Connecticut SB 328: AN ACT REQUIRING NURSING HOMES TO SPEND EIGHTY PER CENT OF REVENUE ON DIRECT PATIENT CARE.

Bill Text

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General Assembly Raised Bill No. 328
February Session, 2026 LCO No. 1501

Referred to Committee on HUMAN SERVICES

Introduced by:
(HS)

AN ACT REQUIRING NURSING HOMES TO SPEND EIGHTY PER
CENT OF REVENUE ON DIRECT PATIENT CARE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsection (a) of section 17b-340d of the 2026 supplement 1
to the general statutes is repealed and the following is substituted in lieu 2
thereof (Effective July 1, 2026): 3
(a) The Commissioner of Social Services shall implement an acuity-4
based methodology for Medicaid reimbursement of nursing home 5
services effective July 1, 2022. Notwithstanding section 17b-340, for the 6
fiscal year ending June 30, 2023, and annually thereafter, the 7
Commissioner of Social Services shall establish Medicaid rates paid to 8
nursing home facilities based on cost years ending on September 9
thirtieth in accordance with the following: 10
(1) Case-mix adjustments to the direct care component, which will be 11
based on Minimum Data Set resident assessment data as well as cost 12
data reported for the cost year ending September 30, 2019, shall be made 13
effective beginning July 1, 2022, and updated every quarter thereafter. 14
After modeling such case-mix adjustments, the Commissioner of Social 15

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Services shall evaluate impact on a facility by facility basis and, not later 16
than October 1, 2021, (A) make recommendations to the Secretary of the 17
Office of Policy and Management, and (B) submit a report on the 18
recommendations, in accordance with the provisions of section 11-4a, to 19
the joint standing committees of the General Assembly having 20
cognizance of matters relating to appropriations and the budgets of state 21
agencies and human services on any adjustments needed to facilitate the 22
transition to the new methodology on July 1, 2022. This evaluation may 23
include a review of inflationary allowances, case mix and budget 24
adjustment factors and stop loss and stop gain corridors and the ability 25
to make such adjustments within available appropriations. 26
(2) Beginning July 1, 2022, facilities will be required to comply with 27
collection and reporting of quality metrics as specified by the 28
Department of Social Services, after consultation with the nursing home 29
industry, consumers, employees and the Department of Public Health. 30
Rate adjustments based on performance on quality metrics will be 31
phased in, beginning July 1, 2022, with a period of reporting only. 32
Effective July 1, 2023, the Department of Social Services shall issue 33
individualized reports annually to each nursing home facility showing 34
the impact to the Medicaid rate for such home based on the quality 35
metrics program. A nursing home facility receiving an individualized 36
quality metrics report may use such report to evaluate the impact of the 37
quality metrics program on said facility's Medicaid reimbursement. On 38
or after October 1, 2026, the Department of Social Services may establish 39
a quality metrics program, within available appropriations designated 40
for such purpose, to provide payments to nursing home facilities (A) for 41
high-quality outcomes based on performance in the quality metrics 42
program, and (B) designed to incentivize the provision of high-quality 43
services to nursing home residents who are Medicaid beneficiaries, as 44
indicated in the individualized report issued to each nursing home 45
facility pursuant to the provisions of this subdivision. Such quality 46
metrics program shall evaluate nursing home facilities based on 47
national quality measures for nursing home facilities issued by the 48
Centers for Medicare and Medicaid Services and state-administered 49

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consumer satisfaction measures. Such quality measures may be 50
weighted higher for desired outcomes, as determined by the 51
department. Not later than February 1, 2027, the department shall 52
submit a report, in accordance with the provisions of section 11-4a, to 53
the joint standing committees of the General Assembly having 54
cognizance of matters relating to appropriations and the budgets of state 55
agencies and human services on the implementation of the quality 56
metrics program. 57
(3) Geographic peer groupings of facilities shall be established by the 58
Department of Social Services pursuant to regulations adopted in 59
accordance with subsection (b) of this section. 60
(4) Allowable costs shall be divided into the following five cost 61
components: (A) Direct costs, which shall include salaries for nursing 62
personnel, related fringe benefits and costs for nursing personnel 63
supplied by a temporary nursing services agency; (B) indirect costs, 64
which shall include professional fees, dietary expenses, housekeeping 65
expenses, laundry expenses, supplies related to patient care, salaries for 66
indir