1.1.................... moves to amend H.F. No. 1565 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 144A.071, subdivision 4c, is amended to
1.4read:
1.5    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The
1.6commissioner of health, in coordination with the commissioner of human services, may
1.7approve the renovation, replacement, upgrading, or relocation of a nursing home or
1.8boarding care home, under the following conditions:
1.9    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
1.10constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
1.11attached to a hospital that is also being replaced. The threshold allowed for this project
1.12under section 144A.073 shall be the maximum amount available to pay the additional
1.13medical assistance costs of the new facility;
1.14    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
1.15Louis County, provided that the 29 beds must be transferred from active or layaway status
1.16at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
1.17The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
1.18rate at that facility shall not be adjusted as a result of this transfer. The operating payment
1.19rate of the facility adding beds after completion of this project shall be the same as it was
1.20on the day prior to the day the beds are licensed and certified. This project shall not
1.21proceed unless it is approved and financed under the provisions of section 144A.073;
1.22    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
1.23the new beds are transferred from a 45-bed facility in Austin under common ownership
1.24that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
1.25under common ownership; (ii) the commissioner of human services is authorized by the
1.262004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
1.27money is available from planned closures of facilities under common ownership to make
2.1implementation of this clause budget-neutral to the state. The bed capacity of the Albert
2.2Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
2.3new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
2.4disease or related dementias;
2.5    (4) to license and certify up to 80 beds transferred from an existing state-owned
2.6nursing facility in Cass County to a new facility located on the grounds of the
2.7Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
2.8determined based on the interim and settle-up payment provisions of Minnesota Rules,
2.9part 9549.0057, and the reimbursement provisions of section 256B.431. The property
2.10payment rate for the first three years of operation shall be $35 per day. For subsequent
2.11years, the property payment rate of $35 per day shall be adjusted for inflation as provided
2.12in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract
2.13under section 256B.434; and
2.14    (5) to initiate a pilot program to license and certify up to 80 beds transferred from
2.15an existing county-owned nursing facility in Steele County relocated to the site of a new
2.16acute care facility as part of the county's Communities for a Lifetime comprehensive plan
2.17to create innovative responses to the aging of its population. Upon relocation to the new
2.18site, the nursing facility shall delicense 28 beds. The property payment rate for the first
2.19three years of operation of the new facility shall be increased by an amount as calculated
2.20according to items (i) to (v):
2.21    (i) compute the estimated decrease in medical assistance residents served by the
2.22nursing facility by multiplying the decrease in licensed beds by the historical percentage
2.23of medical assistance resident days;
2.24    (ii) compute the annual savings to the medical assistance program from the
2.25delicensure of 28 beds by multiplying the anticipated decrease in medical assistance
2.26residents, determined in item (i), by the existing facility's weighted average payment rate
2.27multiplied by 365;
2.28    (iii) compute the anticipated annual costs for community-based services by
2.29multiplying the anticipated decrease in medical assistance residents served by the nursing
2.30facility, determined in item (i), by the average monthly elderly waiver service costs for
2.31individuals in Steele County multiplied by 12;
2.32    (iv) subtract the amount in item (iii) from the amount in item (ii);
2.33    (v) divide the amount in item (iv) by an amount equal to the relocated nursing
2.34facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c),
2.35multiplied by the historical percentage of medical assistance resident days.; and
3.1(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
3.2and to integrate these services with other community-based programs and services under a
3.3communities for a lifetime pilot program and comprehensive plan to create innovative
3.4responses to the aging of its population. Eighty beds in the city of Red Wing shall be
3.5transferred from the downsizing and relocation of an existing 84-bed, hospital-owned
3.6nursing facility and the entire closure or downsizing of beds from a 65-bed nonprofit
3.7nursing facility in the community resulting in the delicensure of 69 beds in the two
3.8existing facilities. Notwithstanding the carryforward of the approval authority in section
3.9144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of
3.10health for a project in Goodhue County shall not carry forward. The closure of the 69 beds
3.11shall not be eligible for a planned closure rate adjustment under section 256B.437. The
3.12construction project permitted in this item shall not be eligible for a threshold project
3.13rate adjustment under section 256B.434, subdivision 4f. The property payment rate for
3.14the first three years of operation of the new facility shall be increased by an amount as
3.15calculated according to items (i) to (vi):
3.16(i) compute the estimated decrease in medical assistance residents served by both
3.17nursing facilities by multiplying the difference between the occupied beds of the two
3.18nursing facilities for the reporting year ended September 30, 2009, and the projected
3.19occupancy of the facility at 95 percent occupancy by the historical percentage of medical
3.20assistance resident days;
3.21(ii) compute the annual savings to the medical assistance program from the
3.22delicensure by multiplying the anticipated decrease in the medical assistance residents,
3.23determined in item (i), by the hospital-owned nursing facility weighted average payment
3.24rate multiplied by 365;
3.25(iii) compute the anticipated annual costs for community-based services by
3.26multiplying the anticipated decrease in medical assistance residents served by the
3.27facilities, determined in item (i), by the average monthly elderly waiver service costs for
3.28individuals in Goodhue County multiplied by 12;
3.29(iv) subtract the amount in item (iii) from the amount in item (ii);
3.30(v) multiply the amount in item (iv) by 57 percent; and
3.31(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
3.32amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
3.33subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
3.34resident days.
4.1    For subsequent years, the adjusted property payment rate shall be adjusted for
4.2inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the
4.3facility has a contract under section 256B.434.
4.4    (b) Projects approved under this subdivision shall be treated in a manner equivalent
4.5to projects approved under subdivision 4a. "
4.6Amend the title accordingly