249L.4 QUALITY ASSURANCE TRUST FUND -- LIMITATIONS OF
USE -- REIMBURSEMENT ADJUSTMENTS TO NURSING FACILITIES.
1. A quality assurance trust fund is created in the state
treasury under the authority of the department. Moneys received
through the collection of the nursing facility quality assurance
assessment imposed under this chapter and any other moneys specified
for deposit in the trust fund shall be deposited in the trust fund.
2. Moneys in the trust fund shall be used, subject to their
appropriation by the general assembly, by the department only for
reimbursement of services for which federal financial participation
under the medical assistance program is available to match state
funds. Any moneys appropriated from the trust fund for reimbursement
of nursing facilities, in addition to the quality assurance
assessment pass-through and the quality assurance assessment rate
add-on which shall be used as specified in subsection 5, paragraph
"b", shall be used in a manner such that no less than thirty-five
percent of the amount received by a nursing facility is used for
increases in compensation and costs of employment for direct care
workers, and no less than sixty percent of the total is used to
increase compensation and costs of employment for all nursing
facility staff. For the purposes of use of such funds, "direct
care worker", "nursing facility staff", "increases in
compensation", and "costs of employment" mean as defined or
specified in this chapter.
3. The trust fund shall be separate from the general fund of the
state and shall not be considered part of the general fund of the
state. The moneys in the trust fund shall not be considered revenue
of the state, but rather shall be funds of the quality assurance
assessment program. The moneys deposited in the trust fund are not
subject to section 8.33 and shall not be transferred, used,
obligated, appropriated, or otherwise encumbered, except to provide
for the purposes of this chapter. Notwithstanding section 12C.7,
subsection 2, interest or earnings on moneys deposited in the trust
fund shall be credited to the trust fund.
4. The department shall adopt rules pursuant to chapter 17A to
administer the trust fund and reimbursements made from the trust
fund.
5. a. The determination of medical assistance reimbursements
to nursing facilities shall continue to be calculated in accordance
with the modified price-based case-mix reimbursement system as
specified in 2001 Iowa Acts, ch. 192, section 4, subsection 2,
paragraph "c". In addition, moneys that are appropriated from
the trust fund for reimbursements to nursing facilities that serve
the medically indigent shall be used to provide the following nursing
facility reimbursement rate adjustment increases within the
parameters specified:
(1) A quality assurance assessment pass-through. This rate
add-on shall account for the cost incurred by the nursing facility in
paying the quality assurance assessment, but only with respect to the
pro rata portion of the assessment that correlates with the patient
days in the nursing facility that are attributable to medically
indigent residents.
(2) A quality assurance assessment rate add-on. This rate add-on
shall be calculated on a per-patient-day basis for medically indigent
residents. The amount paid to a nursing facility as a quality
assurance assessment rate add-on shall be ten dollars per patient
day.
(3) Nursing facility payments for rebasing pursuant to 2001 Iowa
Acts, ch. 192, section 4, subsection 3, paragraph "a",
subparagraph (2).
b. (1) It is the intent of the general assembly that priority
in expenditure of rate adjustment increases provided to nursing
facilities through the quality assurance assessment be related to the
compensation and costs of employment for nursing facility staff.
(2) If the sum of the quality assurance assessment pass-through
and the quality assurance assessment rate add-on is greater than the
total cost incurred by a nursing facility in payment of the quality
assurance assessment, no less than thirty-five percent of the
difference shall be used to increase compensation and costs of
employment for direct care workers and no less than sixty percent of
the difference shall be used to increase compensation and costs of
employment for all nursing facility staff.
(3) For the purposes of determining what constitutes increases in
compensation and costs of employment the following shall apply:
(a) Increases in compensation shall include but are not limited
to starting hourly wages, average hourly wages paid, and total wages
including both productive and nonproductive wages, and as specified
by rule of the department.
(b) Increases in total costs of employment shall include but are
not limited to costs of benefit programs with specific reporting for
group health plans, group retirement plans, leave benefit plans,
employee assistance programs, payroll taxes, workers' compensation,
training, education, career development programs, tuition
reimbursement, transportation, and child care, and as specified by
rule of the department.
(c) Direct care workers and nursing facility staff do not include
nursing facility administrators, administrative staff, or home office
staff.
(4) Each nursing facility shall submit to the department,
information in a form as specified by the department and developed in
cooperation with representatives of the Iowa caregivers association,
the Iowa health care association, the Iowa association of homes and
services for the aging, and the AARP Iowa chapter, that demonstrates
compliance by the nursing facility with the requirements for use of
the rate adjustment increases and other reimbursements provided to
nursing facilities through the quality assurance assessment.
6. The department shall report annually to the general assembly
regarding the use of moneys deposited in the trust fund and
appropriated to the department.
Section History: Recent Form
2009 Acts, ch 160, §4, 5
Referred to in § 249L.3
Footnotes
Implementation of chapter contingent upon departmental
determinations, submission of medical assistance program waiver and
state plan amendment requests, and federal approval of the requests;
2009 Acts, ch 160, §5--9
249L.4 QUALITY ASSURANCE TRUST FUND -- LIMITATIONS OF
USE -- REIMBURSEMENT ADJUSTMENTS TO NURSING FACILITIES.
