Section 1:  Chapter 23 of the General Laws, as appearing in the 2010 official edition is hereby amended by inserting after section 9U the following new section:

                The Commonwealth Corporation shall, subject to appropriation, establish an extended care career ladder grant program, consistent with section 410 of chapter 159 of the Acts of 2000.  Grants shall be available for certified nurses’ aides, home health aides, homemakers and other entry level workers in long-term care.  The grants may include training for English for speakers of other languages and other language and adult basic education programs to improve quality of care and improve direct care worker access to and participation in career ladder training.  The length of such grants shall not exceed a period of 3 years.  The Commonwealth Corporation shall submit quarterly reports to the house and senate committees on ways and means on said grant program including, but not limited to, the number of grants awarded, the amount of each grant, a description of the career ladder programs, changes in care-giving and workplace practices that have occurred and their impact on quality of care and worker retention and the certificates, degrees or professional status attained by each participating employee.  The administrative and program management costs for the implementation of said grant program shall not exceed 4 per cent of the amount of the grant program.  Each grant may include funding for technical assistance and evaluation.

Section 2: Chapter 111 of the General Laws, as appearing in the 2010 official edition, is hereby amended by inserting after section 4O the following new section:-

                4P. The Department shall, subject to appropriation, establish a scholarship program for certified nurses’ aide and direct care worker training.  The department shall establish appropriate guidelines and application criteria for the administration of the program.  The scholarships shall cover the full cost of tuition to an approved certified nurses’ aide or long-term care direct worker training program, including approved programs providing for cross-training.  Funds may also be available to provide adult basic education and English as a second language training for applicants otherwise meeting criteria for the scholarships, as well as pilot training programs using enhanced curricula designed to support increased retention.  The department shall, in consultation with the nursing home industry, consumer groups, the department of labor and workforce development, the Commonwealth Corporation, training providers and other appropriate state and local agencies, conduct outreach regarding the availability of such scholarships.  The department shall consult with the scholarship program advisory council to review and recommend new training requirements for certified nurses’ aides, home health aides and home care workers to improve the quality of the direct care workforce and the quality of care provided in all long-term care settings by developing skill standards, supporting the transition from training to work, improving retention, promoting portability, recognizing career advancement curricula and addressing language and education barriers.  The costs for outreach activities shall not exceed 3 per cent of the amount of the program and administrative costs of the program shall not exceed 3 per cent of the amount of the program.

Section 3: Section 14A of chapter 118E of the General Laws as appearing in the official 2010 edition is hereby amended by adding the following paragraphs:

In the event that a nursing facility resident who is a MassHealth recipient enters a hospital, the division shall pay to preserve his or her bed in the nursing facility for a period of up to10 days.  The division shall reimburse the nursing facility for the medical leave of absence, which shall include an observation stay in a hospital in excess of twenty-four hours, at the recipient’s pre-absence rate during the medical leave and upon the resident’s return.

In the event that a nursing facility resident who is a MassHealth recipient leaves the nursing facility for non-medical reasons, the division shall pay to preserve his or her bed in the facility for a period of up to 15 days.  The division shall reimburse the nursing facility for the non-medical leave of absence at the recipient’s pre-absence rate during the non-medical leave and upon the resident’s return.

Section 4: Chapter 118E as amended by section 123 of chapter 224 of the Acts of 2012 is hereby amended by adding at the end thereof the following new section: - 

Notwithstanding any general or special law to the contrary, the Department, in the calculation of Medicaid payment rates for nursing facility services shall use the wage component of the Medicare Skilled Nursing Facility Prospective Payment System, national Average Hourly Earnings price index, as established in the annual rule published in the Federal Register, to adjust allowable base year labor costs (whether facility-specific or reflected in standard payments) to the rate year; provided further that the Department is required to obtain from IHS Global Insight a wage and salary price index proxy based on New England regional nursing facility labor costs.  Upon establishment of the regional labor-based proxy, the Department shall substitute it for the national index cited above.

Section 5: Chapter 118E as amended by section 123 of chapter 224 of the acts of 2012 is hereby amended by adding the following new section language:

Notwithstanding any general or special law to the contrary, In the event the division conducts or utilizes an audit of nursing facilities’ base year costs for the purpose of reducing rates below levels that would be in effect in the absence of the audit, the division  shall:—

(1) conduct a field audit of 50 per cent of total nursing facilities licensed in the base year in accordance with specified, uniform criteria;

(2) inform each audited nursing facility in writing of its right to appeal to the division of administrative law appeals each and every audit disallowance to which the nursing facility is subject;

(3) delay implementing the audit until all appeals by nursing facilities have been completely adjudicated by the division of administrative law appeals;

(4) delay implementing the audit until the division has conducted a public hearing the notice of which describes with particularity the methodology, audit criteria and substantive standards utilized in the audit and the impact of implementing the audit on quality care for nursing facility residents; and

(5) not implement any audit disallowance that is not fully concluded in accordance with the preceding subsections by one year after the conclusion of the base period.

Section 6: Notwithstanding any general or special law to the contrary, effective July 1, 2013 for the fiscal year ending June 30, 2014 nursing facility MassHealth rates shall be set using 2010 costs.