Existing law, as long as prescribed conditions are met, provides for the imposition of a uniform quality assurance fee on skilled nursing facilities, subject to prescribed exemptions, to be administered by the Director of Health Care Services and deposited in the State Treasury to be available to enhance federal financial participation in the Medi-Cal program or to provide additional reimbursement to, and support facility quality improvement efforts in, licensed skilled nursing facilities. Existing law provides that the quality assurance fee shall be based upon the entire net revenue of all skilled nursing facilities subject to the fee, except an exempt facility, as defined to include, among other facilities, a skilled nursing facility that is part of a continuing care retirement community. Violation of these provisions is a misdemeanor.

This bill would eliminate the exemption for a skilled nursing facility that is part of a continuing care retirement community. By changing the definition of a crime, this bill would impose a state-mandated local program.

Existing law provides that for the 2005–06 rate year and subsequent rate years through and including the 2010–11 rate year, the net revenue projected for all skilled nursing facilities subject to the fee shall be based on the prior rate year’s data.

This bill would require the prior rate year’s data to be updated to the midpoint of the upcoming rate year.

Existing law, the Medi-Cal Long-Term Reimbursement Act, requires the department to implement a cost-based reimbursement rate methodology for freestanding skilled nursing facilities, excluding skilled nursing facilities that are a distinct part of a facility that is licensed as a general acute care hospital. Reimbursement rates for these facilities are funded by a combination of federal funds and moneys collected pursuant to the above-described uniform quality assurance fees. Existing law provides that this rate methodology shall cease to be implemented on July 31, 2011, with these provisions to be repealed on January 1, 2012. Existing law provides, for the 2009–10 and 2010–11 rate years, that the weighted average Medi-Cal reimbursement rate required for purposes of the above-described provisions shall not be increased with respect to the weighted average Medi-Cal reimbursement rate for the 2008–09 rate year.

This bill would, instead, provide that for the 2009–10 rate year, the weighted average Medi-Cal reimbursement rate required for purposes of the above-described provisions shall not exceed 2.5% of the weighted average Medi-Cal reimbursement rate for the prior fiscal year.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

This bill would declare that it is to take effect immediately as an urgency statute.