reglab/statecodes huggingface dataset:
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256N — Northstar Care For Children › Section 256N.261 — Support For Adoptive, Foster, And Kinship Families.

256N.261 SUPPORT FOR ADOPTIVE, FOSTER, AND KINSHIP FAMILIES.
Subdivision 1.
Program established.
The commissioner shall design and implement a coordinated program to reduce the need for placement changes or out-of-home placements of children and youth in foster care, adoptive placements, and permanent physical and legal custody kinship placements, and to improve the functioning and stability of these families. To the extent federal funds are available, the commissioner shall provide the following adoption and foster care-competent services and ensure that placements are trauma-informed and child and family-centered:
(1) a program providing information, referrals, a parent-to-parent support network, peer support for youth, family activities, respite care, crisis services, educational support, and mental health services for children and youth in adoption, foster care, and kinship placements and adoptive, foster, and kinship families in Minnesota;
(2) training offered statewide in Minnesota for foster, adoptive, and kinship families, and the professionals who serve the families, on the effects of trauma, common disabilities of adopted children and children in foster care and kinship placements, and challenges in adoption, foster care, and kinship placements; and
(3) periodic evaluation of these services to ensure program effectiveness in preserving and improving the success of adoptive, foster, and kinship placements.
Subd. 2.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Child and family-centered" means individualized services that respond to a child's or youth's strengths, interests, and current developmental stage, including social, cognitive, emotional, physical, cultural, racial, and spiritual needs, and offer support to the entire adoptive, foster, or kinship family.
(c) "Trauma-informed" means care that acknowledges the effect trauma has on children and the children's families; modifies services to respond to the effects of trauma; emphasizes skill and strength-building rather than symptom management; and focuses on the physical and psychological safety of the child and family.
History:
1Sp2017 c 6 art 7 s 28; 2018 c 182 art 1 s 60
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256P — Economic Assistance Program Eligibility And Verification › Section 256P.001 — Applicability.

256P.001 APPLICABILITY.
General assistance and Minnesota supplemental aid under chapter 256D, child care assistance programs under chapter 119B, and programs governed by chapter 256I or 256J are subject to the requirements of this chapter, unless otherwise specified or exempted.
History:
2014 c 312 art 28 s 31; 2015 c 71 art 5 s 22,35
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256P — Economic Assistance Program Eligibility And Verification › Section 256P.03 — Earned Income Disregard.

256P.03 EARNED INCOME DISREGARD.
Subdivision 1.
Exempted programs.
Participants who qualify for child care assistance programs under chapter 119B, Minnesota supplemental aid under chapter 256D, and housing support under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section.
Subd. 2.
Earned income disregard.
The agency shall disregard the first $65 of earned income plus one-half of the remaining earned income per month.
History:
2014 c 312 art 28 s 34; 2015 c 71 art 5 s 27,35; 1Sp2017 c 6 art 2 s 39
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256P — Economic Assistance Program Eligibility And Verification › Section 256P.05 — Self-employment Earnings.

256P.05 SELF-EMPLOYMENT EARNINGS.
Subdivision 1.
Exempted programs.
Participants who qualify for Minnesota supplemental aid under chapter 256D and housing support under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section. Participants who qualify for child care assistance programs under chapter 119B are exempt from subdivision 3.
Subd. 2.
Self-employment income determinations.
Applicants and participants must choose one of the methods described in this subdivision for determining self-employment earned income. An agency must determine self-employment income, which is either:
(1) one-half of gross earnings from self-employment; or
(2) taxable income as determined from an Internal Revenue Service tax form that has been filed with the Internal Revenue Service for the most recent year and according to guidance provided for the Supplemental Nutrition Assistance Program. A 12-month average using taxable income shall be used to budget monthly income.
Subd. 3.
Self-employment budgeting.
(a) The self-employment budget period begins in the month of application or in the first month of self-employment.
(b) Applicants and participants who elect to use taxable income as described in subdivision 2, clause (2), to determine self-employment income must continue to use this method until recertification, unless there is an unforeseen significant change in gross income equaling a decline in gross income of the amount equal to or greater than the earned income disregard as defined in section 256P.03 from the income used to determine the benefit for the current month.
(c) For applicants and participants who elect to use one-half of gross earnings as described in subdivision 2, clause (1), to determine self-employment income, earnings must be counted as income in the month received.
History:
2014 c 312 art 28 s 36; 2015 c 71 art 5 s 30,35; 1Sp2017 c 6 art 2 s 39; 1Sp2021 c 7 art 7 s 24
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256P — Economic Assistance Program Eligibility And Verification › Section 256P.09 — Prospective Budgeting Of Benefits.

