<a id="pl.1.3"></a><var>1.3</var>in Goodhue County;amending Minnesota Statutes 2008, section 144A.071, <br/>
<a id="pl.1.4"></a><var>1.4</var>subdivision 4c.<br/>
<a id="pl.1.5"></a><var>1.5</var>BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:<br/>
<br/>
<a id="bill.0.1.0"></a><a id="pl.1.6"></a><var>1.6</var>    Section 1. Minnesota Statutes 2008, section 144A.071, subdivision 4c, is amended to <br/>
<a id="pl.1.7"></a><var>1.7</var>read:<br/>
<a id="pl.1.8"></a><var>1.8</var>    Subd. 4c.  <b>Exceptions for replacement beds after June 30, 2003.</b> (a) The <br/>
<a id="pl.1.9"></a><var>1.9</var>commissioner of health, in coordination with the commissioner of human services, may <br/>
<a id="pl.1.10"></a><var>1.10</var>approve the renovation, replacement, upgrading, or relocation of a nursing home or <br/>
<a id="pl.1.11"></a><var>1.11</var>boarding care home, under the following conditions: <br/>
<a id="pl.1.12"></a><var>1.12</var>    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be <br/>
<a id="pl.1.13"></a><var>1.13</var>constructed on the site of a new city-owned hospital to replace an existing 85-bed facility <br/>
<a id="pl.1.14"></a><var>1.14</var>attached to a hospital that is also being replaced. The threshold allowed for this project <br/>
<a id="pl.1.15"></a><var>1.15</var>under section 
         <statute_ref>144A.073</statute_ref> shall be the maximum amount available to pay the additional <br/>
<a id="pl.1.16"></a><var>1.16</var>medical assistance costs of the new facility; <br/>
<a id="pl.1.17"></a><var>1.17</var>    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. <br/>
<a id="pl.1.18"></a><var>1.18</var>Louis County, provided that the 29 beds must be transferred from active or layaway status <br/>
<a id="pl.1.19"></a><var>1.19</var>at an existing facility in St. Louis County that had 235 beds on April 1, 2003. <br/>
<a id="pl.1.20"></a><var>1.20</var>The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment <br/>
<a id="pl.1.21"></a><var>1.21</var>rate at that facility shall not be adjusted as a result of this transfer. The operating payment <br/>
<a id="pl.1.22"></a><var>1.22</var>rate of the facility adding beds after completion of this project shall be the same as it was <br/>
<a id="pl.1.23"></a><var>1.23</var>on the day prior to the day the beds are licensed and certified. This project shall not <br/>
<a id="pl.1.24"></a><var>1.24</var>proceed unless it is approved and financed under the provisions of section 
         <statute_ref>144A.073</statute_ref>;  <br/>
<a id="pl.2.1"></a><var>2.1</var>    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of <br/>
<a id="pl.2.2"></a><var>2.2</var>the new beds are transferred from a 45-bed facility in Austin under common ownership <br/>
<a id="pl.2.3"></a><var>2.3</var>that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea <br/>
<a id="pl.2.4"></a><var>2.4</var>under common ownership; (ii) the commissioner of human services is authorized by the <br/>
<a id="pl.2.5"></a><var>2.5</var>2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) <br/>
<a id="pl.2.6"></a><var>2.6</var>money is available from planned closures of facilities under common ownership to make <br/>
<a id="pl.2.7"></a><var>2.7</var>implementation of this clause budget-neutral to the state. The bed capacity of the Albert <br/>
<a id="pl.2.8"></a><var>2.8</var>Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the <br/>
<a id="pl.2.9"></a><var>2.9</var>new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's <br/>
<a id="pl.2.10"></a><var>2.10</var>disease or related dementias; <br/>
<a id="pl.2.11"></a><var>2.11</var>    (4) to license and certify up to 80 beds transferred from an existing state-owned <br/>
<a id="pl.2.12"></a><var>2.12</var>nursing facility in Cass County to a new facility located on the grounds of the <br/>
<a id="pl.2.13"></a><var>2.13</var>Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be <br/>
<a id="pl.2.14"></a><var>2.14</var>determined based on the interim and settle-up payment provisions of Minnesota Rules, <br/>
<a id="pl.2.15"></a><var>2.15</var>part 
