Source: https://www.revisor.mn.gov/laws/2016/0/99/laws.1.43.0
Timestamp: 2020-08-12 10:18:31
Document Index: 50364825

Matched Legal Cases: ['arts 9549', 'arts 1', 'art 6', 'arts 1', 'arts 2', 'art 9549', 'art 11', 'arts 9549', 'arts 1', 'art 6', 'arts 1', 'arts 2', 'arts 9549', 'arts 9510', 'arts 9520']

﻿ Chapter 99 - MN Laws
SF2539
CHAPTER 99--S.F.No. 2539
relating to human services; recodifying nursing facility payment language; making conforming changes; repealing obsolete provisions;
amending Minnesota Statutes 2014, sections 144A.071, subdivision 2; 256B.0625, by adding a subdivision; 256B.19, subdivision 1e; 256B.431, subdivision 22; 256B.434, subdivision 10; 256B.48, subdivisions 2, 3a; 256B.50, subdivision 1a; Minnesota Statutes 2015 Supplement, sections 144A.15, subdivision 6; 256I.05, subdivision 2; proposing coding for new law as Minnesota Statutes, chapter 256R; repealing Minnesota Statutes 2014, sections 256B.0911, subdivision 7; 256B.25, subdivision 4; 256B.27, subdivision 2a; 256B.41, subdivisions 1, 2, 3; 256B.411, subdivisions 1, 2; 256B.421, subdivisions 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15; 256B.431, subdivisions 1, 2d, 2e, 2n, 2r, 2s, 2t, 3e, 32, 35, 42, 44; 256B.432, subdivisions 1, 2, 3, 4, 4a, 5, 6, 6a, 7, 8; 256B.433, subdivisions 1, 2, 3, 3a; 256B.434, subdivisions 2, 9, 11, 12, 14, 15, 16, 18, 19a, 20, 21; 256B.437, subdivisions 1, 3, 4, 5, 6, 7, 9, 10; 256B.438, subdivisions 1, 2, 3, 4, 5, 6, 7, 8; 256B.441, subdivisions 2, 3, 4, 7, 8, 9, 10, 11, 15, 18, 20, 22, 23, 24, 25, 27, 28a, 29, 32, 33a, 34, 36, 37, 38, 39, 41, 42a, 43, 46b, 47, 49, 57, 59, 60, 61, 64; 256B.47, subdivisions 1, 2, 3, 4; 256B.48, subdivisions 1, 1a, 1b, 1c, 3, 4, 5, 6a, 7, 8; Minnesota Statutes 2015 Supplement, sections 256B.431, subdivisions 2b, 36; 256B.441, subdivisions 1, 5, 6, 11a, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 46d, 48, 50, 51, 51a, 51b, 53, 54, 55a, 56, 63, 65, 66, 67; 256B.495, subdivisions 1, 5; Minnesota Rules, parts 9549.0035, subparts 1, 3, 7, 8; 9549.0041, subpart 6; 9549.0055, subparts 1, 2, 3; 9549.0070, subparts 2, 3.
NURSING FACILITY RECODIFICATION
[256R.01] GENERAL.
Authority of commissioner.
Compliance with federal requirements.
The grant of rulemaking authority to the commissioner of human services in this section is a continuation of authority previously granted in Minnesota Statutes, section 256B.41, subdivision 1.
[256R.02] DEFINITIONS.
Active beds.
Activities costs.
"Administrative costs" means the identifiable costs for administering the overall activities of the nursing home. These costs include salaries and wages of the administrator, assistant administrator, business office employees, security guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related to business office functions, licenses, and permits except as provided in the external fixed costs category, employee recognition, travel including meals and lodging, all training except as specified in subdivision 17, voice and data communication or transmission, office supplies, property and liability insurance and other forms of insurance not designated to other areas, personnel recruitment, legal services, accounting services, management or business consultants, data processing, information technology, Web site, central or home office costs, business meetings and seminars, postage, fees for professional organizations, subscriptions, security services, advertising, board of directors fees, working capital interest expense, and bad debts and bad debt collection fees.
Allowed costs.
Applicable credit.
Assessment reference date.
"Capital assets" means a nursing facility's buildings, attached fixtures, land improvements, leasehold improvements, and all additions to or replacements of those assets used directly for resident care.
Case mix classification.
Case mix index.
Cost to limit ratio.
Desk audit.
Dietary costs.
Direct care costs.
