Oklahoma 2025 Regular Session

Oklahoma Senate Bill SB947 Compare Versions

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	3	+	ENGR. S. B. NO. 947 Page 1 1
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27		-
28		-	HOUSE OF REPRESENTATIVES - FLOOR VERSION
29		-
30		-	STATE OF OKLAHOMA
31		-
32		-	1st Session of the 60th Legislature (2025)
33	27
34	28		ENGROSSED SENATE
35	29		BILL NO. 947 By: Rosino of the Senate
36	30
37	31		and
38	32
39	33		Gise of the House
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44	38		An Act relating to long-term care; amending 56 O.S.
45	39		2021, Section 2002, which relates to the Nursing
46	40		Facilities Quality of Care Fee; updating statutory
47	41		language; amending 63 O.S. 2021, Section 1 -2216, as
48	42		amended by Section 17, Chapter 339, O.S.L. 2024 (63
49	43		O.S. Supp. 2024, Section 1 -2216), which relates to
50	44		the Oklahoma State Council on Aging and Adult
51	45		Protective Services; updating statutory language ; and
52	46		declaring an emergency.
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58	52		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
59	53		SECTION 1. AMENDATORY 56 O.S. 2021, Section 2002, is
60	54		amended to read as follows:
61	55		Section 2002. A. For the purpose of providing quality care
62	56		enhancements, the Okla homa Health Care Authority is authorized to
63	57		and shall assess a Nursing Facilities Quality of Care Fee pursuant
64	58		to this section upon each nursing facility licensed in this state.
65	59		Facilities operated by the Oklahoma Department of Veterans Affairs
66	60		shall be exempt from this fee. Quality of care enhancements
67		-	SB947 HFLR Page 2
68		-	BOLD FACE denotes Committee Amendments. 1
	61	+	include, but are not limited to, the purposes specified in this
	62	+	section.
	63	+
	64	+	ENGR. S. B. NO. 947 Page 2 1
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93		-	include, but are not limited to, the purposes specified in this
94		-	section.
95	89		B. As a basis for determining the Nursing Facilities Quality of
96	90		Care Fee assessed upon each licensed nursing facility, the Authorit y
97	91		shall calculate a uniform per -patient day rate. The rate shall be
98	92		calculated by dividing six percent (6%) of the total annual patient
99	93		gross receipts of all licensed nursing facilities in this state by
100	94		the total number of patient days for all licensed nu rsing facilities
101	95		in this state. The result shall be the per -patient day rate.
102	96		Beginning July 15, 2004, the Nursing Facilities Quality of Care Fee
103	97		shall not be increased unless specifically authorized by the
104	98		Legislature.
105	99		C. Pursuant to any approved Medic aid waiver and pursuant to
106	100		subsection N of this section, the Nursing Facilities Quality of Care
107	101		Fee shall not exceed the amount or rate allowed by federal law for
108	102		nursing home licensed bed days.
109	103		D. The Nursing Facilities Quality of Care Fee owed by a
110	104		licensed nursing facility shall be calculated by the Authority by
111	105		adding the daily patient census of a licensed nursing facility, as
112	106		reported by the facility for each day of the month, and by
113	107		multiplying the ensuing figure by the per -patient day rate
114	108		determined pursuant to the provisions of subsection B of this
115	109		section.
116		-	SB947 HFLR Page 3
117		-	BOLD FACE denotes Committee Amendments. 1
	110	+	E. Each licensed nursing facility which is assessed the Nursing
	111	+	Facilities Quality of Care Fee shall be required to file a report on
	112	+	a monthly basis with the Authority detailing the daily patie nt
	113	+
	114	+	ENGR. S. B. NO. 947 Page 3 1
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142		-	E. Each licensed nursing facility which is assessed the Nursing
143		-	Facilities Quality of Ca re Fee shall be required to file a report on
144		-	a monthly basis with the Authority detailing the daily patie nt
145	139		census and patient gross receipts at such time and in such manner as
146	140		required by the Authority.
147	141		F. 1. The Nursing Facilities Quality of Care Fee for a
148	142		licensed nursing facility for the period beginning October 1, 2000,
149	143		shall be determined using the da ily patient census and annual
150	144		patient gross receipts figures reported to the Authority for the
151	145		calendar year 1999 upon forms supplied by the Authority.
