluded appeals and litigation is available for download in MS Word format here. You should use this information to determine whether your facility has any pending rate appeals or lawsuits which are eligible to be excluded from the Settlement. It is advisable to consult with your attorney, consultant and/or accountant in determining whether your facility has any matters eligible for exclusion. We request that homes that have no excluded items submit the form indicating that they have no exclusions. 

DOH has promised to provide more detailed clarification on several of the exclusion categories which we will send to members when received. To help expedite the process, LeadingAge NY and other associations have agreed to gather the lists of excluded appeals and lawsuits from their respective memberships for submission to the State. To that end, you are asked to review the memo carefully, and e-mail the Excluded Matters form included in the memo to Darius Kirstein at LeadingAge NY (dkirstein@leadingageny.org) by Sun., March 1, 2015. Please contact us if you have any questions in the meantime.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8383, ext. 128