S 4883: Excludes one-time federal assistance in the calculation of operating revenue for purposes of minimum direct resident care spending by residential health care facilities.

  
  STATE OF NEW YORK ________________________________________________________________________ 4883 2025-2026 Regular Sessions  IN SENATE February 13, 2025 ___________ Introduced by Sen. GOUNARDES -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to minimum direct resident care spending by residential health care facilities The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph (i) of paragraph (c) of subdivision 1 of 2 section 2828 of the public health law, as amended by chapter 747 of the 3 laws of 2023, is amended to read as follows: 4 (i) Except as provided in subparagraph (ii) of this paragraph, such 5 regulations shall further include at a minimum that any residential 6 health care facility for which the calculation of total operating reven- 7 ue, as such term is limited by paragraph (a) of subdivision two of this 8 section, exceeds total operating and non-operating expenses by more than 9 five percent of total operating and non-operating expenses or that fails 10 to spend the minimum amount necessary to comply with the minimum spend- 11 ing standards for resident-facing staffing or direct resident care, 12 calculated on an annual basis, or for the year two thousand twenty-two, 13 on a pro-rata basis for only that portion of the year during which the 14 failure of a residential health care facility to spend a minimum of 15 seventy percent of revenue on direct resident care, and forty percent of 16 revenue on resident-facing staffing, may be held to be a violation of 17 this chapter, shall remit such excess revenue, or the difference between 18 the minimum spending requirement and the actual amount of spending on 19 resident-facing staffing or direct care staffing, as the case may be, to 20 the state, with such excess revenue which shall be payable, in a manner 21 to be determined by such regulations, by November first in the year 22 following the year in which the expenses are incurred. The department 23 shall collect such payments by methods including, but not limited to, 24 bringing suit in a court of competent jurisdiction on its own behalf 25 after giving notice of such suit to the attorney general, deductions or EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09626-01-5 
 S. 4883 2 1 offsets from payments made pursuant to the Medicaid program, and shall 2 deposit such recouped funds into the nursing home quality pool, as set 3 forth in paragraph (d) of subdivision two-c of section twenty-eight 4 hundred eight of this article. Provided further that such payments of 5 excess revenue shall be in addition to and shall not affect a residen- 6 tial health care facility's obligations to make any other payments 7 required by state or federal law into the nursing home quality pool, 8 including but not limited to medicaid rate reductions required pursuant 9 to paragraph (g) of subdivision two-c of section twenty-eight hundred 10 eight of this article and department regulations promulgated pursuant 11 thereto. The commissioner or their designees shall have authority to 12 audit the residential health care facilities' reports for compliance in 13 accordance with this section. 14 § 2. Paragraph (a) of subdivision 2 of section 2828 of the public 15 health law, as amended by chapter 27 of the laws of 2024, is amended to 16 read as follows: 17 (a) "Revenue" shall mean the total operating revenue from or on behalf 18 of residents of the residential health care facility, government payers, 19 or third-party payers, to pay for a resident's occupancy of the residen- 20 tial health care facility, resident care, and the operation of the resi- 21 dential health care facility as reported in the residential health care 22 facility cost reports submitted to the department; provided, however, 23 that total operating revenue shall exclude: 24 (i) the capital portion of the Medicaid reimbursement rate; 25 (ii) funding received as reimbursement for the assessment under 26 subparagraph (vi) of paragraph (b) of subdivision two of section twen- 27 ty-eight hundred seven-d of this article, as reconciled pursuant to 28 paragraph (c) of subdivision ten of section twenty-eight hundred seven-d 29 of this article; and 30 (iii) any grant funds from the federal government for reimbursement of 31 COVID-19 pandemic-related expenses, including but not limited to funds 32 received from the federal emergency management agency or health 33 resources and services administration and such other one-time federal 34 financial assistance. 35 § 3. This act shall take effect immediately; provided, however, for 36 purposes of distribution of the supplemental payment to qualified facil- 37 ities authorized by chapter 53 of the laws of 2022, enacting the aid to 38 localities budget, and pursuant to the Medicaid State Plan Amendment 39 22-0007, this act shall be deemed to have been in full force and effect 40 on and after January 1, 2020.