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General Assembly Substitute Bill No. 989
January Session, 2023
AN ACT CONCERNING NURSING HOME AIR CONDITIONING, COST
REPORTING TRANSPARENCY, WAITING LIST REQUIREMENTS,
INVOLUNTARY PATIENT TRANSFER NOTICES AND
TRANSPORTATION FOR RESIDENT SOCIAL VISITS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-522a of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective from passage): 2
(a) On and after July 1, 2024, the Department of Public Health shall 3
conduct a review of each nursing home facility, as defined in section 4
19a-490, to determine which such facilities have air conditioning in all 5
resident rooms. For those facilities that do not have air conditioning in 6
all resident rooms, each such facility shall report to the Department of 7
Public Health in a time and manner prescribed by the Commissioner of 8
Public Health: 9
(1) Whether and how such facility is able to adequately control the 10
climate in resident rooms during hot weather; 11
(2) What air conditioning system options are feasible for installation 12
at such facility; 13
(3) The cost and physical plant needs involved in providing air 14
conditioning in each resident room; and 15 Substitute Bill No. 989
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(4) Other impediments to providing air conditioning in each resident 16
room. 17
(b) Not later than January 1, 2025, the Department of Public Health 18
shall submit a report, in accordance with the provisions of section 11-4a, 19
to the joint standing committees of the General Assembly having 20
cognizance of matters relating to aging, human services and public 21
health on (1) the number of such facilities without air conditioning in all 22
resident rooms, (2) how many such facilities are able to adequately 23
control the temperature and humidity levels in resident rooms, (3) the 24
overall costs for nursing home facilities without air conditioning in 25
every resident room to provide air conditioning in such rooms, and (4) 26
any impediments to providing air conditioning in all resident rooms at 27
specific nursing homes. 28
(c) On or before January 1, 2026, each nursing home facility shall 29
provide air conditioning in every resident room. 30
(d) A chronic and convalescent nursing home or a rest home with 31
nursing supervision may maintain temperatures in resident rooms and 32
other areas used by residents at such facilities at levels that are lower 33
than minimum temperature standards prescribed in the Public Health 34
Code provided temperature levels at such facilities comply with the 35
comfortable and safe temperature standards prescribed under federal 36
law pursuant to 42 CFR 483.15(h)(6). In accordance with section 19a-36, 37
the Commissioner of Public Health shall amend the Public Health Code 38
in conformity with the provisions of this section. 39
(e) The provisions of this section shall not apply to residential care 40
homes, as defined in section 19a-490. 41
Sec. 2. (NEW) (Effective from passage) (a) There is established, within 42
the Connecticut Health and Educational Facilities Authority, a 43
revolving loan account for the purpose of providing financial assistance 44
to an owner of a nursing home facility, as defined in section 19a-490 of 45
the general statutes, for costs incurred to install an air conditioning 46 Substitute Bill No. 989
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system in each resident room. 47
(b) The revolving loan account shall contain any moneys provided or 48
required by law to be deposited in the account. The authority may 49
accept contributions from any source, public or private, for deposit in 50
the account for purposes of the loan program. 51
(c) Loans made pursuant to this section shall have such terms and 52
conditions and shall be subject to such eligibility, loan approval, credit 53
and other underwriting requirements and criteria as are determined by 54
the authority to be reasonable in light of the purpose of the loan 55
program. 56
(d) On or before January 1, 2026, the authority shall submit to the joint 57
standing committees of the General Assembly having cognizance of 58
matters relating to aging, human services and public health a report, in 59
accordance with section 11-4a of the general statutes, setting forth the 60
following information: (1) A list of the loans made under the program, 61
a general description of the terms and conditions of such loans and the 62
repayment history; (2) an assessment of the impact of such loans on 63
compliance with any requirements for nursing home facilities to 64
provide an air conditioning system in each resident room; (3) the need 65
for additional funding for the loan program authorized by this section; 66
and (4) such other information as the authority deems relevant to 67
evaluating the success of the loan program in meeting its objectives. 68