Employer health insurance costs.
"Employer health insurance costs" means premium expenses for group coverage and reinsurance, actual expenses incurred for self-insured plans, and employer contributions to employee health reimbursement and health savings accounts. Premium and expense costs and contributions are allowable for (1) all employees and (2) the spouse and dependents of employees who meet the definition of full-time employees under the federal Affordable Care Act, Public Law 111-148.
"External fixed costs" means costs related to the nursing home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; family advisory council fee under section 144A.33; scholarships under section 256R.37; planned closure rate adjustments under section 256R.40; single-bed room incentives under section 256R.41; property taxes, assessments, and payments in lieu of taxes; employer health insurance costs; quality improvement incentive payment rate adjustments under section 256R.39; performance-based incentive payments under section 256R.38; special dietary needs under section 256R.51; and Public Employees Retirement Association.
Facility average case mix index.
Field audit.
Fringe benefit costs.
"Fringe benefit costs" means the costs for group life, dental, workers' compensation, and other employee insurances and pension, except for the Public Employees Retirement Association and employer health insurance costs; profit sharing; and retirement plans for which the employer pays all or a portion of the costs.
Housekeeping costs.
Identifiable cost.
Leave day.
Maintenance and plant operations costs.
Other care-related costs.
Other direct care costs.
Prior system operating cost payment rate.
Private paying resident.
Rate year.
Raw food costs.
Resident day.
Resource utilization group.
Social services costs.
Standardized days.
Statistical and cost report.
Therapy costs.
Working capital debt.
Working capital interest expense.
[256R.03] CONDITIONS FOR FUNDING.
Requirements for funding.
Payment during suspended admissions.
Payments to facilities withdrawing from medical assistance.
[256R.04] PROHIBITED PRACTICES.
Restricting resident choice of vendors of medical services.
Refusing readmissions.
For a period not to exceed 180 days, the commissioner may continue to make medical assistance payments to a nursing facility or boarding care home which is in violation of this section if extreme hardship to the residents would result. In these cases the commissioner shall issue an order requiring the nursing facility to correct the violation. The nursing facility shall have 20 days from its receipt of the order to correct the violation. If the violation is not corrected within the 20-day period the commissioner may reduce the payment rate to the nursing facility by up to 20 percent. The amount of the payment rate reduction shall be related to the severity of the violation and shall remain in effect until the violation is corrected. The nursing facility or boarding care home may appeal the commissioner's action pursuant to the provisions of chapter 14 pertaining to contested cases. An appeal shall be considered timely if written notice of appeal is received by the commissioner within 20 days of notice of the commissioner's proposed action.
Temporary reimbursement to facilities in violation of this section.
[256R.05] REQUIRED PRACTICES.
Preadmission screening.
Referrals to Medicare providers.
[256R.06] PRIVATE PAY RESIDENTS; REQUIRED PRACTICES.
Medical assistance rates not to exceed private pay residents' rates.
Private pay rates not to exceed medical assistance residents' rates.
Notice to residents.
(a) No increase in nursing facility rates for private paying residents shall be effective unless the nursing facility notifies the resident or person responsible for payment of the increase in writing 30 days before the increase takes effect.
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.
(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 increase, that a rate increase will be effective on that date.
Refund of excess charges.
Notification to a spouse or health care agent.
[256R.07] ADEQUATE DOCUMENTATION.
Documentation of compensation.
Adequate documentation supporting nursing facility payrolls.
Documentation of mileage.
Records for cost allocations.
[256R.08] REPORTING OF FINANCIAL STATEMENTS.
Reporting of financial statements.
[256R.09] REPORTING OF STATISTICAL AND COST REPORTS.
Reporting timeline.
Reporting of statistical and cost information.
Incomplete or inaccurate reports; reports not submitted in a timely manner.
Amending statistical and cost information.
Reporting of false statistical and cost information.
[256R.10] ALLOWED COSTS.
General cost principles.
Employees represented by a collective bargaining agent.
Employer sponsored retirement plans.
Workers' compensation insurance costs.
[256R.11] NONALLOWED COSTS.
The grant of rulemaking authority to the commissioner of human services in this section is a continuation of authority previously granted in Minnesota Statutes, section 256B.47, subdivision 1.
[256R.12] COST ALLOCATION.
Allocation; direct identification of costs; management agreement.
Allocation; direct identification of costs to other activities.
Cost allocation on a functional basis.