1. A quality assurance trust fund is created in the state
treasury under the authority of the department. Moneys received
through the collection of the nursing facility quality assurance
assessment imposed under this chapter and any other moneys specified
for deposit in the trust fund shall be deposited in the trust fund.
2. Moneys in the trust fund shall be used, subject to their
appropriation by the general assembly, by the department only for
reimbursement of services for which federal financial participation
under the medical assistance program is available to match state
funds. Any moneys appropriated from the trust fund for reimbursement
of nursing facilities, in addition to the quality assurance
assessment pass-through and the quality assurance assessment rate
add-on which shall be used as specified in subsection 5, paragraph
"b", shall be used in a manner such that no less than thirty-five
percent of the amount received by a nursing facility is used for
increases in compensation and costs of employment for direct care
workers, and no less than sixty percent of the total is used to
increase compensation and costs of employment for all nursing
facility staff. For the purposes of use of such funds, "direct
care worker", "nursing facility staff", "increases in
compensation", and "costs of employment" mean as defined or
specified in this chapter.
3. The trust fund shall be separate from the general fund of the
state and shall not be considered part of the general fund of the
state. The moneys in the trust fund shall not be considered revenue
of the state, but rather shall be funds of the quality assurance
assessment program. The moneys deposited in the trust fund are not
subject to section 8.33 and shall not be transferred, used,
obligated, appropriated, or otherwise encumbered, except to provide
for the purposes of this chapter. Notwithstanding section 12C.7,
subsection 2, interest or earnings on moneys deposited in the trust
fund shall be credited to the trust fund.
4. The department shall adopt rules pursuant to chapter 17A to
administer the trust fund and reimbursements made from the trust
fund.
5. a. The determination of medical assistance reimbursements
to nursing facilities shall continue to be calculated in accordance
with the modified price-based case-mix reimbursement system as
specified in 2001 Iowa Acts, ch. 192, section 4, subsection 2,
paragraph "c". In addition, moneys that are appropriated from
the trust fund for reimbursements to nursing facilities that serve
the medically indigent shall be used to provide the following nursing
facility reimbursement rate adjustment increases within the
parameters specified:
(1) A quality assurance assessment pass-through. This rate
add-on shall account for the cost incurred by the nursing facility in
paying the quality assurance assessment, but only with respect to the
pro rata portion of the assessment that correlates with the patient
days in the nursing facility that are attributable to medically
indigent residents.
(2) A quality assurance assessment rate add-on. This rate add-on
shall be calculated on a per-patient-day basis for medically indigent
residents. The amount paid to a nursing facility as a quality
assurance assessment rate add-on shall be ten dollars per patient
day.
(3) Nursing facility payments for rebasing pursuant to 2001 Iowa
Acts, ch. 192, section 4, subsection 3, paragraph "a",
subparagraph (2).
b. (1) It is the intent of the general assembly that priority
in expenditure of rate adjustment increases provided to nursing
facilities through the quality assurance assessment be related to the
compensation and costs of employment for nursing facility staff.
(2) If the sum of the quality assurance assessment pass-through
and the quality assurance assessment rate add-on is greater than the
total cost incurred by a nursing facility in payment of the quality
assurance assessment, no less than thirty-five percent of the
difference shall be used to increase compensation and costs of
employment for direct care workers and no less than sixty percent of
the difference shall be used to increase compensation and costs of
employment for all nursing facility staff.
(3) For the purposes of determining what constitutes increases in
compensation and costs of employment the following shall apply:
(a) Increases in compensation shall include but are not limited
to starting hourly wages, average hourly wages paid, and total wages
including both productive and nonproductive wages, and as specified
by rule of the department.
(b) Increases in total costs of employment shall include but are
not limited to costs of benefit programs with specific reporting for
group health plans, group retirement plans, leave benefit plans,
employee assistance programs, payroll taxes, workers' compensation,
training, education, career development programs, tuition
reimbursement, transportation, and child care, and as specified by
rule of the department.
(c) Direct care workers and nursing facility staff do not include
nursing facility administrators, administrative staff, or home office
staff.
(4) Each nursing facility shall submit to the department,
information in a form as specified by the department and developed in
cooperation with representatives of the Iowa caregivers association,
the Iowa health care association, the Iowa association of homes and
services for the aging, and the AARP Iowa chapter, that demonstrates
compliance by the nursing facility with the requirements for use of
the rate adjustment increases and other reimbursements provided to
nursing facilities through the quality assurance assessment.
6. The department shall report annually to the general assembly
regarding the use of moneys deposited in the trust fund and
appropriated to the department.
Section History: Recent Form
2009 Acts, ch 160, §4, 5
Referred to in § 249L.3
Footnotes
Implementation of chapter contingent upon departmental
determinations, submission of medical assistance program waiver and
state plan amendment requests, and federal approval of the requests;
2009 Acts, ch 160, §5--9
249L.4 QUALITY ASSURANCE TRUST FUND -- LIMITATIONS OF
USE -- REIMBURSEMENT ADJUSTMENTS TO NURSING FACILITIES.