(e) In connection with the making and administration of loans 69
pursuant to this section, the authority shall have and may exercise such 70
powers as are necessary or appropriate to carry out the purposes of this 71
section, including the same powers expressly granted to the authority 72
in section 10a-180 of the general statutes with respect to other loans. 73
(f) No new loan may be made pursuant to this section after January 74
1, 2026, and any moneys then remaining in, or thereafter received to the 75
credit of, the account established in subsection (b) of this section may be 76
withdrawn by the authority from such account and used for other 77 Substitute Bill No. 989
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purposes of the authority, subject to specific restrictions governing any 78
contribution to such account pursuant to subsection (b) of this section. 79
(g) The authority shall adopt written procedures, in accordance with 80
section 1-121 of the general statutes, to carry out the provisions of this 81
section. 82
Sec. 3. Subsection (c) of section 19a-535 of the general statutes is 83
repealed and the following is substituted in lieu thereof (Effective from 84
passage): 85
(c) (1) Before effecting any transfer or discharge of a resident from the 86
facility, the facility shall notify, in writing, the resident and the resident's 87
guardian or conservator, if any, or legally liable relative or other 88
responsible party if known, of the proposed transfer or discharge, the 89
reasons therefor, the effective date of the proposed transfer or discharge, 90
the location to which the resident is to be transferred or discharged, the 91
right to appeal the proposed transfer or discharge and the procedures 92
for initiating such an appeal as determined by the Department of Social 93
Services, the date by which an appeal must be initiated in order to 94
preserve the resident's right to an appeal hearing and the date by which 95
an appeal must be initiated in order to stay the proposed transfer or 96
discharge and the possibility of an exception to the date by which an 97
appeal must be initiated in order to stay the proposed transfer or 98
discharge for good cause, that the resident may represent himself or 99
herself or be represented by legal counsel, a relative, a friend or other 100
spokesperson, and information as to bed hold and nursing home 101
readmission policy when required in accordance with section 19a-537. 102
The notice shall also include the name, mailing address and telephone 103
number of the State [Long-Term Care] Ombudsman. If the resident is, 104
or the facility alleges a resident is, mentally ill or developmentally 105
disabled, the notice shall include the name, mailing address and 106
telephone number of the nonprofit entity designated by the Governor in 107
accordance with section 46a-10b to serve as the Connecticut protection 108
and advocacy system. The notice shall be given at least thirty days and 109
no more than sixty days prior to the resident's proposed transfer or 110 Substitute Bill No. 989
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discharge, except where the health or safety of individuals in the facility 111
are endangered, or where the resident's health improves sufficiently to 112
allow a more immediate transfer or discharge, or where immediate 113
transfer or discharge is necessitated by urgent medical needs or where 114
a resident has not resided in the facility for thirty days, in which cases 115
notice shall be given as many days before the transfer or discharge as 116
practicable. 117
(2) The resident may initiate an appeal pursuant to this section by 118
submitting a written request to the Commissioner of Social Services not 119
later than sixty calendar days after the facility issues the notice of the 120
proposed transfer or discharge, except as provided in subsection (h) of 121
this section. In order to stay a proposed transfer or discharge, the 122
resident must initiate an appeal not later than twenty days after the date 123
the resident receives the notice of the proposed transfer or discharge 124
from the facility unless the resident demonstrates good cause for failing 125
to initiate such appeal within the twenty-day period. 126
(3) On the date that the facility provides notice of a proposed 127
involuntary transfer or discharge of a resident pursuant to the 128
provisions of subdivision (1) of this subsection, the facility shall notify 129
the State Ombudsman, appointed pursuant to section 17a-870, in a 130
manner prescribed by the State Ombudsman, of such proposed 131
involuntary transfer or discharge. Failure to provide notice to the State 132
Ombudsman pursuant to the provisions of this subdivision shall 133
invalidate any notice of the proposed involuntary transfer or discharge 134
of a resident submitted pursuant to the provisions of subdivision (1) of 135