256P.09 PROSPECTIVE BUDGETING OF BENEFITS.
Subdivision 1.
Exempted programs.
Assistance units that qualify for child care assistance programs under chapter 119B, assistance units that receive housing support under chapter 256I and are not subject to reporting under section 256P.10, and assistance units that qualify for Minnesota supplemental aid under chapter 256D are exempt from this section.
Subd. 2.
Prospective budgeting of benefits.
An agency subject to this chapter must use prospective budgeting to calculate the assistance payment amount.
Subd. 3.
Initial income.
For the purpose of determining an assistance unit's level of benefits, an agency must take into account the income already received by the assistance unit during or anticipated to be received during the application period. Income anticipated to be received only in the initial month of eligibility must only be counted in the initial month.
Subd. 4.
Income determination.
An agency must use prospective budgeting to determine the amount of the assistance unit's benefit for the eligibility period based on the best information available at the time of approval. An agency shall only count anticipated income when the participant and the agency are reasonably certain of the amount of the payment and the month in which the payment will be received. If the exact amount of the income is not known, the agency shall consider only the amounts that can be anticipated as income.
Subd. 5.
Income changes.
An increase in income shall not affect an assistance unit's eligibility or benefit amount until the next review unless otherwise required to be reported in section 256P.07. A decrease in income shall be effective on the date that the change occurs if the change is reported by the tenth of the month following the month when the change occurred. If the assistance unit does not report the change in income by the tenth of the month following the month when the change occurred, the change in income shall be effective on the date that the change was reported.
History:
2023 c 70 art 10 s 91
NOTE:
This section, as added by Laws 2023, chapter 70, article 10, section 91, is effective March 1, 2025. Laws 2023, chapter 70, article 10, section 91, the effective date.
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256P — Economic Assistance Program Eligibility And Verification › Section 256P.10 — Six-month Reporting.

256P.10 SIX-MONTH REPORTING.
Subdivision 1.
Exempted programs.
Assistance units that qualify for child care assistance programs under chapter 119B, assistance units that qualify for Minnesota supplemental aid under chapter 256D, and assistance units that qualify for housing support under chapter 256I and also receive Supplemental Security Income are exempt from this section.
Subd. 2.
Reporting.
(a) Every six months, an assistance unit that qualifies for the Minnesota family investment program under chapter 256J, an assistance unit that qualifies for general assistance under chapter 256D with an earned income of $100 per month or greater, or an assistance unit that qualifies for housing support under chapter 256I with an earned income of $100 per month or greater is subject to six-month reviews. The initial reporting period may be shorter than six months in order to align with other programs' reporting periods.
(b) An assistance unit that qualifies for the Minnesota family investment program or an assistance unit that qualifies for general assistance with an earned income of $100 per month or greater must complete household report forms as required by the commissioner for redetermination of benefits.
(c) An assistance unit that qualifies for housing support with an earned income of $100 per month or greater must complete household report forms as prescribed by the commissioner to provide information about earned income.
(d) An assistance unit that qualifies for housing support and also receives assistance through the Minnesota family investment program is subject to the requirements of this section for purposes of the Minnesota family investment program but not for housing support.
(e) An assistance unit covered by this section must submit a household report form in compliance with the provisions in section 256P.04, subdivision 11.
(f) An assistance unit covered by this section may choose to report changes under this section at any time.
Subd. 3.
When to terminate assistance.
(a) An agency must terminate benefits when the assistance unit fails to submit the household report form before the end of the six-month review period. If the assistance unit submits the household report form within 30 days of the termination of benefits and remains eligible, benefits must be reinstated and made available retroactively for the full benefit month.
(b) When an assistance unit is determined to be ineligible for assistance according to this section and chapter 256D, 256I, or 256J, the agency must terminate assistance.
History:
2023 c 70 art 10 s 92
NOTE:
This section, as added by Laws 2023, chapter 70, article 10, section 92, is effective March 1, 2025. Laws 2023, chapter 70, article 10, section 92, the effective date.
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256Q — Minnesota Able Plan › Section 256Q.01 — Plan Established.

