130th MAINE LEGISLATURE
FIRST REGULAR SESSION-2021
Legislative Document No. 250
H.P. 171 House of Representatives, January 29, 2021
An Act To Assist Nursing Homes in the Management of Facility
Beds
Received by the Clerk of the House on January 27, 2021. Referred to the Committee on
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative PERRY of Calais.
Cosponsored by Senator CLAXTON of Androscoggin and
Representative: McCREA of Fort Fairfield.
Printed on recycled paper
 1 Be it enacted by the People of the State of Maine as follows:
2 Sec. 1. 22 MRSA §333, sub-§1, as amended by PL 2011, c. 648, §2, is further
3 amended to read:
4 1. Procedures. A nursing facility that voluntarily reduces the number of its licensed
5 beds at any time prior to July 1, 2007, for any reason except to create private rooms may
6 convert the beds back and thereby increase the number of nursing facility beds to no more
7 than the previously licensed number of nursing facility beds, after obtaining a certificate of
8 need in accordance with this section, as long as the nursing facility has been in continuous
9 operation without material change of ownership. For purposes of this section and sections
10 333-A and 334-A, beds voluntarily removed from service prior to July 1, 2007 and
11 available to be reinstated under this section are referred to as "reserved beds." Reserved
12 beds remain facility property until they lapse as provided for in this section or are
13 transferred. To reinstate reserved beds under this subsection, the nursing facility must
14 shall:
15 A. Give notice of the number of beds it is reserving no later than 30 days after the
16 effective date of the license reduction;
17 A-1. Annually provide notice to the department no later than July 1st of each year of
18 the nursing facility's intent to retain these reserved beds, subject to the limitations set
19 forth in subsection 2, paragraph B. Notice provided under this paragraph preserves the
20 reserved beds through June 30th of the following year. The annual notice on reserved
21 beds may be filed by an individual nursing facility or by multiple nursing facilities
22 through a membership organization approved by the department by a single filing; and
23 B. Obtain a certificate of need to convert beds back under section 335, except that, if
24 no construction is required for the conversion of beds back, the application must be
25 processed in accordance with subsection 2. The department in its review shall evaluate
26 the impact that the nursing facility beds to be converted back would have on those
27 existing nursing facility beds and facilities within 30 miles of the applicant's facility
28 and shall determine whether to approve the request based on current certificate of need
29 criteria and methodology.
30 Sec. 2. 22 MRSA §333, sub-§2, ¶A, as enacted by PL 2001, c. 664, §2, is amended
31 to read:
32 A. Review of applications that meet the requirements of this section must be based on
33 the requirements of section 335, subsection 7, except that the determinations required
34 by section 335, subsection 7, paragraph B must be based on the historical costs of
35 operating the beds and must consider whether the projected costs are consistent with
36 the costs of the beds prior to closure, adjusted for inflation applications that seek to
37 reopen reserved beds must be approved if the projected incremental costs of reopening
38 and operating the reserved beds are consistent with the facility's costs of operating its
39 other beds. Applicants are not required to demonstrate that any increases in MaineCare
40 costs are offset by other MaineCare savings. The costs of ongoing operation of both
41 the reopened beds and the complement of facility beds at the time the reserved beds
42 are reopened must be recognized as allowable costs and incorporated into the facility's
43 MaineCare payment rates; and
44 Sec. 3. 22 MRSA §1720, as enacted by PL 2005, c. 242, §1, is amended to read:
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 1 §1720. Nursing facility medical director reimbursement
2 The department shall include in its calculation of reimbursement for services provided
3 by a nursing facility an allowance for the cost of incurred by the facility for a medical
4 director in a base year amount not to exceed $10,000, with that amount being subject to an
5 annual cost-of-living adjustment.
6 Sec. 4. Cost of computer and cloud-based software systems a fixed cost.
7 Beginning October 1, 2021, the cost incurred by a nursing facility for the acquisition,
8 including set-up costs, use and maintenance, of computer or cloud-based software systems
9 must be included as a fixed cost by the Department of Health and Human Services in its
10 rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of
11 Reimbursement for Nursing Facilities. Costs included pursuant to this section must include
12 without limitation the costs of hardware, if any, software and software support.
13 SUMMARY
14 This bill restores the ability of nursing facilities to voluntarily reduce the number of
15 their licensed beds and then later increase the number of their licensed beds to the prior
16 level after obtaining a certificate of need and meeting certain conditions.
17 The bill modifies the process to obtain certificate of need approval to reopen reserved
18 beds. Applications that seek to reopen reserved beds must be approved if the projected
19 incremental costs of reopening and operating the reopened beds are consistent with the
20 facility's costs of operating its other beds. Applicants are not required to demonstrate that
21 any increases in MaineCare costs are offset by other MaineCare savings. The costs of
22 ongoing operation of both the restored beds and the complement of facility beds at the time
23 the reserved beds are reopened must be recognized as allowable costs and incorporated into
24 the facility's MaineCare payment rates.
25 The bill requires the Department of Health and Human Services to include in its
26 calculation of reimbursement for services provided by a nursing facility the cost incurred
27 by the facility for a medical director.
28 The bill requires the cost incurred by a nursing facility for the acquisition, use and
29 maintenance of computer or cloud-based software systems to be included as a fixed cost.
30
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Statutes affected:
Bill Text LD 250, HP 171: 22.333, 22.1720