256R.36 HOLD HARMLESS. No nursing facility’s operating payment rate, plus its employer health insurance costs portion of the external fixed costs payment rate, will be less than its prior system operating cost payment rate. History: 2016 c 99 art 1 s 23
256R.37 SCHOLARSHIPS. (a) The commissioner shall provide a scholarship per diem rate calculated using the criteria in paragraphs (b) to (d). The per diem rate must be based on the allowable costs the facility paid for employee scholarships for any eligible employee, except the facility administrator, who works an average of at least ten hours […]
256R.38 PERFORMANCE-BASED INCENTIVE PAYMENTS. The commissioner shall develop additional incentive-based payments of up to five percent above a facility’s operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit proposals and select those which, on a competitive basis, best meet the state’s policy objectives. The commissioner shall limit the amount of […]
256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM. The commissioner shall develop a quality improvement incentive program in consultation with stakeholders. The annual funding pool available for quality improvement incentive payments must be equal to 0.8 percent of all operating payments, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under […]
256R.40 NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES. Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section. (b) “Closure” means the cessation of operations of a nursing facility and delicensure and decertification of all beds within the facility. (c) “Closure plan” means a plan to close a nursing facility and reallocate a portion […]
256R.41 SINGLE-BED ROOM INCENTIVE. (a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed under this chapter shall be increased by 20 percent multiplied by the ratio of the number of new single-bed rooms created divided by the number of active beds on July 1, 2005, for each bed closure that results […]
256R.42 RATE ADJUSTMENT FOR THE FIRST 30 DAYS. (a) During the first 30 calendar days after admission, the total payment rate for a case mix classification must be increased by 20 percent. Beginning with the 31st calendar day after admission, the total payment rate is the rate otherwise determined under this chapter. (b) The enhanced […]
256R.43 BED HOLDS. The commissioner shall limit payment for leave days in a nursing facility to 30 percent of that nursing facility’s total payment rate for the involved resident, and shall allow this payment only when the occupancy of the nursing facility, inclusive of bed hold days, is equal to or greater than 96 percent, […]
256R.44 RATE ADJUSTMENT FOR PRIVATE ROOMS FOR MEDICAL NECESSITY. (a) The amount paid for a private room is 111.5 percent of the established total payment rate for a resident if the resident is a medical assistance recipient and the private room is considered a medical necessity for the resident or others who are affected by […]
256R.45 RATE ADJUSTMENT FOR VENTILATOR-DEPENDENT PERSONS. The commissioner may negotiate with a nursing facility eligible to receive medical assistance payments to provide services to a ventilator-dependent person identified by the commissioner according to criteria developed by the commissioner, including: (1) nursing facility care has been recommended for the person by a preadmission screening team; (2) […]
256R.46 SPECIALIZED CARE FACILITIES. (a) The total care-related payment rate limit for specialized care facilities shall be increased by 50 percent. (b) “Specialized care facilities” are defined as a facility having a program licensed under chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1, 2015, located in Robbinsdale […]
256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING FACILITIES. (a) The commissioner, in consultation with the commissioner of health, may designate certain nursing facilities as critical access nursing facilities. The designation shall be granted on a competitive basis, within the limits of funds appropriated for this purpose. (b) The commissioner shall request proposals from nursing facilities […]
256R.48 PUBLICLY OWNED FACILITIES. (a) The commissioner shall allow nursing facilities whose physical plant is owned or whose license is held by a city, county, or hospital district to apply for a higher payment rate under this section if the local governmental entity agrees to pay a specified portion of the nonfederal share of medical […]
256R.481 RATE ADJUSTMENTS FOR BORDER CITY FACILITIES. (a) The commissioner shall allow each nonprofit nursing facility located within the boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once annually for a rate add-on to the facility’s external fixed costs payment rate. (b) A facility seeking an add-on to […]
256R.50 BED RELOCATIONS. Subdivision 1. Method for determining budget-neutral nursing facility rates for relocated beds. Nursing facility rates for bed relocations must be calculated by comparing the estimated medical assistance costs prior to and after the proposed bed relocation using the calculations in this section. All payment rates are based on a case mix index […]
256R.51 RATE ADJUSTMENT FOR SPECIAL DIETARY NEEDS. (a) The commissioner shall adjust the rates of a nursing facility that meets the criteria for the special dietary needs of its residents and the requirements in section 31.651 or 31.658. The adjustment for raw food cost shall be the difference between the nursing facility’s most recently reported […]
256R.52 NURSING FACILITY RECEIVERSHIP FEES. Subdivision 1. Payment of receivership fees. (a) When the commissioner of health notifies the commissioner of human services that a nursing facility is subject to the receivership provisions under section 144A.15 and provides a recommendation in accordance with section 144A.154, the commissioner in consultation with the commissioner of health may […]
256R.53 FACILITY SPECIFIC EXEMPTIONS. Subdivision 1. Nursing facility in Golden Valley. The operating payment rate for a facility located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed rehabilitation beds as of January 7, 2015, is the sum of its direct care costs per standardized day, its other care-related costs […]