this subsection. 136
Sec. 4. Subsection (k) of section 19a-535 of the general statutes is 137
repealed and the following is substituted in lieu thereof (Effective from 138
passage): 139
(k) [A] Except as otherwise provided in subdivision (3) of subsection 140
(c) of this section, a facility shall electronically report each involuntary 141
transfer or discharge to the State Ombudsman, appointed pursuant to 142 Substitute Bill No. 989
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section [17a-405] 17a-870, (1) in a manner prescribed by the State 143
Ombudsman, and (2) on an Internet web site portal maintained by the 144
State Ombudsman in accordance with patient privacy provisions of the 145
Health Insurance Portability and Accountability Act of 1996, P.L. 104-146
191, as amended from time to time. 147
Sec. 5. (NEW) (Effective July 1, 2023) (a) Any nursing home facility, as 148
defined in section 19a-490 of the general statutes, with available vehicles 149
equipped to transport nonambulatory residents, may provide 150
nonemergency transportation of such residents to the homes of such 151
residents' family members, provided: (1) Such family members live 152
within fifteen miles of the nursing home facility, and (2) such 153
transportation is approved not less than five business days in advance 154
by a physician or physician's assistant, licensed pursuant to chapter 370 155
of the general statutes, or an advanced practice registered nurse licensed 156
pursuant to chapter 378 of the general statutes. 157
(b) The Commissioner of Social Services, within available 158
appropriations, may establish a grant program to fund such 159
nonemergency transportation. The commissioner shall prescribe forms 160
and procedures for a nursing home facility to apply for a grant through 161
any such grant program. The commissioner shall evaluate whether the 162
need for such transportation would qualify as a health-related social 163
need and file a report not later than October 1, 2023, with the Council on 164
Medical Assistance Program Oversight on such evaluation and 165
potential federal funding that may be available for such transportation. 166
For purposes of this subsection, "health-related social need" means a 167
health need deriving from an adverse social condition that contributes 168
to poor health and health disparities, including, but not limited to, the 169
need for reliable transportation. 170
Sec. 6. (Effective from passage) (a) The State Ombudsman, appointed 171
pursuant to section 17a-870 of the general statutes, shall convene a 172
working group concerning any revisions necessary to nursing home 173
waiting list requirements as described in section 19a-533 of the general 174
statutes. The working group shall include, but need not be limited to, 175 Substitute Bill No. 989
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the State Ombudsman, or the State Ombudsman's designee; not less 176
than two representatives of the nursing home industry, appointed by 177
the State Ombudsman; the Commissioners of Public Health and Social 178
Services, or their designees; and any other member the State 179
Ombudsman may appoint. 180
(b) The State Ombudsman, or the State Ombudsman's designee, shall 181
serve as chairperson of the working group, which shall meet not less 182
than once monthly. Not later than January 1, 2024, the State 183
Ombudsman shall file a report, in accordance with section 11-4a of the 184
general statutes, with the joint standing committees of the General 185
Assembly having cognizance of matters relating to human services and 186
public health with recommendations concerning any changes to the 187
waiting list requirements, including, but not limited to, authorizing 188
nursing homes to maintain waiting lists in electronic form. 189
Sec. 7. (NEW) (Effective July 1, 2023) (a) As used in this section, 190
"allowable costs" has the same meaning as provided in section 17b-340d 191
of the general statutes. Beginning with the cost report year ending on 192
September 30, 2024, and annually thereafter, each nursing home facility, 193
as defined in section 19a-490 of the general statutes, shall submit to the 194
Commissioner of Social Services narrative summaries of expenditures 195
in addition to the cost reports required pursuant to section 17b-340 of 196
the general statutes, as amended by this act. The summaries shall be in 197
plain language and include the percentage of Medicaid funding 198
allocated to (1) the five cost components of allowable costs, broken 199
down to include individual expenditure categories of each cost 200
component described in subdivision (4) of subsection (a) of section 17b-201
340d of the general statutes, and (2) any related party, as defined in 202
section 17b-340 of the general statutes, as amended by this act. 203
(b) Not later than January 1, 2025, and annually thereafter, the 204