Allocation of remaining costs; allocation ratio.
Cost allocation between nursing facilities.
Related organization costs.
Allocation of costs for therapy services; non-hospital-attached facilities.
Allocation of costs for therapy services; hospital-attached facilities.
Allocation of self-insurance costs.
[256R.13] AUDITING REQUIREMENTS.
Audit authority.
Desk and field audits of statistical and cost reports.
Extended record retention requirements.
[256R.16] QUALITY OF CARE.
Calculation of a quality score.
Subdivision 1, paragraph (d), is effective February 1, 2017.
[256R.17] CASE MIX.
Case mix classifications.
Case mix indices.
Resident assessment schedule.
Notice of resident reimbursement case mix classification.
Reconsideration of resident case mix classification.
[256R.21] TOTAL PAYMENT RATE.
Total payment rates.
Determination of total care-related payment rates.
Determination of operating payment rates.
Determination of total payment rates.
[256R.22] CASE MIX ADJUSTED TOTAL PAYMENT RATE.
Case mix adjusted payment rates generally.
Determination of case mix adjusted total care-related payment rates.
Determination of case mix adjusted operating payment rates.
Determination of case mix adjusted total payment rates.
[256R.23] TOTAL CARE-RELATED PAYMENT RATES.
Determination of total care-related cost per day.
Calculation of direct care cost per standardized day.
Calculation of other care-related cost per resident day.
Determination of the median total care-related cost per day.
Determination of total care-related payment rate limits.
Payment rate limit reduction.
Determination of direct care payment rates.
Determination of other care-related payment rates.
[256R.24] OTHER OPERATING PAYMENT RATE.
Determination of other operating cost per day.
Determination of the median other operating cost per day.
Determination of the other operating payment rate.
[256R.25] EXTERNAL FIXED COSTS PAYMENT RATE.
(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs (b) to (m).
(g) The portion related to single-bed room incentives is as determined under section 256R.41.
(h) The portions related to real estate taxes, special assessments, and payments made in lieu of real estate taxes directly identified or allocated to the nursing facility are the actual amounts divided by the sum of the facility's resident days. Allowable costs under this paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate taxes shall not exceed the amount which the nursing facility would have paid to a city or township and county for fire, police, sanitation services, and road maintenance costs had real estate taxes been levied on that property for those purposes.
(i) The portion related to employer health insurance costs is the allowable costs divided by the sum of the facility's resident days.
(j) The portion related to the Public Employees Retirement Association is actual costs divided by the sum of the facility's resident days.
(k) The portion related to quality improvement incentive payment rate adjustments is the amount determined under section 256R.39.
(l) The portion related to performance-based incentive payments is the amount determined under section 256R.38.
(m) The portion related to special dietary needs is the amount determined under section 256R.51.
[256R.26] PROPERTY PAYMENT RATE.
The property payment rate for a nursing facility is the property rate established for the facility under sections 256B.431 and 256B.434.
[256R.32] APPEALS.
ADJUSTMENTS AND ADD-ONS TO THE TOTAL PAYMENT RATE
[256R.36] HOLD HARMLESS.
[256R.37] SCHOLARSHIPS.
(i) scholarships are available to all employees who work an average of at least ten hours per week at the facility except the administrator, and to reimburse student loan expenses for newly hired and recently graduated registered nurses and licensed practical nurses, and training expenses for nursing assistants as defined in section 144A.611, subdivision 2, who are newly hired and have graduated within the last 12 months; and
[256R.38] PERFORMANCE-BASED INCENTIVE PAYMENTS.
[256R.39] QUALITY IMPROVEMENT INCENTIVE PROGRAM.
[256R.40] NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES.
Applications for planned closure rate.
Review and approval of applications.
Planned closure rate adjustment.
Assignment of closure rate to another facility.
Other rate adjustments.
[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 during a calendar quarter 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 second month following that calendar quarter.
[256R.42] RATE ADJUSTMENT FOR THE FIRST 30 DAYS.
[256R.43] BED HOLDS.
[256R.44] RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL NECESSITY.
The amount paid for a private room is 111.5 percent of the established total payment rate for a resident if the resident is a medical assistance recipient and the private room is considered a medical necessity for the resident or others who are affected by the resident's condition, except as provided in Minnesota Rules, part 9549.0060, subpart 11, item C. Conditions requiring a private room must be determined by the resident's attending physician and submitted to the commissioner for approval or denial by the commissioner on the basis of medical necessity.