152	146		2. Annually the Nursing Facilities Quality of Care Fee shall be
153	147		determined by:
154	148		a. using the daily patie nt census and patient gross
155	149		receipts reports received by the Authority for the
156	150		most recent available twelve (12) months, and
157	151		b. annualizing those figures.
158	152		Each year thereafter, the annualization of the Nursing
159	153		Facilities Quality of Care Fee specified in th is paragraph shall be
160	154		subject to the limitation in subsection B of this section unless the
161	155		provision of subsection C of this section is met.
162	156		G. The payment of the Nursing Facilities Quality of Care Fee by
163	157		licensed nursing facilities shall be an allowable cost for Medicaid
164	158		reimbursement purposes.
165		-	SB947 HFLR Page 4
166		-	BOLD FACE denotes Committee Amendments. 1
	159	+	H. 1. There is hereby created in the State Treasury a
	160	+	revolving fund to be designated the “Nursing Facility Quality of
	161	+	Care Fund”.
	162	+
	163	+	ENGR. S. B. NO. 947 Page 4 1
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191		-	H. 1. There is hereby created in the State Treasury a
192		-	revolving fund to be designated the “Nursing Facility Quality of
193		-	Care Fund”.
194	188		2. The fund shall be a continuing fund, not subject to fiscal
195	189		year limitations, and shall consist of:
196	190		a. all monies received by the Authority pursuant to this
197	191		section and otherwise specified or authorized by law,
198	192		b. monies received by the Authority due to federal
199	193		financial participation pursuant to Title XIX of the
200	194		Social Security Act, and
201	195		c. interest attributable to investment of money in the
202	196		fund.
203	197		3. All monies accruing to the credit of the fund are hereby
204	198		appropriated and shall be budgeted and expended by the Authority
205	199		for:
206	200		a. reimbursement of the additional costs paid to
207	201		Medicaid-certified nursing facilities for purposes
208	202		specified by Sections 1 -1925.2 and 5022.2 of Title 63
209	203		of the Oklahoma Statutes,
210	204		b. reimbursement of the Medicaid rate increases for
211	205		intermediate care facilities for individuals with
212	206		intellectual disabilities (ICFs/ IID),
213	207		c. nonemergency transportation services for Medicaid -
214	208		eligible nursing home clients,
215		-	SB947 HFLR Page 5
216		-	BOLD FACE denotes Committee Amendments. 1
	209	+	d. eyeglass and denture services for Medicaid -eligible
	210	+	nursing home clients,
	211	+
	212	+	ENGR. S. B. NO. 947 Page 5 1
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241		-	d. eyeglass and denture services for Medicaid -eligible
242		-	nursing home clients,
243	237		e. fifteen ombudsmen employed by the Department of Human
244	238		Services Office of the Attorney General,
245	239		f. ten additional nursing facility inspectors employed by
246	240		the State Department of Health,
247	241		g. pharmacy and other Medicaid services to qualified
248	242		Medicare beneficiaries whose incomes are at or below
249	243		one hundred percent (100%) of the federal poverty
250	244		level; provided however, pharmacy benefits authorized
251	245		for such qualified Medicare beneficiaries shall be
252	246		suspended if the federal government subsequently
253	247		extends pharmacy benefits to this population,
254	248		h. costs incurred by the Authority in the administration
255	249		of the provisions of this section and any programs
256	250		created pursuant to this section,
257	251		i. durable medical equipment and supplies services for
258	252		Medicaid-eligible elderly adults, and
259	253		j. personal needs allowance increases for residents of
260	254		nursing homes and Inter mediate Care Facilities for
261	255		Individuals with Intellectual Disabilities (ICFs/IID)
262	256		from Thirty Dollars ($30.00) to Fifty Dollars ($50.00)
263	257		per month per resident.
264		-	SB947 HFLR Page 6
265		-	BOLD FACE denotes Committee Amendments. 1
	258	+	4. Expenditures from the fund shall be made upon warrants
	259	+	issued by the State Treasurer agains t claims filed as prescribed by
	260	+
	261	+	ENGR. S. B. NO. 947 Page 6 1
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290		-	4. Expenditures from the fund shall be made upon warrants
291		-	issued by the State Treasurer against claims filed as prescribed by
292	286		law with the Director of the Office of Management and Enterprise
293	287		Services for approval and payment.
