Source: https://www.revisor.mn.gov/rules/9549/full
Timestamp: 2019-07-15 20:44:07
Document Index: 658611739

Matched Legal Cases: ['art 4', 'art 4', 'art 4', 'art\n9549', 'art 4', 'art 4', 'art 4', 'art\n9549', 'art 4', 'art 4', 'arts 9549', 'art 1', 'art 9549', 'art 7', 'art 7', 'art 4', 'art 5', 'art 1', 'art 7', 'art 4', 'arts 2', 'arts 2', 'art 7', 'art 9549', 'art 1', 'art 2']

﻿ 9549 - MN Rules Chapter
CHAPTER 9549, NURSING FACILITY PAYMENT RATES
9549.0010 SCOPE.
9549.0030 [Repealed, L 2014 c 262 art 4 s 9]
9549.0035 DETERMINATION OF ALLOWABLE COSTS.
9549.0036 [Repealed, L 2014 c 262 art 4 s 9]
9549.0040 [Repealed, L 2014 c 262 art 4 s 9]
9549.0041 Repealed by subpart
9549.0050 [Repealed, L 2014 c 262 art 4 s 9]
9549.0051 DEFINITIONS.
9549.0052 ESTABLISHMENT OF GEOGRAPHIC GROUPS.
9549.0053 [Repealed, L 2014 c 262 art 4 s 9]
9549.0054 [Repealed, L 2014 c 262 art 4 s 9]
9549.0055 Repealed by subpart
9549.0056 [Repealed, L 2014 c 262 art 4 s 9]
9549.0058 RESIDENT CLASSES AND CLASS WEIGHTS.
9549.0061 [Repealed, L 2014 c 262 art 4 s 9]
9549.0070 Repealed by subpart
Parts 9549.0010 to 9549.0080 establish procedures for determining the payment rates for nursing facilities participating in the medical assistance program.
9549.0030
[Repealed, L 2016 c 99 art 1 s 43]
Applicable credits must be used to offset or reduce the expenses of the nursing facility to the extent that the cost to which the credits apply was claimed as a nursing facility cost. Interest income, dividend income, and other investment income of the nursing facility or related organization are not applicable credits except to the extent that the interest expense on working capital debt is incurred and claimed as a reimbursable expense by the nursing facility or related organization. Interest income must not be offset against working capital interest expense if it relates to a bond sinking fund or a restricted fund as defined in part 9549.0060, subpart 7, item B, or other restricted fund if the income is not available to the nursing facility or related organization. Gains or losses on the sales of capital assets used by the nursing facility must not be applicable credits.
9 SR 2659; L 1992 c 513 art 7 s 136; L 2014 c 262 art 4 s 9; art 5 s 6; L 2016 c 99 art 1 s 43
9549.0036
9549.0040
9549.0041
9549.0050
Short length of stay facility.
"Short length of stay facility" means a nursing facility that is certified to provide a skilled level of care and has an average length of stay of 180 days or less in its skilled level of care. For the purpose of this definition the commissioner shall calculate average length of stay for the nursing facility by dividing actual resident days in the skilled level of care for which the nursing facility can bill, by the total number of discharges from the skilled level of care during the reporting year.
11 SR 1990; L 1992 c 513 art 7 s 136; 18 SR 2584; L 2014 c 262 art 4 s 9
The commissioner shall classify Minnesota nursing facilities according to their geographic location as indicated in subparts 2 to 4.
All nursing facilities in Beltrami, Big Stone, Cass, Chippewa, Clearwater, Cottonwood, Crow Wing, Hubbard, Jackson, Kandiyohi, Lac Qui Parle, Lake of the Woods, Lincoln, Lyon, Mahnomen, Meeker, Morrison, Murray, Nobles, Pipestone, Redwood, Renville, Rock, Swift, Todd, Yellow Medicine, and Wadena counties must be placed in geographic group 1.
All nursing facilities in counties other than the counties listed under subparts 2 and 4 must be placed in geographic group 2.
