Minnesota Legislature
SF 1369
1st Unofficial Engrossment - 86th Legislature (2009 - 2010) Posted on 12/26/2012 11:17pm
KEY: stricken = removed, old language.
underscored = added, new language.
1.2relating to health; consolidating and relocating nursing facility beds to a new site
1.3in Goodhue County;amending Minnesota Statutes 2008, section 144A.071,
1.4subdivision 4c.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2008, section 144A.071, subdivision 4c, is amended to
1.7read:
1.8 Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The
1.9commissioner of health, in coordination with the commissioner of human services, may
1.10approve the renovation, replacement, upgrading, or relocation of a nursing home or
1.11boarding care home, under the following conditions:
1.12 (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
1.13constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
1.14attached to a hospital that is also being replaced. The threshold allowed for this project
1.15under section144A.073 shall be the maximum amount available to pay the additional
1.16medical assistance costs of the new facility;
1.17 (2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
1.18Louis County, provided that the 29 beds must be transferred from active or layaway status
1.19at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
1.20The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
1.21rate at that facility shall not be adjusted as a result of this transfer. The operating payment
1.22rate of the facility adding beds after completion of this project shall be the same as it was
1.23on the day prior to the day the beds are licensed and certified. This project shall not
1.24proceed unless it is approved and financed under the provisions of section144A.073 ;
2.1 (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
2.2the new beds are transferred from a 45-bed facility in Austin under common ownership
2.3that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
2.4under common ownership; (ii) the commissioner of human services is authorized by the
2.52004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
2.6money is available from planned closures of facilities under common ownership to make
2.7implementation of this clause budget-neutral to the state. The bed capacity of the Albert
2.8Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
2.9new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
2.10disease or related dementias;
2.11 (4) to license and certify up to 80 beds transferred from an existing state-owned
2.12nursing facility in Cass County to a new facility located on the grounds of the
2.13Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
2.14determined based on the interim and settle-up payment provisions of Minnesota Rules,
2.15part9549.0057 , and the reimbursement provisions of section
256B.431 . The property
2.16payment rate for the first three years of operation shall be $35 per day. For subsequent
2.17years, the property payment rate of $35 per day shall be adjusted for inflation as provided
2.18in section256B.434 , subdivision 4, paragraph (c), as long as the facility has a contract
2.19under section256B.434 ; and
2.20 (5) to initiate a pilot program to license and certify up to 80 beds transferred from
2.21an existing county-owned nursing facility in Steele County relocated to the site of a new
2.22acute care facility as part of the county's Communities for a Lifetime comprehensive plan
2.23to create innovative responses to the aging of its population. Upon relocation to the new
2.24site, the nursing facility shall delicense 28 beds. The property payment rate for the first
2.25three years of operation of the new facility shall be increased by an amount as calculated
2.26according to items (i) to (v):
2.27 (i) compute the estimated decrease in medical assistance residents served by the
2.28nursing facility by multiplying the decrease in licensed beds by the historical percentage
2.29of medical assistance resident days;
2.30 (ii) compute the annual savings to the medical assistance program from the
2.31delicensure of 28 beds by multiplying the anticipated decrease in medical assistance
2.32residents, determined in item (i), by the existing facility's weighted average payment rate
2.33multiplied by 365;
2.34 (iii) compute the anticipated annual costs for community-based services by
2.35multiplying the anticipated decrease in medical assistance residents served by the nursing
3.1facility, determined in item (i), by the average monthly elderly waiver service costs for
3.2individuals in Steele County multiplied by 12;
3.3 (iv) subtract the amount in item (iii) from the amount in item (ii);
3.4 (v) divide the amount in item (iv) by an amount equal to the relocated nursing
3.5facility's occupancy factor under section256B.431, subdivision 3f , paragraph (c),
3.6multiplied by the historical percentage of medical assistance resident days.
