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HF 1341

as introduced - 90th Legislature (2017 - 2018) Posted on 02/16/2017 02:22pm

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Engrossments
Introduction Posted on 02/16/2017

Current Version - as introduced

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A bill for an act
relating to human services; consolidating various nursing facility rate adjustment
effective dates to coincide with the annual operating payment rate adjustment on
January 1 and one mid-year adjustment on July 1; modifying notice requirements;
amending Minnesota Statutes 2016, sections 144A.071, subdivision 4d; 256B.431,
subdivisions 10, 16, 30; 256B.434, subdivision 4f; 256R.06, subdivision 5; 256R.40,
subdivision 5; 256R.41.

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

Section 1.

Minnesota Statutes 2016, section 144A.071, subdivision 4d, is amended to
read:


Subd. 4d.

Consolidation of nursing facilities.

(a) The commissioner of health, in
consultation with the commissioner of human services, may approve a request for
consolidation of nursing facilities which includes the closure of one or more facilities and
the upgrading of the physical plant of the remaining nursing facility or facilities, the costs
of which exceed the threshold project limit under subdivision 2, clause (a). The
commissioners shall consider the criteria in this section, section 144A.073, and section
deleted text begin 256B.437deleted text endnew text begin 256R.40new text end, in approving or rejecting a consolidation proposal. In the event the
commissioners approve the request, the commissioner of human services shall calculate an
external fixed costs rate adjustment according to clauses (1) to (3):

(1) the closure of beds shall not be eligible for a planned closure rate adjustment under
section deleted text begin256B.437, subdivision 6deleted text endnew text begin 256R.40, subdivision 5new text end;

(2) the construction project permitted in this clause shall not be eligible for a threshold
project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
adjustment under section 144A.073; and

(3) the payment rate for external fixed costs for a remaining facility or facilities shall
be increased by an amount equal to 65 percent of the projected net cost savings to the state
calculated in paragraph (b), divided by the state's medical assistance percentage of medical
assistance dollars, and then divided by estimated medical assistance resident days, as
determined in paragraph (c), of the remaining nursing facility or facilities in the request in
this paragraph. The rate adjustment is effective on the deleted text beginlater of the first day of the month
following
deleted text endnew text begin first day of the month of January or July, whichever date occurs immediately
after the
new text end completion of the construction upgrades in the consolidation plan deleted text beginor the first day
of the month following
deleted text endnew text begin andnew text end the complete closure of deleted text beginadeleted text endnew text begin thenew text end facilitynew text begin or facilitiesnew text end designated for
closure in the consolidation plan. If more than one facility is receiving upgrades in the
consolidation plan, each facility's date of construction completion must be evaluated
separately.

(b) For purposes of calculating the net cost savings to the state, the commissioner shall
consider clauses (1) to (7):

(1) the annual savings from estimated medical assistance payments from the net number
of beds closed taking into consideration only beds that are in active service on the date of
the request and that have been in active service for at least three years;

(2) the estimated annual cost of increased case load of individuals receiving services
under the elderly waiver;

(3) the estimated annual cost of elderly waiver recipients receiving support under group
residential housing;

(4) the estimated annual cost of increased case load of individuals receiving services
under the alternative care program;

(5) the annual loss of license surcharge payments on closed beds;

(6) the savings from not paying planned closure rate adjustments that the facilities would
otherwise be eligible for under section deleted text begin256B.437deleted text endnew text begin 256R.40new text end; and

(7) the savings from not paying external fixed costs payment rate adjustments from
submission of renovation costs that would otherwise be eligible as threshold projects under
section 256B.434, subdivision 4f.

(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
assistance resident days of the remaining facility or facilities shall be computed assuming
95 percent occupancy multiplied by the historical percentage of medical assistance resident
days of the remaining facility or facilities, as reported on the facility's or facilities' most
recent nursing facility statistical and cost report filed before the plan of closure is submitted,
multiplied by 365.

(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy
percentages will be those reported on the facility's or facilities' most recent nursing facility
statistical and cost report filed before the plan of closure is submitted, and the average
payment rates shall be calculated based on the approved payment rates in effect at the time
the consolidation request is submitted.

