HF 258

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 02/14/2019 04:21pm

A bill for an act
relating to human services; modifying the external fixed cost payment rate for
certain nonprofit nursing facilities in border cities; amending Minnesota Statutes
2018, sections 256R.02, subdivision 19; 256R.25; proposing coding for new law
in Minnesota Statutes, chapter 256R; repealing Minnesota Statutes 2018, section
256R.53, subdivision 2.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 256R.02, subdivision 19, is amended to read:

Subd. 19.

External fixed costs.

"External fixed costs" means costs related to the nursing
home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
family advisory council fee under section 144A.33; scholarships under section 256R.37;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, assessments, and payments
in lieu of taxes; employer health insurance costs; quality improvement incentive payment
rate adjustments under section 256R.39; performance-based incentive payments under
section 256R.38; special dietary needs under section 256R.51; new text begin rate add-ons for border city
facilities under section 256R.481; new text end rate adjustments for compensation-related costs for
minimum wage changes under section 256R.49 provided on or after January 1, 2018; and
Public Employees Retirement Association employer costs.

Sec. 2.

Minnesota Statutes 2018, section 256R.25, is amended to read:

256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to deleted text begin (n) deleted text end new text begin (o) new text end .

(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.

(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.

(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.

(e) The portion related to scholarships is determined under section 256R.37.

(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.

(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.

(h) The portion related to single-bed room incentives is as determined under section
256R.41.

(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the actual
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.

(j) The portion related to employer health insurance costs is the allowable costs divided
by the sum of the facility's resident days.

(k) The portion related to the Public Employees Retirement Association is actual costs
divided by the sum of the facility's resident days.

(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.

(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.

(n) The portion related to special dietary needs is the amount determined under section
256R.51.

new text begin (o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.
new text end

Sec. 3.

new text begin [256R.481] RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
new text end

new text begin (a) The commissioner shall allow each nonprofit nursing facility located within the
boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once
annually for a rate add-on to the facility's external fixed costs payment rate.
new text end

new text begin (b) A facility seeking an add-on to its external fixed costs payment rate under this section
must apply annually to the commissioner to receive the add-on. A facility must submit the
application within 60 calendar days of the effective date of any add-on under this section.
The commissioner may waive the deadlines required by this paragraph under extraordinary
circumstances.
new text end

new text begin (c) The commissioner shall provide the add-on to each eligible facility that applies by
the application deadline.
new text end

new text begin (d) The add-on to the external fixed costs payment rate is the difference on January 1
of the median total payment rate for case mix classification PA1 of the nonprofit facilities
located in an adjacent city in another state and in cities contiguous to the adjacent city minus
the eligible nursing facility's total payment rate for case mix classification PA1 as determined
under section 256R.22, subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin The add-on to the external fixed costs payment rate described in
Minnesota Statutes, section 256R.481, is available for the rate years beginning on and after
January 1, 2021.
new text end

Sec. 4. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2018, section 256R.53, subdivision 2, new text end new text begin is repealed effective December
31, 2020.
new text end

APPENDIX

Repealed Minnesota Statutes: H0258-1

256R.53 FACILITY SPECIFIC EXEMPTIONS.

Subd. 2.

Nursing facility in Breckenridge.

The operating payment rate of a nonprofit nursing facility that exists on January 1, 2015, is located within the boundaries of the city of Breckenridge, and is reimbursed under this chapter, is equal to the greater of:

(1) the operating payment rate determined under section 256R.21, subdivision 3; or

(2) the median case mix adjusted rates, including comparable rate components as determined by the median case mix adjusted rates, including comparable rate components as determined by the commissioner, for the equivalent case mix indices of the nonprofit nursing facility or facilities located in an adjacent city in another state and in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate with a case mix index of 1.0 is computed by dividing the adjacent city's nursing facility or facilities' median operating payment rate with an index of 1.02 by 1.02.