Read the full stored bill text
Senate
File
526
-
Introduced
SENATE
FILE
526
BY
CELSI
A
BILL
FOR
An
Act
relating
to
nursing
facility
revenue
requirements.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
Section
135C.2,
Code
2025,
is
amended
by
adding
1
the
following
new
subsection:
2
NEW
SUBSECTION
.
8.
The
department
shall
adopt
rules
to
3
implement
section
135C.6,
subsection
11.
4
Sec.
2.
Section
135C.6,
Code
2025,
is
amended
by
adding
the
5
following
new
subsection:
6
NEW
SUBSECTION
.
11.
a.
Beginning
January
1,
2026,
the
7
department
shall
not
approve
a
new
license
or
renew
a
license
8
issued
under
this
chapter
for
a
nursing
facility
unless
the
9
nursing
facility
meets
all
of
the
following
requirements:
10
(1)
Each
calendar
year,
the
nursing
facility
spends
an
11
amount
equal
to
or
greater
than
seventy
percent
of
the
nursing
12
facility’s
gross
revenue
for
the
immediately
preceding
calendar
13
year
for
goods
and
services
directly
related
to
resident
care
14
including
but
not
limited
to
nursing
staff
salaries,
physician
15
services,
medications,
and
necessary
resident
care
supplies.
16
(2)
Each
calendar
year,
the
nursing
facility
spends
an
17
amount
equal
to
or
greater
than
forty
percent
of
the
nursing
18
facility’s
gross
revenue
for
the
immediately
preceding
calendar
19
year
on
salaries
for
nursing
facility
staff
that
directly
20
interact
with
and
provide
care
to
the
nursing
facility’s
21
residents.
Expenditures
on
salaries
for
nursing
facility
staff
22
under
this
subparagraph
shall
count
toward
the
requirements
of
23
subparagraph
(1).
24
(3)
(a)
If
the
nursing
facility
has
gross
revenue
for
a
25
calendar
year
in
excess
of
one
hundred
five
percent
of
the
26
nursing
facility’s
expenses,
the
nursing
facility
remits
the
27
gross
revenue
that
is
in
excess
of
one
hundred
five
percent
of
28
the
nursing
facility’s
expenses
to
the
department.
29
(b)
An
aging
Iowans
care
fund
is
created
in
the
state
30
treasury.
The
department
shall
deposit
all
moneys
received
31
under
subparagraph
subdivision
(a)
into
the
aging
Iowans
32
care
fund.
The
general
assembly
may
appropriate
moneys
from
33
the
aging
Iowans
care
fund
as
the
general
assembly
deems
34
appropriate.
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526
b.
(1)
A
nursing
facility
may
apply
with
the
department,
1
and
the
office
of
the
long-term
care
ombudsman
established
2
in
section
231.42,
for
a
waiver
of
the
requirements
under
3
paragraph
“a”
due
to
unexpected
or
exceptional
circumstances
4
which
prevent
the
nursing
facility
from
complying
with
5
paragraph
“a”
.
Upon
receipt
of
an
application,
the
department
6
and
the
office
of
the
long-term
care
ombudsman
shall
make
a
7
determination
whether
the
nursing
facility
experienced
an
8
unexpected
or
exceptional
circumstance
as
alleged
in
the
9
nursing
facility’s
application
for
a
waiver.
10
(2)
(a)
If
the
department
and
the
office
of
the
long-term
11
care
ombudsman
determine
that
the
nursing
facility
experienced
12
an
unexpected
or
exceptional
circumstance
which
prevented
13
the
nursing
facility
from
complying
with
paragraph
“a”
,
the
14
department
shall
waive
the
requirements
of
paragraph
“a”
to
15
the
extent
that
the
unexpected
or
exceptional
circumstances
16
prevented
the
nursing
facility’s
compliance.
17
(b)
If
the
department,
the
office
of
the
long-term
care
18
ombudsman,
or
both,
determine
that
the
nursing
facility
has
not
19
experienced
an
unexpected
or
exceptional
circumstance
which
20
prevents
the
nursing
facility
from
complying
with
paragraph
21
“a”
,
the
department
shall
not
waive
the
requirements
of
22
paragraph
“a”
.
23
EXPLANATION
24
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
25
the
explanation’s
substance
by
the
members
of
the
general
assembly.
26
This
bill
relates
to
nursing
facility
revenue
requirements.
27
Beginning
January
1,
2026,
the
bill
prohibits
the
department
28
of
inspections,
appeals,
and
licensing
(DIAL)
from
approving
a
29
new
license
or
renewing
a
license
for
a
nursing
facility
unless
30
the
nursing
facility
spends
a
certain
percentage
of
the
nursing
31
facility’s
gross
revenue
for
the
immediately
preceding
calendar
32
year
on
goods
and
services
directly
related
to
resident
care
as
33
detailed
in
the
bill,
and
remits
the
nursing
facility’s
gross
34
revenue
in
excess
of
105
percent
of
its
expenditures
to
DIAL.
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The
bill
creates
an
aging
Iowans
care
fund
(fund)
and
requires
1
DIAL
to
deposit
all
moneys
received
under
the
bill
into
the
2
fund.
The
general
assembly
may
appropriate
moneys
from
the
3
fund
as
the
general
assembly
deems
appropriate.
4
The
bill
allows
a
nursing
facility
to
apply
with
DIAL
and
the
5
office
of
the
long-term
care
ombudsman
(ombudsman)
for
a
waiver
6
of
the
bill’s
requirements
due
to
an
unexpected
or
exceptional
7
circumstance
which
prevents
the
nursing
facility
from
complying
8
with
the
bill
(exceptional
circumstances).
The
bill
requires
9
DIAL
and
the
ombudsman
to
make
a
determination
if
exceptional
10
circumstances
exist
as
alleged
by
the
nursing
facility.
If
11
both
DIAL
and
the
ombudsman
determine
exceptional
circumstances
12
exist,
DIAL
must
grant
the
nursing
facility
a
waiver
of
the
13
bill’s
requirements
to
the
extent
the
exceptional
circumstances
14
prevented
the
nursing
facility’s
compliance.
If
DIAL,
the
15
ombudsman,
or
both,
determine
that
exceptional
circumstances
16
do
not
exist,
DIAL
shall
not
grant
a
waiver
to
the
nursing
17
facility.
18
The
bill
requires
DIAL
to
adopt
rules
to
implement
the
bill.
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