Commissioner of Social Services shall post in a conspicuous area on the 205
department's Internet web site a link to (1) the annual cost reports and 206
the plain language summaries provided by each nursing home facility, 207
(2) comparisons between individual nursing homes by expenditures, 208 Substitute Bill No. 989
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and (3) a summary of the average reported expenditures of all reporting 209
nursing homes for each category. Any cost report forms utilized by the 210
department shall include a glossary and explanation of the terms used 211
and a description of the categories being reported on, including, but not 212
limited to, plain language explanations of formulas and formula terms 213
used to determine maximum costs for direct costs, indirect costs, fair 214
rent, capital-related costs and administrative and general costs, as 215
described in subdivision (4) of subsection (a) of section 17b-340d of the 216
general statutes. 217
(c) Any nursing home facility that violates or fails to comply with the 218
provisions of this section shall be fined not more than ten thousand 219
dollars for each incident of noncompliance. The Commissioner of Social 220
Services may offset payments due a facility to collect the penalty. Prior 221
to imposing any penalty pursuant to this subsection, the commissioner 222
shall notify the nursing home facility of the alleged violation and the 223
accompanying penalty and shall permit such facility to request that the 224
department review its findings. A facility shall request such review not 225
later than fifteen days after receipt of the notice of violation from the 226
department. The department shall stay the imposition of any penalty 227
pending the outcome of the review. The commissioner may impose a 228
penalty upon a facility pursuant to this subsection regardless of whether 229
a change in ownership of the facility has taken place since the time of 230
the violation, provided the department issued notice of the alleged 231
violation and the accompanying penalty prior to the effective date of the 232
change in ownership and record of such notice is readily available in a 233
central registry maintained by the department. Payments of fines 234
received pursuant to this subsection shall be deposited in the General 235
Fund and credited to the Medicaid account. 236
Sec. 8. Section 19a-491a of the general statutes is repealed and the 237
following is substituted in lieu thereof (Effective July 1, 2023): 238
(a) A person seeking a license to establish, conduct, operate or 239
maintain a nursing home shall provide the Department of Public Health 240
with the following information: 241 Substitute Bill No. 989
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(1) (A) The name and business address of the owner and a statement 242
of whether the owner is an individual, partnership, corporation or other 243
legal entity; (B) the names of the officers, directors, trustees, or 244
managing and general partners of the owner, the names of persons 245
having a ten per cent or greater ownership interest in the owner, and a 246
description of each such person's occupation with the owner; [and] (C) 247
if the owner is a corporation which is incorporated in another state, a 248
certificate of good standing from the secretary of state of the state of 249
incorporation; and (D) if a private equity firm owns any portion of the 250
business, the name of the private equity fund's investment advisor and 251
a copy of the most recent quarterly statement provided to the private 252
equity fund's investors, including information regarding fees, expenses 253
and performance of the fund; 254
(2) A description of the relevant business experience of the owner and 255
of the administrator of the nursing home and evidence that the 256
administrator has a license issued pursuant to section 19a-514; 257
(3) Affidavits signed by the owner, any of the persons described in 258
subdivision (1) of this subsection, the administrator, assistant 259
administrator, the medical director, the director of nursing and assistant 260
director of nursing disclosing any matter in which such person has been 261
convicted of a felony, as defined in section 53a-25, or has pleaded nolo 262
contendere to a felony charge, or has been held liable or enjoined in a 263
civil action by final judgment, if the felony or civil action involved fraud, 264
embezzlement, fraudulent conversion or misappropriation of property; 265
or is subject to an injunction or restrictive or remedial order of a court of 266
record at the time of application, within the past five years has had any 267
state or federal license or permit suspended or revoked as a result of an 268
action brought by a governmental agency or department, arising out of 269
