SF No. 654 makes various policy and technical changes to the language governing nursing facility payment rates.

Section 1 (144.0724, subdivision 6) reduces by a factor of ten the threshold at which facilities may apply for a reduction in their penalty for late or nonsubmission of resident assessments, as well as the length of time during which the facilities are penalized.

Section 2 (256B.431, subdivision 30) limits to just twice a year the effective date of property rate adjustments resulting from bed layaway or bed delicensure.

Section 3 (256B.431, subdivision 46) permits facilities to change their single-bed election provided they notify the commissioner by August 15 prior to the rate year in which the facility seeks a rate adjustment as a result of the change in their single-bed election.

Section 4 (256B.434, subdivision 4) strikes obsolete language, thereby clarifying that the inflationary adjustments apply only to the property rate and not to the other rates that were extensively modified in 2015 and recodified in 2016 as Minnesota Statutes, chapter 256R.

Section 5 (256R.04, subdivision 4 ) clarifies which forms of insurance are administrative costs and which are fringe benefit costs.

Section 6 (256R.02, subdivision 17) adds to the direct care cost category the costs associated with nurse consultants, pharmacy consultants, and medical directors, and specifies how the costs of certain nurse consultants are to be allocated between facilities.

Section 7 (256R.02, subdivision 18) includes in the employer health insurance cost category the costs of health care reinsurance and the costs associated with administrating employer-provided health insurance, as well as modifying who may be covered under an employer-provided health insurance plan falling in this cost category.

Section 10 (256B.02, subdivision 19) adds to the external fixed costs category the rate adjustment for compensation-related costs resulting from increases in the minimum wage. 

Section 9 (256R.02, subdivision 22) adds the costs associated with a number of different kinds of insurance to the fringe benefit costs category, including health insurance for the families of part-time employees and retirees.

Section 10 (256R.02, subdivision 42) clarifies that dietary credits are included in the raw food cost category.

Section 11 (256R.02, subdivision 42a) defines “real estate taxes.”

Section 12 (256R.02, subdivision 48a) defines “special assessment.”

Section 13 (256R.02, subdivision 52) modifies the definition of “therapy costs.”

Section 14 (256R.07, subdivision 1) strikes a cross-reference to a subdivision included in the bill’s repealer.

Section 15 (256R.07, subdivision 6) permits electronic signatures on documents submitted to the commissioner for the purposes of setting nursing facility rates.

Section 16 (256R.10, subdivision 7) specifies the conditions under which bad debt is an allowable cost that must be reimbursed through a facility’s rate.

Section 17 (256R.13, subdivision 4) strikes a cross-reference to a subdivision included in the bill’s repealer.

Section 18 (256R.18) requires the commissioner to provide a biennial report to the legislature concerning various aspects of the nursing facility rate-setting system.

Section 19 (256R.37) removes the requirement that registered nurses or licensed practical nurses who receive scholarships must be recent graduates.

Section 20 (256R.40, subdivision 1) modifies the definition of "completion of closure" to clarify its meaning with respect to partial closures.

Section 21 (256R.40, subdivision 5) limits to just twice a year the effective date of planned closure rate adjustments.

Section 22 (256R.41) limits to just twice a year the effective date of single-bed room incentive rate adjustments.

Section 23 (256R.47) extends for an additional two years the existing suspension of the rate adjustment for critical access nursing facilities.

Section 24 (256R.49) establishes a rolling two-year expiration of rate increases for compensation-related costs for minimum wage changes and strikes obsolete language.

Section 25 (Repealer) repeals language governing payment rates for certain therapy costs and certain notification requirements imposed on facilities.