3.7 For subsequent years, the adjusted property payment rate shall be adjusted for
3.8inflation as provided in section256B.434, subdivision 4 , paragraph (c), as long as the
3.9facility has a contract under section256B.434 .; and
3.10(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
3.11and to integrate these services with other community-based programs and services under a
3.12communities for a lifetime pilot program and comprehensive plan to create innovative
3.13responses to the aging of its population. Eighty beds in the city of Red Wing shall be
3.14transferred from the downsizing and relocation of an existing 84-bed, hospital-owned
3.15nursing facility and the entire closure or downsizing of beds from a 65-bed nonprofit
3.16nursing facility in the community resulting in the delicensure of 69 beds in the two
3.17existing facilities. Notwithstanding the carryforward of the approval authority in section
3.18144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of
3.19health for a project in Goodhue County shall not carry forward. The closure of the 69 beds
3.20shall not be eligible for a planned closure rate adjustment under section 256B.437. The
3.21construction project permitted in this clause shall not be eligible for a threshold project
3.22rate adjustment under section 256B.434, subdivision 4f. The property payment rate for
3.23the first three years of operation of the new facility shall be increased by an amount as
3.24calculated according to items (i) to (vi):
3.25(i) compute the estimated decrease in medical assistance residents served by both
3.26nursing facilities by multiplying the difference between the occupied beds of the two
3.27nursing facilities for the reporting year ending September 30, 2009, and the projected
3.28occupancy of the facility at 95 percent occupancy by the historical percentage of medical
3.29assistance resident days;
3.30(ii) compute the annual savings to the medical assistance program from the
3.31delicensure by multiplying the anticipated decrease in the medical assistance residents,
3.32determined in item (i), by the hospital-owned nursing facility weighted average payment
3.33rate multiplied by 365;
3.34(iii) compute the anticipated annual costs for community-based services by
3.35multiplying the anticipated decrease in medical assistance residents served by the
4.1facilities, determined in item (i), by the average monthly elderly waiver service costs for
4.2individuals in Goodhue County multiplied by 12;
4.3(iv) subtract the amount in item (iii) from the amount in item (ii);
4.4(v) multiply the amount in item (iv) by 48.5 percent; and
4.5(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
4.6amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
4.7subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
4.8resident days.
4.9For subsequent years, the adjusted property payment rate shall be adjusted for
4.10inflation as provided in section256B.434, subdivision 4 , paragraph (c), as long as the
4.11facility has a contract under section256B.434 .
4.12 (b) Projects approved under this subdivision shall be treated in a manner equivalent
4.13to projects approved under subdivision 4a.
1.3in Goodhue County;amending Minnesota Statutes 2008, section 144A.071,
1.4subdivision 4c.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2008, section 144A.071, subdivision 4c, is amended to
1.7read:
1.8 Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The
1.9commissioner of health, in coordination with the commissioner of human services, may
1.10approve the renovation, replacement, upgrading, or relocation of a nursing home or
1.11boarding care home, under the following conditions:
1.12 (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
1.13constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
1.14attached to a hospital that is also being replaced. The threshold allowed for this project
1.15under section
1.16medical assistance costs of the new facility;
1.17 (2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
1.18Louis County, provided that the 29 beds must be transferred from active or layaway status
1.19at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
1.20The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
1.21rate at that facility shall not be adjusted as a result of this transfer. The operating payment
1.22rate of the facility adding beds after completion of this project shall be the same as it was
1.23on the day prior to the day the beds are licensed and certified. This project shall not
1.24proceed unless it is approved and financed under the provisions of section
2.1 (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
2.2the new beds are transferred from a 45-bed facility in Austin under common ownership
2.3that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
2.4under common ownership; (ii) the commissioner of human services is authorized by the
2.52004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
2.6money is available from planned closures of facilities under common ownership to make
2.7implementation of this clause budget-neutral to the state. The bed capacity of the Albert
2.8Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
2.9new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
2.10disease or related dementias;