[256R.45] RATE ADJUSTMENT FOR VENTILATOR-DEPENDENT PERSONS.
[256R.46] SPECIALIZED CARE FACILITIES.
[256R.47] RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING FACILITIES.
(e) This section is suspended and no state or federal funding shall be appropriated or allocated for the purposes of this section from January 1, 2016, to December 31, 2017.
[256R.48] PUBLICLY OWNED FACILITIES.
(a) The commissioner shall allow nursing facilities whose physical plant is owned or whose license is held by a city, county, or hospital district to apply for a higher payment rate under this section if the local governmental entity agrees to pay a specified portion of the nonfederal share of medical assistance costs. Nursing facilities that apply are eligible to select an operating payment rate with a case mix index of 1.00, up to an amount determined by the commissioner to be allowable under the Medicare upper payment limit test. The case mix adjusted rates shall be computed under section 256R.22. The rate increase allowed in this paragraph shall take effect only upon federal approval.
[256R.49] RATE ADJUSTMENTS FOR COMPENSATION-RELATED COSTS FOR MINIMUM WAGE CHANGES.
Rate adjustments for compensation-related costs.
(a) Operating payment rates of all nursing facilities that are reimbursed under this chapter shall be increased effective for rate years beginning on and after October 1, 2014, to address changes in compensation costs for nursing facility employees paid less than $14 per hour in accordance with this section.
Additional application requirements for facilities with employees represented by an exclusive bargaining representative.
Determination of the rate adjustments for compensation-related costs.
[256R.50] BED RELOCATIONS.
Determination of costs in originating facility.
Determination of costs in receiving facility.
Determination of costs prior to relocation.
Estimation of costs after bed relocation.
Determination of rate adjustment.
[256R.51] ADJUSTMENT FOR SPECIAL DIETARY NEEDS.
[256R.52] NURSING FACILITY RECEIVERSHIP FEES.
Payment of receivership fees.
(d) Notification of the payment rate increase must meet the requirements of section 256R.06, subdivisions 5.
Sale or transfer of a nursing facility in receivership after closure.
[256R.53] FACILITY SPECIFIC EXEMPTIONS.
Nursing facility in Golden Valley.
Nursing facility in Breckenridge.
[256R.54] ANCILLARY SERVICES.
Setting payment; monitoring use of therapy services.
Certification that treatment is appropriate.
Separate billings for therapy services; nursing facility provider number.
Separate billings for therapy services; related vendors.
Separate billings for therapy services; unrelated vendors.
Separate billings for therapy services; cost to revenue ratio.
Separate billings for therapy services; base year.
Separate billings for therapy services; transition from unrelated to related vendor.
Separate billings for therapy services; prohibited practices.
The grant of rulemaking authority to the commissioner of human services in this section is a continuation of authority previously granted in Minnesota Statutes, section 256B.433, subdivision 1.
The revisor of statutes shall make necessary cross-reference changes and remove statutory cross-references in Minnesota Statutes and Minnesota Rules to conform with the recodification and repealer in this act. The revisor may make technical and other necessary changes to sentence structure to preserve the meaning of the text. The revisor may alter the statutory coding in this act to incorporate statutory changes made by other law in the 2016 regular legislative session. If a provision repealed in this act is also amended in the 2016 regular legislative session by other law, the revisor shall merge the amendment into the recodification, notwithstanding Minnesota Statutes, section 645.30.
(a) Minnesota Statutes 2014, sections 256B.0911, subdivision 7; 256B.25, subdivision 4; 256B.27, subdivision 2a; 256B.41, subdivisions 1, 2, and 3; 256B.411, subdivisions 1 and 2; 256B.421, subdivisions 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, and 15; 256B.431, subdivisions 1, 2d, 2e, 2n, 2r, 2s, 2t, 3e, 32, 35, 42, and 44; 256B.432, subdivisions 1, 2, 3, 4, 4a, 5, 6, 6a, 7, and 8; 256B.433, subdivisions 1, 2, 3, and 3a; 256B.434, subdivisions 2, 9, 11, 12, 14, 15, 16, 18, 19a, 20, and 21; 256B.437, subdivisions 1, 3, 4, 5, 6, 7, 9, and 10; 256B.438, subdivisions 1, 2, 3, 4, 5, 6, 7, and 8; 256B.441, subdivisions 2, 3, 4, 7, 8, 9, 10, 11, 15, 18, 20, 22, 23, 24, 25, 27, 28a, 29, 32, 33a, 34, 36, 37, 38, 39, 41, 42a, 43, 46b, 47, 49, 57, 59, 60, 61, and 64; 256B.47, subdivisions 1, 2, 3, and 4; and 256B.48, subdivisions 1, 1a, 1b, 1c, 3, 4, 5, 6a, 7, and 8, are repealed.
