An Act To Assist Nursing Homes in the Management of Facility Beds

Sec. 1. 22 MRSA §333, sub-§1,  as amended by PL 2011, c. 648, §2, is further amended to read:

Sec. 2. 22 MRSA §333, sub-§2, ¶A,  as enacted by PL 2001, c. 664, §2, is amended to read:

Sec. 3. 22 MRSA §1720,  as enacted by PL 2005, c. 242, §1, is amended to read:

§ 1720. Nursing facility medical director reimbursement

The department shall include in its calculation of reimbursement for services provided by a nursing facility an allowance for the cost of incurred by the facility for a medical director in a base year amount not to exceed $10,000, with that amount being subject to an annual cost-of-living adjustment.

Sec. 4. Cost of computer and cloud-based software systems a fixed cost. Beginning October 1, 2019, the cost incurred by a nursing facility for the acquisition, including set-up costs, use and maintenance, of computer or cloud-based software systems must be included as a fixed cost by the Department of Health and Human Services in its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities. Costs included pursuant to this section must include without limitation the costs of hardware, if any, software and software support.

Sec. 5. Bed hold reimbursement for adult family care services. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 2, Adult Family Care Services, no later than December 15, 2019 to provide reimbursement for up to 30 bed hold days per calendar year when the resident is absent from the facility.

Sec. 6. Cost of health insurance a fixed cost. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities no later than December 15, 2019 to include the cost of health insurance for employees attributable to MaineCare residents as a fixed cost.

Sec. 7. Partial reimbursement to nursing facilities for certain bad debt. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities no later than December 15, 2019 to include reimbursement for 50% of a nursing facility's charges for a maximum of 6 months for a newly admitted resident who is determined to be financially ineligible for MaineCare after the resident is admitted to the nursing facility and the charges remain unpaid after reasonable efforts are made by the nursing facility to collect the debt based on these charges.

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This bill restores the ability of nursing facilities to voluntarily reduce the number of their licensed beds and then later increase the number of their licensed beds to the prior level after obtaining a certificate of need and meeting certain conditions.

The bill modifies the process to obtain certificate of need approval to reopen reserved beds. Applications that seek to reopen reserved beds must be approved if the projected incremental costs of reopening and operating the reopened beds are consistent with the facility's costs of operating its other beds. Applicants are not required to demonstrate that any increases in MaineCare costs are offset by other MaineCare savings. The costs of ongoing operation of both the restored beds and the complement of facility beds at the time the reserved beds are reopened must be recognized as allowable costs and incorporated into the facility's MaineCare payment rates.

The bill requires the Department of Health and Human Services to include in its calculation of reimbursement for services provided by a nursing facility the cost incurred by the facility for a medical director.

The bill requires the cost incurred by a nursing facility for the acquisition, use and maintenance of computer or cloud-based software systems to be included as a fixed cost.

The bill requires the Department of Health and Human Services to amend its rules governing adult family care services to provide reimbursement for up to 30 bed hold days per calendar year when a resident is absent from a facility.

The bill requires the Department of Health and Human Services to amend its rules governing principles of reimbursement for nursing facilities to include the cost of health insurance for employees attributable to MaineCare residents as a fixed cost. It also requires the department to amend these rules to include reimbursement for 50% of a nursing facility's charges for a maximum of 6 months for a newly admitted resident who is determined to be financially ineligible for MaineCare after the resident is admitted to the nursing facility and the charges remain unpaid after reasonable efforts are made by the nursing facility to collect the debt based on these charges.