Minnesota · statute · Minn. Stat. ch. 256R · 47 active provisions
Subdivision 1. Payment rates. Payment rates paid to any nursing facility receiving medical assistance payments must be those rates established pursuant to this chapter and rules adopted under it. Subd. 1a. Payment rates for nursing care provided to a patient in a swing bed. Payment rates paid to any hospital for nursin…
Subdivision 1. Application. For purposes of this chapter, the terms in this section have the meanings given unless otherwise provided for in this chapter. Subd. 2. Active beds. "Active beds" means licensed beds that are not currently in layaway status. Subd. 3. Activities costs. "Activities costs" means the costs for t…
Subdivision 1. Requirements for funding. (a) No medical assistance payments shall be made to any nursing facility unless the nursing facility is certified to participate in the medical assistance program under title XIX of the federal Social Security Act and has in effect a provider agreement with the commissioner meet…
Subdivision 1. Financial exploitation. A nursing facility is not eligible to receive medical assistance payments unless it refrains from all of the following: (1) charging, soliciting, accepting, or receiving from an applicant for admission to the facility, or from anyone acting on behalf of the applicant, as a conditi…
Subdivision 1. Preadmission screening. (a) Medical assistance reimbursement for nursing facilities shall be authorized for a medical assistance recipient only if a preadmission screening has been conducted prior to admission or the county has authorized an exemption. Medical assistance reimbursement for nursing facilit…
Subdivision 1. Medical assistance rates not to exceed private pay residents' rates. (a) The total payment rate must not exceed the rate paid by private paying residents for similar services for the same period. (b) The medical assistance rate limitation in paragraph (a) shall not apply to retroactive adjustments to the…
Subdivision 1. Criteria. A nursing facility must keep adequate documentation. In order to be adequate, documentation must: (1) be maintained in orderly, well-organized files; (2) not include documentation of more than one nursing facility in one set of files unless transactions may be traced by the commissioner to the…
Subdivision 1. Reporting of financial statements. (a) No later than February 1 of each year, a nursing facility must: (1) provide the state agency with a copy of its working trial balance; (2) provide the state agency with a copy of its audited financial statements for each year an audit is conducted; (3) provide the s…
Subdivision 1. Reporting timeline. Each nursing facility shall file a statistical and cost report for the prior reporting period by February 1 in a form and manner specified by the commissioner. Notice of rates shall be distributed by November 15. Subd. 2. Reporting of statistical and cost information. All nursing faci…
Subdivision 1. General cost principles. Only costs determined to be allowable shall be used to compute the total payment rate for nursing facilities participating in the medical assistance program. To be considered an allowable cost for rate-setting purposes, a cost must satisfy the following criteria: (1) the cost is…
Subdivision 1. Generally. (a) The following costs shall not be recognized as allowable: (1) political contributions; (2) salaries or expenses of a lobbyist, as defined in section 10A.01, subdivision 21, for lobbying activities; (3) advertising designed to encourage potential residents to select a particular nursing fac…
Subdivision 1. Allocation; direct identification of costs; management agreement. All costs that can be directly identified with a specific nursing facility that is a related organization to the central, affiliated, or corporate office, or that is controlled by the central, affiliated, or corporate office under a manage…
Subdivision 1. Audit authority. (a) The commissioner shall provide for an audit of the cost and statistical data of nursing facilities participating as vendors of medical assistance. The commissioner shall select for audit at least 15 percent of the nursing facilities' data reported at random or using factors including…
Subdivision 1. Calculation of a quality score. (a) The commissioner shall determine a quality score for each nursing facility using quality measures established in section 256B.439, according to methods determined by the commissioner in consultation with stakeholders and experts, and using the most recently available d…
Subdivision 1. Case mix classifications. The case mix classifications shall be those established under section 144.0724. Subd. 2. Case mix indices. (a) The commissioner shall assign a case mix index to each case mix classification as determined by the commissioner of health under section 144.0724. (b) An index maximiza…
Subdivision 1. Total payment rates. For each facility, the commissioner shall calculate a total payment rate using the statistical and cost report filed by each nursing facility for the reporting period ending 15 months prior to the rate year. The total payment rates are the total payment rates in effect on the first d…
Subdivision 1. Case mix adjusted payment rates generally. For each facility, the commissioner shall calculate case mix adjusted payment rates for each case mix classification. Subd. 2. Determination of case mix adjusted total care-related payment rates. A facility's case mix adjusted total care-related payment rate for…
Subdivision 1. Determination of total care-related cost per day. Each facility's total care-related cost per day is the sum of its direct care cost per standardized day and its other care-related cost per resident day. Subd. 2. Calculation of direct care cost per standardized day. Each facility's direct care cost per s…
Subdivision 1. Determination of other operating cost per day. Each facility's other operating cost per day is its other operating costs divided by the sum of the facility's resident days. Subd. 2. Determination of the median other operating cost per day. The commissioner must determine the median other operating cost p…
Subdivision 1. Determination of external fixed cost payment rate. The payment rate for external fixed costs is the sum of the amounts in subdivisions 2 to 17. [See Note.] Subd. 2. Provider surcharges. (a) For a facility licensed as a nursing home, the portion related to the provider surcharge under section 256.9657 is…
Subdivision 1. Determination of limited undepreciated replacement cost. A facility's limited URC is the lesser of: (1) the facility's recognized URC from the appraisal; or (2) the product of (i) the number of the facility's licensed beds three months prior to the beginning of the rate year, (ii) the construction cost p…
Subdivision 1. Definitions. For purposes of sections 256R.26 to 256R.267, the terms in this section have the meanings given unless otherwise provided for in this chapter. Subd. 2. Addition. "Addition" means an extension, enlargement, or expansion of the nursing facility for the purpose of increasing the number of licen…
Subdivision 1. Selection of valuation system and appraisal firms. The commissioner shall select a commercial valuation system that property appraisal firms selected by the commissioner must utilize for all nursing facility property appraisals. The commissioner shall use appraisal reports produced by commissioner-select…
(a) A facility reimbursed under section 256R.26, subdivisions 1 to 8, may receive a property payment rate interim adjustment for threshold projects the cumulative cost of which during the three years between physical appraisals is between the following threshold project cost limits: (1) the lesser of $316,816 or $10,00…
Subdivision 1. Generally. (a) The commissioner shall determine the interim payment rates and settle-up payment rates for a newly constructed nursing facility, or a nursing facility with an increase in licensed capacity of 50 percent or more, according to subdivisions 2 and 3. (b) The nursing facility must submit a writ…