294	288		5. The fund and the programs specified in this section funded
295	289		by revenues collected from the Nursing Facilities Quality of Care
296	290		Fee pursuant to this section are exempt from budgetary cuts,
297	291		reductions, or eliminations.
298	292		6. The Medicaid rate increases for intermediate care facilities
299	293		for individuals with intellectual disabilities (ICFs/IID) shall not
300	294		exceed the net Medicaid rate increase for nursing facilities
301	295		including, but not limited to, the Medicaid rate increase for which
302	296		Medicaid-certified nursing facilities are eligible due to the
303	297		Nursing Facilities Quality of Care Fee less the portion of that
304	298		increase attributable to trea ting the Nursing Facilities Quality of
305	299		Care Fee as an allowable cost.
306	300		7. The reimbursement rate for nursing facilities shall be made
307	301		in accordance with Oklahoma ’s Medicaid reimbursement rate
308	302		methodology and the provisions of this section.
309	303		8. No nursing facility shall be guaranteed, expressly or
310	304		otherwise, that any additional costs reimbursed to the facility will
311	305		equal or exceed the amount of the Nursing Facilities Quality of Care
312	306		Fee paid by the nursing facility.
313		-	SB947 HFLR Page 7
314		-	BOLD FACE denotes Committee Amendments. 1
	307	+	I. 1. In the event that federal financia l participation
	308	+	pursuant to Title XIX of the Social Security Act is not available to
	309	+	the Oklahoma Medicaid program, for purposes of matching expenditures
	310	+
	311	+	ENGR. S. B. NO. 947 Page 7 1
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339		-	I. 1. In the event that federal financia l participation
340		-	pursuant to Title XIX of the Social Security Act is not available to
341		-	the Oklahoma Medicaid program, for purposes of matching expenditur es
342	336		from the Nursing Facility Quality of Care Fund at the approved
343	337		federal medical assistance percentage f or the applicable fiscal
344	338		year, the Nursing Facilities Quality of Care Fee shall be null and
345	339		void as of the date of the nonavailability of such federal funding,
346	340		through and during any period of nonavailability.
347	341		2. In the event of an invalidation of this se ction by any court
348	342		of last resort under circumstances not covered in subsection J of
349	343		this section, the Nursing Facilities Quality of Care Fee shall be
350	344		null and void as of the effective date of that invalidation.
351	345		3. In the event that the Nursing Facilities Quality of Care Fee
352	346		is determined to be null and void for any of the reasons enumerated
353	347		in this subsection, any Nursing Facilities Quality of Care Fee
354	348		assessed and collected for any periods after such invalidation shall
355	349		be returned in full within sixty (6 0) days by the Authority to the
356	350		nursing facility from which it was collected.
357	351		J. 1. If any provision of this section or the application
358	352		thereof shall be adjudged to be invalid by any court of last resort,
359	353		such judgment shall not affect, impair or invalid ate the provisions
360	354		of the section, but shall be confined in its operation to the
361	355		provision thereof directly involved in the controversy in which such
362		-	SB947 HFLR Page 8
363		-	BOLD FACE denotes Committee Amendments. 1
	356	+	judgment was rendered. The applicability of such provision to other
	357	+	persons or circumstances shall not be affected thereby.
	358	+	2. This subsection shall not apply to any judgment that affects
	359	+	the rate of the Nursing Facilities Quality of Care Fee, its
	360	+
	361	+	ENGR. S. B. NO. 947 Page 8 1
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388		-	judgment was rendered. The applicability of such provision to other
389		-	persons or circumstances shall not be affected thereby.
390		-	2. This subsection shall not apply to any judgment that affects
391		-	the rate of the Nursing Facilities Quality of Care Fee, its
392	386		applicability to all licensed nursing homes in the state, the usage
393	387		of the fee for the purposes prescribed in th is section, or the
394	388		ability of the Authority to obtain full federal participation to
395	389		match its expenditures of the proceeds of the fee.
396	390		K. The Authority shall promulgate rules for the implementation
397	391		and enforcement of the Nursing Facilities Quality of Care Fee
398	392		established by this section.