2.11 (4) to license and certify up to 80 beds transferred from an existing state-owned
2.12nursing facility in Cass County to a new facility located on the grounds of the
2.13Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
2.14determined based on the interim and settle-up payment provisions of Minnesota Rules,
2.15part
2.16payment rate for the first three years of operation shall be $35 per day. For subsequent
2.17years, the property payment rate of $35 per day shall be adjusted for inflation as provided
2.18in section
2.19under section
2.20 (5) to initiate a pilot program to license and certify up to 80 beds transferred from
2.21an existing county-owned nursing facility in Steele County relocated to the site of a new
2.22acute care facility as part of the county's Communities for a Lifetime comprehensive plan
2.23to create innovative responses to the aging of its population. Upon relocation to the new
2.24site, the nursing facility shall delicense 28 beds. The property payment rate for the first
2.25three years of operation of the new facility shall be increased by an amount as calculated
2.26according to items (i) to (v):
2.27 (i) compute the estimated decrease in medical assistance residents served by the
2.28nursing facility by multiplying the decrease in licensed beds by the historical percentage
2.29of medical assistance resident days;
2.30 (ii) compute the annual savings to the medical assistance program from the
2.31delicensure of 28 beds by multiplying the anticipated decrease in medical assistance
2.32residents, determined in item (i), by the existing facility's weighted average payment rate
2.33multiplied by 365;
2.34 (iii) compute the anticipated annual costs for community-based services by
2.35multiplying the anticipated decrease in medical assistance residents served by the nursing
3.1facility, determined in item (i), by the average monthly elderly waiver service costs for
3.2individuals in Steele County multiplied by 12;
3.3 (iv) subtract the amount in item (iii) from the amount in item (ii);
3.4 (v) divide the amount in item (iv) by an amount equal to the relocated nursing
3.5facility's occupancy factor under section
3.6multiplied by the historical percentage of medical assistance resident days.
3.7 For subsequent years, the adjusted property payment rate shall be adjusted for
3.8inflation as provided in section
3.9facility has a contract under section
3.10(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
3.11and to integrate these services with other community-based programs and services under a
3.12communities for a lifetime pilot program and comprehensive plan to create innovative
3.13responses to the aging of its population. Eighty beds in the city of Red Wing shall be
3.14transferred from the downsizing and relocation of an existing 84-bed, hospital-owned
3.15nursing facility and the entire closure or downsizing of beds from a 65-bed nonprofit
3.16nursing facility in the community resulting in the delicensure of 69 beds in the two
3.17existing facilities. Notwithstanding the carryforward of the approval authority in section
3.18144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of
3.19health for a project in Goodhue County shall not carry forward. The closure of the 69 beds
3.20shall not be eligible for a planned closure rate adjustment under section 256B.437. The
3.21construction project permitted in this clause shall not be eligible for a threshold project
3.22rate adjustment under section 256B.434, subdivision 4f. The property payment rate for
3.23the first three years of operation of the new facility shall be increased by an amount as
3.24calculated according to items (i) to (vi):
3.25(i) compute the estimated decrease in medical assistance residents served by both
3.26nursing facilities by multiplying the difference between the occupied beds of the two
3.27nursing facilities for the reporting year ending September 30, 2009, and the projected
3.28occupancy of the facility at 95 percent occupancy by the historical percentage of medical
3.29assistance resident days;
3.30(ii) compute the annual savings to the medical assistance program from the
3.31delicensure by multiplying the anticipated decrease in the medical assistance residents,
3.32determined in item (i), by the hospital-owned nursing facility weighted average payment
3.33rate multiplied by 365;
3.34(iii) compute the anticipated annual costs for community-based services by
3.35multiplying the anticipated decrease in medical assistance residents served by the
4.1facilities, determined in item (i), by the average monthly elderly waiver service costs for
4.2individuals in Goodhue County multiplied by 12;
4.3(iv) subtract the amount in item (iii) from the amount in item (ii);
4.4(v) multiply the amount in item (iv) by 48.5 percent; and
4.5(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
4.6amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
4.7subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
4.8resident days.
4.9For subsequent years, the adjusted property payment rate shall be adjusted for
4.10inflation as provided in section
4.11facility has a contract under section
4.12 (b) Projects approved under this subdivision shall be treated in a manner equivalent
4.13to projects approved under subdivision 4a.