5341-S2AMHAPPH3026.12SSB 5341H COMM AMDBy Committee on AppropriationsADOPTED 04/25/2003 Strike everything after the enacting clause and insert thefollowing:NEW SECTION.Sec. The definitions in this section applythroughout this chapter unless the context clearly requires otherwise. (1) "Department" means the department of revenue. (2) "Gross income" means all revenue, without deduction, that isderived from the performance of nursing facility services. "Grossincome" does not include other operating revenue or nonoperatingrevenue. (3) "Other operating revenue" means income from nonpatient careservices to patients, as well as sales and activities to persons otherthan patients. It is derived in the course of operating the facility,such as providing personal laundry service for patients, or from othersources such as meals provided to persons other than patients, personaltelephones, gift shops, and vending machine commissions. (4) "Nonoperating revenue" means income from activities notrelating directly to the daytoday operations of an organization."Nonoperating revenue" includes such items as gains on disposal of afacility's assets, dividends, and interest from security investments,gifts, grants, and endowments. (5) "Patient day" means a calendar day of care provided to anursing facility resident, excluding a medicare patient day. Patientdays include the day of admission and exclude the day of discharge;except that, when admission and discharge occur on the same day, oneday of care shall be deemed to exist. (6) "Medicare patient day" means a patient day for medicarebeneficiaries on a medicare Part A stay and a patient day for personswho have opted for managed care coverage using their medicare benefit. (7) "Nonexempt nursing facility" means a nursing facility that is 1 not exempt from the quality maintenance fee under section 4 of thisact. (8) "Nursing facility" has the same meaning as the term is definedin RCW 18.51.010; it does not include a boarding home as defined in RCW18.20.020 or an adult family home as defined in RCW 70.128.010. (9) "Nursing facility operator" means a person who engages in thebusiness of operating a nursing facility or facilities within thisstate. (10) "Nursing facility services" means healthrelated services toindividuals who do not require hospital care, but whose mental orphysical condition requires services that are above the level of roomand board and can be made available only through institutionalfacilities.NEW SECTION.Sec. (1) In addition to any other tax, a qualitymaintenance fee is imposed on every nonexempt nursing facility in thisstate. The quality maintenance fee shall be six dollars per patientday. (2) Each operator of a nonexempt nursing facility shall file areturn with the department on a monthly basis. The return is duewithin thirty days after the end of each calendar month. The returnshall include the following: (a) The number of patient days for nonexempt nursing facilitiesoperated by that person in that month; and (b) Remittance of the nonexempt nursing facility operator's qualitymaintenance fee for that month.NEW SECTION.Sec. All of chapter 82.32 RCW, except RCW82.32.045 and 82.32.270, applies to the fee imposed by this chapter, inaddition to any other provisions of law for the payment and enforcementof the fee imposed by this chapter. The department may adopt rules, inaccordance with chapter 34.05 RCW, as necessary to provide for theeffective administration of this chapter.NEW SECTION.Sec. (1) By June 1st of each year, each nursingfacility operator shall file a report with the department of social and 2 health services listing the patient days and the gross income for theprior calendar year for each nursing facility that he or she operates. (2) By August 1, 2003, the department of social and health servicesshall submit for approval to the federal department of health and humanservices a request for a waiver pursuant to 42 C.F.R. 433.68. Thewaiver shall identify the nursing facilities that the departmentproposes to exempt from the quality maintenance fee. Those facilitiesshall include at least: (a) Nursing facilities operated by any agency of the state ofWashington; (b) Nursing facilities operated by a public hospital district; and (c) As many nursing facilities with no or disproportionately lownumbers of medicaidfunded residents as, within the judgment of thedepartment, may be exempted from the fee pursuant to 42 C.F.R. 433.68. (3) The department of social and health services shall notify thedepartment of revenue and the nursing facility operator of the nursingfacilities that would be exempted from the quality maintenance feepursuant to the waiver request submitted to the federal department ofhealth and human services. The nursing facilities included in thewaiver request may withhold payment of the fee pending final action bythe federal government on the request for waiver. (4) If the request for waiver is approved, the department of socialand health services shall notify the department of revenue and thenursing facility operator that no quality maintenance fee is due fromthe facility. If the request for waiver is denied, nursing facilityoperators who have withheld payment of the fee shall pay all such feesas have been withheld. (5) The department of social and health services shall takewhatever action is necessary to continue the waiver from the federalgovernment. (6) The department of social and health services may adopt suchrules, in accordance with chapter 34.05 RCW, as necessary to providefor effective administration of this section and section 5 of this act.NEW SECTION.Sec. The department of social and health servicesshall prospectively add the medicaid cost of the quality maintenance 3 fee under section 2 of this act to the nursing facility component rateallocation calculated after application of all other provisions of RCW74.46.521.NEW SECTION.Sec. (1) Sections 1 through 5 of this act shallexpire on the effective date that federal medicaid matching funds aresubstantially reduced or that a federal sanction is imposed due to thequality maintenance fee under section 2 of this act, as such date iscertified by the secretary of social and health services. (2) The expiration of sections 1 through 5 of this act shall not beconstrued as affecting any existing right acquired or liability orobligation incurred under those sections or under any rule or orderadopted under those sections, nor as affecting any proceedinginstituted under those sections.NEW SECTION.Sec. If any provision of this act or itsapplication to any person or circumstance is held invalid, theremainder of the act or the application of the provision to otherpersons or circumstances is not affected.NEW SECTION.Sec. (1) Sections 1 through 3 of this actconstitute a new chapter in Title 82 RCW. (2) Sections 4 and 5 of this act are each added to chapter 74.46RCW.NEW SECTION.Sec. This act is necessary for the immediatepreservation of the public peace, health, or safety, or support of thestate government and its existing public institutions, and takes effectJune 1, 2003. Correct the title.--- END --- 4