An Act To Amend Principles of Reimbursement for Nursing Facilities and for Residential Care Facilities
Maine Legislature, Session 128, LD 0517
Committee Amendment CA_A-SA_A_S321 (Senate)

SENATE AMENDMENT" A "to COMMITTEE AMENDMENT "A" to S.P. 178, 
L.D. 517, Bill, "An Act To Amend Principles of Reimbursement for Nursing Facilities 
and for Residential Care Facilities" 
Amend the amendment by inserting after the title the following: 
'Amend the bill by striking out the title and substituting the following: 
'An Act To Amend Principles of Reimbursement for Residential Care Facilities' ' 
Amend the amendment in the first line after the title (page 1, line 12 in amendment) 
by striking out the following: 
and inserting the following: 
and inserting the following: '.' 
Amend the amendment by striking out all of section 1. 
Amend the amendment on page 1 by striking out all of lines 27 to 33 and on page 2 
by striking out all of lines 1 to 12. 
Amend the amendment by inserting at the end the following: 
'Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively.' 
SUMMARY 
FISCAL 1\'0TE REQt:IRED 
{See attached) 
SENATE AMENDMENT 
Approved: 07/11/17 feac 
LD517 
LR 975(04) 
An Act To Amend Principles of Reimbursement for Nursing Facilities and for Residential Care 
Facilities 
Fiscal Note for Senate Amendment'~' to Committee Amendment "A" 
Sponsor: Sen. Hamper of Oxford 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2017-18 
($26,448) 
($26,448) 
($57,401) 
($5,352) 
($57,401) 
($5,352) 
FY 2018-19 
($28,862) 
($28,862) 
($62,609) 
($5,839) 
($62,609) 
($5,839) 
Projections 
FY 2019-20 
($28,862) 
($28,862) 
($62,609) 
($5,839) 
($62,609) 
($5,839) 
Projections 
FY 2020-21 
($28,862) 
($28,862) 
($62,609) 
($5,839) 
($62,609) 
($5,839) 
This amendment removes section 1 of the bill which allowed for nursing facilites to increase the cap on the cost of a 
medical director from $10,000 to $22,000. Removing this section eliminates all appropriations and allocations from 
the bill. 
As amended, this bill would still require the Department of Health and Human Services to permit capital expenditures 
by residential care facilities (RCF) that are less than $500,000 without prior approval and to provide an extraordinary 
circumstance allowance in permitted reimbursement to RCF's. As outlined in the original fiscal note, the costs 
incurred by an RCF to comply with federal or state laws, regulations and rules shall be considered reasonable and 
necessary costs. These additional changes to the Residential Care Facilities will increase costs that will largely be 
necessitated by decisions of the RCFs that cannot be projected by the department. Since new construction, 
acquisitions, and renovations apply to room and board and not direct care, which cannot be reimbursed with federal 
funds per 42 CPR 440.182, it is also expected that these costs would be reimbursed entirely by the General Fund. 
LR0975(04) - Fiscal Note - Page 1 of 1