Chapter 256R — Long-term Services and Supports Loan Program

256.4792 Long-term Services and Supports Loan Program The state runs a loan program for long-term care providers like nursing homes and home care agencies. Providers can … 256R.01 General This section sets the basic rules for how nursing facilities get paid through Medical Assistance (Medicaid). Payment … 256R.02 Definitions This section defines over 50 key terms used throughout the nursing facility rate chapter. It covers terms like active … 256R.03 Conditions for Funding Nursing facilities must meet several conditions to receive Medical Assistance payments. They must be certified for … 256R.04 Prohibited Practices Nursing facilities that want Medical Assistance payments must not charge extra fees for admission, require loans from … 256R.05 Required Practices Before a person can receive Medical Assistance for nursing facility care, they must go through a preadmission screening. … 256R.06 Private Pay Residents; Required Practices Nursing facilities cannot charge private-pay residents more than the Medical Assistance rate for similar services, and … 256R.07 Adequate Documentation Nursing facilities must keep detailed, well-organized records to support their costs. Records must include paid … 256R.08 Reporting of Financial Statements Nursing facilities must submit financial statements to the state every year by February 1. These include audited … 256R.09 Reporting of Statistical and Cost Reports Nursing facilities must file an annual cost report by February 1. The state uses accrual accounting to set payment … 256R.10 Allowed Costs Only costs that are ordinary, necessary, and related to resident care can be used to set nursing facility payment rates. … 256R.11 Nonallowed Costs Certain costs cannot be included when setting nursing facility payment rates. These include political contributions, … 256R.12 Cost Allocation When a nursing facility is part of a larger organization, costs from the central or corporate office must be fairly … 256R.13 Auditing Requirements The state audits at least 15 percent of nursing facilities each year. Audits can be desk reviews or on-site field audits … 256R.16 Quality of Care Each nursing facility gets a quality score based on quality indicators from resident data, resident satisfaction … 256R.17 Case Mix Nursing facility residents are classified into case mix groups based on their care needs. The commissioner assigns a … 256R.18 This section has been repealed. 256R.21 Total Payment Rate The total payment rate for each nursing facility is made up of three parts: the operating payment rate (care-related … 256R.22 Case Mix Adjusted Total Payment Rate The commissioner calculates a case mix adjusted payment rate for each resident classification. The direct care portion … 256R.23 Total Care-related Payment Rates This section sets the limits and calculations for care-related payment rates. The median cost per day is based on … 256R.24 Other Operating Payment Rate The other operating payment rate covers non-care costs like administration, dietary, housekeeping, laundry, and building … 256R.25 External Fixed Costs Payment Rate External fixed costs are costs outside a facility's direct control that are passed through in the payment rate. These … 256R.26 Property Payment Rate The property payment rate pays nursing facilities for using their buildings and equipment. It is based on a fair rental … 256R.261 Property Rate Definitions This section defines 20 terms used in calculating the property payment rate, including building, depreciated replacement … 256R.265 Appraisals and Determination of Replacement Costs The commissioner selects appraisal firms and a valuation system to appraise nursing facility properties. Appraisals must … 256R.267 Threshold Project Property Payment Rate Interim Adjustments Nursing facilities on the fair rental value property system can get interim rate adjustments for building projects that … 256R.27 Interim and Settle-up Payment Rates New nursing facilities or those expanding by 50 percent or more receive interim payment rates based on estimated costs … 256R.32 Appeals Nursing facilities can appeal their payment rate decisions. The appeal process follows the procedures described in … 256R.36 This section has been repealed. 256R.37 Scholarships Nursing facilities can get extra payment for providing employee scholarships. Allowable costs include tuition, student … 256R.38 Performance-based Incentive Payments Nursing facilities can earn extra payments of up to 5 percent above their operating rate by meeting performance goals in … 256R.39 Quality Improvement Incentive Program The state sets aside 0.8 percent of all nursing facility operating payments for quality improvement incentive payments. … 256R.40 Nursing Facility Voluntary Closure; Alternatives When a nursing facility voluntarily closes or reduces beds through a state-approved plan, a portion of the resulting … 256R.405 Consolidation Rates Nursing facilities that complete a state-approved consolidation project receive a consolidation rate adjustment added to … 256R.41 Single-bed Room Incentive Nursing facilities that convert shared rooms into single-bed rooms get a 20 percent operating rate increase for each … 256R.42 Rate Adjustment for the First 30 Days During the first 30 days after a new resident is admitted, the nursing facility receives a 20 percent higher payment … 256R.43 Bed Holds When a nursing facility resident leaves temporarily (like for a hospital stay), the facility can receive a bed hold … 256R.44 Rate Adjustment for Private Rooms for Medical Necessity When a Medical Assistance resident needs a private room for medical reasons, the facility receives 111.5 percent of the … 256R.45 Rate Adjustment for Ventilator-dependent Persons The commissioner can negotiate a higher payment rate for nursing facilities caring for ventilator-dependent residents … 256R.46 Specialized Care Facilities Specialized care facilities get a 50 percent higher care-related payment rate limit. These are facilities licensed under … 256R.47 Rate Adjustment for Critical Access Nursing Facilities The commissioner can designate certain nursing facilities as critical access facilities to preserve care in isolated … 256R.48 Publicly Owned Facilities Nursing facilities owned by a city, county, or hospital district can apply for a higher payment rate if the local … 256R.481 Rate Adjustments for Border City Facilities Nonprofit nursing facilities in Breckenridge and Moorhead can apply for a rate add-on to help them compete with … 256R.49 This section has been repealed. 256R.495 Rate Adjustment for Nursing Home Employment Standards Nursing facilities can receive a rate adjustment to cover costs of meeting employment standards set by the Nursing Home … 256R.50 Bed Relocations When nursing facility beds are moved from one location to another, the payment rates must be calculated so the total … 256R.51 Rate Adjustment for Special Dietary Needs Nursing facilities with special dietary requirements for their residents, such as kosher or halal food, can receive a … 256R.52 Nursing Facility Receivership Fees When a nursing facility is placed in receivership, the commissioner can add a receivership fee to the facility's payment … 256R.53 Facility Specific Exemptions A specific nursing facility in Golden Valley with 44 rehabilitation beds gets a special exemption from normal rate … 256R.531 Patient Driven Payment Model Phase-in From October 2025 through December 2028, the commissioner must phase in the transition from the old RUG-IV case mix … 256R.54 Ancillary Services The commissioner sets payment rules for ancillary services like therapy and pharmacy provided to nursing facility … 256R.55 This section has been repealed.