(b) Minnesota Statutes 2015 Supplement, sections 256B.431, subdivisions 2b and 36; 256B.441, subdivisions 1, 5, 6, 11a, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 46d, 48, 50, 51, 51a, 51b, 53, 54, 55a, 56, 63, 65, 66, and 67; and 256B.495, subdivisions 1 and 5, are repealed.
(c) Minnesota Rules, parts 9549.0035, subparts 1, 3, 7, and 8; 9549.0041, subpart 6; 9549.0055, subparts 1, 2, and 3; and 9549.0070, subparts 2 and 3, are repealed.
Minnesota Statutes 2014, section 144A.071, subdivision 2, is amended to read:
The commissioner of health, in coordination with the commissioner of human services, shall deny each request for new licensed or certified nursing home or certified boarding care beds except as provided in subdivision 3 or 4a, or section 144A.073. "Certified bed" means a nursing home bed or a boarding care bed certified by the commissioner of health for the purposes of the medical assistance program, under United States Code, title 42, sections 1396 et seq. Certified beds in facilities which do not allow medical assistance intake shall be deemed to be decertified for purposes of this section only.
Minnesota Statutes 2015 Supplement, section 144A.15, subdivision 6, is amended to read:
Postreceivership period; facility remaining open.
(a) If a facility remains open after the receivership is concluded, a new operator is only legally responsible under state law for its actions after the receivership has concluded.
(b) The commissioner of human services may adjust, reclassify, or disallow costs reported for a facility that was in receivership for periods of a reporting year during which the receivership was in effect and for the prior year.
Minnesota Statutes 2014, section 256B.0625, is amended by adding a subdivision to read:
Subd. 57a.
Payment limitation for Medicare-covered skilled nursing facility stays.
For services rendered on or after July 1, 2003, for facilities reimbursed under this chapter or chapter 256R, the Medicaid program shall only pay a co-payment during a Medicare-covered skilled nursing facility stay if the Medicare rate less the resident's co-payment responsibility is less than the case mix adjusted total payment rate under chapter 256R. The amount that shall be paid by the Medicaid program is equal to the amount by which the case mix adjusted total payment rate exceeds the Medicare rate less the co-payment responsibility. Health plans paying for nursing home services under section 256B.69, subdivision 6a, may limit payments as allowed under this subdivision.
Minnesota Statutes 2014, section 256B.19, subdivision 1e, is amended to read:
Additional local share of certain nursing facility costs.
Beginning October 1, 2011, Participating local governmental entities that own the physical plant or are the license holders of nursing facilities receiving rate adjustments under section 256B.441, subdivision 55a 256R.48, shall be responsible for paying the portion of nonfederal costs calculated under section 256B.441, subdivision 55a, paragraph (e) 256R.48, paragraph (d). Payments of the nonfederal share shall be submitted to the commissioner by the 15th day of the month prior to payment to the nursing facility for that month's services. If any participating governmental entity obligated to pay an amount under this subdivision does not make timely payment of the monthly installment, the commissioner shall revoke participation under this subdivision and end payments determined under section 256B.441, subdivision 55a 256R.48, to the participating nursing facility effective on the first day of the month for which timely payment was not received. In the event of revocation, the nursing facility may not bill, collect, or retain the amount allowed in section 256B.441, subdivision 55a 256R.48, from private-pay residents for days of service on or after the first day of the month following the month in which the revocation occurred.
Minnesota Statutes 2014, section 256B.431, subdivision 22, is amended to read:
Changes to nursing facility reimbursement.
The nursing facility reimbursement changes in paragraphs (a) to (d) apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this section, and are effective for rate years beginning on or after July 1, 1993, unless otherwise indicated.
(a) In addition to the approved pension or profit-sharing plans allowed by the reimbursement rule, the commissioner shall allow those plans specified in Internal Revenue Code, sections 403(b) and 408(k).