256Q.01 PLAN ESTABLISHED.
A savings plan known as the Minnesota ABLE plan is established. In establishing this plan, the legislature seeks to encourage and assist individuals and families in saving private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life, and to provide secure funding for disability-related expenses on behalf of designated beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, the Medicaid program under title XIX of the Social Security Act, the Supplemental Security Income program under title XVI of the Social Security Act, the beneficiary's employment, and other sources.
History:
2015 c 71 art 7 s 44
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256Q — Minnesota Able Plan › Section 256Q.04 — Able Plan Requirements.

256Q.04 ABLE PLAN REQUIREMENTS.
Subdivision 1.
State residency requirement.
The designated beneficiary of an ABLE account must be a resident of Minnesota, or the resident of a state that has entered into a contract with Minnesota to provide its residents access to the Minnesota ABLE plan.
Subd. 2.
Single account requirement.
No more than one ABLE account shall be established per beneficiary, except as permitted under section 529A(c)(4) of the Internal Revenue Code.
Subd. 3.
Accounts-type plan.
The plan must be operated as an accounts-type plan. A separate account must be maintained for each designated beneficiary for whom contributions are made.
Subd. 4.
Contribution and account requirements.
Contributions to an ABLE account are subject to the requirements of section 529A(b)(2) of the Internal Revenue Code prohibiting noncash contributions and contributions in excess of the annual contribution limit. The total account balance may not exceed the maximum account balance limit imposed under section 136G.09, subdivision 8.
Subd. 5.
Limited investment direction.
Designated beneficiaries may not direct the investment of assets in their accounts more than twice in any calendar year.
Subd. 6.
Security for loans.
An interest in an account must not be used as security for a loan.
History:
2015 c 71 art 7 s 47
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256Q — Minnesota Able Plan › Section 256Q.06 — Plan Accounts.

256Q.06 PLAN ACCOUNTS.
Subdivision 1.
Contributions to an account.
Any person may make contributions to an ABLE account on behalf of a designated beneficiary. Contributions to an account made by persons other than the account owner become the property of the account owner. A person does not acquire an interest in an ABLE account by making contributions to an account. Contributions to an account must be made in cash, by check, or by other commercially acceptable means, as permitted by the Internal Revenue Service and approved by the plan administrator in cooperation with the commissioner and the board.
Subd. 2.
Contribution and account limitations.
Contributions to an ABLE account are subject to the requirements of section 529A(b) of the Internal Revenue Code. The total account balance of an ABLE account may not exceed the maximum account balance limit imposed under section 136G.09, subdivision 8. The plan administrator must reject any portion of a contribution to an account that exceeds the annual contribution limit or that would cause the total account balance to exceed the maximum account balance limit imposed under section 136G.09, subdivision 8.
Subd. 3.
Authority of account owner.
An account owner is the only person entitled to:
(1) request distributions;
(2) request rollover distributions; or
(3) change the beneficiary of an ABLE account to a member of the family of the current beneficiary, but only if the beneficiary to whom the ABLE account is transferred is an eligible individual.
Subd. 4.
Effect of plan changes on participation agreement.
Amendments to this chapter automatically amend the participation agreement. Any amendments to the operating procedures and policies of the plan automatically amend the participation agreement after adoption by the commissioner or the board.
Subd. 5.
Special account to hold plan assets in trust.
All assets of the plan, including contributions to accounts, are held in trust for the exclusive benefit of account owners. Assets must be held in a separate account in the state treasury to be known as the Minnesota ABLE plan account or in accounts with the third-party provider selected pursuant to section 256Q.05, subdivision 4. Plan assets are not subject to claims by creditors of the state, are not part of the general fund, and are not subject to appropriation by the state. Payments from the Minnesota ABLE plan account shall be made under this chapter.
Subd. 6.
Account creation.
If an eligible individual is unable to establish the eligible individual's own ABLE account, an ABLE account may be established on behalf of the eligible individual by the eligible individual's agent under a power of attorney or, if none, by the eligible individual's conservator or legal guardian, spouse, parent, sibling, or grandparent or a representative payee appointed for the eligible individual by the Social Security Administration, in that order.
History:
2015 c 71 art 7 s 49; 2022 c 98 art 4 s 48
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256Q — Minnesota Able Plan › Section 256Q.07 — Investment Of Able Accounts.