         <statute_ref>9549.0057</statute_ref>, and the reimbursement provisions of section 
         <statute_ref>256B.431</statute_ref>. The property <br/>
<a id="pl.2.16"></a><var>2.16</var>payment rate for the first three years of operation shall be $35 per day. For subsequent <br/>
<a id="pl.2.17"></a><var>2.17</var>years, the property payment rate of $35 per day shall be adjusted for inflation as provided <br/>
<a id="pl.2.18"></a><var>2.18</var>in section 
         <statute_ref>256B.434</statute_ref>, subdivision 4, paragraph (c), as long as the facility has a contract <br/>
<a id="pl.2.19"></a><var>2.19</var>under section 
         <statute_ref>256B.434</statute_ref>; and <br/>
<a id="pl.2.20"></a><var>2.20</var>    (5) to initiate a pilot program to license and certify up to 80 beds transferred from <br/>
<a id="pl.2.21"></a><var>2.21</var>an existing county-owned nursing facility in Steele County relocated to the site of a new <br/>
<a id="pl.2.22"></a><var>2.22</var>acute care facility as part of the county's Communities for a Lifetime comprehensive plan <br/>
<a id="pl.2.23"></a><var>2.23</var>to create innovative responses to the aging of its population. Upon relocation to the new <br/>
<a id="pl.2.24"></a><var>2.24</var>site, the nursing facility shall delicense 28 beds. The property payment rate for the first <br/>
<a id="pl.2.25"></a><var>2.25</var>three years of operation of the new facility shall be increased by an amount as calculated <br/>
<a id="pl.2.26"></a><var>2.26</var>according to items (i) to (v): <br/>
<a id="pl.2.27"></a><var>2.27</var>    (i) compute the estimated decrease in medical assistance residents served by the <br/>
<a id="pl.2.28"></a><var>2.28</var>nursing facility by multiplying the decrease in licensed beds by the historical percentage <br/>
<a id="pl.2.29"></a><var>2.29</var>of medical assistance resident days; <br/>
<a id="pl.2.30"></a><var>2.30</var>    (ii) compute the annual savings to the medical assistance program from the <br/>
<a id="pl.2.31"></a><var>2.31</var>delicensure of 28 beds by multiplying the anticipated decrease in medical assistance <br/>
<a id="pl.2.32"></a><var>2.32</var>residents, determined in item (i), by the existing facility's weighted average payment rate <br/>
<a id="pl.2.33"></a><var>2.33</var>multiplied by 365; <br/>
<a id="pl.2.34"></a><var>2.34</var>    (iii) compute the anticipated annual costs for community-based services by <br/>
<a id="pl.2.35"></a><var>2.35</var>multiplying the anticipated decrease in medical assistance residents served by the nursing <br/>
<a id="pl.3.1"></a><var>3.1</var>facility, determined in item (i), by the average monthly elderly waiver service costs for <br/>
<a id="pl.3.2"></a><var>3.2</var>individuals in Steele County multiplied by 12; <br/>
<a id="pl.3.3"></a><var>3.3</var>    (iv) subtract the amount in item (iii) from the amount in item (ii); <br/>
<a id="pl.3.4"></a><var>3.4</var>    (v) divide the amount in item (iv) by an amount equal to the relocated nursing <br/>
<a id="pl.3.5"></a><var>3.5</var>facility's occupancy factor under section 
         <statute_ref>256B.431, subdivision 3f</statute_ref>, paragraph (c), <br/>
<a id="pl.3.6"></a><var>3.6</var>multiplied by the historical percentage of medical assistance resident days. <br/>
<a id="pl.3.7"></a><var>3.7</var>    For subsequent years, the adjusted property payment rate shall be adjusted for <br/>
<a id="pl.3.8"></a><var>3.8</var>inflation as provided in section 
         <statute_ref>256B.434, subdivision 4</statute_ref>, paragraph (c), as long as the <br/>
<a id="pl.3.9"></a><var>3.9</var>facility has a contract under section 
         <statute_ref>256B.434</statute_ref>.; and <br/>
<a id="pl.3.10"></a><var>3.10</var>(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County <br/>
<a id="pl.3.11"></a><var>3.11</var>and to integrate these services with other community-based programs and services under a <br/>
<a id="pl.3.12"></a><var>3.12</var>communities for a lifetime pilot program and comprehensive plan to create innovative <br/>
