Senate Bill No. 904 seeks to improve the reimbursement rate plan for nursing facilities under the Oklahoma Medicaid program, emphasizing enhanced resident outcomes and quality of life. The bill requires the Oklahoma Health Care Authority to create an incentive reimbursement rate plan that allocates $5.00 per patient day for facilities meeting specific long-stay quality measures. It introduces a tiered system where facilities with higher quality ratings receive a larger share of these funds, and it includes a staff retention initiative allowing facilities to earn up to $3.00 per Medicaid patient day for retaining nursing staff for at least twelve months. Additionally, the bill mandates the recalculation of reimbursement rates based on actual audited costs and establishes minimum direct-care staff-to-resident ratios.

Furthermore, the bill amends existing laws regarding staffing requirements for intermediate care facilities for individuals with intellectual disabilities (ICFs/IID) with seventeen or more beds, introducing a tiered staffing level based on direct care hours per occupied bed. It also creates the Oklahoma Nursing Facility Funding Advisory Committee to develop a new methodology for calculating Medicaid reimbursements based on direct care staffing expenditures. The bill sets a new average rate for nursing facilities effective October 1, 2019, increases the personal needs allowance for residents, and includes provisions for training requirements for clinical employees. The act is scheduled to take effect on July 1, 2025, with an emergency clause for immediate implementation upon passage.