reglab/housing_qa huggingface dataset:
MN Stat § 256R.39 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.39 — Quality Improvement Incentive Program.

256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM. The commissioner shall develop a quality improvement incentive program in consultation with stakeholders. The annual funding pool available for quality improvement incentive payments shall be equal to 0.8 percent of all operating payments, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under section 256R.48, critical access nursing facility program participation under section 256R.47, or performance-based incentive payment program participation under section 256R.38. For the period from October 1, 2015, to December 31, 2016, rate adjustments provided under this section shall be effective for 15 months. Beginning January 1, 2017, annual rate adjustments provided under this section shall be effective for one rate year. History:   2016 c 99 art 1 s 26
MN Stat § 256R.41 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.41 — Single-bed Room Incentive.

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 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 either the first day of the month of January or July, whichever occurs first following the date of the bed delicensure. (b) A nursing facility is prohibited from discharging residents for purposes of establishing single-bed rooms. A nursing facility must submit documentation to the commissioner in a form prescribed by the commissioner, certifying the occupancy status of beds closed to create single-bed rooms. In the event that the commissioner determines that a facility has discharged a resident for purposes of establishing a single-bed room, the commissioner shall not provide a rate adjustment under paragraph (a). History:  2016 c 99 art 1 s 28; 1Sp2017 c 6 art 3 s 44
MN Stat § 256R.42 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.42 — Rate Adjustment For The First 30 Days.

256R.42 RATE ADJUSTMENT FOR THE FIRST 30 DAYS. (a) During the first 30 calendar days after admission, the total payment rate for a case mix classification must be increased by 20 percent. Beginning with the 31st calendar day after admission, the total payment rate is the rate otherwise determined under this chapter. (b) The enhanced rates under this section shall not be allowed if a resident has resided during the previous 30 calendar days in: (1) the same nursing facility; (2) a nursing facility owned or operated by a related party; or (3) a nursing facility or part of a facility that closed or was in the process of closing. History:   2016 c 99 art 1 s 29
MN Stat § 256R.43 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.43 — Bed Holds.

256R.43 BED HOLDS. The commissioner shall limit payment for leave days in a nursing facility to 30 percent of that nursing facility's total payment rate for the involved resident, and shall allow this payment only when the occupancy of the nursing facility, inclusive of bed hold days, is equal to or greater than 96 percent, notwithstanding Minnesota Rules, part 9505.0415. History:   2016 c 99 art 1 s 30
MN Stat § 256R.44 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.44 — Rate Adjustment For Private Rooms For Medical Necessity.

256R.44 RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL NECESSITY. (a) 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 or advanced practice registered nurse and submitted to the commissioner for approval or denial by the commissioner on the basis of medical necessity. (b) For a nursing facility with a total property payment rate determined under section 256R.26, subdivision 8, 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. 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. History:  2016 c 99 art 1 s 31; 1Sp2019 c 9 art 4 s 24; 2020 c 115 art 4 s 132
MN Stat § 256R.45 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.45 — Rate Adjustment For Ventilator-dependent Persons.

256R.45 RATE ADJUSTMENT FOR VENTILATOR-DEPENDENT PERSONS. The commissioner may negotiate with a nursing facility eligible to receive medical assistance payments to provide services to a ventilator-dependent person identified by the commissioner according to criteria developed by the commissioner, including: (1) nursing facility care has been recommended for the person by a preadmission screening team; (2) the person has been hospitalized and no longer requires inpatient acute care hospital services; and (3) the commissioner has determined that necessary services for the person cannot be provided under existing nursing facility rates. The commissioner may negotiate an adjustment to the operating payment rate for a nursing facility with a resident who is ventilator-dependent, for that resident. The negotiated adjustment must reflect only the actual additional cost of meeting the specialized care needs of a ventilator-dependent person identified by the commissioner for whom necessary services cannot be provided under existing nursing facility rates and which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 9505.0475. The negotiated payment rate must not exceed 300 percent of the case mix adjusted operating payment rate for the highest case mix classification. The negotiated adjustment shall not affect the payment rate charged to private paying residents under the provisions of section 256R.06, subdivision 2. History:   2016 c 99 art 1 s 32
MN Stat § 256R.46 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.46 — Specialized Care Facilities.

256R.46 SPECIALIZED CARE FACILITIES. (a) The total care-related payment rate limit for specialized care facilities shall be increased by 50 percent. (b) "Specialized care facilities" are defined as a facility having a program licensed under chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1, 2015, located in Robbinsdale that specializes in the treatment of Huntington's Disease. History:   2016 c 99 art 1 s 33
MN Stat § 256R.48 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.48 — Publicly Owned Facilities.

