S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6567
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2025
                                ___________
 
 Introduced  by M. of A. SIMON -- read once and referred to the Committee
   on Health
 
 AN ACT to amend the public health law, in  relation  to  minimum  direct
   resident care spending by residential health care facilities
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1.   Subparagraph (i) of paragraph (c)  of  subdivision  1  of
 section  2828 of the public health law, as amended by chapter 747 of the
 laws of 2023, is amended to read as follows:
   (i) Except as provided in subparagraph (ii) of  this  paragraph,  such
 regulations  shall  further  include  at  a minimum that any residential
 health care facility for which THE CALCULATION OF total operating reven-
 ue, AS SUCH TERM IS LIMITED BY SUBPARAGRAPH (III) OF  PARAGRAPH  (A)  OF
 SUBDIVISION TWO OF THIS SECTION, exceeds total operating and non-operat-
 ing  expenses by more than five percent of total operating and non-oper-
 ating expenses or that fails to spend the minimum  amount  necessary  to
 comply  with the minimum spending standards for resident-facing staffing
 or direct resident care, calculated on an annual basis, or for the  year
 two  thousand  twenty-two,  on a pro-rata basis for only that portion of
 the year during which the failure of a residential health care  facility
 to  spend  a  minimum  of  seventy percent of revenue on direct resident
 care, and forty percent of revenue on resident-facing staffing,  may  be
 held to be a violation of this chapter, shall remit such excess revenue,
 or the difference between the minimum spending requirement and the actu-
 al  amount of spending on resident-facing staffing or direct care staff-
 ing, as the case may be, to the state, with such  excess  revenue  which
 shall  be  payable, in a manner to be determined by such regulations, by
 November first in the year following the year in which the expenses  are
 incurred.  The department shall collect such payments by methods includ-
 ing, but not limited to, bringing suit in a court of competent jurisdic-
 tion on its own behalf after giving notice of such suit to the  attorney
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09626-03-5
              

 A. 6567                             2
 
 general,  deductions or offsets from payments made pursuant to the Medi-
 caid program, and shall deposit such recouped  funds  into  the  nursing
 home quality pool, as set forth in paragraph (d) of subdivision two-c of
 section  twenty-eight  hundred  eight  of this article. Provided further
 that such payments of excess revenue shall be in addition to  and  shall
 not  affect a residential health care facility's obligations to make any
 other payments required by state or federal law into  the  nursing  home
 quality  pool,  including  but  not  limited to medicaid rate reductions
 required pursuant to paragraph (g) of subdivision two-c of section twen-
 ty-eight hundred  eight  of  this  article  and  department  regulations
 promulgated  pursuant thereto. The commissioner or their designees shall
 have authority to audit the residential health care facilities'  reports
 for compliance in accordance with this section.
   §  2.  Paragraph  (a)  of  subdivision 2 of section 2828 of the public
 health law, as amended by chapter 27 of the laws of 2024, is amended  to
 read as follows:
   (a) "Revenue" shall mean the total operating revenue from or on behalf
 of residents of the residential health care facility, government payers,
 or third-party payers, to pay for a resident's occupancy of the residen-
 tial health care facility, resident care, and the operation of the resi-
 dential  health care facility as reported in the residential health care
 facility cost reports submitted to the  department;  provided,  however,
 that TOTAL OPERATING revenue shall exclude:
   (i) the capital portion of the Medicaid reimbursement rate;
   (ii)  funding  received  as  reimbursement  for  the  assessment under
 subparagraph (vi) of paragraph (b) of subdivision two of  section  twen-
 ty-eight  hundred  seven-d  of  this  article, as reconciled pursuant to
 paragraph (c) of subdivision ten of section twenty-eight hundred seven-d
 of this article; and
   (iii) any grant funds from the federal government for reimbursement of
 COVID-19 pandemic-related expenses, including but not limited  to  funds
 received   from  the  federal  emergency  management  agency  or  health
 resources and services administration AND SUCH  OTHER  ONE-TIME  FEDERAL
 FINANCIAL ASSISTANCE.
   §  3.  This  act shall take effect immediately; provided, however, for
 purposes of distribution of the supplemental payment to  qualified  not-
 for-profit  facilities  authorized  by  chapter  53 of the laws of 2022,
 enacting the aid to localities budget,  and  pursuant  to  the  Medicaid
 State  Plan  Amendment 22-0007, this act shall be deemed to have been in
 full force and effect on and after January 1, 2020.