<a id="pl.3.13"></a><var>3.13</var>responses to the aging of its population. Eighty beds in the city of Red Wing shall be <br/>
<a id="pl.3.14"></a><var>3.14</var>transferred from the downsizing and relocation of an existing 84-bed, hospital-owned <br/>
<a id="pl.3.15"></a><var>3.15</var>nursing facility and the entire closure or downsizing of beds from a 65-bed nonprofit <br/>
<a id="pl.3.16"></a><var>3.16</var>nursing facility in the community resulting in the delicensure of 69 beds in the two <br/>
<a id="pl.3.17"></a><var>3.17</var>existing facilities. Notwithstanding the carryforward of the approval authority in section <br/>
<a id="pl.3.18"></a><var>3.18</var>144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of <br/>
<a id="pl.3.19"></a><var>3.19</var>health for a project in Goodhue County shall not carry forward. The closure of the 69 beds <br/>
<a id="pl.3.20"></a><var>3.20</var>shall not be eligible for a planned closure rate adjustment under section 256B.437. The <br/>
<a id="pl.3.21"></a><var>3.21</var>construction project permitted in this clause shall not be eligible for a threshold project <br/>
<a id="pl.3.22"></a><var>3.22</var>rate adjustment under section 256B.434, subdivision 4f. The property payment rate for <br/>
<a id="pl.3.23"></a><var>3.23</var>the first three years of operation of the new facility shall be increased by an amount as <br/>
<a id="pl.3.24"></a><var>3.24</var>calculated according to items (i) to (vi):<br/>
<a id="pl.3.25"></a><var>3.25</var>(i) compute the estimated decrease in medical assistance residents served by both <br/>
<a id="pl.3.26"></a><var>3.26</var>nursing facilities by multiplying the difference between the occupied beds of the two <br/>
<a id="pl.3.27"></a><var>3.27</var>nursing facilities for the reporting year ending September 30, 2009, and the projected <br/>
<a id="pl.3.28"></a><var>3.28</var>occupancy of the facility at 95 percent occupancy by the historical percentage of medical <br/>
<a id="pl.3.29"></a><var>3.29</var>assistance resident days;<br/>
<a id="pl.3.30"></a><var>3.30</var>(ii) compute the annual savings to the medical assistance program from the <br/>
<a id="pl.3.31"></a><var>3.31</var>delicensure by multiplying the anticipated decrease in the medical assistance residents, <br/>
<a id="pl.3.32"></a><var>3.32</var>determined in item (i), by the hospital-owned nursing facility weighted average payment <br/>
<a id="pl.3.33"></a><var>3.33</var>rate multiplied by 365;<br/>
<a id="pl.3.34"></a><var>3.34</var>(iii) compute the anticipated annual costs for community-based services by <br/>
<a id="pl.3.35"></a><var>3.35</var>multiplying the anticipated decrease in medical assistance residents served by the <br/>
<a id="pl.4.1"></a><var>4.1</var>facilities, determined in item (i), by the average monthly elderly waiver service costs for <br/>
<a id="pl.4.2"></a><var>4.2</var>individuals in Goodhue County multiplied by 12;<br/>
<a id="pl.4.3"></a><var>4.3</var>(iv) subtract the amount in item (iii) from the amount in item (ii);<br/>
<a id="pl.4.4"></a><var>4.4</var>(v) multiply the amount in item (iv) by 48.5 percent; and<br/>
<a id="pl.4.5"></a><var>4.5</var>(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an <br/>
<a id="pl.4.6"></a><var>4.6</var>amount equal to the relocated nursing facility's occupancy factor under section 256B.431, <br/>
<a id="pl.4.7"></a><var>4.7</var>subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance <br/>
<a id="pl.4.8"></a><var>4.8</var>resident days.<br/>
<a id="pl.4.9"></a><var>4.9</var>For subsequent years, the adjusted property payment rate shall be adjusted for <br/>
<a id="pl.4.10"></a><var>4.10</var>inflation as provided in section 
<statute_ref>256B.434, subdivision 4</statute_ref>, paragraph (c), as long as the <br/>
<a id="pl.4.11"></a><var>4.11</var>facility has a contract under section 
<statute_ref>256B.434</statute_ref>.<br/>
<a id="pl.4.12"></a><var>4.12</var>    (b) Projects approved under this subdivision shall be treated in a manner equivalent <br/>
<a id="pl.4.13"></a><var>4.13</var>to projects approved under subdivision 4a.<br/>