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General Assembly Substitute Bill No. 289
February Session, 2026
AN ACT CONCERNING FUNDING OF THE QUALITY METRICS
PROGRAM FOR NURSING HOMES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subdivision (2) of subsection (a) of section 17b -340d of the 1
2026 supplement to the general statutes is repealed and the following is 2
substituted in lieu thereof (Effective from passage): 3
(2) (A) Beginning July 1, 2022, facilities will be required to comply 4
with collection and reporting of quality metrics as specified by the 5
Department of Social Services, after consultation with the nursing home 6
industry, consumers, employees and the Department of Public Health. 7
Rate adjustments based on performance on quality metrics will be 8
phased in, beginning July 1, 2022, with a period of reporting only. 9
Effective July 1, 2023, the Department of Social Services shall issue 10
individualized reports annually to each nursing home facility showing 11
the impact to the Medicaid rate for such home based on the quality 12
metrics program. A nursing home facility receiving an individualized 13
quality metrics report may use such report to evaluate the impact of the 14
quality metrics program on said facility's Medicaid reimbursement. On 15
or after October 1, 2026, the Department of Social Services may establish 16
a quality metrics program, within available appropriations designated 17
for such purpose, to provide payments to nursing home facilities [(A)] 18
(i) for high -quality outcomes based on performance in the quality 19
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metrics program, and [(B)] (ii) designed to incentivize the provision of 20
high-quality services to nursing home residents who are Medicaid 21
beneficiaries, as indicated in the individualized report issued to each 22
nursing home facility pursuant to the provisions of this subdivision. 23
Such quality metrics program shall evaluate nursing home facilities 24
based on national quality measures for nursing home facilities issued by 25
the Centers for Medicare and Medicaid Services and state-administered 26
consumer satisfaction measures. Such quality measures may be 27
weighted higher for desired outcomes, as determined by the 28
department. Not later than February 1, 2027, the department shall 29
submit a report, in accordance with the provisions of section 11 -4a, to 30
the joint standing committees of the General Assembly having 31
cognizance of matters relating to appropriations and the budgets of state 32
agencies and human services on the implementation of the quality 33
metrics program. 34
(B) For the fiscal year ending June 30, 2029, and each fiscal year 35
thereafter, the Department of Social Services shall make distributions, 36
from an annual pool of ten million dollars of enhanced Medicaid quality 37
performance payments, to eligible nursing home facilities based on each 38
nursing home facility's performance in the quality metric s program. 39
Payments will be determined based on the maximum quality score 40
points a nursing home facility may be awarded for its performance in 41
improving its quality metrics. In determining a nursing home facility's 42
maximum quality score points, the department may use the Centers for 43
Medicare and Medicaid Services ' nursing home quarterly metrics for 44
patients with stays of one hundred one days or longer, a consumer 45
satisfaction survey and Department of Public Health data. Nursing 46
home facilities that have been identified by the Centers for Medicare and 47
Medicaid Services as special focus facilities for serious quality of care 48
issues, special focus facility candidates or with an abuse icon on the 49
centers' Nursing Home Compare Internet web site shall not be eligible 50
for participation in the quality metrics program and shall not receive 51
payment. Enhanced Medicaid quality performance payments may be 52
prorated to stay within available appropriations. 53
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(C) On and after July 1, 2026, the Department of Social Services shall 54
utilize the nursing component of the Patient Driven Payment Model 55
resident assessment to calculate quarterly adjustments to the Medicaid 56
nursing home facility reimbursement case -mix index scores. To align 57
Medicaid cost data with the Patient Driven Payment Model resident 58
assessment data, the department shall rebase nursing home facility 59
Medicaid per diem rates using the cost year ending September 30, 2024, 60
for rates effective July 1, 2026. To incorporate Patient Driven Payment 61
Model data into the Medicaid per diem payment calculation, the 62
department shall adjust Medicaid rates over a three -year phase -in 63
period. The three -year phase-in period shall use phase -in parameters, 64
including, but not limited to, budget adjustment factors, case -mix 65
neutrality factors and stop loss and stop gain corridors, as necessary, to 66
stay within available appropriations. 67
(D) Not later than July 1, 2026, the Department of Social Services shall 68
implement a Medicaid utilization pool that provides enhanced 69
Medicaid payments to nursing home facilities that have a resident payor 70
mix that comprises more than seventy-five per cent Medicaid members. 71
Utilizing annual Medicaid cost reports, the department shall determine 72
each nursing home facility's payor mix to identify nursing home 73
facilities eligible to receive enhanced Medicaid payments on an annual 74
basis. Payments shall be for the purpose of supporting increased 75
Medicaid utilization and enhanced access and services for Medicaid 76
members. Eligible nursing home facilities shall receive enhanced 77
Medicaid funding from a funding pool limited to two million five 78
hundred thousand dollars for the fiscal year ending June 30, 2027, and 79
five million dollars for subsequent fiscal years. The Commissioner of 80
Social Services may prorate enhanced Medicaid utilization payments to 81
stay within available appropriations. 82
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 17b-340d(a)(2)
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AGE Joint Favorable Subst.
APP Joint Favorable