This bill creates a critical access designation for nursing facilities. The Department of Human Services (DHS) will work with the Department of Health (MDH) and stakeholders in establishing the designation proposal process, and grant the designation on a competitive basis. The funding will be limited to a $2 million appropriation in fiscal year 2013, which will be ongoing and added to the base.

DHS will request designation proposals every two years. Facilities currently designated may apply for continued designation; if the continued designation is not granted, the benefits listed below will no longer apply.

In developing the criteria for designation, DHS, MDH and stakeholders should consider proposals that preserve access to nursing facility services in isolated areas, rebalance long-term care, and improve quality.

Nursing facilities will receive the following benefits during the designation period:

• Partial rebasing
• Enhanced payments for leave days
• MDH may allow two designated nursing facilities, with up to 100 beds, to jointly employ a nursing director
• Replacement-costs-new per bed limits will be 40 percent of the amount that would otherwise apply
• Quality-based rate limits, and the removal of planned closure rate adjustments and single-bed room incentives from external fixed costs, will apply

The effective date of this bill, excluding the appropriation section, is the day following final enactment.

DL/rdr