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

2. 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

3. Nursing Facility Rates & Policy Division 3 COLA 2007 1.87% effective 10/1/2007 75% for compensation related costs 2/3 of that for equal percent wage increase Application required Union issues

4. 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%

5. 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

6. 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

7. 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

8. 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

9. Nursing Facility Rates & Policy Division 9 Technical and limited applicability provisions COLA 06-07 PERA Property LTC Consultation

10. Nursing Facility Rates & Policy Division 10 Questions? Robert Held Nursing Facility Rates and Policy Division MN Department of Human Services PO Box 64973 St. Paul MN 55164-0973 Located at 540 Cedar St. in downtown St. Paul Voice 651-431-2261 Fax 651-431-7415 robert.held@state.mn.us