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Department of Elder Affairs

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Account	Description	FY07 GAA	FY08 House 1
4000-0640	MassHealth Nursing Home Supplemental Rates For nursing facility Medicaid rates; provided, that the division of health care finance and policy shall establish rates effective July 1, 2007 through June 30, 2008, that cumulatively total $288,500,000 more than the annual payment rates established by the division under the rates in effect as of June 30, 2002; provided further, that $287,950,000 shall be expended for the purposes of Medicaid per diem rate payments to nursing homes participating in the MassHealth program for services provided to MassHealth members during fiscal year 2008; provided further, that as a condition for funding, the division shall require that each nursing home document to the division that its allotted share of at least $50,000,000 of the funds are spent only on direct care staff by increasing the wages, hours and benefits of direct care staff, increasing the facility's staff-to-patient ratio or by demonstrably improving the facility's recruitment and retention of nursing staff to provide quality care, which shall include expenditure of funds for nursing facilities which document actual nursing spending that is higher than the median nursing cost per management minute in the base year used to calculate Medicaid nursing facility rates; provided further, that a facility's direct care staff shall include any and all nursing personnel including registered nurses, licensed practical nurses and certified nurses' aides hired by the facility from any temporary nursing agency or nursing pool registered with the department of public health; provided further, that the division shall credit wage increases that are over and above any previously collectively bargained for wage increases; provided further, that in monitoring compliance under this item, the division's regulations shall adjust any spending compliance test to reflect any Medicaid nursing facility payment reductions, including, but not limited to, rate reductions imposed on or after October 1, 2002; provided further, that the expenditure of these funds shall be subject to audit by the division in consultation with the department of public health and the executive office of health and human services; provided further, that $300,000 shall be expended for the purposes of an audit of funds distributed under this item; and provided further, that the division of health care finance and policy, in consultation with the department of public health and with the assistance of the executive office of health and human services, shall establish penalties sufficient to deter noncompliance to be imposed against any facility that expends any or all monies in violation of the provisions set forth in this item, including, but not limited to recoupment, assessment of fines or interest; and provided further, that $250,000 shall be expended for expenses at the division of health care finance and policy related to the implementation and administration of section 25 of chapter 118G of the General Laws	0	288,500,000

Established appropriation to move off budget spending onto the operating budget.

 
 

HISTORICAL SPENDING CATEGORIES ($000)

SPENDING CATEGORY	FY04 Expended	FY05 Expended	FY06 Expended	FY07 Projected Spending	FY08 House 1
Wages & Salaries	0	0	0	0	550
Public Assistance	0	0	0	0	287,950
TOTAL	0	0	0	0	288,500

* FY07 Projected Spending includes the budget plus nearly $1 billion in spending from FY06 supplemental budgets.