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 1.0, 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. (b) Rates determined under this section shall take effect in accordance with the rate year in section 256R.02, subdivision 41, based on the most recent available cost report. (c) Eligible nursing facilities that wish to participate under this section shall make an application to the commissioner by September 30 to be allowed participation on the following January 1. (d) For each participating nursing facility, the public entity that owns the physical plant or is the license holder of the nursing facility shall pay to the state the entire nonfederal share of medical assistance payments received as a result of the difference between the nursing facility's payment rate under this section, and the rates that the nursing facility would otherwise be paid without application of this section under section 256R.21 as determined by the commissioner. (e) The commissioner may, at any time, reduce the payments under this section based on the commissioner's determination that the payments shall cause nursing facility rates to exceed the state's Medicare upper payment limit or any other federal limitation. If the commissioner determines a reduction is necessary, the commissioner shall reduce all payment rates for participating nursing facilities by a percentage applied to the amount of increase they would otherwise receive under this section and shall notify participating facilities of the reductions. If payments to a nursing facility are reduced, payments under section 256B.19, subdivision 1e, shall be reduced accordingly. History:   2016 c 99 art 1 s 35
MN Stat § 256R.481 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.481 — Rate Adjustments For Border City Facilities.

256R.481 RATE ADJUSTMENTS FOR BORDER CITY FACILITIES. (a) The commissioner shall allow each nonprofit nursing facility located within the boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once annually for a rate add-on to the facility's external fixed costs payment rate. (b) A facility seeking an add-on to its external fixed costs payment rate under this section must apply annually to the commissioner to receive the add-on. A facility must submit the application within 60 calendar days of the effective date of any add-on under this section. The commissioner may waive the deadlines required by this paragraph under extraordinary circumstances. (c) The commissioner shall provide the add-on to each eligible facility that applies by the application deadline. (d) The add-on to the external fixed costs payment rate is the difference on January 1 of the median total payment rate for case mix classification PA1 of the nonprofit facilities located in an adjacent city in another state and in cities contiguous to the adjacent city minus the eligible nursing facility's total payment rate for case mix classification PA1 as determined under section 256R.22, subdivision 4. History:   1Sp2019 c 9 art 4 s 25
MN Stat § 256R.51 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.51 — Rate Adjustment For Special Dietary Needs.

256R.51 RATE ADJUSTMENT FOR SPECIAL DIETARY NEEDS. (a) The commissioner shall adjust the rates of a nursing facility that meets the criteria for the special dietary needs of its residents and the requirements in section 31.651 or 31.658. The adjustment for raw food cost shall be the difference between the nursing facility's most recently reported allowable raw food cost per resident day and 115 percent of the median allowable raw food cost per resident day. This amount shall be removed from other care-related costs per resident day as determined in section 256R.23, subdivision 3, and included in the external fixed costs payment rate under section 256R.25. (b) In calculating a nursing facility's other care-related costs per day for the purposes of comparing to an array, a median, or other statistical measure of nursing facility payment rates used to determine future rate adjustments under this chapter, the commissioner shall exclude adjustments for raw food costs under this section. History:   2016 c 99 art 1 s 38
MN Stat § 256R.53 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256R — Nursing Facility Rates|Section 256R.53 — Facility Specific Exemptions.

256R.53 FACILITY SPECIFIC EXEMPTIONS. Subdivision 1. Nursing facility in Golden Valley. The operating payment rate for a facility located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed rehabilitation beds as of January 7, 2015, is the sum of its direct care costs per standardized day, its other care-related costs per resident day, and its other operating costs per day. Subd. 2.  MS 2018 [Repealed, 1Sp2019 c 9 art 4 s 30] History:   2016 c 99 art 1 s 40
MN Stat § 256S.01 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.01 — Generally.

256S.01 GENERALLY. Subdivision 1. Authority. The commissioner is authorized to apply for a home and community-based services waiver for the elderly, authorized under section 1915(c) of the Social Security Act, to obtain federal financial participation to expand the availability of services for persons who are eligible for medical assistance. The commissioner may apply for additional waivers or pursue other federal financial participation that is advantageous to the state for funding home care services for the elderly who are eligible for medical assistance. The provision of waiver services to an elderly person receiving medical assistance must comply with the criteria for service definitions and provider standards approved in the elderly waiver. Subd. 2. Transition plan compliance. The commissioner shall comply with the requirements in the federally approved transition plan for the elderly waiver authorized under this chapter. Subd. 3. Services and supports requirements. (a) Services and supports provided under this chapter must meet the requirements in United States Code, title 42, section 1396n. (b) Services and supports provided under this chapter must promote consumer choice and be arranged and provided consistent with individualized, written coordinated service and support plans. Subd. 4. Payment for services. Reimbursement for the services provided to a participant under this chapter and under the elderly waiver must be made from the medical assistance account through the invoice processing procedures of the department's Medicaid Management Information System (MMIS), only with the approval of the participant's case manager. Subd. 5. Expenditure forecast. The budget for the state share of the Medicaid expenditures under this chapter must be forecasted with the medical assistance budget, and shall be consistent with the elderly waiver. Subd. 6. Immunity; consumer-directed community supports. The state of Minnesota, or a county, managed care plan, county-based purchasing plan, or tribal government under contract to administer the elderly waiver, is not liable for damages, injuries, or liabilities sustained as a result of the participant, the participant's family, or the participant's authorized representatives purchasing direct supports or goods with funds received through consumer-directed community supports under the elderly waiver. Liabilities include, but are not limited to, workers' compensation liability, Federal Insurance Contributions Act under United States Code, title 26, subtitle c, chapter 21, or Federal Unemployment Tax Act under Internal Revenue Code, chapter 23. History:  2019 c 54 art 1 s 1; 1Sp2020 c 2 art 2 s 31
MN Stat § 256S.03 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.03 — Administration By Tribes.