or relating to health care business activity, including, but not limited to, 270
actions affecting the operation of a nursing home, retirement home, 271
residential care home or any facility subject to sections 17b-520 to 17b-272
535, inclusive, or a similar statute in another state or country; 273
(4) (A) A statement as to whether or not the owner is, or is affiliated 274 Substitute Bill No. 989
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with, a religious, charitable or other nonprofit organization; (B) the 275
extent of the affiliation, if any; (C) the extent to which the affiliate 276
organization will be responsible for the financial obligations of the 277
owner; and (D) the provision of the Internal Revenue Code of 1986, or 278
any subsequent corresponding internal revenue code of the United 279
States, as from time to time amended, if any, under which the owner or 280
affiliate is exempt from the payment of income tax; 281
(5) The location and a description of other health care facilities of the 282
owner, existing or proposed, and, if proposed, the estimated completion 283
date or dates and whether or not construction has begun; [and] 284
(6) Audited and certified financial statements of the owner, including 285
(A) a balance sheet as of the end of the most recent fiscal year, and (B) 286
income statements for the most recent fiscal year of the owner or such 287
shorter period of time as the owner shall have been in existence; and 288
[(6)] (7) If the operation of the nursing home has not yet commenced, 289
a statement of the anticipated source and application of the funds used 290
or to be used in the purchase or construction of the home, including: 291
(A) An estimate of such costs as financing expense, legal expense, 292
land costs, marketing costs and other similar costs which the owner 293
expects to incur or become obligated for prior to the commencement of 294
operations; and 295
(B) A description of any mortgage loan or any other financing 296
intended to be used for the financing of the nursing home, including the 297
anticipated terms and costs of such financing. 298
[(b) In addition to the information provided pursuant to subsection 299
(a) of this section, the commissioner may reasonably require an 300
applicant for a nursing home license or renewal of a nursing home 301
license to submit additional information. Such information may include 302
audited and certified financial statements of the owner, including, (1) a 303
balance sheet as of the end of the most recent fiscal year, and (2) income 304
statements for the most recent fiscal year of the owner or such shorter 305 Substitute Bill No. 989
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period of time as the owner shall have been in existence.] 306
[(c)] (b) No person acting individually or jointly with any other 307
person shall establish, conduct, operate or maintain a nursing home 308
without maintaining professional liability insurance or other indemnity 309
against liability for professional malpractice. The amount of insurance 310
which such person shall maintain as insurance or indemnity against 311
claims for injury or death for professional malpractice shall be not less 312
than one million dollars for one person, per occurrence, with an 313
aggregate of not less than three million dollars. The requirements of this 314
subsection shall not apply to any person who establishes, conducts, 315
operates or maintains a residential care home. 316
[(d)] (c) A person seeking to renew a nursing home license shall 317
furnish the department with any information required under this 318
section that was not previously submitted and with satisfactory written 319
proof that the owner of the nursing home consents to such renewal, if 320
the owner is different from the person seeking renewal, and shall 321
provide data on any change in the information submitted. The 322
commissioner shall refuse to issue or renew a nursing home license if 323
the person seeking renewal fails to provide the information required 324
under this section. Upon such refusal, the commissioner shall grant such 325
license to the holder of the certificate of need, provided such holder 326
meets all requirements for such licensure. If such holder does not meet 327
such requirements, the commissioner shall proceed in accordance with 328
sections 19a-541 to 19a-549, inclusive. If the commissioner is considering 329
a license renewal application pursuant to an order of the commissioner, 330
the procedures in this subsection shall apply to such consideration. 331
Sec. 9. Subsection (a) of section 17b-340 of the general statutes is 332
repealed and the following is substituted in lieu thereof (Effective July 1, 333
2023): 334
(a) For purposes of this subsection, (1) a "related party" includes, but 335
is not limited to, any company related to a chronic and convalescent 336