(e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
the closing facilities shall:

(1) submit an application for closure according to section deleted text begin256B.437, subdivision 3deleted text endnew text begin
256R.40, subdivision 2
new text end; and

(2) follow the resident relocation provisions of section 144A.161.

(f) The county or counties in which a facility or facilities are closed under this subdivision
shall not be eligible for designation as a hardship area under subdivision 3 for five years
from the date of the approval of the proposed consolidation. The applicant shall notify the
county of this limitation and the county shall acknowledge this in a letter of support.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for consolidations occurring after July
1, 2017.
new text end

Sec. 2.

Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:


Subd. 10.

Property rate adjustments and construction projects.

A nursing facility
completing a construction project that is eligible for a rate adjustment under section
256B.434, subdivision 4f, and that was not approved through the moratorium exception
process in section 144A.073 must request from the commissioner a property-related payment
rate adjustment. deleted text beginIf the request is made within 60 days after the construction project's
completion date,
deleted text end The effective date of the rate adjustment is the firstnew text begin daynew text end of the monthnew text begin of
January or July, whichever date occurs immediately
new text end following thenew text begin construction project'snew text end
completion datenew text begin and submission of the provider's rate adjustment requestnew text end. deleted text beginIf the request is
made more than 60 days after the completion date, the rate adjustment is effective on the
first of the month following the request.
deleted text end The commissioner shall provide a rate notice
reflecting the allowable costs within 60 days after receiving all the necessary information
to compute the rate adjustment. No sooner than the effective date of the rate adjustment for
the construction project, a nursing facility may adjust its rates by the amount anticipated to
be allowed. Any amounts collected from private pay residents in excess of the allowable
rate must be repaid to private pay residents with interest at the rate used by the commissioner
of revenue for the late payment of taxes and in effect on the date the rate increase is effective.
Construction projects with completion dates within one year of the completion date associated
with the property rate adjustment request and phased projects with project completion dates
within three years of the last phase of the phased project must be aggregated for purposes
of the minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section
144A.071, subdivision 2. "Construction project" and "project construction costs" have the
meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for projects completed after January 1,
2018.
new text end

Sec. 3.

Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:


Subd. 16.

Major additions and replacements; equity incentive.

For rate years beginning
after June 30, 1993, if a nursing facility acquires capital assets in connection with a project
approved under the moratorium exception process in section 144A.073 or in connection
with an addition to or replacement of buildings, attached fixtures, or land improvements
for which the total historical cost of those capital asset additions exceeds the lesser of
$150,000 or ten percent of the most recent appraised value, the nursing facility shall be
eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation
is separate from the determination of the nursing facility's rental rate. An equity incentive
payment rate as computed under this subdivision is limited to one in a 12-month period.

(a) An eligible nursing facility shall receive an equity incentive payment rate equal to
the allowable historical cost of the capital asset acquired, minus the allowable debt directly
identified to that capital asset, multiplied by the equity incentive factor as described in
paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under
subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total
payment rate and shall be effective the same day as the incremental increase in paragraph
(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable
debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080,
and this section.

(b) The equity incentive factor shall be determined under clauses (1) to (4):

(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the
capital asset additions referred to in paragraph (a), then cube the quotient,

(2) subtract the amount calculated in clause (1) from the number one,

(3) determine the difference between the rental factor and the lesser of two percentage
points above the posted yield for standard conventional fixed rate mortgages of the Federal
Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on
the first day of the month the debt or cost is incurred, or 16 percent,

(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).

(c) The equity incentive payment rate shall be limited to the term of the allowable debt
in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in
acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The
sale of a nursing facility under subdivision 14 shall terminate application of the equity
incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for
the sale.

(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures,
or land improvements meeting the criteria in this subdivision and not receiving the
property-related payment rate adjustment in subdivision 17, shall receive the incremental
increase in the nursing facility's rental rate as determined under Minnesota Rules, parts
9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the
nursing facility's property-related payment rate. The effective date of this incremental
increase shall be the first day of the monthnew text begin of January or July, whichever occurs immediatelynew text end
following the deleted text beginmonth indeleted text endnew text begin date onnew text end which the addition or replacement is completed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for additions or replacements completed
after January 1, 2018.
new text end

Sec. 4.

Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:


Subd. 30.

Bed layaway and delicensure.

(a) For rate years beginning on or after July
1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
(c), and calculation of the rental per diem, have those beds given the same effect as if the
beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
a facility may change its single bed election for use in calculating capacity days under
Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
effective the first day of the month following the month in which the layaway of the beds
becomes effective under section 144A.071, subdivision 4b.

(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
the contrary under section 256B.434new text begin or chapter 256Rnew text end, a nursing facility reimbursed under
that sectionnew text begin or chapternew text end which has placed beds on layaway shall, for so long as the beds
remain on layaway, be allowed to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the layaway
and the number of beds after the layaway.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
(3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be effective the first day of the
monthnew text begin of January or July, whichever occurs immediatelynew text end following the deleted text beginmonth indeleted text endnew text begin date onnew text end
which the layaway of the beds becomes effective.

(c) If a nursing facility removes a bed from layaway status in accordance with section
144A.071, subdivision 4b, the commissioner shall establish capacity days based on the
number of licensed and certified beds in the facility not on layaway and shall reduce the
nursing facility's property payment rate in accordance with paragraph (b).

(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
to the contrary under section 256B.434new text begin or chapter 256Rnew text end, a nursing facility reimbursed under
that sectionnew text begin or chapternew text end, which has delicensed beds after July 1, 2000, by giving notice of
the delicensure to the commissioner of health according to the notice requirements in section
144A.071, subdivision 4b, shall be allowed to:

(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;

(2) retain or change the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and

(3) establish capacity days based on the number of beds immediately prior to the
delicensure and the number of beds after the delicensure.

The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
paragraph (c). The property payment rate increase shall be effective the first day of the
monthnew text begin of January or July, whichever occurs immediatelynew text end following the deleted text beginmonth indeleted text endnew text begin date onnew text end
which the delicensure of the beds becomes effective.

(e) For nursing facilities reimbursed under this section deleted text beginordeleted text endnew text begin,new text end section 256B.434new text begin, or chapter
256R
new text end, any beds placed on layaway shall not be included in calculating facility occupancy
as it pertains to leave days defined in Minnesota Rules, part 9505.0415.

(f) For nursing facilities reimbursed under this section deleted text beginordeleted text endnew text begin,new text end section 256B.434new text begin, or chapter
256R
new text end, the rental rate calculated after placing beds on layaway may not be less than the rental
rate prior to placing beds on layaway.

(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
with section deleted text begin256B.47, subdivision 2deleted text endnew text begin 256R.06, subdivision 5new text end.

(h) A facility that does not utilize the space made available as a result of bed layaway
or delicensure under this subdivision to reduce the number of beds per room or provide
more common space for nursing facility uses or perform other activities related to the
operation of the nursing facility shall have its property rate increase calculated under this
subdivision reduced by the ratio of the square footage made available that is not used for
these purposes to the total square footage made available as a result of bed layaway or
delicensure.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for layaways occurring after July 1, 2017.
new text end

Sec. 5.

Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:


Subd. 4f.

Construction project rate adjustments effective October 1, 2006.

(a)
Effective October 1, 2006, facilities reimbursed under this section may receive a property
rate adjustment for construction projects exceeding the threshold in section 256B.431,
subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For
these projects, capital assets purchased shall be counted as construction project costs for a
rate adjustment request made by a facility if they are: (1) purchased within 24 months of
the completion of the construction project; (2) purchased after the completion date of any
prior construction project; and (3) are not purchased prior to July 14, 2005. Except as
otherwise provided in this subdivision, the definitions, rate calculation methods, and
principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to
9549.0080, shall be used to calculate rate adjustments for allowable construction projects
under this subdivision and section 144A.073. Facilities completing construction projects
between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment
effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible
for a property rate adjustment effective on the first day of the month following the completion
date.new text begin Facilities completing projects after January 1, 2018, are eligible for a property rate
adjustment effective on the first day of the month of January or July, whichever occurs
immediately following the completion date.
new text end

(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under
section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a
construction project on or after October 1, 2004, and do not have a contract under subdivision
3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431,
subdivision 10, through September 30, 2006. If the request results in the commissioner
determining a rate adjustment is allowable, the rate adjustment is effective on the first of
the month following project completion. These facilities shall be allowed to accumulate
construction project costs for the period October 1, 2004, to September 30, 2006.

