Modifying certain long term care and nursing facility provisions ARTICLE 1 - LONG TERM CARE Clarifying the definition of housing with services establishment relating to boarding care homes; requiring the commissioner of human services to include the total annual payment for preadmission screening for each nursing facility under certain medical assistance (MA) rate determination procedures; expanding covered services under the medical assistance alternative care program and providing an exception to the requirement for persons or agencies to be employed by or under contract with a county or public health nursing agency for direct cash payments purposes and providing for the payments for certain services; providing for commissioner distribution of alternative care funds under certain deficiency conditions; modifying the calculation of client premiums under the program; making optional the requirement for certain transfers to the elderly waiver program; modifying certain contract requirements under the nursing facility contractual payment demonstration program and continuing the advisory committee; modifying a certain provision specifying prohibited practices of nursing facilities for medical assistance payments eligibility purposes; modifying certain provisions under the group residential housing (GRH) program relating to the payment rates for certain bed moratorium exceptions, monthly room and board negotiated rates and supplementary service rates ARTICLE 2 - NURSING FACILITIES Modifying the medical assistance (MA) payment rate system for nursing facilities; modifying the rate determination procedure and certain duties of the commissioner of human services relating to the establishment of operating and property related costs and payment rates and the salary adjustment per diem; requiring the consideration of payment rates determined for certain repair and replacement costs as components of the operating cost payment rate; continuing certain appraisal update requirements; eliminating the increase in the care related operating rate to reimburse facilities for unfunded federal mandates; modifying certain provisions under the performance based contracting system; requiring commissioner renegotiation of contracts under the contractual alternative payment demonstration project, specifying certain requests for proposals requirements and certain criteria for consideration in developing contract terms; modifying certain performance based contract requirements, specifying the duration and authorizing termination; modifying certain payment rate provisions; providing for contract payment rates pending appeal; creating certain general exemptions to the moratorium on licensure or certification of new nursing home beds; specifying certain consumer protection requirements of nursing homes under the system; requiring commissioner implementation of the system consistent with federal requirements; authorizing the commissioner to establish an external review panel for advice on the development and implementation of the system; modifying certain appeal procedures; eliminating certain obsolete provisions; repealing certain provisions relating to operating and property related costs, special payment rates, certain adjustments, payments for ancillary services and settlement of certain unresolved appeals (rla)