256Q.07 INVESTMENT OF ABLE ACCOUNTS.
Subdivision 1.
State Board of Investment to invest.
The State Board of Investment shall invest the money deposited in accounts in the plan.
Subd. 2.
Permitted investments.
The board may invest the accounts in any permitted investment under section 11A.24, except that the accounts may be invested without limit in investment options from open-ended investment companies registered under the federal Investment Company Act of 1940, United States Code, title 15, sections 80a-1 to 80a-64.
Subd. 3.
Contracting authority.
The board may contract with one or more third parties for investment management, record keeping, or other services in connection with investing the accounts. The board and commissioner may jointly contract with third-party providers, if the commissioner and board determine that it is desirable to contract with the same entity or entities for administration and investment management.
History:
2015 c 71 art 7 s 50
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256Q — Minnesota Able Plan › Section 256Q.08 — Account Distributions.

256Q.08 ACCOUNT DISTRIBUTIONS.
Subdivision 1.
Qualified distribution methods.
(a) Qualified distributions may be made:
(1) directly to participating providers of goods and services that are qualified disability expenses, if purchased for a beneficiary;
(2) in the form of a check payable to both the beneficiary and provider of goods or services that are qualified disability expenses; or
(3) directly to the beneficiary, if the beneficiary has already paid qualified disability expenses.
(b) Qualified distributions must be withdrawn proportionally from contributions and earnings in an account owner's account on the date of distribution as provided in section 529A of the Internal Revenue Code.
Subd. 2.
Distributions upon death of a beneficiary.
Upon the death of a beneficiary, the amount remaining in the beneficiary's account must be distributed pursuant to section 529A(f) of the Internal Revenue Code.
Subd. 3.
Nonqualified distribution.
An account owner may request a nonqualified distribution from an account at any time. Nonqualified distributions are based on the total account balances in an account owner's account and must be withdrawn proportionally from contributions and earnings as provided in section 529A of the Internal Revenue Code. The earnings portion of a nonqualified distribution is subject to a federal additional tax pursuant to section 529A of the Internal Revenue Code. For purposes of this subdivision, "earnings portion" means the ratio of the earnings in the account to the total account balance, immediately prior to the distribution, multiplied by the distribution.
History:
2015 c 71 art 7 s 51
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.01 — General.

256R.01 GENERAL.
Subdivision 1.
Payment rates.
Payment rates paid to any nursing facility receiving medical assistance payments must be those rates established pursuant to this chapter and rules adopted under it.
Subd. 2.
Authority of commissioner.
The commissioner shall establish, by rule, procedures for determining rates for care of residents of nursing facilities which qualify as vendors of medical assistance, and for implementing the provisions of this chapter and section 256B.50. The procedures shall specify the costs that are allowable for establishing payment rates through medical assistance.
Subd. 3.
Compliance with federal requirements.
If any provision of this chapter and section 256B.50 is determined by the United States government to be in conflict with existing or future requirements of the United States government with respect to federal participation in medical assistance, the federal requirements shall prevail.
History:
2016 c 99 art 1 s 1
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.05 — Required Practices.