(c) Facilities shall be allowed construction project rate adjustments no sooner than 12
months after completing a previous construction project. Facilities must request the rate
adjustment according to section 256B.431, subdivision 10.

(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
subpart 11. For rate calculations under this section, the number of licensed beds in the
nursing facility shall be the number existing after the construction project is completed and
the number of days in the nursing facility's reporting period shall be 365.

(e) The value of assets to be recognized for a total replacement project as defined in
section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value
of assets to be recognized for all other projects shall be computed as described in clause
(2).

(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
maximum amount of assets allowable in a facility's property rate calculation. If a facility's
current request for a rate adjustment results from the completion of a construction project
that was previously approved under section 144A.073, the assets to be used in the rate
calculation cannot exceed the lesser of the amount determined under sections 144A.071,
subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction
project. A current request that is not the result of a project under section 144A.073 cannot
exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits
must be deducted from the cost of the construction project.

(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be
used to compute the maximum amount of assets allowable in a facility's property rate
calculation.

(ii) The value of a facility's assets to be compared to the amount in item (i) begins with
the total appraised value from the last rate notice a facility received when its rates were set
under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value
shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each
rate year the facility received an inflation factor on its property-related rate when its rates
were set under this section. The value of assets listed as previous capital additions, capital
additions, and special projects on the facility's base year rate notice and the value of assets
related to a construction project for which the facility received a rate adjustment when its
rates were determined under this section shall be added to the indexed appraised value.

(iii) The maximum amount of assets to be recognized in computing a facility's rate
adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the
construction project.

(iv) If a facility's current request for a rate adjustment results from the completion of a
construction project that was previously approved under section 144A.073, the assets to be
added to the rate calculation cannot exceed the lesser of the amount determined under
sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
costs of the construction project. A current request that is not the result of a project under
section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
paragraph (a). Assets disposed of as a result of a construction project and applicable credits
must be deducted from the cost of the construction project.

(f) For construction projects approved under section 144A.073, allowable debt may
never exceed the lesser of the cost of the assets purchased, the threshold limit in section
144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital
debt.

(g) For construction projects that were not approved under section 144A.073, allowable
debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such
construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously
existing capital debt. Amounts of debt taken out that exceed the costs of a construction
project shall not be allowed regardless of the use of the funds.

For all construction projects being recognized, interest expense and average debt shall
be computed based on the first 12 months following project completion. "Previously existing
capital debt" means capital debt recognized on the last rate determined under section
256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt
recognized for a construction project for which the facility received a rate adjustment when
its rates were determined under this section.

For a total replacement project as defined in section 256B.431, subdivision 17d, the
value of previously existing capital debt shall be zero.

(h) In addition to the interest expense allowed from the application of paragraph (f), the
amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and
(3), will be added to interest expense.

(i) The equity portion of the construction project shall be computed as the allowable
assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be
multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added.
This sum must be divided by 95 percent of capacity days to compute the construction project
rate adjustment.

(j) For projects that are not a total replacement of a nursing facility, the amount in
paragraph (i) is adjusted for nonreimbursable areas and then added to the current property
payment rate of the facility.

(k) For projects that are a total replacement of a nursing facility, the amount in paragraph
(i) becomes the new property payment rate after being adjusted for nonreimbursable areas.
Any amounts existing in a facility's rate before the effective date of the construction project
for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements
under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431,
subdivision 19, shall be removed from the facility's rates.

(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060,
subpart 10, as the result of construction projects under this section. Allowable equipment
shall be included in the construction project costs.

(m) Capital assets purchased after the completion date of a construction project shall be
counted as construction project costs for any future rate adjustment request made by a facility
under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months
of the completion of the future construction project.

(n) In subsequent rate years, the property payment rate for a facility that results from
the application of this subdivision shall be the amount inflated in subdivision 4.

