# RCW 74.46.022: RCW 74.46.022: Nursing facility medicaid payment system—Establishing procedures, principles, and conditions > Washington · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S022 ## Section - **Citation:** RCW 74.46.022 - **Heading:** RCW 74.46.022: Nursing facility medicaid payment system—Establishing procedures, principles, and conditions - **Jurisdiction:** Washington - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Washington Code / Title 74 / Chapter 46 / Section 022 ## Text The department shall establish, by rule, the procedures, principles, and conditions for the nursing facility medicaid payment system addressed by the following principles: (1) The department must receive complete, annual reporting of all costs and the financial condition of each contractor, prepared and presented in a standardized manner. The department shall establish, by rule, due dates, requirements for cost report completion, actions required for improperly completed or late cost reports, fines for any statutory or regulatory noncompliance, retention requirements, and public disclosure requirements. (2) The department shall examine all cost reports to determine whether the information is correct, complete, and reported in compliance with this chapter, department rules and instructions, and generally accepted accounting principles. (3) Each contractor must establish and maintain, as a service to the resident, a bookkeeping system incorporated into the business records for all resident funds entrusted to the contractor and received by the contractor for the resident. The department shall adopt rules to ensure that resident personal funds handled by the contractor are maintained by each contractor in a manner that is, at a minimum, consistent with federal requirements. (4) The department shall have the authority to audit resident trust funds and receivables, at its discretion. (5) Contractors shall provide the department access to the nursing facility, all financial and statistical records, and all working papers that are in support of the cost report, receivables, and resident trust funds. (6) The department shall establish a settlement process in order to reconcile medicaid resident days to billed days and medicaid payments for the preceding calendar year. The settlement process shall ensure that any savings in the direct care or therapy care component rates be shifted only between direct care and therapy care component rates, and shall not be shifted into any other rate components. (7) The department shall define and identify allowable and unallowable costs. (8) A contractor shall bill the department for care provided to medicaid recipients, and the department shall pay a contractor for service rendered under the facility contract and appropriately billed. Billing and payment procedures shall be specified by rule. (9) The department shall establish the conditions for participation in the nursing facility medicaid payment system. (10) The department shall establish procedures and a rate setting methodology for a change of ownership. (11) The department shall establish, consistent with federal requirements for nursing facilities participating in the medicaid program, an appeals or exception procedure that allows individual nursing home providers an opportunity to receive prompt administrative review of payment rates with respect to such issues as the department deems appropriate. (12) The department shall have authority to adopt, amend, and rescind such administrative rules and definitions as it deems necessary to carry out the policies and purposes of this chapter. ## Nearby sections - [RCW 74.46.010 RCW 74.46.010: Short title—Purpose—Finding.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S010.md) - [RCW 74.46.020 RCW 74.46.020: Definitions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S020.md) - [RCW 74.46.022 RCW 74.46.022: Nursing facility medicaid payment system—Establishing procedures, principles, and conditions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S022.md) - [RCW 74.46.024 RCW 74.46.024: Pay-for-performance supplemental payment structure—Establishing procedures, principles, and conditions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S024.md) - [RCW 74.46.421 RCW 74.46.421: Purpose of part E—Nursing facility medicaid payment rates.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S421.md) - [RCW 74.46.441 RCW 74.46.441: Public disclosure of rate-setting information.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S441.md) - [RCW 74.46.475 RCW 74.46.475: Submitted cost report—Analysis and adjustment by department.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S475.md) - [RCW 74.46.485 RCW 74.46.485: Case mix method implementation.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S485.md) - [RCW 74.46.496 RCW 74.46.496: Case mix weights—Determination.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S496.md) - [RCW 74.46.501 RCW 74.46.501: Average case mix indexes determined quarterly—Facility average case mix index—Medicaid average case mix index.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S501.md) - [RCW 74.46.531 RCW 74.46.531: Department may adjust component rates—Contractor may request—Errors or omissions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S531.md) - [RCW 74.46.541 RCW 74.46.541: Skilled nursing facility safety net assessment—Reimbursement of medicaid share.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S541.md) - [RCW 74.46.551 RCW 74.46.551: Facility-based payment rates—Comparative analysis—Rate add-ons.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S551.md) - [RCW 74.46.561 RCW 74.46.561: Nursing home payment rates—System components—Quality incentive—Reimbursement of safety net assessment—Rate reductions or increases limited.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S561.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S022. 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