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*hb0671*
HOUSE BILL 671
O2, J1 6lr2064
CF SB 340
By: Delegates Shetty and Lopez
Introduced and read first time: February 2, 2026
Assigned to: Appropriations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 4, 2026
CHAPTER ______
AN ACT concerning 1
Nursing Facilities – Medicaid Quality Assessment – Funding of Office of the 2
Long–Term Care Ombudsman – Mandatory Appropriation 3
FOR the purpose of requiring the Governor to include in the annual budget bill a minimum 4
percentage of the special funds collected from the Medicaid quality assessment 5
imposed on certain nursing facilities to fund the operations of appropriation for the 6
Office of the Long–Term Care Ombudsman from certain money remitted by managed 7
care organizations and, under certain circumstances, general funds ; and generally 8
relating to the quality assessments imposed on nursing facilities Office o f the 9
Long–Term Care Ombudsman. 10
BY repealing and reenacting, with amendments, 11
Article – Health – General 12
Section 19–310.1 13
Annotated Code of Maryland 14
(2023 Replacement Volume and 2025 Supplement) 15
BY repealing and reenacting, without with amendments, 16
Article – Human Services 17
Section 10–903 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2025 Supplement) 20
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
That the Laws of Maryland read as follows: 22
2 HOUSE BILL 671
Article – Health – General 1
19–310.1. 2
(a) (1) This section applies to a nursing facility, as defined in § 19 –301 of this 3
subtitle, that: 4
(i) Has 45 or more beds; and 5
(ii) Operates in the State. 6
(2) This section does not apply to a nursing home bed in a continuing care 7
retirement community that has obtained a certificate of registration to provide continuing 8
care under Title 10, Subtitle 4 of the Human Services Article. 9
(b) (1) The Department may impose a quality assessment on each freestanding 10
nursing facility subject to this section. 11
(2) The amount assessed in the aggregate on all nursing facilities may not 12
exceed 6.0% of the operating revenue for all nursing facilities subject to this section for the 13
previous fiscal quarter. 14
(3) The assessment authorized by this section shall be paid by each nursing 15
facility in accordance with this section. 16
(c) (1) On or before the 60th day after each quarter of the State fiscal year, 17
each nursing facility subject to this section shall pay to the Comptroller an amount 18
determined by the Department based on an amount per non –Medicare day of service for 19
the previous fiscal quarter. 20
(2) The assessment shall be based on an amount per patient day, not 21
including Medicare days. 22
(d) (1) [All] EXCEPT AS PROVIDED UN DER PARAGRAPH (3) OF THIS 23
SUBSECTION, ALL amounts collected by the State Comptroller under this section shall be 24
distributed to a special fund, to be used by the Department only to fund reimbursements to 25
nursing facilities under the Medicaid program. 26
(2) At least 65% of the funds allocated by the Department as 27
reimbursements to nursing facilities under this section shall be in addition to and may not 28
supplant funds already appropriated for this purpose. 29
(3) (I) IN FISCAL YEAR 2027 AND EACH FISCAL YEAR THEREAFTER, 30
THE GOVERNOR SHALL INCLUDE IN THE ANNUAL BUDGET BILL AT LEAST 3% OF THE 31
FUNDS COLLECTED BY T HE DEPARTMENT UNDER THIS SECTION TO FUND THE 32
HOUSE BILL 671 3
OPERATIONS OF THE OFFICE OF THE LONG–TERM CARE OMBUDSMAN IN THE 1
DEPARTMENT OF AGING. 2
(II) FUNDS APPROPRIATED UNDER SUBPARAGRAPH (I) OF THIS 3
PARAGRAPH SHALL BE I N ADDITION TO AND MA Y NOT SUPPLANT FUNDI NG THAT 4
WOULD OTHERWISE BE APPROPRIATED FOR THE OFFICE OF THE LONG–TERM CARE 5
OMBUDSMAN. 6
(e) The Department shall adopt regulations to implement this section. 7
(f) On or before September 1, 2015, and each year thereafter, the Department 8
shall report to the General Assembly, in accordance with § 2–1257 of the State Government 9
Article, on the implementation of this section, including: 10
(1) The percentage and amount of the assessment charged to each nursing 11
facility subject to this section; 12
(2) The number of nursing facilities subject to this section with a net loss; 13
