Senate Bill No. 328 requires nursing homes to allocate at least eighty percent of their revenue from Medicaid, Medicare, and other payment sources towards direct patient care, starting from the fiscal year 2027. The bill amends subsection (a) of section 17b-340d of the general statutes, repealing existing language and introducing new provisions for Medicaid reimbursement methodologies. The Commissioner of Social Services will implement an acuity-based methodology for reimbursement, which will include case-mix adjustments based on resident assessments and historical cost data. Nursing homes will also be required to report quality metrics, and the Department of Social Services will provide annual individualized reports on Medicaid rates based on these metrics.

Additionally, the bill establishes new quality measures for nursing homes as defined by the Centers for Medicare and Medicaid Services and allows for a quality metrics program to incentivize high-quality care for Medicaid beneficiaries. It outlines allowable costs for nursing homes, categorizing them into five components with specific limits for direct and indirect costs, and includes provisions for fair rent calculations and adjustments. The bill also specifies that the allowable fair rent will be determined based on the rate of return for the cost year in which bonds were issued, with rebasing occurring no more frequently than every two years. The effective date for these changes is set for July 1, 2026.