The bill amends Washington State's laws regarding nursing facility rates, specifically RCW 74.46.501 and 74.46.561, by establishing a new methodology for calculating average case mix indexes for Medicaid nursing facilities. This new approach includes all residents present during the quarter for the facility average case mix index and incorporates default cases for the Medicaid average case mix index. Additionally, it introduces a direct care component rate based on 111% or greater of statewide case mix neutral median costs, with a cap for fiscal year 2023. The bill also allows for adjustments to case mix calculations if the federal Department of Health and Human Services modifies the minimum data set used for resource utilization groups.

Moreover, the legislation aims to enhance compensation and support for low-wage direct and indirect care workers by mandating that a portion of annual rate increases be allocated to low-wage equity. Starting July 1, 2023, 29% of the direct care rate increase and 10% of the indirect care rate increase must be dedicated to improving wages for low-wage workers, such as certified nursing assistants and housekeeping staff. Facilities will be required to report average wages, and a verification process will ensure that funds are used effectively. The bill also establishes a stakeholder work group to study the impacts of low-wage funding on staff retention and recruitment, with a report due to the legislature by December 1, 2025. Overall, the legislation seeks to improve the quality of care in nursing facilities while ensuring fair compensation for workers.

Statutes affected:
Original Bill: 74.46.501, 74.46.561
Substitute Bill: 74.46.501, 74.46.561