Nursing Facility Rates & Policy Division 1 MDH LTC Issues Committee Legislative Update July 24, 2007 Bob Held

Nursing Facility Rates & Policy Division 2 Legislative Update COLA Quality Add-On Rebasing Case Mix Indices Moratorium Exception funding Sprinklers Technical and limited applicability provisions

Nursing Facility Rates & Policy Division 3 COLA % effective 10/1/ % for compensation related costs 2/3 of that for equal percent wage increase Application required Union issues

Nursing Facility Rates & Policy Division 4 Quality Add-On Up to 0.3% effective 10/1/2007 Average will be 0.13% Measures to be used –Quality of life – 20% –MN quality indicators – 35% –Direct care staffing level – 10% –Direct care staff retention – 20% –Pool usage – 5% –MDH certification findings – 10%

Nursing Facility Rates & Policy Division 5 Moratorium Exceptions Authority to approve projects with annual MA cost up to $3 million Additional money available from cancelled or expired projects approved earlier New criteria – demonstrated continuing need for nursing home in community

Nursing Facility Rates & Policy Division 6 Rebasing Categories – operating, external fixed, property Cost based for operating Limits –Care related – 120% of median for peer group and facility type –Other operating – 105% of median for peer group Efficiency incentive Phase-in of operating over 8 years Hold harmless Quality

Nursing Facility Rates & Policy Division 7 Case Mix Indices Staff time measurement study completed in about 2004 How to implement? –Budget neutral –Hold harmless Incorporated into rebasing

Nursing Facility Rates & Policy Division 8 Sprinklers $2.5 million appropriated Sprinkler system only Applications were due July 2 Equal discount if cost of requests exceeds money available

Nursing Facility Rates & Policy Division 9 Technical and limited applicability provisions COLA PERA Property LTC Consultation

Nursing Facility Rates & Policy Division 10 Questions? Robert Held Nursing Facility Rates and Policy Division MN Department of Human Services PO Box St. Paul MN Located at 540 Cedar St. in downtown St. Paul Voice Fax