nursing home through family association, common ownership, control 337 Substitute Bill No. 989
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or business association with any of the owners, operators or officials of 338
such nursing home; (2) "company" means any person, partnership, 339
association, holding company, limited liability company or corporation; 340
(3) "family association" means a relationship by birth, marriage or 341
domestic partnership; and (4) "profit and loss statement" means the 342
most recent annual statement on profits and losses finalized by a related 343
party before the annual report mandated under this subsection. The 344
rates to be paid by or for persons aided or cared for by the state or any 345
town in this state to licensed chronic and convalescent nursing homes, 346
to chronic disease hospitals associated with chronic and convalescent 347
nursing homes, to rest homes with nursing supervision, to licensed 348
residential care homes, as defined by section 19a-490, and to residential 349
facilities for persons with intellectual disability that are licensed 350
pursuant to section 17a-227 and certified to participate in the Title XIX 351
Medicaid program as intermediate care facilities for individuals with 352
intellectual disabilities, for room, board and services specified in 353
licensing regulations issued by the licensing agency shall be determined 354
annually, except as otherwise provided in this subsection by the 355
Commissioner of Social Services, to be effective July first of each year 356
except as otherwise provided in this subsection. Such rates shall be 357
determined on a basis of a reasonable payment for such necessary 358
services, which basis shall take into account as a factor the costs of such 359
services. Cost of such services shall include reasonable costs mandated 360
by collective bargaining agreements with certified collective bargaining 361
agents or other agreements between the employer and employees, 362
provided "employees" shall not include persons employed as managers 363
or chief administrators or required to be licensed as nursing home 364
administrators, and compensation for services rendered by proprietors 365
at prevailing wage rates, as determined by application of principles of 366
accounting as prescribed by said commissioner. Cost of such services 367
shall not include amounts paid by the facilities to employees as salary, 368
or to attorneys or consultants as fees, where the responsibility of the 369
employees, attorneys, or consultants is to persuade or seek to persuade 370
the other employees of the facility to support or oppose unionization. 371
Nothing in this subsection shall prohibit inclusion of amounts paid for 372 Substitute Bill No. 989
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legal counsel related to the negotiation of collective bargaining 373
agreements, the settlement of grievances or normal administration of 374
labor relations. The commissioner may, in the commissioner's 375
discretion, allow the inclusion of extraordinary and unanticipated costs 376
of providing services that were incurred to avoid an immediate negative 377
impact on the health and safety of patients. The commissioner may, in 378
the commissioner's discretion, based upon review of a facility's costs, 379
direct care staff to patient ratio and any other related information, revise 380
a facility's rate for any increases or decreases to total licensed capacity 381
of more than ten beds or changes to its number of licensed rest home 382
with nursing supervision beds and chronic and convalescent nursing 383
home beds. The commissioner may, in the commissioner's discretion, 384
revise the rate of a facility that is closing. An interim rate issued for the 385
period during which a facility is closing shall be based on a review of 386
facility costs, the expected duration of the close-down period, the 387
anticipated impact on Medicaid costs, available appropriations and the 388
relationship of the rate requested by the facility to the average Medicaid 389
rate for a close-down period. The commissioner may so revise a facility's 390
rate established for the fiscal year ending June 30, 1993, and thereafter 391
for any bed increases, decreases or changes in licensure effective after 392
October 1, 1989. Effective July 1, 1991, in facilities that have both a 393
chronic and convalescent nursing home and a rest home with nursing 394
supervision, the rate for the rest home with nursing supervision shall 395
not exceed such facility's rate for its chronic and convalescent nursing 396
home. All such facilities for which rates are determined under this 397
subsection shall report on a fiscal year basis ending on September 398
thirtieth. Such report shall be submitted to the commissioner by 399
February fifteenth. Each for-profit chronic and convalescent nursing 400