All nursing facilities in Aitkin, Anoka, Carlton, Carver, Cook, Dakota, Hennepin, Itasca, Koochiching, Lake, Ramsey, Saint Louis, Scott, and Washington counties must be placed in geographic group 3.
11 SR 1990; L 1992 c 513 art 7 s 136
9549.0053
9549.0054
9549.0055
9549.0056
Resident classes.
Each resident or applicant must be assessed according to items A to E based on the information on the assessment form completed in accordance with part 9549.0059.
A resident or applicant must be assessed as dependent in an activity of daily living or ADL according to the following table:
ADL Dependent if Score At or Above
Bed mobility 2
A resident or applicant assessed as dependent in fewer than four of the ADLs in item A must be defined as Low ADL. A resident or applicant assessed as dependent in four through six of the ADLs in item A must be defined as Medium ADL. Each resident or applicant assessed as dependent in seven or eight of the ADLs in item A must be defined as High ADL.
A resident or applicant must be defined as special nursing if the resident or applicant meets the criteria in subitem (1) or (2):
the resident or applicant is assessed to require tube feeding; or
the resident or applicant is assessed to require clinical monitoring every day on each shift and the resident is assessed to require one or more of the following special treatments:
oxygen and respiratory therapy;
ostomy/catheter care;
wound or decubitus care;
drainage tubes;
symptom control for the terminally ill; or
A resident or applicant must be defined as having a neuromuscular condition if the resident or applicant is assessed to have one or more of the diagnoses coded to the categories in subitems (1) to (8) according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), as published by the Commission on Professional and Hospital Activities, 1968 Green Road, Ann Arbor, Michigan (1978). This publication is incorporated by reference. The publication is available through the Minitex interlibrary loan system and is not subject to frequent change.
diseases of nervous system excluding sense organs (320-359 excluding 331.0);
cerebrovascular disease (430-438 excluding 437);
fracture of skull (800-804), excluding cases without intracranial injury;
intercranial injury, excluding those with skull fracture (850-854);
fracture of vertebral column with spinal cord injury (806);
spinal cord injury without evidence of spinal bone injury (952);
injury to nerve roots and spinal plexus (953); or
neoplasms of the brain and spine (170.2, 170.6, 191, 192, 198.3, 198.4, 213.2, 213.6, 225, 237.5, 237.6, and 239.6).
A resident or applicant must be defined as having a behavioral condition if the resident's or applicant's assessment score is two or more for behavior on the assessment form.
The commissioner shall establish resident classes according to items A to K. The resident classes must be established based on the definitions in subpart 1.
A resident must be assigned to class A if the resident is assessed as:
Low ADL;
not defined behavioral condition; and
not defined special nursing.
A resident must be assigned to class B if the resident is assessed as:
defined behavioral condition; and
A resident must be assigned to class C if the resident is assessed as:
Low ADL; and
defined special nursing.
A resident must be assigned to class D if the resident is assessed as:
Medium ADL;
A resident must be assigned to class E if the resident is assessed as:
A resident must be assigned to class F if the resident is assessed as:
Medium ADL; and
A resident must be assigned to class G if the resident is assessed as:
High ADL;
scoring less than three on the eating ADL;
not defined special nursing; and
not defined behavioral condition.
A resident must be assigned to class H if the resident is assessed as:
A resident must be assigned to class I if the resident is assessed as:
scoring three or four on the eating ADL;
not defined neuromuscular condition.
A resident must be assigned to class J if the resident is assessed as:
defined neuromuscular condition or scoring three or four on behavior.
A resident must be assigned to class K if the resident is assessed as:
High ADL; and
Class weights.
The commissioner shall assign weights to each resident class established in subpart 2 according to items A to K.
Class A, 1.00;
Class B, 1.30;
Class C, 1.64;
Class D, 1.95;
Class E, 2.27;
Class F, 2.29;
Class G, 2.56;
Class H, 3.07;
Class I, 3.25;
Class J, 3.53;
Class K, 4.12.
11 SR 1990
9549.0061