1. A quality assurance trust fund is created in the state
treasury under the authority of the department. Moneys received
through the collection of the nursing facility quality assurance
assessment imposed under this chapter and any other moneys specified
for deposit in the trust fund shall be deposited in the trust fund.
2. Moneys in the trust fund shall be used, subject to their
appropriation by the general assembly, by the department only for
reimbursement of services for which federal financial participation
under the medical assistance program is available to match state
funds. Any moneys appropriated from the trust fund for reimbursement
of nursing facilities, in addition to the quality assurance
assessment pass-through and the quality assurance assessment rate
add-on which shall be used as specified in subsection 5, paragraph
"b", shall be used in a manner such that no less than thirty-five
percent of the amount received by a nursing facility is used for
increases in compensation and costs of employment for direct care
workers, and no less than sixty percent of the total is used to
increase compensation and costs of employment for all nursing
facility staff. For the purposes of use of such funds, "direct
care worker", "nursing facility staff", "increases in
compensation", and "costs of employment" mean as defined or
specified in this chapter.
3. The trust fund shall be separate from the general fund of the
state and shall not be considered part of the general fund of the
state. The moneys in the trust fund shall not be considered revenue
of the state, but rather shall be funds of the quality assurance
assessment program. The moneys deposited in the trust fund are not
subject to section 8.33 and shall not be transferred, used,
obligated, appropriated, or otherwise encumbered, except to provide
for the purposes of this chapter. Notwithstanding section 12C.7,
subsection 2, interest or earnings on moneys deposited in the trust
fund shall be credited to the trust fund.
4. The department shall adopt rules pursuant to chapter 17A to
administer the trust fund and reimbursements made from the trust
fund.
5. a. The determination of medical assistance reimbursements
to nursing facilities shall continue to be calculated in accordance
with the modified price-based case-mix reimbursement system as
specified in 2001 Iowa Acts, ch. 192, section 4, subsection 2,
paragraph "c". In addition, moneys that are appropriated from
the trust fund for reimbursements to nursing facilities that serve
the medically indigent shall be used to provide the following nursing
facility reimbursement rate adjustment increases within the
parameters specified:
(1) A quality assurance assessment pass-through. This rate
add-on shall account for the cost incurred by the nursing facility in
paying the quality assurance assessment, but only with respect to the
pro rata portion of the assessment that correlates with the patient
days in the nursing facility that are attributable to medically
indigent residents.
(2) A quality assurance assessment rate add-on. This rate add-on
shall be calculated on a per-patient-day basis for medically indigent
residents. The amount paid to a nursing facility as a quality
assurance assessment rate add-on shall be ten dollars per patient
day.
(3) Nursing facility payments for rebasing pursuant to 2001 Iowa
Acts, ch. 192, section 4, subsection 3, paragraph "a",
subparagraph (2).
b. (1) It is the intent of the general assembly that priority
in expenditure of rate adjustment increases provided to nursing
facilities through the quality assurance assessment be related to the
compensation and costs of employment for nursing facility staff.
(2) If the sum of the quality assurance assessment pass-through
and the quality assurance assessment rate add-on is greater than the
total cost incurred by a nursing facility in payment of the quality
assurance assessment, no less than thirty-five percent of the
difference shall be used to increase compensation and costs of
employment for direct care workers and no less than sixty percent of
the difference shall be used to increase compensation and costs of
employment for all nursing facility staff.
(3) For the purposes of determining what constitutes increases in
compensation and costs of employment the following shall apply:
(a) Increases in compensation shall include but are not limited
to starting hourly wages, average hourly wages paid, and total wages
including both productive and nonproductive wages, and as specified
by rule of the department.
(b) Increases in total costs of employment shall include but are
not limited to costs of benefit programs with specific reporting for
group health plans, group retirement plans, leave benefit plans,
employee assistance programs, payroll taxes, workers' compensation,
training, education, career development programs, tuition
reimbursement, transportation, and child care, and as specified by
rule of the department.
(c) Direct care workers and nursing facility staff do not include
nursing facility administrators, administrative staff, or home office
staff.
(4) Each nursing facility shall submit to the department,
information in a form as specified by the department and developed in
cooperation with representatives of the Iowa caregivers association,
the Iowa health care association, the Iowa association of homes and
services for the aging, and the AARP Iowa chapter, that demonstrates
compliance by the nursing facility with the requirements for use of
the rate adjustment increases and other reimbursements provided to
nursing facilities through the quality assurance assessment.
6. The department shall report annually to the general assembly
regarding the use of moneys deposited in the trust fund and
appropriated to the department.
Section History: Recent Form
2009 Acts, ch 160, §4, 5
Referred to in § 249L.3
Footnotes
Implementation of chapter contingent upon departmental
determinations, submission of medical assistance program waiver and
state plan amendment requests, and federal approval of the requests;
2009 Acts, ch 160, §5--9
