1.1                          A bill for an act 
  1.2             relating to human services; changing provisions for 
  1.3             nursing facility reimbursement; amending Laws 1996, 
  1.4             chapter 451, article 3, section 1. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  Laws 1996, chapter 451, article 3, section 1, 
  1.7   is amended to read: 
  1.8      Section 1.  [NURSING FACILITY REIMBURSEMENT ~~FOR FISCAL YEAR~~ 
  1.9   ~~1997~~.] 
  1.10     (a) Notwithstanding any contrary provisions of Minnesota 
  1.11  Statutes, section 256B.431, subdivision 25, the provisions of 
  1.12  this section shall apply for ~~the~~ rate ~~year~~ years beginning on or 
  1.13  after July 1, ~~1996~~ 1997. 
  1.14     (b) The commissioner of human services shall group nursing 
  1.15  facilities into two groups, freestanding and nonfreestanding, 
  1.16  within each geographic group, using their operating cost per 
  1.17  diem for the case mix A classification.  A nonfreestanding 
  1.18  nursing facility is a nursing facility whose other operating 
  1.19  cost per diem is subject to the hospital attached, short length 
  1.20  stay, or the rule 80 limits.  All other nursing facilities shall 
  1.21  be considered freestanding nursing facilities.  The commissioner 
  1.22  shall then array all nursing facilities in each grouping by 
  1.23  their allowable case mix A operating cost per diem.  In 
  1.24  calculating a nursing facility's operating cost per diem for 
  1.25  this purpose, the commissioner shall exclude the raw food cost 
  2.1   per diem related to providing special diets that are based on 
  2.2   religious beliefs, as determined in Minnesota Statutes, section 
  2.3   256B.431, subdivision 2b, paragraph (h).  For those nursing 
  2.4   facilities in each grouping whose case mix A operating cost per 
  2.5   diem:  
  2.6      (1) is at or above the median plus 1.0 standard deviation 
  2.7   of the array, the commissioner shall limit the nursing 
  2.8   facility's allowable operating cost per diem for each case mix 
  2.9   category to the lesser of the prior reporting year's allowable 
  2.10  operating cost per diems plus the inflation factor as 
  2.11  established in paragraph (d), or the current reporting year's 
  2.12  corresponding allowable operating cost per diem; 
  2.13     (2) is between .5 standard deviation and 1.0 standard 
  2.14  deviation above the median of the array, the commissioner shall 
  2.15  limit the nursing facility's allowable operating cost per diem 
  2.16  for each case mix category to the lesser of the prior reporting 
  2.17  year's allowable operating cost per diems plus the inflation 
  2.18  factor as established in paragraph (d), increase by one 
  2.19  percentage point, or the current reporting year's corresponding 
  2.20  allowable operating cost per diem; or 
  2.21     (3) is equal to or below .5 standard deviation above the 
  2.22  median of the array, the commissioner shall limit the nursing 
  2.23  facility's allowable operating cost per diem for each case mix 
  2.24  category to the lesser of the prior reporting year's allowable 
  2.25  operating cost per diems plus the inflation factor as 
  2.26  established in paragraph (d), increased by two percentage 
  2.27  points, or the current reporting year's corresponding allowable 
  2.28  operating cost per diem. 
  2.29     (c) For ~~the~~ rate ~~year~~ years beginning on or after July 1, 
  2.30  ~~1996~~ 1997, the provisions of Minnesota Statutes, section 
  2.31  256B.431, subdivision 25, paragraph (d), shall not apply. 
  2.32     (d) For ~~the~~ rate ~~year~~ years beginning on or after July 1, 
  2.33  ~~1996~~ 1997, the forecasted index for operating cost limits 
  2.34  referred to in Minnesota Statutes, section 256B.431, subdivision 
  2.35  21, paragraph (b), shall be based on the change in the nursing 
  2.36  home market basket as forecasted by Data Resources Inc., for the 
  3.1   12-month period between the midpoints of the two reporting years 
  3.2   preceding the rate year. 
  3.3      (e) For ~~the~~ rate ~~year~~ years beginning on or after July 1, 
  3.4   ~~1996~~ 1997, the operating cost limits established in Minnesota 
  3.5   Statutes, section 256B.431, subdivisions 2b, 2i, and 3c, and any 
  3.6   previously effective corresponding limits in law or rule shall 
  3.7   not apply, except that these cost limits shall still be 
  3.8   calculated for purposes of determining efficiency incentive per 
  3.9   diems. 
  3.10     (f) For ~~the~~ rate ~~year~~ years beginning on or after July 1, 
  3.11  ~~1996~~ 1997, the commissioner shall exempt all rule 80 facilities 
  3.12  from any limits described in Minnesota Statutes, section 
  3.13  256B.431, subdivision 25, paragraph (b), clause (2), that affect 
  3.14  care-related operating per diems.  For ~~the~~ rate ~~year~~ years 
  3.15  beginning on or after July 1, ~~1996~~ 1997, the operating cost per 
  3.16  diem referred to in paragraph (b), clause (2), is the sum of the 
  3.17  care-related and other operating cost per diems for a given case 
  3.18  mix class.  
  3.19     (g) Any reductions to the combined operating per diem shall 
  3.20  be divided proportionately between the care-related and other 
  3.21  operating per diems. 
  3.22     ~~(h) Notwithstanding paragraphs (a) to (f), the commissioner~~ 
  3.23  ~~must also compute nursing facility payment rates based on the~~ 
  3.24  ~~laws in effect on March 1, 1996, and use the resulting allowable~~ 
  3.25  ~~care-related and other operating cost per diems as the basis for~~ 
  3.26  ~~the spend-up limits for the rate year beginning July 1, 1997.~~