The proposed legislation, General Assembly Raised Bill No. 289, aims to establish a quality metrics program for nursing homes, which will be implemented by the Department of Social Services (DSS) starting October 1, 2026. The bill mandates that nursing facilities comply with the collection and reporting of quality metrics, with the DSS providing individualized reports to each facility beginning July 1, 2023. These reports will detail the impact of the quality metrics on Medicaid reimbursement rates. The bill also introduces a performance-based payment system, where nursing homes can receive enhanced Medicaid quality performance payments based on their performance in the quality metrics program, with a total annual pool of ten million dollars allocated for this purpose.

Additionally, the bill outlines specific criteria for nursing homes to be eligible for these payments, including the exclusion of facilities identified as special focus facilities or those with serious quality of care issues. The DSS is also tasked with implementing a Medicaid utilization pool to provide enhanced payments to nursing homes with a high percentage of Medicaid residents, with funding limits set for the fiscal years 2027 and beyond. The legislation emphasizes the importance of aligning Medicaid reimbursement rates with quality outcomes and aims to improve the overall quality of care in nursing homes.