256S.03 ADMINISTRATION BY TRIBES. Notwithstanding any other state laws or rules, the commissioner may develop a model for tribal management of the elderly waiver and implement this model through a contract between the state and any of the state's federally recognized tribal governments. The model shall include the provision of tribal elderly waiver case management, assessment for personal care assistance, and administrative requirements otherwise carried out by lead agencies but shall not include tribal financial eligibility determination for medical assistance. History:   2019 c 54 art 1 s 3
MN Stat § 256S.04 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.04 — Limits Of Elderly Waiver Cases.

256S.04 LIMITS OF ELDERLY WAIVER CASES. The number of elderly waiver participants that a lead agency may serve must be allocated according to the number of elderly waiver cases open on July 1 of each fiscal year. Additional elderly waiver participants may be served with the approval of the commissioner. History:   2019 c 54 art 1 s 4
MN Stat § 256S.05 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.05 — Eligibility.

256S.05 ELIGIBILITY. Subdivision 1. Elderly waiver plan eligibility requirements. In addition to the requirements of this section, applicants and participants must meet all eligibility requirements in the elderly waiver plan. Subd. 2. Nursing facility level of care determination required. Notwithstanding other assessments identified in section 144.0724, subdivision 4, only assessments conducted according to section 256B.0911, subdivisions 3, 3a, and 3b, that result in a nursing facility level of care determination at initial and subsequent assessments shall be accepted for purposes of a participant's initial and ongoing participation in the elderly waiver and a service provider's access to service payments under this chapter. Subd. 3. Maintenance needs allowance. Notwithstanding section 256B.056, when applying posteligibility treatment of income rules to the gross income of an elderly waiver participant, unless the participant's income is in excess of the special income standard according to Code of Federal Regulations, title 42, section 435.236, the participant's maintenance needs allowance is the sum of the MSA equivalent rate, as defined in section 256I.03, subdivision 5, plus the medical assistance personal needs allowance, as described in section 256B.35, subdivision 1, paragraph (a). Each participant's maintenance needs allowance must be adjusted each July 1. Subd. 4. Spousal impoverishment policies. For the purposes of eligibility for elderly waiver services, the commissioner shall apply the spousal impoverishment criteria as authorized under United States Code, title 42, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059, except that a participant with income at or below the special income standard according to Code of Federal Regulations, title 42, section 435.236, shall receive the maintenance needs allowance in subdivision 3. Subd. 5. Managed care elderly waiver services. A participant who is enrolled in a managed care organization is not eligible to receive county-administered fee-for-service elderly waiver services. History:  2019 c 54 art 1 s 5; 1Sp2021 c 7 art 6 s 25
MN Stat § 256S.06 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.06 — Assessments And Reassessments.

256S.06 ASSESSMENTS AND REASSESSMENTS. Subdivision 1. Initial assessments. A lead agency shall provide each participant with an initial long-term care consultation assessment of strengths, informal supports, and need for services according to section 256B.0911, subdivisions 3, 3a, and 3b. Subd. 2. Annual reassessments. At least every 12 months, a lead agency shall provide each participant with an annual long-term care consultation reassessment according to section 256B.0911, subdivisions 3, 3a, and 3b. Subd. 3. Change-in-condition reassessments. (a) The lead agency shall conduct a change-in-condition reassessment before the annual reassessment if a participant's condition changed due to a major health event, an emerging need or risk, or a worsening health condition, or when the current services do not meet the participant's needs. (b) A change-in-condition reassessment may be initiated by the lead agency, may be requested by the participant, or may be requested on the participant's behalf by another party, such as a service provider. (c) The lead agency shall: (1) complete a change-in-condition reassessment no later than 20 calendar days from the date of a request; (2) conduct a change-in-condition reassessment in a timely manner and expedite urgent requests; and (3) evaluate urgent requests based on the participant's needs and the risk to the participant if a change-in-condition reassessment is not completed. History:   2019 c 54 art 1 s 6
MN Stat § 256S.07 (2021)
2021 Minnesota Statutes|Chapters 245 - 267 — Public Welfare And Related Activities|Chapter 256S — Medical Assistance Elderly Waiver|Section 256S.07 — Case Management Administration.

256S.07 CASE MANAGEMENT ADMINISTRATION. Subdivision 1. Elderly waiver case management provided by counties and tribes. For participants not enrolled in a managed care organization, the county of residence or tribe must provide or arrange to provide elderly waiver case management activities under section 256S.09, subdivisions 2 and 3. Subd. 2. Elderly waiver case management provided by managed care organizations. Notwithstanding any requirements in this chapter and in accordance with contract requirements established by the commissioner, for participants enrolled in a managed care organization, the managed care organization must provide or arrange to provide elderly waiver case management activities under section 256S.09, subdivisions 2 and 3. History:   2019 c 54 art 1 s 7