256R.05 REQUIRED PRACTICES.
Subdivision 1.
Preadmission screening.
(a) Medical assistance reimbursement for nursing facilities shall be authorized for a medical assistance recipient only if a preadmission screening has been conducted prior to admission or the county has authorized an exemption. Medical assistance reimbursement for nursing facilities shall not be provided for any recipient who the local screener has determined does not meet the level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 1987, unless an admission for a recipient with mental illness is approved by the local mental health authority or an admission for a recipient with developmental disability is approved by the state developmental disability authority.
(b) The nursing facility must not bill a person who is not a medical assistance recipient for resident days that preceded the date of completion of screening activities as required under section 256.975, subdivisions 7a to 7c. The nursing facility must include unreimbursed resident days in the nursing facility resident day totals reported to the commissioner.
Subd. 2.
Referrals to Medicare providers.
(a) Notwithstanding sections 256R.04 and 256R.06, subdivisions 2 and 4, nursing facility providers that do not participate in or accept Medicare assignment must refer and document the referral of dual eligible recipients for whom placement is requested and for whom the resident would be qualified for a Medicare-covered stay to Medicare providers. The commissioner shall audit nursing facilities that do not accept Medicare and determine if dual eligible individuals with Medicare qualifying stays have been admitted. If such a determination is made, the commissioner shall deny Medicaid payment for the first 20 days of that resident's stay.
(b) A nursing facility that violates this subdivision is subject to section 256R.04, subdivisions 7 and 8.
History:
2016 c 99 art 1 s 5
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.11 — Nonallowed Costs.

256R.11 NONALLOWED COSTS.
Subdivision 1.
Generally.
(a) The following costs shall not be recognized as allowable:
(1) political contributions;
(2) salaries or expenses of a lobbyist, as defined in section 10A.01, subdivision 21, for lobbying activities;
(3) advertising designed to encourage potential residents to select a particular nursing facility;
(4) assessments levied by the commissioner of health for uncorrected violations;
(5) legal and related expenses for unsuccessful challenges to decisions by governmental agencies;
(6) memberships in sports, health or similar social clubs or organizations;
(7) costs incurred for activities directly related to influencing employees with respect to unionization; and
(8) costs of providing services which are billed separately from the nursing facility's payment rate or pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475.
(b) The commissioner shall by rule exclude the costs of any other items not directly related to the provision of resident care.
Subd. 2.
Collective bargaining.
Costs incurred for any activities which are directed at or are intended to influence or dissuade employees in the exercise of their legal rights to freely engage in the process of selecting an exclusive representative for the purpose of collective bargaining with their employer shall not be allowable for purposes of setting payment rates.
History:
2016 c 99 art 1 s 11; 2016 c 158 art 1 s 123
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.16 — Quality Of Care.

256R.16 QUALITY OF CARE.
Subdivision 1.
Calculation of a quality score.
(a) The commissioner shall determine a quality score for each nursing facility using quality measures established in section 256B.439, according to methods determined by the commissioner in consultation with stakeholders and experts, and using the most recently available data as provided in the Minnesota Nursing Home Report Card. These methods must be exempt from the rulemaking requirements under chapter 14.
(b) For each quality measure, a score must be determined with the number of points assigned as determined by the commissioner using the methodology established according to this subdivision. The determination of the quality measures to be used and the methods of calculating scores may be revised annually by the commissioner.
(c) The quality score must include up to 50 points related to the Minnesota quality indicators score derived from the minimum data set, up to 40 points related to the resident quality of life score derived from the consumer survey conducted under section 256B.439, subdivision 3, and up to ten points related to the state inspection results score.
(d) The commissioner, in cooperation with the commissioner of health, may adjust the formula in paragraph (c), or the methodology for computing the total quality score, with five months advance public notice. In changing the formula, the commissioner shall consider quality measure priorities registered by report card users, advice of stakeholders, and available research.
Subd. 2.
Monitoring quality of care.
If an annual cost report or field audit indicates that expenditures for direct resident care have been reduced in amounts large enough to indicate a possible detrimental effect on the quality of care, the commissioner shall notify the commissioner of health.
History:
2016 c 99 art 1 s 14; 2022 c 98 art 7 s 25
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.17 — Case Mix.

