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House Journal: Page 1137: Wednesday, April 7, 1999

	Amendment H?1444 was adopted.

Heaton of Henry offered the following amendment H?1449 filed by 
Heaton, et al., and moved its adoption:
H-1449
 1     Amend House File 760 as follows:
 2     1.  Page 19, by inserting after line 23, the
 3   following:
 4     "     .  The department shall adopt rules to apply
 5   the reimbursement system utilized for nursing
 6   facilities to skilled nursing facilities beginning
 7   July 1, 2000.  Funds available for reimbursement for
 8   both nursing facilities and skilled nursing facilities
 9   shall be combined for distribution in the fiscal year
10   beginning July 1, 2000.
11        .  The department shall expand the requirements
12   of the cost reports submitted by nursing facilities to
13   include all of the following information:
14     a.  Information concerning staffing ratios and
15   staffing costs including the number of hours spent per
16   resident per day on all of the following:  nursing
17   services provided by registered nurses, licensed
18   practical nurses, certified nurse aides, restorative
19   aides, and certified medical aides; other care
20   services; administrative functions; housekeeping and
21   maintenance; and dietary services.
22     b.  The starting and average hourly wage for all
23   classes of employees.
24     The information submitted shall be compiled by the
25   department and submitted to the general assembly to be
26   used to develop a new reimbursement system which links
27   higher reimbursement rates to improved nursing
28   staffing ratios and which distributes funding in a
29   manner which prioritizes the provision of direct care
30   to residents."
31     2.  Page 51, by striking lines 16 through 25, and
32   inserting the following:
33     "f.  The basis for establishing the maximum medical
34   assistance reimbursement rate for nursing facilities
35   shall be the 70th percentile of facility costs as
36   calculated from the June 30, 1999, unaudited
37   compilation of cost and statistical data.  However, to
38   the extent funds are available within the amount
39   projected for reimbursement of nursing facilities
40   within the appropriation for medical assistance in
41   this Act for the fiscal year beginning July 1, 1999,
42   and within the appropriation for medical assistance as
43   a whole for the fiscal year beginning July 1, 1999,
44   the department shall adjust the maximum medical

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