(b) The commissioner shall allow as workers' compensation insurance costs under section 256B.421, subdivision 14, the costs of workers' compensation coverage obtained under the following conditions:
(vi) required security deposits, whether in the form of cash, investments, securities, assets, letters of credit, or in any other form are not allowable costs for purposes of establishing the facilities payment rate; and
(vii) for the rate year beginning on July 1, 1998, a group of nursing facilities related by common ownership that self-insures workers' compensation may allocate its directly identified costs of self-insuring its Minnesota nursing facility workers among those nursing facilities in the group that are reimbursed under this section or section 256B.434. The method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries and wages to that of the nursing facility group's total allowable salaries and wages, then similarly allocated within each nursing facility's operating cost categories. The costs associated with the administration of the group's self-insurance plan must remain classified in the nursing facility's administrative cost category. A written request of the nursing facility group's election to use this alternate method of allocation of self-insurance costs must be received by the commissioner no later than May 1, 1998, to take effect July 1, 1998, or such costs shall continue to be allocated under the existing cost allocation methods. Once a nursing facility group elects this method of cost allocation for its workers' compensation self-insurance costs, it shall remain in effect until such time as the group no longer self-insures these costs;
(c) In the determination of incremental increases in the nursing facility's rental rate as required in subdivisions 14 to 21, except for a refinancing permitted under subdivision 19, the commissioner must adjust the nursing facility's property-related payment rate for both incremental increases and decreases in recomputations of its rental rate;.
(d) A nursing facility's administrative cost limitation must be modified as follows:
(1) if the nursing facility's licensed beds exceed 195 licensed beds, the general and administrative cost category limitation shall be 13 percent;
(2) if the nursing facility's licensed beds are more than 150 licensed beds, but less than 196 licensed beds, the general and administrative cost category limitation shall be 14 percent; or
(3) if the nursing facility's licensed beds is less than 151 licensed beds, the general and administrative cost category limitation shall remain at 15 percent.
(e) For the rate year beginning on July 1, 1998, a group of nursing facilities related by common ownership that self-insures group health, dental, or life insurance may allocate its directly identified costs of self-insuring its Minnesota nursing facility workers among those nursing facilities in the group that are reimbursed under this section or section 256B.434. The method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries and wages to that of the nursing facility group's total allowable salaries and wages, then similarly allocated within each nursing facility's operating cost categories. The costs associated with the administration of the group's self-insurance plan must remain classified in the nursing facility's administrative cost category. A written request of the nursing facility group's election to use this alternate method of allocation of self-insurance costs must be received by the commissioner no later than May 1, 1998, to take effect July 1, 1998, or those self-insurance costs shall continue to be allocated under the existing cost allocation methods. Once a nursing facility group elects this method of cost allocation for its group health, dental, or life insurance self-insurance costs, it shall remain in effect until such time as the group no longer self-insures these costs.
Minnesota Statutes 2014, section 256B.434, subdivision 10, is amended to read:
(b) A facility that is under contract with the commissioner under this section is not subject to the moratorium on licensure or certification of new nursing home beds in section 144A.071, unless the project results in a net increase in bed capacity or involves relocation of beds from one site to another. Contract payment rates must not be adjusted to reflect any additional costs that a nursing facility incurs as a result of a construction project undertaken under this paragraph subdivision. In addition, as a condition of entering into a contract under this section, a nursing facility must agree that any future medical assistance payments for nursing facility services will not reflect any additional costs attributable to the sale of a nursing facility under this section and to construction undertaken under this paragraph subdivision that otherwise would not be authorized under the moratorium in section 144A.073. Nothing in this section prevents a nursing facility participating in the alternative payment demonstration project under this section from seeking approval of an exception to the moratorium through the process established in section 144A.073, and if approved the facility's rates shall be adjusted to reflect the cost of the project. Nothing in this section prevents a nursing facility participating in the alternative payment demonstration project from seeking legislative approval of an exception to the moratorium under section 144A.071, and, if enacted, the facility's rates shall be adjusted to reflect the cost of the project.
