Bill Text: NY A05685 | 2021-2022 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Requires nursing homes to spend at least the resident care amount necessary to achieve a required resident care percentage and a sufficient direct care service amount so it does not have a direct care service deficit.

Spectrum: Partisan Bill (Democrat 50-2)

Status: (Engrossed - Dead) 2022-01-25 - enacting clause stricken [A05685 Detail]

Download: New_York-2021-A05685-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          5685

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                    February 23, 2021
                                       ___________

        Introduced by M. of A. GOTTFRIED, GUNTHER, GALEF, CLARK, TAYLOR, PAULIN,
          ABINANTI,   BICHOTTE HERMELYN,  McDONALD,  HEVESI,  BRONSON,  WALLACE,
          STECK, DINOWITZ, THIELE, PERRY  --  read  once  and  referred  to  the
          Committee on Health

        AN  ACT  to  amend  the public health law, in relation to establishing a
          required resident care spending ratio for nursing homes

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  The  public health law is amended by adding a new section
     2  2805-ee to read as follows:
     3    § 2805-ee. Nursing home direct care ratio. 1. As used in this section,
     4  the following terms have the following meanings:
     5    (a) "Resident care" means: (i) direct care by certified  nurse  aides,
     6  licensed  practical nurses, and registered nurses; (ii) support services
     7  including housing, laundry, housekeeping, food service,  nurse  adminis-
     8  tration, activity program, social services and transportation as identi-
     9  fied  in  reports  required  by  the department; (iii) ancillary program
    10  services including medical, dental, podiatric and  laboratory  services,
    11  inhalation  and  other  physical,  mental,  occupational therapeutics as
    12  identified in reports required  by  the  department;  and  (iv)  program
    13  services  for  residents  including  personal grooming, as identified in
    14  reports required by the  department.  Resident  care  does  not  include
    15  administrative  costs  other  than  nurse administration, capital costs,
    16  rent, or debt service.
    17    (b) "Resident care amount" means the amount spent by the nursing  home
    18  for  care of residents of the nursing home; provided that for any amount
    19  spent for contracted or purchased personal services, only eighty percent
    20  of that amount shall count as spending on resident care.
    21    (c) "Total operating revenue" means the revenue received by the  nurs-
    22  ing  home from or on behalf of residents of the nursing home, government

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09825-02-1
        A. 5685                             2

     1  payers, or third-party payers, to pay for a resident's occupancy of  the
     2  nursing home, resident care, and the operation of the nursing home.
     3    (d)  "Required  resident care percentage" means the ratio of a nursing
     4  home's resident care amount to its total operating revenue, expressed as
     5  a percentage, for a calendar year, required by subdivision two  of  this
     6  section.
     7    (e)  "Direct  care  service  amount" means the portion of the resident
     8  care amount attributable to costs under subparagraph  (i)  of  paragraph
     9  (a) of this subdivision.
    10    (f) "Resident care deficit" means the amount, in dollars, by which the
    11  nursing home's resident care amount is less than the amount necessary to
    12  achieve the required resident care percentage, where it is less.
    13    (g)  "Direct  care  service  deficit" means the amount, in dollars, by
    14  which the nursing home's  direct  service  amount  is  less  than  sixty
    15  percent  of  the  resident care amount, in dollars, necessary to achieve
    16  the required resident care percentage, where it is less.
    17    2. Every nursing home shall, in every calendar year,  spend  at  least
    18  (a)  the resident care amount necessary to achieve the required resident
    19  care percentage and (b) a sufficient direct care service  amount  so  it
    20  does  not  have a direct care service deficit. For the calendar year two
    21  thousand twenty-two, the required  resident  care  percentage  shall  be
    22  seventy  percent.   For the calendar year two thousand twenty-three, the
    23  required resident care percentage  shall  be  eighty  percent.  For  the
    24  calendar  year  two  thousand twenty-four and every year thereafter, the
    25  required resident care percentage shall be ninety percent.
    26    3. For any calendar year in which a nursing home has a  resident  care
    27  deficit  or  direct care service deficit, it shall pay to the department
    28  an amount equal to what the nursing home would  have  had  to  spend  to
    29  avoid  having either deficit, payable in a manner and time determined by
    30  the commissioner in regulations. Where a nursing home does  not  pay  as
    31  required  by  this  subdivision,  the commissioner shall sue the nursing
    32  home to obtain the unpaid amount, deduct the unpaid amount from  medical
    33  assistance  payments otherwise due to the nursing home, or a combination
    34  of those methods. Moneys so collected shall be transferred to the  nurs-
    35  ing  home  quality  improvement  demonstration program, to be used under
    36  subdivision six of section twenty-eight hundred eight-d of this  article
    37  in support of projects or programs designed to improve specific areas of
    38  quality of care.
    39    4.  For  purposes  of this section, a nursing home's spending, revenue
    40  and percentages of various amounts shall be  calculated  on  an  accrual
    41  basis, under regulations of the commissioner.
    42    5.  The  commissioner  shall make regulations, make medical assistance
    43  state plan amendments, seek waivers from the federal centers  for  Medi-
    44  care  and Medicaid services, and take other actions reasonably necessary
    45  to implement this section.
    46    6. The commissioner shall, by regulations  and  otherwise,  make  sure
    47  that  reports by nursing homes under section twenty-eight hundred five-e
    48  of this article include information as to all items referred to in  this
    49  section  and organize that information consistent with the terms of this
    50  section.
    51    § 2. This act shall take effect immediately.