The bill provides for the allocation of the total net outstanding debt among remaining facilities within a multi- facility operator's system in proportion to the number of licensed beds owned by each remaining nursing facility.

Under current law, hospitals, intermediate care facilities, skilled nursing facilities and other facilities licensed under chapter 405 may provide home health care services to clients residing in those facilities, or at any one time, to 6 or fewer clients residing in their homes under a department-approved care plan. In either case, the licensed home health care agencies serving the patient's area must either have indicated that they are unable to provide those services or have agreed that the plan of care is an acceptable plan. The bill eliminates the requirement for obtaining approval of the care plan by the department or by the home health care agency; eliminates the condition that the home health care agencies in the area indicate that they are unable to provide the services in question; and adds the requirement that the facilities must notify the home health agencies of the fact that the facilities will be providing those services.

The bill revises the medical eligibility provisions applicable to the Medicaid program to require the department to discontinue its current practice of denying all reimbursement to a nursing facility that inadvertently misses the established deadline for asking the department to reassess a resident's eligibility. Instead, the department would be allowed to apply 2 sanctions. First, it could penalize the facility up to 10% of its regular reimbursement rate for the days between the due date for the assessment and the date the facility actually requested reassessment. Second, the department could reduce the rate to the much lower residential care rate, if the reassessment, when performed, showed that the resident no longer required a nursing facility level of care.

The bill requires the department to utilize 1997 data for calculating the maximum allowable reimbursement for facilities' routine costs. The bill also requires that the department distinguish between facilities with 30 or more beds and those with fewer than 30 beds in establishing the maximum amount of reimbursable costs for the various cost categories established for residential care.

The bill directs the department to resume its approval of staffing requests by residential care facilities as had been the department's practice prior to June of 1998.