According to the Minnesota Department of Human Services (DHS), 32 eligible nursing facilities have applied for a rate increase under the Equitable Cost-Sharing for Publicly-Owned Nursing Facilities (ECPN) program established by the 2010 Legislature. The ECPN Program was established as a mechanism to allow any nursing facility whose physical plant is owned by or whose license is held by a city, county or hospital district to participate in this program, and choose to contribute funds to the operation of that facility, to receive federal match for those contributions. The 2007 rebasing statute will be used to determine the maximum rate increase available to a qualified nursing facility. We wanted to be sure you were all aware of this new law, and which of your “neighboring” facilities may be taking advantage of this opportunity for rate increases, and possibly “protection” from any proposed reductions.

The 32 eligible nursing facilities that have applied for a rate increase under the ECPN are:
Adrian Country Living
Appleton Municipal Nursing Home
Bigfork Valley Communities
Clara City Care Center
Clarkfield Care Center
Colonial Manor of Balaton
Cook Community Hospital
Cook County North Shore CC
Cuyuna Care Center
Eveleth Health Services
Field Crest Care Center
Grand Village
Granite Falls Municipal Hospital
Heritage Living Center
Johnson Memorial
Lakewood Health System
LifeCare - Roseau Manor
Littlefork Medical Center
Mahnomen Health Center
New River Medical Center
Northridge Residence (Ortonville)
Parkview Manor
Pelican Valley Health Center
Perham Memorial Home
Pine Villa (CentraCare)
Ramsey County Care Center
Rice Care Center
Saint Michael's Nursing Home
Stewartville Care Center
Sunnyside Care Center
Trimont Health Care Center
Virginia Hospital

According to the Minnesota Department of Human Services, there are 45 facilities in Minnesota that meet the qualifications for the ECPN program. While DHS has provided the state plan amendment materials to the Centers for Medicare and Medicaid Services (CMS) for program approval, DHS has not yet heard from CMS. DHS believes once the paperwork and estimates are provided, CMS will likely approve, and the program could then be implemented.

The “Nursing Facility Policy Changes in 2010 Legislation” bulletin (#10-62-02) provides a detailed overview of the ECPN program. The bulletin may be downloaded from the DHS website at http://www.dhs.state.mn.us/dhs16_151044.pdf. DHS has sent letters regarding the program to qualified nursing facilities and has made data available to the qualifying facilities. Only a small percentage of eligible facilities would not see a benefit due to the rebasing calculations. This program, while similar to the Inter-Governmental Transfer (IGT) program that was repealed in 2009, differs in significant ways. The key difference is that all of the benefit of the program goes to the nursing facility rather than to the state’s general fund. It is very important to note that the city/county government entity will sign an affidavit that makes it clear that government entity and nursing facility are utilizing the intergovernmental transfer program IGT on the “straight and narrow,” which means the city/county/hospital will pay what equates to the state share to draw down federal matching funds, but the matching funds coming back to the facility must be used by the facility, and not transferred back to the city/county “coffers.” While application to participate in this program is voluntary, participation, once established, may not be stopped by the owner.

Since the ECPN program is similar to an intergovernmental transfer (IGT), the only way CMS would approve such a program is if it was limited to governmentally-owned buildings. Hence the program will never be extended to proprietary or non-proprietary nursing facilities.

Patti Cullen, CAE
952.851.2487
pcullen@careproviders.org

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