home that receives state funding pursuant to this section shall include 401
in such annual report a profit and loss statement from each related party 402
that receives from such chronic and convalescent nursing home [fifty 403
thousand dollars or more per year] any amount of income for goods, 404
fees and services. No cause of action or liability shall arise against the 405
state, the Department of Social Services, any state official or agent for 406
failure to take action based on the information required to be reported 407 Substitute Bill No. 989
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under this subsection. The commissioner may reduce the rate in effect 408
for a facility that fails to submit a complete and accurate report on or 409
before February fifteenth by an amount not to exceed ten per cent of 410
such rate. If a licensed residential care home fails to submit a complete 411
and accurate report, the department shall notify such home of the failure 412
and the home shall have thirty days from the date the notice was issued 413
to submit a complete and accurate report. If a licensed residential care 414
home fails to submit a complete and accurate report not later than thirty 415
days after the date of notice, such home may not receive a retroactive 416
rate increase, in the commissioner's discretion. The commissioner shall, 417
annually, on or before April first, report the data contained in the reports 418
of such facilities on the department's Internet web site. For the cost 419
reporting year commencing October 1, 1985, and for subsequent cost 420
reporting years, facilities shall report the cost of using the services of any 421
nursing personnel supplied by a temporary nursing services agency by 422
separating said cost into two categories, the portion of the cost equal to 423
the salary of the employee for whom the nursing personnel supplied by 424
a temporary nursing services agency is substituting shall be considered 425
a nursing cost and any cost in excess of such salary shall be further 426
divided so that seventy-five per cent of the excess cost shall be 427
considered an administrative or general cost and twenty-five per cent of 428
the excess cost shall be considered a nursing cost, provided if the total 429
costs of a facility for nursing personnel supplied by a temporary nursing 430
services agency in any cost year are equal to or exceed fifteen per cent 431
of the total nursing expenditures of the facility for such cost year, no 432
portion of such costs in excess of fifteen per cent shall be classified as 433
administrative or general costs. The commissioner, in determining such 434
rates, shall also take into account the classification of patients or 435
boarders according to special care requirements or classification of the 436
facility according to such factors as facilities and services and such other 437
factors as the commissioner deems reasonable, including anticipated 438
fluctuations in the cost of providing such services. The commissioner 439
may establish a separate rate for a facility or a portion of a facility for 440
traumatic brain injury patients who require extensive care but not acute 441
general hospital care. Such separate rate shall reflect the special care 442 Substitute Bill No. 989
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requirements of such patients. If changes in federal or state laws, 443
regulations or standards adopted subsequent to June 30, 1985, result in 444
increased costs or expenditures in an amount exceeding one-half of one 445
per cent of allowable costs for the most recent cost reporting year, the 446
commissioner shall adjust rates and provide payment for any such 447
increased reasonable costs or expenditures within a reasonable period 448
of time retroactive to the date of enforcement. Nothing in this section 449
shall be construed to require the Department of Social Services to adjust 450
rates and provide payment for any increases in costs resulting from an 451
inspection of a facility by the Department of Public Health. Such 452
assistance as the commissioner requires from other state agencies or 453
departments in determining rates shall be made available to the 454
commissioner at the commissioner's request. Payment of the rates 455
established pursuant to this section shall be conditioned on the 456
establishment by such facilities of admissions procedures that conform 457
with this section, section 19a-533 and all other applicable provisions of 458
the law and the provision of equality of treatment to all persons in such 459
facilities. The established rates shall be the maximum amount 460
chargeable by such facilities for care of such beneficiaries, and the 461
acceptance by or on behalf of any such facility of any additional 462
compensation for care of any such beneficiary from any other person or 463
source shall constitute the offense of aiding a beneficiary to obtain aid 464
