Budget Amendment ID: FY2017-S4-22-R2

2nd Redraft OTH 22

Preventing Patient Abuse in Nursing Homes

Messrs. Montigny and Moore, Ms. Forry, Messrs. O'Connor, Brady and Lewis moved that the proposed new text be amended in section 25, by adding the following section:-

“Section 2UUUU. There shall be a Long-Term Care Facility Quality Improvement Fund. The commissioner of public health shall administer the fund and shall make expenditures from the fund for measures to improve the safety and quality of care provided in long-term care facilities including, but not limited to: (i) staff training and education; (ii) technical assistance to implement best practices; (iii) dissemination of best practice models on quality of care; (iv) state operation of facilities pending correction of deficiencies or closure; (v) costs of relocating residents from 1 facility to another; and (vi) funding to support adequate department resources to inspect facilities under state and federal law.

The fund shall consist of: (A) revenue generated from fines and penalties imposed by the department on long-term care facilities under section 73 of chapter 111; (B) revenue from appropriations or other monies authorized by the general court and specifically designated to be credited to the fund; and (C) funds from public or private sources including, but not limited to, gifts, grants, donations, rebates and settlements received by the commonwealth that are specifically designated to be credited to the fund.  The department may incur expenses and the comptroller may certify for payment, amounts in anticipation of expected receipts; provided, however, that no expenditure shall be made from the fund that shall cause the fund to be in deficit at the close of a fiscal year. Amounts credited to the fund shall not be subject to further appropriation and money remaining in the fund at the end of a fiscal year shall not revert to the General Fund. The commissioner shall report annually, not later than October 1, on the fund's activity to the senate and house chairs of the joint committee on elder affairs and the house and senate committees on ways and means. The report shall include, but not be limited to: (1) revenue received by the fund; and (2) expenditures from the fund, including the recipient, date and reason for the expenditure.”; and

by inserting after section 35 the following section:-

“SECTION 35A.  Section 73 of chapter 111 of the General Laws, as so appearing, is hereby amended by striking out, in line 14, the word “fifty” and inserting in place thereof the following figure:- $10,000.”; and

and by inserting after section 74 the following section:-

“SECTION 74A. Notwithstanding any special or general law to the contrary, the center for health information and analysis, in consultation with the office of Medicaid, the department of elder affairs, and the health policy commission, shall conduct an examination of cost trends and financial performance among nursing facilities, as defined by 957 CMR 7.02. The information shall be analyzed on an institution-specific, provider organization, and industry-wide basis and shall include, but not be limited to: (i) gross and net patient service revenues; (ii) other sources of operating and non-operating revenue; (iii) trends in relative price, payer mix, case mix, utilization, and length of stay dating back to 2010; (iv) affiliations with other health care providers, including, but not limited to, preferred clinical relationships and partnerships; (v) categories of costs, including, but not limited to, general and administrative costs, nursing and other labor costs and salaries, building costs, capital costs, and other operating costs; (vi) total spending on direct patient care as a percent of total operating expenses; (vii) operating and total margin; (viii) occupancy rates, and (ix) other relevant measures of financial performance and service delivery. These measures should distinguish long-term from short-stay residents where possible.

The report and any recommendations for legislation shall be filed with the clerks of the house of representatives and the senate, and the joint committee on elder affairs not later than January 1, 2017.”