Resolve, To Implement the Recommendations of the Commission To Continue the Study of Long-term Care Facilities
Maine Legislature, Session 127, LD 0087
Committee: Health and Human Services
Sponsors: STUCKEY, BURNS, FARNSWORTH, MAKER, TURNER, BREEN, SAVIELLO

Legislative Document 
No. 87 
H.P. 70 
House of Representatives, January 16, 2015 
Resolve, To Implement the Recommendations of the Commission To 
Continue the Study of Long-term Care Facilities 
(EMERGENCY) 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
ROBERT B. HUNT 
Clerk 
Presented by Representative STUCKEY of Portland. 
Cosponsored by Senator BURNS of Washington and 
Representatives: FARNSWORTH of Portland, MAKER of Calais, McELWEE of Caribou, 
TURNER of Burlington, Senators: BREEN of Cumberland, SAVIELLO of Franklin. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, the people of the State need and deserve a variety of well-planned and 
financially stable long-term care services in home-based and community-based care 
settings and in nursing facilities in their communities; and 
Whereas, recent closures of nursing facilities, in particular in rural and underserved 
areas of the State, have had a significant impact on Maine families and communities; and 
Whereas, in order to provide high-quality care to Maine's elderly and disabled 
persons and to maintain access to services across the State, the Legislature must take 
immediate action to continue a thoughtful and thorough planning process; 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 
Sec. 1.  Amendment of Principles of Reimbursement for Nursing 
Facilities.  Resolved:  That the Department of Health and Human Services shall amend 
Rule Chapter 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of 
Reimbursement for Nursing Facilities as follows. 
1.  Occupancy adjustment.  The rule must be amended to decrease the occupancy 
percentage threshold required for a nursing facility with more than 60 beds from 90% to 
80% and for a nursing facility with 60 beds or fewer from 85% to 75%. 
2.  Continuing education for direct care staff.  The rule must be amended so that 
the cost of continuing education for direct care staff is included as a direct care cost 
component rather than a routine cost component. 
3.  Crossover payments.  The rule must be amended to restore crossover payments 
to nursing facilities related to the nondual Qualified Medicare Beneficiary program 
population of the Medicare Savings Program for whom coverage was eliminated in 
Public Law 2013, chapter 368. 
4.  Critical access nursing facility designation.  The rule must be amended to create 
a critical access nursing facility designation using criteria that are sensitive to the unique 
access challenges in remote areas of the State.  The rule must also be amended to provide 
that a critical access nursing facility designation qualifies as an allowable exception to 
MaineCare budget neutrality.  The department shall seek the approval of the federal 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
for the new designation and implement it by April 15, 2015. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This resolve directs the Department of Health and Human Services to amend Rule 
Chapter 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of 
Reimbursement for Nursing Facilities to: 
1.  Decrease the occupancy percentage threshold required for a nursing facility with 
more than 60 beds from 90% to 80% and for a nursing facility with 60 beds or fewer from 
85% to 75%; 
2.  Provide that the cost of continuing education for direct care staff is included as a 
direct care cost component rather than a routine cost component; 
3.  Restore crossover payments to nursing facilities related to the nondual Qualified 
Medicare Beneficiary program population of the Medicare Savings Program for whom 
coverage was eliminated in Public Law 2013, chapter 368; and 
4.  Create a critical access nursing facility designation using criteria that are sensitive 
to the unique access challenges in remote areas of the State and provide that a critical 
access nursing facility designation qualifies as an allowable exception to MaineCare 
budget neutrality.