The article discusses the ways that partner interest flips starting in year 11 or 15 can be used in (a) preventing limited partner negative capital accounts, (b) allowing general partners to actually recover their negotiated residual value share, (c) providing financially doable exit transactions, (d) negotiating sale of capital accounts and other uses. The tax issues are discussed, and strategies for incorporating partner interest flips are presented.

On June 2, the Centers for Medicare and Medicaid Services (CMS) sent letters indicating initial approval of both Kentucky and Ohio's statewide transition plans (STPs) required under the home and community-based services (HCBS) settings rule. These initial approvals are based on the states' systemic assessments of their regulations, certifications, policies, and procedures, plans to remediate any findings of non-compliance with the HCBS settings rule in those procedures, and the outlining of milestones to complete remediation activities. 

While the states of Kentucky and Ohio have made much progress toward completing each of these remaining components, there are several technical issues that have been outlined in the attachment to this letter that must be resolved to CMS’ satisfaction before the state can receive final approval of its State Transition Plan.

CMS granted Tennessee both initial and final approval of its Statewide Transition Plan (STP) in April 2016.

LeadingAge has been meeting with officials from CMS to discuss our concerns with the implementation of the HCBS settings final rule especially in relation to co-located adult day centers , Assisted Living in Nursing Homes, as well as secure settings in adult day centers and Assisted living that provide services for individuals with dementia. 

 

 

 

The move comes in response to OSHA's settlement of a legal challenge to the Letter.  The lawsuit asserted that the Letter was contrary to OSHA regulations that stated employee representatives “shall be” employees of the employer unless third parties could provide specific expertise such as language interpretation or technical expertise. The Letter expanded this to include union representatives as identified by employees.

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