Connecticut 2023 2023 Regular Session

Connecticut House Bill HB06678 Comm Sub / Analysis

Filed 04/28/2023

                     
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OLR Bill Analysis 
sHB 6678 (as amended by House "A")*  
 
AN ACT CONCERNING NURSING HOME TRANSPARENCY.  
 
SUMMARY 
This bill makes various changes related to nursing home oversight 
and the information these homes must give state agencies. It requires (1) 
nursing homes to submit to the Department of Social Services (DSS) 
narrative summaries of certain expenditures, in addition to their 
annually required cost reports, and (2) DSS to post this information on 
its website. The bill subjects nursing homes that fail to do so to a fine of 
up to $10,000 per incident. 
The bill expands the information that nursing home licensure 
applicants must give to the Department of Public Health (DPH) to 
include (1) information on any private equity fund that owns any part 
of the home, the name of the fund’s investment advisor, and a copy of 
the most recent quarterly statement given to the private fund’s 
investors, including information on fees, expenses, and the fund’s 
performance, and (2) the owner’s audited and certified financial 
statements. The financial statement must include a balance sheet from 
the end of the most recent fiscal year and income statements from the 
most recent fiscal year (or an applicable shorter period if the owner has 
not existed for a full fiscal year). Existing law, unchanged by the bill, 
allows the DPH commissioner to require an applicant to submit 
additional information, including these statements. 
The bill broadens certain reporting requirements for chronic and 
convalescent nursing homes that receive Medicaid funding. Current law 
requires these types of for-profit homes to include in their annual 
reports a profit and loss statement from each related party (i.e., a 
company related to the home through family association, common 
ownership, control, or business association with the home’s owners or  2023HB-06678-R01-BA.DOCX 
 
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operators) that receives at least $50,000 of income from the home per 
year. The bill extends the requirement to all of these types of nursing 
homes, not just for-profits.  
The bill also requires the DSS commissioner to develop a guidebook 
that at least includes a glossary and a plain language (1) description of 
the Medicaid nursing home rate setting process and (2) explanation of 
terms related to it. The commissioner must post the guidebook in a 
conspicuous place on the agency’s website by July 1, 2024, and may 
update it as needed.    
*House Amendment “A” (1) changes the information required in 
nursing homes’ expenditure narrative summaries, (2) requires the 
commissioner to develop a Medicaid nursing home rate setting 
guidebook, and (3) removes provisions that would have (a) allowed the 
DSS commissioner to collect penalties by offsetting payments due to a 
facility and (b) eliminated the income threshold at which nursing homes 
must report third-party expenditures. 
EFFECTIVE DATE: July 1, 2023, except that the requirement for the 
DSS commissioner to develop a Medicaid nursing home rate setting 
guidebook is effective upon passage. 
COST REPORTING REQUIREMEN TS 
Beginning with the current cost reporting year, the bill requires 
nursing homes to annually submit narrative summaries of cost 
expenditures to the DSS commissioner, alongside their statutorily 
required cost reports. The summaries must include (1) profit and loss 
statements for the preceding three cost report years, (2) total revenue, 
(3) total expenditures, (4) total assets, (5) total liabilities, (6) short-term 
debt, (7) long-term debt, and (8) cash flows from investing, operating, 
and financing activities. Starting by January 1, 2024, the DSS 
commissioner must annually post these cost reports and summaries for 
each nursing home in a conspicuous place on the agency’s website.   
The bill requires a nursing home that fails to comply with this 
reporting requirement to be fined up to $10,000. Before imposing a  2023HB-06678-R01-BA.DOCX 
 
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penalty, the social services commissioner must notify the nursing home 
about the violation and allow it to request a review. The home must 
request a review within 15 days after receiving the notice, and DSS 
cannot impose the penalty while the review is pending. 
Under the bill, the penalty may be imposed even if the nursing 
home’s ownership changes after the violation takes place, as long as DSS 
issued the notice about the violation before the change in ownership 
became effective and the record of the notice is readily available in a 
central registry maintained by DSS. Payments made for these penalties 
must be deposited in the General Fund and credited to the Medicaid 
account.  
COMMITTEE ACTION 
Aging Committee 
Joint Favorable Substitute 
Yea 15 Nay 0 (02/28/2023)