and 14
(3) A comparison of the total amount provided in the Medicaid budget for 15
nursing home reimbursement in the current fiscal year to the actual amount received in 16
the immediately prior fiscal year. 17
Article – Human Services 18
10–903. 19
(a) There is an Office of the Long–Term Care Ombudsman in the Department. 20
(b) (1) Unless the Secretary is subject to a conflict of interest that cannot be 21
removed, the Secretary shall select a State Long–Term Care Ombudsman. 22
(2) If the Secretary is subject to a conflict of interest that cannot be 23
removed, the Secretary shall designate another individual, who is not subject to a conflict 24
of interest, to select the State Long–Term Care Ombudsman. 25
(c) The State Long–Term Care Ombudsman: 26
(1) shall personally administer the Office; 27
(2) shall have expertise and experience in the field of long –term care 28
advocacy; 29
(3) may not have any conflict of interest with the position; and 30
4 HOUSE BILL 671
(4) shall, on a full–time basis, perform duties related to the Program. 1
(d) The State Long –Term Care Ombudsman shall personally or through 2
designated ombudsmen: 3
(1) identify, investigate, and resolve complaints from any source made by, 4
or on behalf of, a resident relating to any action, inaction, or decision, that may adversely 5
affect the health, safety, welfare, or rights of a resident including the welfare and rights of 6
residents with respect to the appointment and activities of guardians and representative 7
payees, of: 8
(i) a provider, or a representative of a provider, of long –term care 9
services; 10
(ii) a public agency; or 11
(iii) a health or social service agency; 12
(2) represent the interests of residents before governmental agencies and 13
seek administrative, legal, and other remedies to protect the health, safety, welfare, and 14
rights of residents; 15
(3) provide informa tion as appropriate to other agencies and the public 16
regarding the problems and concerns of residents; 17
(4) inform residents, family members, and others acting on behalf of 18
residents about how to access the assistance and services of the Office and the services and 19
assistance of other providers or agencies, including legal services; 20
(5) ensure regular and timely access to and response from the Office; 21
(6) comment on, facilitate public comment on, and recommend changes to 22
existing or proposed laws, rules, regulations, and other governmental policies and actions 23
that affect the health, safety, welfare, and rights of residents; 24
(7) provide technical support for the development of resident and family 25
councils to protect the well–being and rights of residents; 26
(8) provide for the education and training of ombudsmen; 27
(9) educate facilities, agencies, and staff members concerning the rights 28
and welfare of residents; 29
(10) promote the development of citizen organizations to advocate for the 30
well–being and rights of residents; 31
HOUSE BILL 671 5
(11) provide services to assist residents in protecting the health, safety, 1
welfare, and rights of residents; and 2
(12) carry out any other activities that the Secretary determines to be 3
appropriate or that are required by the federal Older Americans Act. 4
(E) (1) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , IN 5
FISCAL YEAR 2027 AND EACH FISCAL YEAR THEREAFTER, THE GOVERNOR SHALL 6
INCLUDE IN THE ANNUAL BUDGET BILL AT LEAST $2,000,000 FOR THE OFFICE FROM 7
THE MONEY REMITTED B Y MANAGED CARE ORGAN IZATIONS UNDER COMAR 8
10.67.04.19–4(I) IN THE SECOND IMMEDIATELY PRECEDING FISCAL YEAR. 9
(II) IF THE TOTAL AMOUNT OF MONEY REMITTED BY MANAGED 10
CARE ORGANIZATIONS I N THE SECOND IMMEDIA TELY PRECEDING FISCA L YEAR 11
TOTALS LESS THAN $2,000,000, THE GOVERNOR SHALL INCLUD E IN THE ANN UAL 12
BUDGET BILL A GENERAL FUND APPROPRIATION EQ UAL TO THE DIFFERENC E 13
BETWEEN THE AMOUNT REMITTED AND $2,000,000. 14
(2) FUNDS APPROPRIATED UN DER THIS SUBSECTION SHALL BE IN 15
ADDITION TO AND MAY NOT SUPPLANT FUNDING THAT WOULD OTHERWISE BE 16
APPROPRIATED FOR THE OFFICE. 17
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 18
1, 2026. 19
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.