Minnesota Statutes 2014, section 256B.48, subdivision 2, is amended to read:
(a) No later than December 31 of each year, a skilled nursing facility or an intermediate care facility, including boarding care facilities, which receives medical assistance payments or other reimbursements from the state agency shall:
(1) provide the state agency with a copy of its audited financial statements. The audited financial statements must include a balance sheet, income statement, statement of the rate or rates charged to private paying residents, statement of retained earnings, statement of cash flows, notes to the financial statements, audited applicable supplemental information, and the certified public accountant's or licensed public accountant's opinion. The examination by the certified public accountant or licensed public accountant shall be conducted in accordance with generally accepted auditing standards as promulgated and adopted by the American Institute of Certified Public Accountants. Beginning with the reporting year which begins October 1, 1992, a nursing facility is no longer required to have a certified audit of its financial statements. The cost of a certified audit shall not be an allowable cost in that reporting year, nor in subsequent reporting years unless the nursing facility submits its certified audited financial statements in the manner otherwise specified in this subdivision. A nursing facility which does not submit a certified audit must submit its working trial balance;
(3) provide the state agency with separate, audited financial statements as specified in clause (1) for every other facility owned in whole or part by an individual or entity which has an ownership interest in the facility;
(4) upon request, provide the state agency with separate, audited financial statements as specified in clause (1) for every organization with which the facility conducts business and which is owned in whole or in part by an individual or entity which has an ownership interest in the facility;
(6) upon request, provide the state agency with copies of leases, purchase agreements, and other documents related to the acquisition of equipment, goods, and services which are claimed as allowable costs; and.
(7) permit access by the state agency to the certified public accountant's and licensed public accountant's audit work papers which support the audited financial statements required in clauses (1), (3), and (4).
(b) Audited financial statements submitted under paragraph (a) must include a balance sheet, income statement, statement of the rate or rates charged to private paying residents, statement of retained earnings, statement of cash flows, notes to the financial statements, audited applicable supplemental information, and the certified public accountant's report. Certified public accountants must conduct audits in accordance with chapter 326A. The cost of an audit shall not be an allowable cost unless the intermediate care facility submits its audited financial statements in the manner otherwise specified in this subdivision. An intermediate care facility must permit access by the state agency to the certified public accountant's work papers that support the audited financial statements submitted under paragraph (a).
(d) If the requirements of clauses (1) to (7) paragraphs (a) and (b) are not met, the reimbursement rate may be reduced to 80 percent of the rate in effect on the first day of the fourth calendar month after the close of the reporting year, period and the reduction shall continue until the requirements are met.
(e) Both nursing facilities and Intermediate care facilities for the developmentally disabled must maintain statistical and accounting records in sufficient detail to support information contained in the facility's cost report for at least six years, including the year following the submission of the cost report. For computerized accounting systems, the records must include copies of electronically generated media such as magnetic discs and tapes.
Minnesota Statutes 2014, section 256B.48, subdivision 3a, is amended to read:
If the commissioner requests supporting documentation during an audit for an item of cost reported by a long-term care an intermediate care facility, and the long-term care facility's response does not adequately document the item of cost, the commissioner may make reasoned assumptions considered appropriate in the absence of the requested documentation to reasonably establish a payment rate rather than disallow the entire item of cost. This provision shall not diminish the long-term care facility's appeal rights.
Minnesota Statutes 2014, section 256B.50, subdivision 1a, is amended to read:
(a) (b) "Determination of a payment rate" means the process by which the commissioner establishes the payment rate paid to a provider pursuant to this chapter, including determinations made in desk audit, field audit, or pursuant to an amendment filed by the provider.
(b) (c) "Provider" means a nursing facility as defined in section 256B.421, subdivision 7 256R.02, subdivision 33, or a facility as defined in section 256B.501, subdivision 1.
(c) "Reimbursement rules" means Minnesota Rules, parts 9510.0010 to 9510.0480, 9510.0500 to 9510.0890, and rules adopted by the commissioner pursuant to sections 256B.41 and 256B.501, subdivision 3.
Minnesota Statutes 2015 Supplement, section 256I.05, subdivision 2, is amended to read:
Monthly rates; exemptions.
This subdivision applies to a residence that on August 1, 1984, was licensed by the commissioner of health only as a boarding care home, certified by the commissioner of health as an intermediate care facility, and licensed by the commissioner of human services under Minnesota Rules, parts 9520.0500 to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to a facility reimbursed under this subdivision shall be determined under section 256B.431, 256B.434, or 256B.441 chapter 256R, if the facility is accepted by the commissioner for participation in the alternative payment demonstration project. The rate paid to this facility shall also include adjustments to the group residential housing rate according to subdivision 1, and any adjustments applicable to supplemental service rates statewide.
Presented to the governor May 9, 2016
Signed by the governor May 12, 2016, 1:22 p.m.