An Act Regarding Implementation of Cost-of-living Increases for Nursing Facilities
Maine Legislature, Session 126, LD 1189
Committee: Health and Human Services
Sponsors: GATTINE
Amends: 36 MRSA §2873

Legislative Document 
No. 1189 
H.P. 833 
House of Representatives, March 26, 2013 
An Act Regarding Implementation of Cost-of-living Increases for 
Nursing Facilities 
(EMERGENCY) 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative GATTINE of Westbrook. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, Public Law 2011, chapter 411 requires that funds received from an 
increased provider tax be applied to provide cost-of-living reimbursement to nursing 
homes and to medical and remedial private nonmedical institutions in accordance with 
rules adopted by the Department of Health and Human Services; and 
Whereas, this legislation specifies that for the first year such an adjustment is made, 
reimbursement may be made to facilities that provided a cost-of-living increase to its 
frontline employees in certain prior years; and 
Whereas, in order to ensure this legislation is enacted in sufficient time to apply to 
the first year such an adjustment is made, it must be enacted as an emergency measure; 
and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  36 MRSA §2873, sub-§4, ¶A, as amended by PL 2011, c. 411, §7, is 
further amended to read: 
A.    All revenues received by the assessor during the month pursuant to this chapter 
from nursing homes net of refunds must be credited to the Nursing Facilities Other 
Special Revenue funds account in the Department of Health and Human Services.  
Beginning October 1, 2011, the revenues received in each fiscal year that result from 
the increase in the tax rate from 5.5% to 6% pursuant to section 2872, subsection 1, 
paragraph E must be applied first to reimburse nursing homes for the MaineCare 
portion of the increased tax expense, and all remaining revenue resulting from the 
increase must be applied to provide cost-of-living increases to MaineCare 
reimbursement to nursing homes and to medical and remedial private nonmedical 
institutions that are reimbursed room and board costs and certain other allowable 
costs under rules adopted by the Department of Health and Human Services. These 
rules must use a methodology that provides a cost-of-living increase that ensures that 
such nursing facilities and medical and remedial private nonmedical institutions 
receive a share of the revenues through MaineCare reimbursement of allowable costs 
; and in accordance with this paragraph.  A facility or institution that accepts the cost-
of-living adjustment authorized under this paragraph must provide an equal 
percentage increase in the wages and benefits of all frontline employees in each fiscal 
year for which the adjustment is made, and a facility or institution that does not 
comply with this requirement must have the amount of its reimbursement reduced by 
that portion of the adjustment that: 
(1)  Applies to wage and benefit expense; and 
(2)  Exceeds the percentage increase in wages and benefits actually provided to 
frontline employees during that fiscal year; except that, during the first year in 
which an adjustment is made pursuant to this paragraph, the amount of 
reimbursement is reduced by that portion of the adjustment that exceeds the 
percentage increase in wages and benefits actually provided to frontline 
employees during the facility's or institution's fiscal years ending in 2009, 2010 
and 2011. 
For purposes of this paragraph, "frontline employee" means an employee who works 
in the facility or institution, excluding the administrator.  The Department of Health 
and Human Services shall adopt rules to implement this paragraph to ensure that any 
reduction in reimbursement is limited in accordance with this paragraph; and 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill amends the law governing the nursing facility and assisted living facility 
cost-of-living adjustment enacted by the 125th Legislature to specify that during the first 
year in which an adjustment is made, the reimbursement is reduced by that portion of the 
adjustment that exceeds the percentage increase in wages and benefits actually provided 
to frontline employees during the facility's fiscal years ending in 2009, 2010 and 2011.