1.1.................... moves to amend S.F. No. 2934, the first unofficial engrossment, as follows:
1.2Page 76, after line 28, insert:

1.3    "Sec. .... Minnesota Statutes 2022, section 256R.02, subdivision 16, is amended to read:
1.4    Subd. 16. Dietary costs. "Dietary costs" means the costs for the salaries and wages of
1.5the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned
1.6to the kitchen and dining room, and associated fringe benefits and payroll taxes. Dietary
1.7costs also includes the salaries or fees of dietary consultants, dietary supplies, and food
1.8preparation and serving.
1.9EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
1.102025, or upon federal approval, whichever is later. The commissioner of human services
1.11shall notify the revisor of statutes when federal approval is obtained.

1.12    Sec. .... Minnesota Statutes 2022, section 256R.02, is amended by adding a subdivision
1.13to read:
1.14    Subd. 16a. Dietary labor costs. "Dietary labor costs" means the costs for the salaries
1.15and wages of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other
1.16employees assigned to the kitchen and dining room, and associated fringe benefits and
1.17payroll taxes.
1.18EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
1.192025, or upon federal approval, whichever is later. The commissioner of human services
1.20shall notify the revisor of statutes when federal approval is obtained.

2.1    Sec. .... Minnesota Statutes 2022, section 256R.02, subdivision 24, is amended to read:
2.2    Subd. 24. Housekeeping costs. "Housekeeping costs" means the costs for the salaries
2.3and wages of the housekeeping supervisor, housekeepers, and other cleaning employees
2.4and associated fringe benefits and payroll taxes. It also includes the cost of housekeeping
2.5supplies, including, but not limited to, cleaning and lavatory supplies and contract services.
2.6EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
2.72025, or upon federal approval, whichever is later. The commissioner of human services
2.8shall notify the revisor of statutes when federal approval is obtained.

2.9    Sec. .... Minnesota Statutes 2022, section 256R.02, is amended by adding a subdivision
2.10to read:
2.11    Subd. 24a. Housekeeping labor costs. "Housekeeping labor costs" means the costs for
2.12the salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
2.13employees, and associated fringe benefits and payroll taxes.
2.14EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
2.152025, or upon federal approval, whichever is later. The commissioner of human services
2.16shall notify the revisor of statutes when federal approval is obtained.

2.17    Sec. .... Minnesota Statutes 2022, section 256R.02, is amended by adding a subdivision
2.18to read:
2.19    Subd. 25b. Known cost change factor. "Known cost change factor" means 1.00 plus
2.20the forecasted percentage change in the CPI-U index from July 1 of the reporting period to
2.21July 1 of the rate year as determined by the national economic consultant used by the
2.22commissioner of management and budget.
2.23EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
2.242025, or upon federal approval, whichever is later. The commissioner of human services
2.25shall notify the revisor of statutes when federal approval is obtained.

2.26    Sec. .... Minnesota Statutes 2022, section 256R.02, subdivision 26, is amended to read:
2.27    Subd. 26. Laundry costs. "Laundry costs" means the costs for the salaries and wages
2.28of the laundry supervisor and other laundry employees, associated fringe benefits, and
2.29payroll taxes. It also includes the costs of linen and bedding, the laundering of resident
2.30clothing, laundry supplies, and contract services.
3.1EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
3.22025, or upon federal approval, whichever is later. The commissioner of human services
3.3shall notify the revisor of statutes when federal approval is obtained.

3.4    Sec. .... Minnesota Statutes 2022, section 256R.02, is amended by adding a subdivision
3.5to read:
3.6    Subd. 26a. Laundry labor costs. "Laundry labor costs" means the costs for the salaries
3.7and wages of the laundry supervisor and other laundry employees, and associated fringe
3.8benefits and payroll taxes.
3.9EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
3.102025, or upon federal approval, whichever is later. The commissioner of human services
3.11shall notify the revisor of statutes when federal approval is obtained.

3.12    Sec. .... Minnesota Statutes 2022, section 256R.02, subdivision 29, is amended to read:
3.13    Subd. 29. Maintenance and plant operations costs. "Maintenance and plant operations
3.14costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
3.15heating-plant employees, and other maintenance employees and associated fringe benefits
3.16and payroll taxes. It also includes identifiable costs for maintenance and operation of the
3.17building and grounds, including, but not limited to, fuel, electricity, plastic waste bags,
3.18medical waste and garbage removal, water, sewer, supplies, tools, repairs, and minor
3.19equipment not requiring capitalization under Medicare guidelines.
3.20EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
3.212025, or upon federal approval, whichever is later. The commissioner of human services
3.22shall notify the revisor of statutes when federal approval is obtained.

3.23    Sec. .... Minnesota Statutes 2022, section 256R.02, is amended by adding a subdivision
3.24to read:
3.25    Subd. 29a. Maintenance and plant operations labor costs. "Maintenance and plant
3.26operations labor costs" means the costs for the salaries and wages of the maintenance
3.27supervisor, engineers, heating-plant employees, and other maintenance employees, and
3.28associated fringe benefits and payroll taxes.
3.29EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
3.302025, or upon federal approval, whichever is later. The commissioner of human services
3.31shall notify the revisor of statutes when federal approval is obtained.

