BILL REQ. #:  S-1322.1 

Read first time 02/08/2005.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to the quality maintenance fee on nursing facility operators; amending RCW 82.71.010 and 74.46.091; creating a new section; and providing a contingent expiration date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 82.71.010 and 2003 1st sp.s. c 16 s 1 are each amended to read as follows:
     The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Department" means the department of revenue.
     (2) "Gross income" means all revenue, without deduction, that is derived from the performance of nursing facility services. "Gross income" does not include other operating revenue or nonoperating revenue.
     (3) "Other operating revenue" means income from nonpatient care services to patients, as well as sales and activities to persons other than patients. It is derived in the course of operating the facility, such as providing personal laundry service for patients, or from other sources such as meals provided to persons other than patients, personal telephones, gift shops, and vending machine commissions.
     (4) "Nonoperating revenue" means income from activities not relating directly to the day-to-day operations of an organization. "Nonoperating revenue" includes such items as gains on disposal of a facility's assets, dividends, and interest from security investments, gifts, grants, and endowments.
     (5) "Patient day" means a calendar day of care provided to a nursing facility resident, excluding a medicare patient day. Patient days include the day of admission and exclude the day of discharge; except that, when admission and discharge occur on the same day, one day of care shall be deemed to exist.
     (6) "Medicare patient day" means a patient day for medicare beneficiaries on a medicare Part A stay and a patient day for persons who have opted for managed care coverage using their medicare benefit.
     (7) "Nonexempt nursing facility" means a nursing facility that is not exempt from the quality maintenance fee under RCW 74.46.091.
     (8) "Nursing facility" has the same meaning as the term is defined in RCW 18.51.010((; it)), except that facilities identified as institutions for mental disease by the federal department of health and human services and classified as "nursing homes" shall not be included as nursing facilities for purposes of this chapter and are not subject to the quality maintenance fee, subject to approval of this provision by the federal department of health and human services. The term "nursing facility" does not include a boarding home as defined in RCW 18.20.020 or an adult family home as defined in RCW 70.128.010.
     (9) "Nursing facility operator" means a person who engages in the business of operating a nursing facility or facilities within this state.
     (10) "Nursing facility services" means health-related services to individuals who do not require hospital care, but whose mental or physical condition requires services that are above the level of room and board and can be made available only through institutional facilities.

Sec. 2   RCW 74.46.091 and 2003 1st sp.s. c 16 s 4 are each amended to read as follows:
     (1) By July 1st of each year, each nursing facility operator shall file a report with the department of social and health services listing the patient days and the gross income for the prior calendar year for each nursing facility that he or she operates.
     (2) By August 1, 2003, the department of social and health services shall submit for approval to the federal department of health and human services a request for a waiver pursuant to 42 C.F.R. 433.68. The waiver shall identify the nursing facilities that the department proposes to exempt from the quality maintenance fee. Those facilities shall include at least:
     (a) Nursing facilities operated by any agency of the state of Washington;
     (b) Nursing facilities operated by a public hospital district; and
     (c) As many nursing facilities with no or disproportionately low numbers of medicaid-funded residents as, within the judgment of the department, may be exempted from the fee pursuant to 42 C.F.R. 433.68.
     (3) By October 15, 2005, the department of social and health services shall submit for approval to the federal department of health and human services a waiver amendment pursuant to 42 C.F.R. 433.68. The amendment shall identify nursing facilities identified as institutions for mental disease as exempt from the quality maintenance fee.
     (4) The department of social and health services shall notify the department of revenue and the nursing facility operator of the nursing facilities that would be exempted from the quality maintenance fee pursuant to the waiver request submitted to the federal department of health and human services. The nursing facilities included in the waiver request may withhold payment of the fee pending final action by the federal government on the request for waiver.
     (((4))) (5) If the request for waiver is approved, the department of social and health services shall notify the department of revenue and the nursing facility operator that no quality maintenance fee is due from the facility. If the request for waiver is denied, nursing facility operators who have withheld payment of the fee shall pay all such fees as have been withheld. No interest or penalties shall be due upon such withheld payments for the period during which final federal action was pending.
     (((5))) (6) The department of social and health services shall take whatever action is necessary to continue the waiver from the federal government.
     (((6))) (7) The department of social and health services may adopt such rules, in accordance with chapter 34.05 RCW, as necessary to provide for effective administration of this section and RCW 74.46.535.

NEW SECTION.  Sec. 3   Sections 1 and 2 of this act apply retroactively to July 1, 2003, upon approval of the federal department of health and human services.

NEW SECTION.  Sec. 4   Sections 1 and 2 of this act expire if the contingency in section 6, chapter 16, Laws of 2003 1st sp. sess. occurs.