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132nd MAINE LEGISLATURE
FIRST REGULAR SESSION-2025
Legislative Document No. 772
S.P. 330 In Senate, February 25, 2025
An Act to Assist Nursing Facilities in the Management of Facility
Beds
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BALDACCI of Penobscot.
Page 1 - 132LR1477(01)
1Be it enacted by the People of the State of Maine as follows:
2Sec. 1. 22 MRSA §333, sub-§1, as amended by PL 2011, c. 648, §2, is further
3 amended to read:
41. Procedures. A nursing facility that voluntarily reduces the number of its licensed
5 beds at any time prior to July 1, 2007, for any reason except to create private rooms may
6 convert the beds back and thereby increase the number of nursing facility beds to no more
7 than the previously licensed number of nursing facility beds, after obtaining a certificate of
8 need in accordance with this section, as long as the nursing facility has been in continuous
9 operation without material change of ownership. For purposes of this section and sections
10 333-A and 334-A, beds voluntarily removed from service prior to July 1, 2007 and
11 available to be reinstated under this section are referred to as "reserved beds." Reserved
12 beds remain facility property until they lapse as provided for in this section or are
13 transferred. To reinstate reserved beds under this subsection, the nursing facility must
14 shall:
15 A. Give notice of the number of beds it is reserving no later than 30 days after the
16 effective date of the license reduction;
17 A-1. Annually provide notice to the department no later than July 1st of each year of
18 the nursing facility's intent to retain these reserved beds, subject to the limitations set
19 forth in subsection 2, paragraph B. Notice provided under this paragraph preserves the
20 reserved beds through June 30th of the following year. The annual notice on reserved
21 beds may be filed by an individual nursing facility or by multiple nursing facilities
22 through a membership organization approved by the department by a single filing; and
23 B. Obtain a certificate of need to convert beds back under section 335, except that, if
24 no construction is required for the conversion of beds back, the application must be
25 processed in accordance with subsection 2. The department in its review shall evaluate
26 the impact that the nursing facility beds to be converted back would have on those
27 existing nursing facility beds and facilities within 30 miles of the applicant's facility
28 and shall determine whether to approve the request based on current certificate of need
29 criteria and methodology.
30Sec. 2. 22 MRSA §333, sub-§2, ¶A, as enacted by PL 2001, c. 664, §2, is amended
31 to read:
32 A. Review of applications that meet the requirements of this section must be based on
33 the requirements of section 335, subsection 7, except that the determinations required
34 by section 335, subsection 7, paragraph B must be based on the historical costs of
35 operating the beds and must consider whether the projected costs are consistent with
36 the costs of the beds prior to closure, adjusted for inflation applications that seek to
37 reopen reserved beds must be approved if the projected incremental costs of reopening
38 and operating the reserved beds are consistent with the nursing facility's costs of
39 operating its other beds. Applicants are not required to demonstrate that any increases
40 in MaineCare costs are offset by other MaineCare savings. The costs of ongoing
41 operation of both the reopened beds and the complement of nursing facility beds at the
42 time the reserved beds are reopened must be recognized as allowable costs and
43 incorporated into the nursing facility's MaineCare payment rates; and
44Sec. 3. 22 MRSA §1720, as enacted by PL 2005, c. 242, §1, is amended to read:
Page 2 - 132LR1477(01)
1§1720. Nursing facility medical director reimbursement
2 The department shall include in its calculation of reimbursement for services provided
3 by a nursing facility an allowance for the cost of incurred by the facility for a medical
4 director in a base year amount not to exceed $10,000, with that amount being subject to an
5 annual cost-of-living adjustment.
6SUMMARY
7 This bill modifies the provision of law governing procedures for reinstating beds that
8 have been voluntarily removed from a nursing facility. The bill expands the criteria
9 governing which removed beds qualify as reserved beds that may be reinstated under this
10 provision by removing language that limits reinstatement to beds that were removed prior
11 to July 1, 2007 for a reason other than to create private rooms.
12 The bill modifies the expedited review process to obtain certificate of need approval to
13 reopen reserved beds. Applications that seek to reopen reserved beds must be approved if
14 the projected incremental costs of reopening and operating the reserved beds are consistent
15 with the facility's costs of operating its other beds. Applicants are not required to
16 demonstrate that any increases in MaineCare costs are offset by other MaineCare savings.
17 The costs of ongoing operation of both the reopened beds and the complement of facility
18 beds at the time the reserved beds are reopened must be recognized as allowable costs and
19 incorporated into the facility's MaineCare payment rates.
20 The bill requires the Department of Health and Human Services to include in its
21 calculation of reimbursement for services provided by a nursing facility the cost incurred
22 by the facility for a medical director. Current law only requires the department to include
23 in its calculation an allowance for the cost of a medical director in a base year amount not
24 to exceed $10,000 adjusted for cost of living.
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