SB3026 Summary

• Implements a Resource Utilization Groups (RUG-IV 48) based reimbursement system for nursing facility services effective January 1, 2014, replacing previous methodology.

• Establishes resident-driven, facility-specific, cost-based reimbursement with annually rebased costs and quarterly case mix index updates, using regional wage adjustors and Centers for Medicare and Medicaid Services staff time measurements.

• Provides transition rates for nursing homes between January 1-December 31, 2014, with facilities receiving rate increases multiplied by 0.88 and rate decreases multiplied by 0.13 to soften impact of system change.

• Adds $34.00 per resident per day service fee and $174.00 per resident per day supply fee for ventilator services (including weaning services) beginning January 1, 2014.

• Excludes facilities designated as "Institutions for Mental Disease" from the RUG-IV system and requires a separate reimbursement methodology for low-need residents by January 1, 2015.