An Act To Amend the Laws Governing Reimbursement of Nursing Facilities
Maine Legislature, Session 123, LD 1669
Committee: Health and Human Services
Sponsors: CUMMINGS, EDMONDS, FISCHER, MILLER, PERRY, PINGREE, MITCHELL
Amends: 22 MRSA §1708

Legislative Document 
No. 1669 
H.P.1178 
House of Representatives, March 22, 2007 
An Act To Amend the Laws Governing Reimbursement of Nursing 
Facilities 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Speaker CUMMINGS of Portland. 
Cosponsored by President EDMONDS of Cumberland and 
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frl.1Jld£~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: FISCHER of Presque Isle, MILLER of Somerville, PERRY of Calais, 
PINGREE of North Haven, Senator: MITCHELL of Kennebec. 
Printed on recyc led paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRS A §1708, sub-§3, 'J]}, as corrected by RR 2001, c. 2, Pt. A, §33 
and amended by PL 2003, c. 689, Pt. B, §6, is further amended to read: 
D. 
Ensure that any calculation of an occupancy percentage or other basis for 
adjusting the rate of reimbursement for nursing facility services to reduce the amount 
paid in response to a decrease in the number of residents in the facility or the 
percentage of the facility's occupied beds excludes all beds that the facility has 
removed from service for all or part of the relevant fiscal period in accordance with 
section 333. If the excluded beds are converted to residential care beds or another 
program for which the department provides reimbursement, nothing in this paragraph 
precludes the department from including those beds for purposes of any occupancy 
standard applicable to the residential care or other program pursuant to duly adopted 
rules of the department; aHd 
Sec. 2. 22 MRSA §1708, sub-§3, ~, as enacted by PL 200 I, c. 666, Pt. A, § I 
and affected by Pt. E, § I, is amended to read: 
E. Contain an annual inflation adjustment that: 
(I) Recognizes regional variations in labor costs and the rates of increase in 
labor costs determined pursuant to the principles of reimbursement and 
establishes at least 4 regions for purposes of annual inflation adjustments; and 
(2) Uses the applicable regional inflation factor as established by a national 
economic research organization selected by the department to adjust costs other 
than labor costs or fixed costs. 
Rules adopted pursuant to this paragraph are routine technical rules as defined in 
Title 5, chapter 375, subchapter-J.l-A,. 2-A; 
Sec. 3. 22 MRSA §1708, sub-§3, ~ 
is enacted to read: 
F. For a facility's fiscal year that ends subsequent to July 1,2007, use as base year 
costs the audited allowable costs of the facility detailed in the facility's audited cost 
report for the fiscal year ending between July 1, 2004 and June 30, 2005; 
Sec. 4. 22 MRS A §1708, sub-§3, ~G is enacted to read: 
G. For a facility's fiscal year that ends subsequent to July 1, 2007, fully reimburse 
the facility's actual heating costs by treating these costs as fixed costs that are not 
subject to routine cost caps or other types of limitations; and 
Sec. 5. 22 MRSA §1708, sub-§3, ~ 
is enacted to read: 
H. 
For a facility's fiscal year ending subsequent to July \, 2007, increase the 
administration and policy-planning ceiling as follows: 
(1) For up to 30 beds, $51,699 plus an additional $873 for each licensed bed over 
beds; 
, 
(2) For 31 to 50 beds, $74,242 plus an additional $747 for each licensed bed over 
beds; 
(3) For 51 to 100 beds, $92,294 plus an additional $496 for each licensed bed 
over 50 beds; and 
(4) For over 100 beds, $124,215 plus an additional $379 for each licensed bed 
over 100 beds. 
The department shall increase the ceiling under this paragraph quarterly to reflect the 
rate of inflation. 
Sec. 6. 22 MRSA § 1720, as enacted by PL 2005, c. 242, § 1, is amended to read: 
§1720. Nursing facility medical director reimbursement 
The department shall include in its calculation of reimbursement for services 
provided by a nursing facility an allowance for the cost of a medical director in a base 
year amount not to exceed equal to the facility's actual costs for compensating medical 
director services up to $10,000, with that amount being subject to an annual cost-of-living 
adjustment. 
Sec. 7. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Nursing Facilities 0148 
Initiative: Appropriates and allocates funds for the costs of rebasing nursing facility costs 
to a base year determined by audited allowable costs for a facility's fiscal year ending 
between July 1,2004 and June 30, 2005. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2007-08 
$6,000,000 
$6,000,000 
2007-08 
$12,000,000 
$12,000,000 
2008-09 
$12,000,000 
$12,000,000 
2008-09 
$24,000,000 
$24,000,000 
SUMMARY 
This bill makes ongoing General Fund appropriations of $6,000,000 in fiscal year 
2007-08 and $12,000,000 in fiscal year 2008-09 and ongoing Federal Expenditure Fund 
allocations of $12,000,000 in fiscal year 2007-08 and $24,000,000 in fiscal year 2008-09 
for the costs of rebasing nursing facility costs to a base year determined by audited 
allowable costs for a facility's fiscal year ending between July 1,2004 and June 30, 2005. 
.. 
This bill requires the Department of Health and Human Services to fully reimburse a 
nursing home's actual heating costs and adjusts the administration and policy-planning 
ceiling and requires the ceiling to be adjusted quarterly according to inflation. This bill 
also requires the Department of Health and Human Services to reimburse a nursing 
facility for actual additional medical director expenses up to $10,000.