399	393		L. The Authority shall provide for administrative penalties in
400	394		the event nursing facilities fail to:
401	395		1. Submit the Quality of Care Fee;
402	396		2. Submit the fee in a timely manner;
403	397		3. Submit reports as required by this sectio n; or
404	398		4. Submit reports timely.
405	399		M. As used in this section:
406	400		1. “Nursing facility” means any home, establishment or
407	401		institution, or any portion thereof, licensed by the State
408	402		Department of Health as defined in Section 1 -1902 of Title 63 of the
409	403		Oklahoma Statutes;
410		-	SB947 HFLR Page 9
411		-	BOLD FACE denotes Committee Amendments. 1
	404	+	2. “Medicaid” means the medical assistance program established
	405	+	in Title XIX of the federal Social Security Act and administered in
	406	+	this state by the Authority;
	407	+	3. “Patient gross revenues ” means gross revenues received in
	408	+	compensation for service s provided to residents of nursing
	409	+	facilities including, but not limited to, client participation. The
	410	+
	411	+	ENGR. S. B. NO. 947 Page 9 1
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436		-	2. “Medicaid” means the medical assistance program established
437		-	in Title XIX of the federal Social Security Act and administered in
438		-	this state by the Authority;
439		-	3. “Patient gross revenues ” means gross revenues received in
440		-	compensation for services provided to residents of nursing
441		-	facilities including, but not limited to, client participation. The
442	436		term “patient gross revenues ” shall not include amounts received by
443	437		nursing facilities as charitable contributions; and
444	438		4. “Additional costs paid to Me dicaid-certified nursing
445	439		facilities under Oklahoma ’s Medicaid reimbursement methodology ”
446	440		means both state and federal Medicaid expenditures including, but
447	441		not limited to, funds in excess of the aggregate amounts that would
448	442		otherwise have been paid to Medic aid-certified nursing facilities
449	443		under the Medicaid reimbursement methodology which have been updated
450	444		for inflationary, economic, and regulatory trends and which are in
451	445		effect immediately prior to the inception of the Nursing Facilities
452	446		Quality of Care Fee.
453	447		N. 1. As per any approved federal Medicaid waiver, the
454	448		assessment rate subject to the provision of subsection C of this
455	449		section is to remain the same as those rates that were in effect
456	450		prior to January 1, 2012, for all state -licensed continuum of care
457	451		facilities.
458	452		2. Any facilities that made application to the State Department
459	453		of Health to become a licensed continuum of care facility no later
460		-	SB947 HFLR Page 10
461		-	BOLD FACE denotes Committee Amendments. 1
	454	+	than January 1, 2012, shall be assessed at the same rate as those
	455	+	facilities assessed pursuant to paragraph 1 of this subsection;
	456	+	provided, that any facility making the application shall receive the
	457	+	license on or before September 1, 2012. Any facility that fails to
	458	+	receive such license from the State Department of Health by
	459	+
	460	+	ENGR. S. B. NO. 947 Page 10 1
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486		-	than January 1, 2012, shall be assessed at the same rate as those
487		-	facilities assessed pursuant to paragraph 1 of this subsection;
488		-	provided, that any facility making the application shall receive the
489		-	license on or before September 1, 2012. Any facility that fails to
490		-	receive such license from the State Department of Health by
491	485		September 1, 2012, shall be assessed at t he rate established by
492	486		subsection C of this section subsequent to September 1, 2012.
493	487		O. If any provision of this section, or the application
494	488		thereof, is determined by any controlling federal agency, or any
495	489		court of last resort to prevent the state from ob taining federal
496	490		financial participation in the state ’s Medicaid program, such
497	491		provision shall be deemed null and void as of the date of the
498	492		nonavailability of such federal funding and through and during any
499	493		period of nonavailability. All other provisions of the bill shall
500	494		remain valid and enforceable.
