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Universal Settlement Participation Survey

An agreement has recently been reached between the State of New York and legal counsels representing nursing homes on the terms of an $850 million universal settlement of most Medicaid rate appeals and reimbursement litigation. The agreement is subject to ratification by nursing homes, and the State is seeking to have responses from all facilities by 1/9/15. To ensure that your response is registered timely with the State, we ask that you complete and submit this survey by no later than 1/7/15.

Please note that this is just an opportunity to indicate your interest. Your response will not legally bind you to participate in the Settlement.
If you are a former owner with financial interest in the Universal Settlement please skip to question 5.

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* 1. Facility Name:
(A separate survey must be completed for each facility)

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* 2. Operating Certificate (Opcert) Number

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* 3. Point of Contact

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* 4. Will the facility above participate in the Universal Settlement as described in materials separately circulated in December, 2014, to all New York State Nursing Facilities?

NOTE: Unless you are a FORMER owner, please hit "done" at the bottom of the page. IF you are a former owner please answer ONLY questions 5 and 6. Thank You

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* 5. Former Facility Information

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* 6. As a former owner of the above facility, do you wish to participate in the Universal Settlement for the above named home?

Please contact your trade association should you have any questions about this survey. Thank you.

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