SB 5802 — Providing flexibility in calculation of nursing rates.

S-4785.1Z-0489.1 SUBSTITUTE SENATE BILL 5802 State of Washington 68th Legislature 2024 Regular Session By Senate Ways & Means (originally sponsored by Senators Muzzall, Hasegawa, Lovelett, Nobles, Rivers, and Robinson;

by request of Department of Social and Health Services)Services READPrefiled FIRST12/06/23. TIME 02/05/24.

Read first time 01/08/24.

Referred to Committee on Health & Long Term Care.

1 SSBSB 5802 facilities involved in the transactions shall not be considered as arm's-length transactions for purposes of this chapter.

2 SSBSB 5802 (13) "Depreciation" means the systematic distribution of the cost or other basis of tangible assets, less salvage, over the estimated useful life of the assets.

3 SSBSB 5802 (24) "High labor-cost county" means an urban county in which the median allowable facility cost per case mix unit is more than ten percent higher than the median allowable facility cost per case mix unit among all other urban counties, excluding that county.

4 SSBSB 5802 (32) "Minimum data set" means the overall data component of the resident assessment instrument, indicating the strengths, needs, and preferences of an individual nursing facility resident.

5 SSBSB 5802 (e) An occupational therapist who is a graduate of a program in occupational therapy, or who has the equivalent of such education or training;

6 SSBSB 5802 care, that are provided by qualified therapists, or support personnel under their supervision, including related costs as designated by the department.

(a) ((EmployEmploy the((the resource utilization group IV case mix classification methodology.

The department may adjust by no more than thirteen percent the case mix index for resource utilization group categories beginning with PA1 through PB2 to any case mix index that aids in achieving the purpose and intent of RCW 74.39A.007 and cost-efficient care, excluding behaviors, and allowing for exceptions for limited placement options)) Develop a method for applying case mix to the rate.

((and))and (b) ((Implement minimum data set 3.0 under the authority of this section.

In the notification, the department must identify for all semiannual rate settings following the date of minimum data set 3.0 implementation a previously established semiannual case mix adjustment established for the semiannual rate settings that will be used for semiannual case mix calculations in direct care until p.

7 SSBSB 5802 used for semiannual case mix calculations in direct care until minimum data set 3.0 is fully)) Develop and implement rules to outline what data is used and how it is implemented;implemented.

and (c) Subject to the availability of amounts appropriated for this specific purpose, employ the method to adjust rates of individual facilities for case mix changes.

(a) Set the certified nurse aide wage weight at 1.000 and calculate wage weights for registered nurse and licensed practical p.nurse average wages by dividing the certified nurse aide average wage into the registered nurse average wage and licensed practical nurse average wage;

8p. SSB 5802 nurse average wages by dividing the certified nurse aide average wage into the registered nurse average wage and licensed practical nurse average wage;

8 SB 5802 (b) Calculate the total weighted minutes for each case mix group in the resource utilization group classification system by multiplying the wage weight for each worker classification by the average number of minutes that classification of worker spends caring for a resident in that resource utilization group classification group, and summing the products;

(2)(a) In calculating a facility's two average case mix indexes for each quarter, the department shall include all residents or medicaid residents, as applicable, who were physically in the facility during the quarter in question based on the resident assessment instrument completed by the facility and the requirements and limitations for the instrument's completion and transmission p.

9 SSBSB 5802 facility during the quarter in question based on the resident assessment instrument completed by the facility and the requirements and limitations for the instrument's completion and transmission (January 1st through March 31st, April 1st through June 30th, July 1st through September 30th, or October 1st through December 31st).

Otherwise, a)) A facility's medicaid p.average case mix index shall be used to update a nursing facility's direct care component rate semiannually.

10p. SSB 5802 average case mix index shall be used to update a nursing facility's direct care component rate semiannually.

10 SB 5802 (((b) Except during the 2021-2023 fiscal biennium, the facility average case mix index used to establish each nursing facility's direct care component rate shall be based on an average of calendar quarters of the facility's average case mix indexes from the four calendar quarters occurring during the cost report period used to rebase the direct care component rate allocations as specified in RCW 74.46.561.

11 SSBSB 5802