Nursing homes and their workers receive state aid

Addressing the financial strains that have beset nursing homes during the COVID-19 pandemic, the state will provide $303.4 million to create grant programs for facilities, workforce incentive programs and a temporary rate add-on, and provide partial reimbursement to hospitals for qualifying avoidable patient days.

Sponsored by Rep. Mohamud Noor (DFL-Mpls) and Sen. John Hoffman (DFL-Champlin), the law took effect May 27, 2023, unless noted. It contains four programs.

Nursing facility workforce incentive grant program: Designed to help recruit and retain workers, this portion of the law takes effect July 1, 2023, and distributes $74.5 million in fiscal year 2024 to nursing facilities, with the money available for:

• retention, recruitment and incentive payments;

• employee-owned benefits, such as health savings accounts, Health Resources and Services Administration accounts, and flexible spending accounts;

• employee contributions to a 401k account;

• education, professional development and financial counseling;

• child care, meals, transportation and housing;

• health and wellness; and

• other flexible needs related to workforce challenges as determined by the Department of Human Services.

An eligible worker may receive payments of up to $3,000 per year from the workforce incentive grant account and all other state money intended for the same purpose.

Payments to nursing facilities: The Department of Human Services will provide a onetime $225,000 payment to nursing facilities, with additional funds available based upon a formula involving how many active beds are in a facility. Outlays will go to nursing facilities in two equal lump sums on Aug. 1 of both 2023 and 2024. The money can be used for:

• covering operating- or property-related long-term debt payments;

• closing lines of credit;

• debt restructuring;

• paying off covenants or avoiding receivership;

• rent payments in arrears;

• physical plant improvements and maintenance not claimed for a rate increase; and

• any other item deemed allowable by the department.

An appropriation of $173.1 million in fiscal year 2024 is earmarked for this purpose. Each facility must expend the total payment by Sept. 30, 2025.

Nursing facility temporary rate add-on: The department will provide a temporary daily rate add-on for facilities that would come to $12.35 per resident day. Effective July 1, 2023, or upon federal approval, the add-on will expire on Dec. 31, 2024. The law earmarks $21.3 million in fiscal year 2024 and $15.2 million in fiscal year 2025 for the purpose.

Payments to hospitals: A high-acuity patient is a hospital patient with obesity or who has a disability, has a need for wound care, has a mental illness, has high behavior needs, has a substance use disorder, is receiving intravenous fluid or intravenous medication, or requires dialysis. A “qualifying avoidable patient day” is any day that such a patient was boarded in an emergency department because they did not meet the applicable admission criteria and the hospital could not identify a setting to which the patient could be safely released.

Beginning July 1, 2023, the Department of Human Services will make payments to hospitals as partial reimbursement for qualifying avoidable patient days at a rate of $1,400 per submitted qualifying avoidable patient day. An appropriation of $18 million in fiscal year 2024 is earmarked for the purpose.

An appropriation of $1.2 million in fiscal year 2024 goes toward administration of the programs.

HF3342*/SF3363/CH74

HF3342* / SF3363 / CH74