SF 1369

2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 02:20am

A bill for an act
relating to health; consolidating and relocating nursing facility beds to a new site
in Goodhue County; amending Minnesota Statutes 2008, section 144A.071,
subdivision 4c.

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

Section 1.

Minnesota Statutes 2008, section 144A.071, subdivision 4c, is amended to
read:

Subd. 4c.

Exceptions for replacement beds after June 30, 2003.

(a) The
commissioner of health, in coordination with the commissioner of human services, may
approve the renovation, replacement, upgrading, or relocation of a nursing home or
boarding care home, under the following conditions:

(1) to license and certify an 80-bed city-owned facility in Nicollet County to be
constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
attached to a hospital that is also being replaced. The threshold allowed for this project
under section 144A.073 shall be the maximum amount available to pay the additional
medical assistance costs of the new facility;

(2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
Louis County, provided that the 29 beds must be transferred from active or layaway status
at an existing facility in St. Louis County that had 235 beds on April 1, 2003.

The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
rate at that facility shall not be adjusted as a result of this transfer. The operating payment
rate of the facility adding beds after completion of this project shall be the same as it was
on the day prior to the day the beds are licensed and certified. This project shall not
proceed unless it is approved and financed under the provisions of section 144A.073;

(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
the new beds are transferred from a 45-bed facility in Austin under common ownership
that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
under common ownership; (ii) the commissioner of human services is authorized by the
2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
money is available from planned closures of facilities under common ownership to make
implementation of this clause budget-neutral to the state. The bed capacity of the Albert
Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
disease or related dementias;

(4) to license and certify up to 80 beds transferred from an existing state-owned
nursing facility in Cass County to a new facility located on the grounds of the
Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
determined based on the interim and settle-up payment provisions of Minnesota Rules,
part 9549.0057, and the reimbursement provisions of section 256B.431. The property
payment rate for the first three years of operation shall be $35 per day. For subsequent
years, the property payment rate of $35 per day shall be adjusted for inflation as provided
in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract
under section 256B.434; deleted text begin and deleted text end

(5) to initiate a pilot program to license and certify up to 80 beds transferred from
an existing county-owned nursing facility in Steele County relocated to the site of a new
acute care facility as part of the county's Communities for a Lifetime comprehensive plan
to create innovative responses to the aging of its population. Upon relocation to the new
site, the nursing facility shall delicense 28 beds. The property payment rate for the first
three years of operation of the new facility shall be increased by an amount as calculated
according to items (i) to (v):

(i) compute the estimated decrease in medical assistance residents served by the
nursing facility by multiplying the decrease in licensed beds by the historical percentage
of medical assistance resident days;

(ii) compute the annual savings to the medical assistance program from the
delicensure of 28 beds by multiplying the anticipated decrease in medical assistance
residents, determined in item (i), by the existing facility's weighted average payment rate
multiplied by 365;

(iii) compute the anticipated annual costs for community-based services by
multiplying the anticipated decrease in medical assistance residents served by the nursing
facility, determined in item (i), by the average monthly elderly waiver service costs for
individuals in Steele County multiplied by 12;

(iv) subtract the amount in item (iii) from the amount in item (ii);

(v) divide the amount in item (iv) by an amount equal to the relocated nursing
facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c),
multiplied by the historical percentage of medical assistance resident days.

For subsequent years, the adjusted property payment rate shall be adjusted for
inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the
facility has a contract under section 256B.434 deleted text begin . deleted text end new text begin ; and new text end

new text begin (6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
and to integrate these services with other community-based programs and services under a
communities for a lifetime pilot program and comprehensive plan to create innovative
responses to the aging of its population. Eighty beds in the city of Red Wing shall be
transferred from the downsizing and relocation of an existing 84-bed, hospital-owned
nursing facility and the entire closure or downsizing of beds from a 65-bed nonprofit
nursing facility in the community resulting in the delicensure of 69 beds in the two
existing facilities. Notwithstanding the carryforward of the approval authority in section
144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of
health for a project in Goodhue County shall not carry forward. The closure of the 69 beds
shall not be eligible for a planned closure rate adjustment under section 256B.437. The
construction project permitted in this clause shall not be eligible for a threshold project
rate adjustment under section 256B.434, subdivision 4f. The property payment rate for
the first three years of operation of the new facility shall be increased by an amount as
calculated according to items (i) to (vi):
new text end

new text begin (i) compute the estimated decrease in medical assistance residents served by both
nursing facilities by multiplying the difference between the occupied beds of the two
nursing facilities for the reporting year ending September 30, 2009, and the projected
occupancy of the facility at 95 percent occupancy by the historical percentage of medical
assistance resident days;
new text end

new text begin (ii) compute the annual savings to the medical assistance program from the
delicensure by multiplying the anticipated decrease in the medical assistance residents,
determined in item (i), by the hospital-owned nursing facility weighted average payment
rate multiplied by 365;
new text end

new text begin (iii) compute the anticipated annual costs for community-based services by
multiplying the anticipated decrease in medical assistance residents served by the
facilities, determined in item (i), by the average monthly elderly waiver service costs for
individuals in Goodhue County multiplied by 12;
new text end

new text begin (iv) subtract the amount in item (iii) from the amount in item (ii);
new text end

new text begin (v) multiply the amount in item (iv) by 57 percent; and
new text end

new text begin (vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
resident days.
new text end

new text begin For subsequent years, the adjusted property payment rate shall be adjusted for
inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the
facility has a contract under section 256B.434.
new text end

(b) Projects approved under this subdivision shall be treated in a manner equivalent
to projects approved under subdivision 4a.