(o) Construction projects are eligible for an equity incentive under section 256B.431,
subdivision 16. When computing the equity incentive for a construction project under this
subdivision, only the allowable costs and allowable debt related to the construction project
shall be used. The equity incentive shall not be a part of the property payment rate and not
inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing
facilities reimbursed under this section shall be allowed for a duration determined under
section 256B.431, subdivision 16, paragraph (c).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2018.
new text end

Sec. 6.

Minnesota Statutes 2016, section 256R.06, subdivision 5, is amended to read:


Subd. 5.

Notice to residents.

(a) No deleted text beginincreasedeleted text endnew text begin adjustmentnew text end in nursing facility rates for
private paying residents shall be effective unless the nursing facility notifies the resident or
person responsible for payment deleted text beginof the increasedeleted text end in writing 30 days before the deleted text beginincreasedeleted text endnew text begin
adjustment
new text end takes effect.new text begin The notice must include the amount of the rate adjustment, the new
payment rate, and the date the rate adjustment takes effect.
new text end

A nursing facility may adjust its rates without giving the notice required by this
subdivision when the purpose of the rate adjustment is to reflect a change in the case mix
classification of the resident.

If the state fails to set rates as required by section 256R.09, subdivision 1, the time
required for giving notice is decreased by the number of days by which the state was late
in setting the rates.

(b) If the state does not set rates by the date required in section 256R.09, subdivision 1,
nursing facilities shall meet the requirement for advance notice by informing the resident
or person responsible for payments, on or before the effective date of the deleted text beginincreasedeleted text endnew text begin adjustmentnew text end,
that a rate deleted text beginincreasedeleted text endnew text begin adjustmentnew text end will be effective on that date.

If the exact amount has not yet been determined, the nursing facility may deleted text beginraisedeleted text endnew text begin adjustnew text end
the rates by the amount anticipated to be allowed. Any amounts collected from private pay
residents in excess of the allowable rate must be repaid to private pay residents with interest
at the rate used by the commissioner of revenue for the late payment of taxes and in effect
on the date the rate deleted text beginincreasedeleted text endnew text begin adjustmentnew text end is effective.

Sec. 7.

Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:


Subd. 5.

Planned closure rate adjustment.

(a) The commissioner shall calculate the
amount of the planned closure rate adjustment available under subdivision 6 according to
clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned
closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under clause
(2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided by
capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day of
the monthnew text begin of January or July, whichever occurs immediatelynew text end following completion of closure
of the facility designated for closure in the application and becomes part of the nursing
facility's external fixed payment rate.

(c) Upon the request of a closing facility, the commissioner must allow the facility a
closure rate adjustment as provided under section 144A.161, subdivision 10.

(d) A facility that has received a planned closure rate adjustment may reassign it to
another facility that is under the same ownership at any time within three years of its effective
date. The amount of the adjustment is computed according to paragraph (a).

(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the
commissioner shall recalculate planned closure rate adjustments for facilities that delicense
beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar
amount. The recalculated planned closure rate adjustment is effective from the date the per
bed dollar amount is increased.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for closures occurring after July 1, 2017.
new text end

Sec. 8.

Minnesota Statutes 2016, section 256R.41, is amended to read:


256R.41 SINGLE-BED ROOM INCENTIVE.

(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed
under this chapter shall be increased by 20 percent multiplied by the ratio of the number of
new single-bed rooms created divided by the number of active beds on July 1, 2005, for
each bed closure that results in the creation of a single-bed room after July 1, 2005. The
commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each
year. For eligible bed closures for which the commissioner receives a notice from a facility
deleted text begin during a calendar quarterdeleted text end that a bed has been delicensed and a new single-bed room has
been established, the rate adjustment in this paragraph shall be effective on the first day of
the deleted text beginseconddeleted text end monthnew text begin of January or July, whichever occurs immediatelynew text end following deleted text beginthat calendar
quarter
deleted text endnew text begin the date of the bed delicensurenew text end.

(b) A nursing facility is prohibited from discharging residents for purposes of establishing
single-bed rooms. A nursing facility must submit documentation to the commissioner in a
form prescribed by the commissioner, certifying the occupancy status of beds closed to
create single-bed rooms. In the event that the commissioner determines that a facility has
discharged a resident for purposes of establishing a single-bed room, the commissioner shall
not provide a rate adjustment under paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for closures occurring after July 1, 2017.
new text end