256R.17 CASE MIX.
Subdivision 1.
Case mix classifications.
The case mix classifications shall be those established under section 144.0724.
Subd. 2.
Case mix indices.
(a) The commissioner shall assign a case mix index to each case mix classification as determined by the commissioner of health under section 144.0724.
(b) An index maximization approach shall be used to classify residents. "Index maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).
Subd. 3.
Resident assessment schedule.
(a) Nursing facilities must conduct and submit case mix classification assessments according to the schedule established by the commissioner of health under section 144.0724, subdivisions 4 and 5.
(b) The case mix classifications established under section 144.0724, subdivision 3a, are effective the day of admission for new admission assessments. The effective date for significant change assessments is the assessment reference date. The effective date for annual and quarterly assessments and significant corrections assessments is the first day of the month following assessment reference date.
Subd. 4.
Notice of resident reimbursement case mix classification.
Nursing facilities shall provide notice to a resident of the resident's case mix classification according to procedures established by the commissioner of health under section 144.0724, subdivision 7.
Subd. 5.
Reconsideration of resident case mix classification.
Any request for reconsideration of a resident case mix classification must be made under section 144.0724, subdivision 8.
History:
2016 c 99 art 1 s 15; 2016 c 158 art 1 s 122; 2022 c 98 art 7 s 26; 2023 c 61 art 2 s 8
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.18 — Report By Commissioner Of Human Services.

256R.18 REPORT BY COMMISSIONER OF HUMAN SERVICES.
(a) Beginning January 1, 2019, the commissioner shall provide to the house of representatives and senate committees with jurisdiction over nursing facility payment rates a biennial report on the effectiveness of the reimbursement system in improving quality, restraining costs, and any other features of the system as determined by the commissioner.
(b) This section expires January 1, 2026.
History:
1Sp2017 c 6 art 3 s 40; 2022 c 98 art 14 s 26
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.21 — Total Payment Rate.

256R.21 TOTAL PAYMENT RATE.
Subdivision 1.
Total payment rates.
For each facility, the commissioner shall calculate a total payment rate using the statistical and cost report filed by each nursing facility for the reporting period ending 15 months prior to the rate year.
The total payment rates are the total payment rates in effect on the first day of the rate year, unless another date is specified.
Subd. 2.
Determination of total care-related payment rates.
A facility's total care-related payment rate is the sum of:
(1) its direct care payment rate as determined in section 256R.23, subdivision 7; and
(2) its other care-related payment rate as determined in section 256R.23, subdivision 8.
A facility's total care-related payment rate is its total care-related payment rate associated with a case mix index of 1.00.
Subd. 3.
Determination of operating payment rates.
A facility's operating payment rate is the sum of:
(1) its total care-related payment rate as determined in subdivision 2; and
(2) its other operating payment rate as determined in section 256R.24.
A facility's operating payment rate is its operating payment rate associated with a case mix index of 1.00.
Subd. 4.
Determination of total payment rates.
A facility's total payment rate is the sum of:
(1) its operating payment rate as determined in subdivision 3;
(2) its external fixed costs payment rate as determined in section 256R.25; and
(3) its property payment rate as determined in section 256R.26.
A facility's total payment rate is its total payment rate associated with a case mix index of 1.00.
Subd. 5.
Total payment rate for new facilities.
For a new nursing facility created under section 144A.071, subdivisions 2 and 3, the total payment rate must be determined according to section 256R.27.
History:
2016 c 99 art 1 s 16; 1Sp2019 c 9 art 4 s 17
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.22 — Case Mix Adjusted Total Payment Rate.

256R.22 CASE MIX ADJUSTED TOTAL PAYMENT RATE.
Subdivision 1.
Case mix adjusted payment rates generally.
For each facility, the commissioner shall calculate case mix adjusted payment rates for each case mix classification.
Subd. 2.
Determination of case mix adjusted total care-related payment rates.
A facility's case mix adjusted total care-related payment rate for each case mix classification is the sum of:
(1) its direct care payment rate as determined in section 256R.23, subdivision 7, multiplied by the case mix index; and
(2) its other care-related payment rate as determined in section 256R.23, subdivision 8.
Subd. 3.
Determination of case mix adjusted operating payment rates.
A facility's case mix adjusted operating payment rate for each case mix classification is the sum of:
(1) its case mix adjusted total care-related payment rate as determined in subdivision 2; and
(2) its other operating payment rate as determined in section 256R.24.
Subd. 4.
Determination of case mix adjusted total payment rates.
A facility's case mix adjusted total payment rate for each case mix classification is the sum of:
(1) its case mix adjusted operating payment rate as determined in subdivision 3;
(2) its external fixed costs payment rate as determined in section 256R.25; and
(3) its property payment rate as determined in section 256R.26.
History:
2016 c 99 art 1 s 17
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.23 — Total Care-related Payment Rates.

