Bill Text: IA SF2160 | 2011-2012 | 84th General Assembly | Enrolled
Bill Title: A bill for an act relating to allowing financial supplementation to a nursing facility for provision of a private room to a recipient of medical assistance. (Formerly SSB 3054.) Effective 7-1-12.
Spectrum: Committee Bill
Status: (Passed) 2012-03-30 - Signed by Governor. S.J. 700. [SF2160 Detail]
Download: Iowa-2011-SF2160-Enrolled.html
Senate
File
2160
AN
ACT
RELATING
TO
ALLOWING
FINANCIAL
SUPPLEMENTATION
TO
A
NURSING
FACILITY
FOR
PROVISION
OF
A
PRIVATE
ROOM
TO
A
RECIPIENT
OF
MEDICAL
ASSISTANCE.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
Section
1.
Section
249A.4,
Code
2011,
is
amended
by
adding
the
following
new
subsection:
NEW
SUBSECTION
.
9A.
a.
Allow
supplementation
of
the
combination
of
client
participation
and
payment
made
through
the
medical
assistance
program
for
those
items
and
services
identified
in
42
C.F.R.
§
483.10(c)(8)(ii),
by
the
resident
of
a
nursing
facility
or
the
resident’s
family.
Supplementation
under
this
subsection
may
include
supplementation
for
provision
of
a
private
room
not
otherwise
covered
under
the
medical
assistance
program
unless
either
of
the
following
applies:
(1)
The
private
room
is
therapeutically
required
pursuant
to
42
C.F.R.
§
483.10(c)(8)(ii).
(2)
No
room
other
than
the
private
room
is
available.
b.
The
rules
adopted
to
administer
this
subsection
shall
require
all
of
the
following
if
a
nursing
facility
provides
for
supplementation
for
provision
of
a
private
room:
(1)
The
nursing
facility
shall
inform
all
current
and
prospective
residents
and
residents’
legal
representatives
of
the
following:
(a)
If
the
resident
desires
a
private
room,
the
resident
or
resident’s
family
may
provide
supplementation
by
directly
paying
the
facility
the
amount
of
supplementation.
Supplementation
by
a
resident’s
family
shall
not
be
treated
as
income
of
the
resident
for
purposes
of
medical
assistance
program
eligibility
or
client
participation.
Senate
File
2160,
p.
2
(b)
The
nursing
facility’s
policy
if
a
resident
residing
in
a
private
room
converts
from
private
pay
to
payment
under
the
medical
assistance
program,
but
the
resident
or
resident’s
family
is
not
willing
or
able
to
pay
supplementation
for
the
private
room.
(c)
A
description
and
identification
of
the
private
rooms
for
which
supplementation
is
available.
(d)
The
process
for
an
individual
to
take
legal
responsibility
for
providing
supplementation,
including
identification
of
the
individual
and
the
extent
of
the
legal
responsibility.
(2)
For
a
resident
for
whom
the
nursing
facility
receives
supplementation,
the
nursing
facility
shall
indicate
in
the
resident’s
record
all
of
the
following:
(a)
A
description
and
identification
of
the
private
room
for
which
the
nursing
facility
is
receiving
supplementation.
(b)
The
identity
of
the
individual
making
the
supplemental
payments.
(c)
The
private
pay
charge
for
the
private
room
for
which
the
nursing
facility
is
receiving
supplementation.
(d)
The
total
charge
to
the
resident
for
the
private
room
for
which
the
nursing
facility
is
receiving
supplementation,
the
portion
of
the
total
charge
reimbursed
under
the
medical
assistance
program,
and
the
portion
of
the
total
charge
reimbursed
through
supplementation.
(3)
If
the
nursing
facility
only
provides
one
type
of
room
or
all
private
rooms,
the
nursing
facility
shall
not
be
eligible
to
request
supplementation.
(4)
A
nursing
facility
may
base
the
supplementation
amount
on
the
difference
between
the
amount
paid
for
a
room
covered
under
the
medical
assistance
program
and
the
private
pay
rate
for
the
private
room
identified
for
supplementation.
However,
the
total
payment
for
the
private
room
from
all
sources
shall
not
be
greater
than
the
aggregate
average
private
room
rate
for
the
type
of
rooms
covered
under
the
medical
assistance
program
for
which
the
resident
would
be
eligible.
(5)
Supplementation
pursuant
to
this
subsection
shall
not
be
required
as
a
precondition
of
admission,
expedited
admission,
or
continued
stay
in
a
facility.
(6)
Supplementation
shall
not
be
applicable
if
the
facility’s
occupancy
rate
is
less
than
eighty
percent.
(7)
The
nursing
facility
shall
ensure
that
all
appropriate
care
is
provided
to
all
residents
notwithstanding
the
Senate
File
2160,
p.
3
applicability
or
availability
of
supplementation.
(8)
A
private
room
for
which
supplementation
is
required
shall
be
retained
for
the
resident
consistent
with
existing
bed-hold
policies.
______________________________
JOHN
P.
KIBBIE
President
of
the
Senate
______________________________
KRAIG
PAULSEN
Speaker
of
the
House
I
hereby
certify
that
this
bill
originated
in
the
Senate
and
is
known
as
Senate
File
2160,
Eighty-fourth
General
Assembly.
______________________________
MICHAEL
E.
MARSHALL
Secretary
of
the
Senate
Approved
_______________,
2012
______________________________
TERRY
E.
BRANSTAD
Governor
