| E-1.__If the department, in implementing periodic |
| reassessments of residents under this section, imposes on |
| nursing facilities the obligation to request reassessment of |
| a resident on a due date set by the department, penalties |
| for failure or delay in meeting that obligation must be |
| limited in accordance with this paragraph.__The department |
| may not impose penalties for failure or delay in requesting |
| reassessments that exceed 10% of the reimbursement that |
| would otherwise be paid for the services rendered to the |
| resident for whom a reassessment is overdue during the |
| period between the due date set by the department and the |
| date on which the reassessment request is made.__If, upon |
| reassessment, the resident is determined no longer medically |
| eligible under the standards duly adopted in the |
| department's rules, then the reimbursement otherwise payable |
| by the department for the services provided after the |
| reassessment due date may be reduced to the rate provided in |
| the department's rules for days awaiting placement to a |
| residential care facility.__When a resident is determined |
| medically eligible upon reassessment, the resident is |
| presumed to have been medically eligible during the period |
| between the due date for the reassessment and the date on |
| which the reassessment was actually conducted, unless the |
| department establishes by clear and convincing evidence that |
| the nursing facility intentionally deferred its request for |
| reassessment of the resident for the purpose of avoiding a |
| determination of medical ineligibility. |