256R.23 TOTAL CARE-RELATED PAYMENT RATES.
Subdivision 1.
Determination of total care-related cost per day.
Each facility's total care-related cost per day is the sum of its direct care cost per standardized day and its other care-related cost per resident day.
Subd. 2.
Calculation of direct care cost per standardized day.
Each facility's direct care cost per standardized day is the facility's direct care costs divided by the sum of the facility's standardized days. A facility's direct care cost per standardized day is the facility's cost per day for direct care services associated with a case mix index of 1.00.
Subd. 3.
Calculation of other care-related cost per resident day.
Each facility's other care-related cost per resident day is its other care-related costs, divided by the sum of the facility's resident days.
Subd. 4.
Determination of the median total care-related cost per day.
The commissioner must determine the median total care-related cost per day using the cost reports from nursing facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties.
Subd. 5.
Determination of total care-related payment rate limits.
The commissioner must determine each facility's total care-related payment rate limit by:
(1) multiplying the facility's quality score, as determined under section 256R.16, subdivision 1, by 0.5625;
(2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100; and
(3) multiplying the amount determined in clause (2) by the median total care-related cost per day.
Subd. 6.
Payment rate limit reduction.
No facility shall be subject in any rate year to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 4.
Subd. 7.
Determination of direct care payment rates.
A facility's direct care payment rate equals the lesser of (1) the facility's direct care costs per standardized day, or (2) the facility's direct care costs per standardized day divided by its cost to limit ratio.
Subd. 8.
Determination of other care-related payment rates.
A facility's other care-related payment rate equals the lesser of (1) the facility's other care-related cost per resident day, or (2) the facility's other care-related cost per resident day divided by its cost to limit ratio.
Subd. 9.
Determination of total care-related payment rates.
A facility's total care-related payment rate is the sum of its direct care payment rate as determined in subdivision 7 and its other care-related payment rate as determined in subdivision 8.
History:
2016 c 99 art 1 s 18
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.24 — Other Operating Payment Rate.

256R.24 OTHER OPERATING PAYMENT RATE.
Subdivision 1.
Determination of other operating cost per day.
Each facility's other operating cost per day is its other operating costs divided by the sum of the facility's resident days.
Subd. 2.
Determination of the median other operating cost per day.
The commissioner must determine the median other operating cost per day using the cost reports from nursing facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties.
Subd. 3.
Determination of the other operating payment rate.
A facility's other operating payment rate equals 105 percent of the median other operating cost per day.
History:
2016 c 99 art 1 s 19
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.267 — Threshold Project Property Payment Rate Interim Adjustments.

256R.267 THRESHOLD PROJECT PROPERTY PAYMENT RATE INTERIM ADJUSTMENTS.
(a) A facility reimbursed under section 256R.26, subdivisions 1 to 8, may receive a property payment rate interim adjustment for threshold projects the cumulative cost of which during the three years between physical appraisals is between the following threshold project cost limits:
(1) the lesser of $316,816 or $10,000 per bed in service; and
(2) the greater of $1,620,943 or $20,000 per bed in service.
The commissioner shall update the threshold project cost limits each January 1 by the annual percent change in the construction cost per square foot value based on the information that is publicly available on November 1 immediately preceding the rate year.
(b) A facility seeking a property payment rate interim adjustment must request an adjustment after the threshold project is completed. The nursing facility or the lease holder must have incurred the threshold project cost subsequent to the facility's last physical appraisal. The nursing facility must submit to the commissioner all building and fixed equipment cost data related to the project within 90 days of completing the project.
(c) Effective January 1 or July 1, whichever occurs first after a facility completes a threshold project and requests the property payment rate interim adjustment, the commissioner shall add the allowable reported threshold project costs to the facility's URC under section 256R.26, subdivision 1, and to the DRC under section 256R.26, subdivision 3, before calculating an adjusted property payment rate under section 256R.26. The commissioner shall not include in the facility's limited URC threshold project costs reported to the commissioner between physical appraisals that exceed the maximum cumulative project cost limits described in paragraph (a).
(d) In subsequent property payment rate calculations following the completion of a physical appraisal, the commissioner shall eliminate any interim adjustment to the DRC and URC under paragraph (c).
(e) At the option of the commissioner, the commissioner may adjust the appraisal schedule for a nursing facility that has completed a threshold project.
(f) If more or less than three years pass between a facility's physical appraisals, the commissioner shall prorate the facility's threshold project cost limits accordingly.
(g) After the initial rate year project adjustments are allowed once annually based on the previous project completion date.
(h) Two threshold projects may not be conducted at the same time. Purchases for a second project must be made after the completion date of the first project.
History:
1Sp2019 c 9 art 4 s 22
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.32 — Appeals.

