The bill amends existing laws governing the state Medicaid program, particularly focusing on the reimbursement rate plan for nursing facilities. It introduces a quality assurance component that allows nursing facilities to earn additional funds based on their long-stay quality measures ratings, with the Oklahoma Health Care Authority tasked with allocating these funds according to the facilities' star ratings. The legislation also establishes a staff retention initiative, providing extra payments to facilities that successfully retain a specified percentage of Registered Nurses and Certified Nurse Aides. Furthermore, the bill updates the statutory language and expands the purpose of the Nursing Facility Quality of Care Fund advisory committee, while requiring the Authority to include detailed information in its annual budget request and submit an annual report on the incentive reimbursement rate plan to key state officials.

In addition to the reimbursement changes, the bill sets new staffing requirements for nursing facilities and intermediate care facilities for individuals with intellectual disabilities (ICFs/IID) with seventeen or more beds, mandating an increase in direct-care staffing levels from 2.86 hours to 4.1 hours per day per occupied bed, contingent on Medicaid reimbursement rates. It also introduces an informal dispute resolution process for facilities facing penalties for staffing noncompliance and requires monthly staffing ratio reports to be made publicly accessible. The bill establishes the Oklahoma Nursing Facility Funding Advisory Committee to develop a new methodology for Medicaid reimbursements based on direct care staffing expenditures, mandates training for clinical employees on Alzheimer's and dementia, and enhances the cost-reporting system for nursing facilities. Administrative penalties for noncompliance with reporting requirements are included, with collected funds directed to the Nursing Facility Quality of Care Fund. The act is set to take effect on July 1, 2025, with an emergency clause for immediate implementation upon passage.