501	495		SECTION 2. AMENDATORY 63 O.S. 2021, Section 1 -2216, as
502	496		amended by Section 17, Chapter 339, O.S.L. 2024 (63 O.S. Supp. 2024,
503	497		Section 1-2216), is amended to read as follows:
504	498		Section 1-2216. A. The Attorney General shall promulgate rules
505	499		regarding:
506	500		1. The powers and official duties of the State Long -Term Care
507	501		Ombudsman consistent with applicable federal law and rules or as
508	502		provided by the Long -Term Care Ombudsman Act;
509		-	SB947 HFLR Page 11
510		-	BOLD FACE denotes Committee Amendments. 1
	503	+	2. Minimum qualifications for persons to serve as
	504	+	representatives of the Office of the State Long -Term Care Ombudsman;
	505	+	3. Initial and continuing training requirements for ombudsman
	506	+	staff and volunteers which shall provide for a minimum of eighteen
	507	+	(18) hours of continui ng education relevant to the care of the aging
	508	+	and disabled;
	509	+
	510	+	ENGR. S. B. NO. 947 Page 11 1
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535		-	2. Minimum qualifications for persons to serve as
536		-	representatives of the Office of the State Long -Term Care Ombudsman;
537		-	3. Initial and continuing training requirement s for ombudsman
538		-	staff and volunteers which shall provide for a minimum of eighteen
539		-	(18) hours of continui ng education relevant to the care of the aging
540		-	and disabled;
541	535		4. The minimum number of visits that must be made by an
542	536		ombudsman to the assigned facilities;
543	537		5. The proper documentation and reporting of visits made to
544	538		facilities by the ombudsman;
545	539		6. Procedures to ensure that officers, employees, or other
546	540		representatives of the Office are not subject to a conflict of
547	541		interest which would impair their ability to carry out their
548	542		official duties in an impartial manner; and
549	543		7. The disclosure by the State Long -Term Care Ombudsman or area
550	544		or local Ombudsman entities of files maintained by the State Long -
551	545		Term Care Ombudsman Program. Such rules shall:
552	546		a. provide that such files and records may be disclosed
553	547		only at the discretion of the State Long -Term Care
554	548		Ombudsman or the person designated by the State Long -
555	549		Term Care Ombudsman to disclose the files and records,
556	550		and
557		-	SB947 HFLR Page 12
558		-	BOLD FACE denotes Committee Amendments. 1
	551	+	b. prohibit the disclosure of the identity of any
	552	+	complainant or resident with respect to whom the
	553	+	Office maintains such files or records unless:
	554	+	(1) the complainant or resident, or the legal
	555	+	representative of the complainant or resident,
	556	+	consents to the disclosure and the consent is
	557	+	given in writing,
	558	+
	559	+	ENGR. S. B. NO. 947 Page 12 1
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583		-	b. prohibit the disclosure of the identity of a ny
584		-	complainant or resident with respect to whom the
585		-	Office maintains such files or records unless:
586		-	(1) the complainant or resident, or the legal
587		-	representative of the complainant or resident,
588		-	consents to the disclosure and the consent is
589		-	given in writing,
590	584		(2) (a) the complainant or resident gives consent
591	585		orally, and
592	586		(b) the consent is documented contemporaneo usly
593	587		in a writing made by a State Long -Term Care
594	588		Ombudsman representative of the Office in
595	589		accordance with such rules as the Attorney
596	590		General shall promulgate, or
597	591		(3) the disclosure is required by court order.
598	592		B. The Oklahoma State Council on Aging and Ad ult Protective
599	593		Services, established by the Attorney General Department of Human
600	594		Services to review, monitor, and evaluate programs targeted to older
601	595		persons, shall serve in an advisory capacity to the State Long -Term
602	596		Care Ombudsman through establishment o f a committee with equal
603	597		provider and consumer representation.
604	598		SECTION 3. It being immediately necessary for the preservation
605	599		of the public peace, health or safety, an emergency is hereby
606		-	SB947 HFLR Page 13
607		-	BOLD FACE denotes Committee Amendments. 1
	600	+	declared to exist, by reason whereof this act shall take effect and
	601	+	be in full force from and after its passage and approval.
	602	+
	603	+	ENGR. S. B. NO. 947 Page 13 1
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632		-	declared to exist, by reason whereof this act shall take effect and
633		-	be in full force from and after its passage and approval.
	628	+	Passed the Senate the 11th day of March, 2025.
634	629
635		-	COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES, dated
636		-	04/16/2025 – DO PASS.
	630	+
	631	+
	632	+	Presiding Officer of the Senate
	633	+
	634	+
	635	+	Passed the House of Representatives the ____ day of __________,
	636	+	2025.
	637	+
	638	+
	639	+
	640	+	Presiding Officer of the House
	641	+	of Representatives
	642	+