256R.32 APPEALS.
Nursing facilities may appeal, as described under section 256B.50, the determination of a payment rate established under this chapter.
History:
2016 c 99 art 1 s 22
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.36 — Hold Harmless.

256R.36 HOLD HARMLESS.
No nursing facility's operating payment rate, plus its employer health insurance costs portion of the external fixed costs payment rate, will be less than its prior system operating cost payment rate.
History:
2016 c 99 art 1 s 23
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.37 — Scholarships.

256R.37 SCHOLARSHIPS.
(a) The commissioner shall provide a scholarship per diem rate calculated using the criteria in paragraphs (b) to (d). The per diem rate must be based on the allowable costs the facility paid for employee scholarships for any eligible employee, except the facility administrator, who works an average of at least ten hours per week in the licensed nursing facility building when the facility has paid expenses related to:
(1) an employee's course of study that is expected to lead to career advancement with the facility or in the field of long-term care;
(2) an employee's job-related training in English as a second language;
(3) the reimbursement of student loan expenses for newly hired registered nurses and licensed practical nurses; and
(4) the reimbursement of training, testing, and associated expenses for newly hired nursing assistants as specified in section 144A.611, subdivisions 2 and 4. The reimbursement of nursing assistant expenses under this clause is not subject to the ten-hour minimum work requirement under this paragraph.
(b) Allowable scholarship costs include: tuition, student loan reimbursement, other direct educational expenses, and reasonable costs for child care and transportation expenses directly related to education, as defined by the commissioner.
(c) The commissioner shall provide a scholarship per diem rate equal to the allowable scholarship costs divided by resident days. The commissioner shall compute the scholarship per diem rate annually and include the scholarship per diem rate in the external fixed costs payment rate.
(d) When the resulting scholarship per diem rate is 15 cents or more, nursing facilities that close beds during a rate year may request to have the scholarship rate recalculated. This recalculation is effective from the date of the bed closure through the remainder of the rate year and reflects the estimated reduction in resident days compared to the previous cost report year.
(e) Facilities seeking to have the facility's scholarship expenses recognized for the payment rate computation in section 256R.25 may apply annually by submitting information to the commissioner on a schedule and in a form supplied by the commissioner.
History:
2016 c 99 art 1 s 24,42; 2016 c 189 art 18 s 8; 1Sp2017 c 6 art 3 s 41; 2022 c 98 art 7 s 29
2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256R — Nursing Facility Rates › Section 256R.38 — Performance-based Incentive Payments.

256R.38 PERFORMANCE-BASED INCENTIVE PAYMENTS.
The commissioner shall develop additional incentive-based payments of up to five percent above a facility's operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit proposals and select those which, on a competitive basis, best meet the state's policy objectives. The commissioner shall limit the amount of any incentive payment and the number of contract amendments under this section to operate the incentive payments within funds appropriated for this purpose. The commissioner shall approve proposals through a memorandum of understanding which shall specify various levels of payment for various levels of performance. Incentive payments to facilities under this section shall be in the form of time-limited rate adjustments which shall be included in the external fixed payment rate under section 256R.25. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives:
(1) successful diversion or discharge of residents to the residents' prior home or other community-based alternatives;
(2) adoption of new technology to improve quality or efficiency;
(3) improved quality as measured in the Minnesota Nursing Home Report Card;
(4) reduced acute care costs; and
(5) any additional outcomes proposed by a nursing facility that the commissioner finds desirable.
History:
2016 c 99 art 1 s 25
2023 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 must 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. An annual rate adjustment provided under this section must be effective for one rate year.
History:
2016 c 99 art 1 s 26; 2022 c 98 art 7 s 30
2023 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
2023 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
2023 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