1.1    .................... moves to amend H. F. No. 3976, the delete everything amendment
1.2(H3976DE2), as follows:
1.3Page 41, after line 22, insert:

1.4    "Section 9. Minnesota Statutes 2007 Supplement, section 256B.441, subdivision 1,
1.5is amended to read:
1.6    Subdivision 1. Rebasing of nursing facility operating cost payment rates. (a)
1.7The commissioner shall rebase nursing facility operating cost payment rates to align
1.8payments to facilities with the cost of providing care. The rebased operating cost payment
1.9rates shall be calculated using the statistical and cost report filed by each nursing facility
1.10for the report period ending one year prior to the rate year.
1.11    (b) The new operating cost payment rates based on this section shall take effect
1.12beginning with the rate year beginning October 1, 2008, and shall be phased in over eight
1.13rate years through October 1, 2015. For each year of the phase-in, the operating cost
1.14payment rates shall be calculated using the statistical and cost report filed by each nursing
1.15facility for the report period ending one year prior to the rate year.
1.16    (c) Operating cost payment rates shall be rebased on October 1, 2016, and every
1.17two years after that date.
1.18    (d) Each cost reporting year shall begin on October 1 and end on the following
1.19September 30. Beginning in 2006, a statistical and cost report shall be filed by each
1.20nursing facility by January 15. Notice of rates shall be distributed by August 15 and the
1.21rates shall go into effect on October 1 for one year.
1.22    (e) Effective October 1, 2014, property rates shall be rebased in accordance with
1.23section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine
1.24what the property payment rate for a nursing facility would be had the facility not had its
1.25property rate determined under section 256B.434. The commissioner shall allow nursing
1.26facilities to provide information affecting this rate determination that would have been
1.27filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report
2.1information necessary to determine allowable debt. The commissioner shall use this
2.2information to determine the property payment rate.

2.3    Sec. 10. Minnesota Statutes 2007 Supplement, section 256B.441, subdivision 55,
2.4is amended to read:
2.5    Subd. 55. Phase-in of rebased operating cost payment rates. (a) For the rate
2.6years beginning October 1, 2008, to October 1, 2012 2015 , the operating cost payment
2.7rate calculated under this section shall be phased in by blending the operating cost rate
2.8with the operating cost payment rate determined under section 256B.434. For purposes of
2.9this subdivision, the rate determined under section 256B.434 shall not include the portion
2.10of the operating payment rate related to the performance-based incentive payments under
2.11section 256B.434, subdivision 4, paragraph (d). For the rate year beginning October 1,
2.122008, the operating cost payment rate for each facility shall be 13 percent of the operating
2.13cost payment rate from this section, and 87 percent of the operating cost payment rate
2.14from section 256B.434. For the rate year beginning October 1, 2009, the operating cost
2.15payment rate for each facility shall be 14 percent of the operating cost payment rate from
2.16this section, and 86 percent of the operating cost payment rate from section 256B.434. For
2.17the rate year beginning October 1, 2010, the operating cost payment rate for each facility
2.18shall be 14 percent of the operating cost payment rate from this section, and 86 percent
2.19of the operating cost payment rate from section 256B.434. For the rate year beginning
2.20October 1, 2011, the operating cost payment rate for each facility shall be 31 percent
2.21of the operating cost payment rate from this section, and 69 percent of the operating
2.22cost payment rate from section 256B.434. For the rate year beginning October 1, 2012,
2.23the operating cost payment rate for each facility shall be 48 percent of the operating
2.24cost payment rate from this section, and 52 percent of the operating cost payment rate
2.25from section 256B.434. For the rate year beginning October 1, 2013, the operating cost
2.26payment rate for each facility shall be 65 percent of the operating cost payment rate from
2.27this section, and 35 percent of the operating cost payment rate from section 256B.434. For
2.28the rate year beginning October 1, 2014, the operating cost payment rate for each facility
2.29shall be 82 percent of the operating cost payment rate from this section, and 18 percent
2.30of the operating cost payment rate from section 256B.434. For the rate year beginning
2.31October 1, 2015, the operating cost payment rate for each facility shall be the operating
2.32cost payment rate determined under this section. The blending of operating cost payment
2.33rates under this section shall be performed separately for each RUG's class.
3.1    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
3.2to the operating payment rate increases under paragraph (a) by creating a minimum
3.3percentage increase and a maximum percentage increase.
3.4    (1) Each nursing facility that receives a blended October 1, 2008, operating payment
3.5rate increase under paragraph (a) of less than one percent, when compared to its operating
3.6payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
3.7shall receive a rate adjustment of one percent.
3.8    (2) The commissioner shall determine a maximum percentage increase that will
3.9result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
3.10facilities with a blended October 1, 2008, operating payment rate increase under paragraph
3.11(a) greater than the maximum percentage increase determined by the commissioner, when
3.12compared to its operating payment rate on September 30, 2008, computed using rates with
3.13a RUG's weight of 1.00, shall receive the maximum percentage increase.
3.14    (3) Nursing facilities with a blended October 1, 2008, operating payment rate
3.15increase under paragraph (a) greater than one percent and less than the maximum
3.16percentage increase determined by the commissioner, when compared to its operating
3.17payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
3.18shall receive the blended October 1, 2008, operating payment rate increase determined
3.19under paragraph (a).
3.20    (b) (c) A portion of the funds received under this subdivision that are in excess of
3.21operating cost payment rates that a facility would have received under section 256B.434,
3.22as determined in accordance with clauses (1) to (3), shall be subject to the requirements in
3.23section 256B.434, subdivision 19, paragraphs (b) to (h).
3.24    (1) Determine the amount of additional funding available to a facility, which shall be
3.25equal to total medical assistance resident days from the most recent reporting year times
3.26the difference between the blended rate determined in paragraph (a) for the rate year being
3.27computed and the blended rate for the prior year.
3.28    (2) Determine the portion of all operating costs, for the most recent reporting year,
3.29that are compensation related. If this value exceeds 75 percent, use 75 percent.
3.30    (3) Subtract the amount determined in clause (2) from 75 percent.
3.31    (4) The portion of the fund received under this subdivision that shall be subject to
3.32the requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal
3.33the amount determined in clause (1) times the amount determined in clause (3).

3.34    Sec. 11. Minnesota Statutes 2007 Supplement, section 256B.441, subdivision 56,
3.35is amended to read:
4.1    Subd. 56. Hold harmless. For the rate years beginning October 1, 2008, to October
4.21, 2016, no nursing facility shall receive an operating cost payment rate less than its
4.3operating cost payment rate under section 256B.434. For rate years beginning on or after
4.4October 1, 2009, no nursing facility shall receive an operating payment rate less than its
4.5operating payment rate in effect on September 30, 2009. The comparison of operating cost
4.6payment rates under this section shall be made for a RUG's rate with a weight of 1.00."
4.7Renumber the sections in sequence and correct the internal references
4.8Amend the title accordingly