to which the beneficiary is not entitled and shall be punishable in the 465
same manner as is provided in subsection (b) of section 17b-97. 466
Notwithstanding any provision of this section, the Commissioner of 467
Social Services may, within available appropriations, provide an interim 468
rate increase for a licensed chronic and convalescent nursing home or a 469
rest home with nursing supervision for rate periods no earlier than April 470
1, 2004, only if the commissioner determines that the increase is 471
necessary to avoid the filing of a petition for relief under Title 11 of the 472
United States Code; imposition of receivership pursuant to sections 19a-473
542 and 19a-543; or substantial deterioration of the facility's financial 474
condition that may be expected to adversely affect resident care and the 475
continued operation of the facility, and the commissioner determines 476
that the continued operation of the facility is in the best interest of the 477 Substitute Bill No. 989
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state. The commissioner shall consider any requests for interim rate 478
increases on file with the department from March 30, 2004, and those 479
submitted subsequently for rate periods no earlier than April 1, 2004. 480
When reviewing an interim rate increase request the commissioner 481
shall, at a minimum, consider: (A) Existing chronic and convalescent 482
nursing home or rest home with nursing supervision utilization in the 483
area and projected bed need; (B) physical plant long-term viability and 484
the ability of the owner or purchaser to implement any necessary 485
property improvements; (C) licensure and certification compliance 486
history; (D) reasonableness of actual and projected expenses; and (E) the 487
ability of the facility to meet wage and benefit costs. No interim rate 488
shall be increased pursuant to this subsection in excess of one hundred 489
fifteen per cent of the median rate for the facility's peer grouping, 490
established pursuant to subdivision (2) of subsection (f) of this section, 491
unless recommended by the commissioner and approved by the 492
Secretary of the Office of Policy and Management after consultation 493
with the commissioner. Such median rates shall be published by the 494
Department of Social Services not later than April first of each year. In 495
the event that a facility granted an interim rate increase pursuant to this 496
section is sold or otherwise conveyed for value to an unrelated entity 497
less than five years after the effective date of such rate increase, the rate 498
increase shall be deemed rescinded and the department shall recover an 499
amount equal to the difference between payments made for all affected 500
rate periods and payments that would have been made if the interim 501
rate increase was not granted. The commissioner may seek recovery of 502
such payments from any facility with common ownership. With the 503
approval of the Secretary of the Office of Policy and Management, the 504
commissioner may waive recovery and rescission of the interim rate for 505
good cause shown that is not inconsistent with this section, including, 506
but not limited to, transfers to family members that were made for no 507
value. The commissioner shall provide written quarterly reports to the 508
joint standing committees of the General Assembly having cognizance 509
of matters relating to aging, human services and appropriations and the 510
budgets of state agencies, that identify each facility requesting an 511
interim rate increase, the amount of the requested rate increase for each 512 Substitute Bill No. 989
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facility, the action taken by the commissioner and the secretary pursuant 513
to this subsection, and estimates of the additional cost to the state for 514
each approved interim rate increase. Nothing in this subsection shall 515
prohibit the commissioner from increasing the rate of a licensed chronic 516
and convalescent nursing home or a rest home with nursing supervision 517
for allowable costs associated with facility capital improvements or 518
increasing the rate in case of a sale of a licensed chronic and convalescent 519
nursing home or a rest home with nursing supervision if receivership 520
has been imposed on such home. For purposes of this section, 521
"temporary nursing services agency" and "nursing personnel" have the 522
same meaning as provided in section 19a-118. 523
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 19a-522a
Sec. 2 from passage New section
Sec. 3 from passage 19a-535(c)
Sec. 4 from passage 19a-535(k)
Sec. 5 July 1, 2023 New section
Sec. 6 from passage New section
Sec. 7 July 1, 2023 New section
Sec. 8 July 1, 2023 19a-491a
Sec. 9 July 1, 2023 17b-340(a)
HS Joint Favorable Subst.
JUD Joint Favorable