HF 1836

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; providing a nursing facility rate increase for the
costs of code compliance; requiring reports; appropriating money; amending
Minnesota Statutes 2006, section 256B.434, subdivision 4.

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

Section 1.

Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to
read:

Subd. 4.

Alternate rates for nursing facilities.

(a) For nursing facilities which
have their payment rates determined under this section rather than section 256B.431, the
commissioner shall establish a rate under this subdivision. The nursing facility must enter
into a written contract with the commissioner.

(b) A nursing facility's case mix payment rate for the first rate year of a facility's
contract under this section is the payment rate the facility would have received under
section 256B.431.

(c) A nursing facility's case mix payment rates for the second and subsequent years
of a facility's contract under this section are the previous rate year's contract payment
rates plus an inflation adjustment and, for facilities reimbursed under this section or
section 256B.431, an adjustment to include the cost of any increase in Health Department
licensing fees for the facility taking effect on or after July 1, 2001. The index for the
inflation adjustment must be based on the change in the Consumer Price Index-All Items
(United States City average) (CPI-U) forecasted by the commissioner of finance's national
economic consultant, as forecasted in the fourth quarter of the calendar year preceding
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001,
July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, and July
1, 2008, this paragraph shall apply only to the property-related payment rate, except
that adjustments to include the cost of any increase in Health Department licensing fees
taking effect on or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to
the property payment rate under this section and section 256B.431 shall be effective on
October 1. In determining the amount of the property-related payment rate adjustment
under this paragraph, the commissioner shall determine the proportion of the facility's
rates that are property-related based on the facility's most recent cost report.

(d) The commissioner shall develop additional incentive-based payments of up to
five percent above a facility's operating payment rate for achieving outcomes specified
in a contract. The commissioner may solicit contract amendments and implement those
which, on a competitive basis, best meet the state's policy objectives. The commissioner
shall limit the amount of any incentive payment and the number of contract amendments
under this paragraph to operate the incentive payments within funds appropriated for this
purpose. The contract amendments may specify various levels of payment for various
levels of performance. Incentive payments to facilities under this paragraph may be in the
form of time-limited rate adjustments or onetime supplemental payments. In establishing
the specified outcomes and related criteria, the commissioner shall consider the following
state policy objectives:

(1) successful diversion or discharge of residents to the residents' prior home or other
community-based alternatives;

(2) adoption of new technology to improve quality or efficiency;

(3) improved quality as measured in the Nursing Home Report Card;

(4) reduced acute care costs; and

(5) any additional outcomes proposed by a nursing facility that the commissioner
finds desirable.

new text begin (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities
that take action to come into compliance with existing or expected requirements of
the federal certification standards, the life safety code, or other building codes may
receive reimbursement for the property, equipment, and technology costs associated with
compliance if all of the following circumstances are met:
new text end

new text begin (1) the expenses associated with compliance occurred on or after January 1, 2005;
new text end

new text begin (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073,
or 256B.434, subdivision 4f; and
new text end

new text begin (3) the total allowable costs reported under this section are greater than $50,000 but
less than the minimum threshold established under section 256B.431, subdivision 15,
paragraph (e), and subdivision 16.
new text end

new text begin The commissioner shall use funds appropriated for this purpose to calculate an average
per patient day increase for each nursing facility for the purposes of this paragraph
beginning October 1, 2007, and ending September 30, 2008. Payments to facilities under
this paragraph may be in the form of rate adjustments limited to one year or onetime
supplemental payments. Facilities shall report to the commissioner by December 31,
2008, on the use of these funds.
new text end

Sec. 2. new text begin APPROPRIATION.
new text end

new text begin $6,000,000 is appropriated from the general fund to the commissioner of human
services for the biennium beginning July 1, 2007, for the purposes of section 1.
new text end