4.1    Sec. .... Minnesota Statutes 2022, section 256R.02, subdivision 34, is amended to read:
4.2    Subd. 34. Other care-related costs. "Other care-related costs" means the sum of activities
4.3costs, other direct care costs, raw food costs, dietary labor costs, housekeeping labor costs,
4.4laundry labor costs, maintenance and plant operations labor costs, therapy costs, and social
4.5services costs.
4.6EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
4.72025, or upon federal approval, whichever is later. The commissioner of human services
4.8shall notify the revisor of statutes when federal approval is obtained."
4.9Page 77, after line 2, insert:

4.10    "Sec. .... Minnesota Statutes 2022, section 256R.23, subdivision 2, is amended to read:
4.11    Subd. 2. Calculation of direct care cost per standardized day. Each facility's direct
4.12care cost per standardized day is (1) the product of the facility's direct care costs and the
4.13known cost change factor, (2) divided by the sum of the facility's standardized days. A
4.14facility's direct care cost per standardized day is the facility's cost per day for direct care
4.15services associated with a case mix index of 1.00.
4.16EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
4.172025, or upon federal approval, whichever is later. The commissioner of human services
4.18shall notify the revisor of statutes when federal approval is obtained.

4.19    Sec. .... Minnesota Statutes 2022, section 256R.23, subdivision 3, is amended to read:
4.20    Subd. 3. Calculation of other care-related cost per resident day. Each facility's other
4.21care-related cost per resident day is (1) the product of its other care-related costs and the
4.22known cost change factor, (2) divided by the sum of the facility's resident days.
4.23EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
4.242025, or upon federal approval, whichever is later. The commissioner of human services
4.25shall notify the revisor of statutes when federal approval is obtained.

4.26    Sec. .... Minnesota Statutes 2022, section 256R.24, subdivision 1, is amended to read:
4.27    Subdivision 1. Determination of other operating cost per day. Each facility's other
4.28operating cost per day is (1) the product of its other operating costs and the known cost
4.29change factor, (2) divided by the sum of the facility's resident days.
5.1EFFECTIVE DATE.This section is effective for the rate year beginning January 1,
5.22025, or upon federal approval, whichever is later. The commissioner of human services
5.3shall notify the revisor of statutes when federal approval is obtained."
5.4Page 77, line 30, after "is" insert ": (1) the product of" and after the second "costs" insert
5.5"and the known cost change factor; (2)"
5.6Page 78, after line 12, insert:
5.7"EFFECTIVE DATE.This section is effective July 1, 2023, except paragraph (j) is
5.8effective for the rate year beginning January 1, 2025, or upon federal approval, whichever
5.9is later. The commissioner of human services shall notify the revisor of statutes when federal
5.10approval is obtained."
5.11Page 86, after line 13, insert:

5.12    "Sec. .... NURSING FACILITY FUNDING.
5.13(a) Effective July 1, 2023, through December 31, 2025, the total payment rate for all
5.14facilities reimbursed under Minnesota Statutes, chapter 256R, must be increased by $28.65
5.15per resident day.
5.16(b) To be eligible to receive a payment under this section, a nursing facility must attest
5.17to the commissioner of human services that the additional revenue will be used exclusively
5.18to increase compensation-related costs for employees directly employed by the facility on
5.19or after July 1, 2023, excluding:
5.20(1) owners of the building and operation;
5.21(2) persons employed in the central office of an entity that has any ownership interest
5.22in the nursing facility or exercises control over the nursing facility;
5.23(3) persons paid by the nursing facility under a management contract; and
5.24(4) persons providing separately billable services.
5.25(c) Contracted housekeeping, dietary, and laundry employees providing services on site
5.26at the nursing facility are eligible for compensation-related cost increases under this section,
5.27provided the agency that employs them submits to the nursing facility proof of the costs of
5.28the increases provided to those employees.
5.29(d) For purposes of this section, compensation-related costs include:
5.30(1) permanent new increases to wages and salaries implemented on or after July 1, 2023,
5.31and before September 1, 2023, for nursing facility employees;
6.1(2) permanent new increases to wages and salaries implemented on or after July 1, 2023,
6.2and before September 1, 2023, for employees in the organization's shared services
6.3departments of hospital-attached nursing facilities for the nursing facility allocated share
6.4of wages; and
6.5(3) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
6.6taxes, PERA, workers' compensation, and pension and employee retirement accounts directly
6.7associated with the wage and salary increases in clauses (1) and (2) incurred no later than
6.8December 31, 2025, and paid for no later than June 30, 2026.
6.9(e) A facility that receives a rate increase under this section must complete a distribution
6.10plan in the form and manner determined by the commissioner. This plan must specify the
6.11total amount of money the facility is estimated to receive from this rate increase and how
6.12that money will be distributed to increase the allowable compensation-related costs described
6.13in paragraph (d) for employees described in paragraphs (b) and (c). This estimate must be
6.14computed by multiplying $28.65 by the sum of the medical assistance and private pay
6.15resident days as defined in Minnesota Statutes, section 256R.02, subdivision 45, for the
6.16period beginning October 1, 2021, through September 30, 2022, dividing this sum by 365
6.17and multiplying the result by 915. A facility must submit its distribution plan to the
6.18commissioner by October 1, 2023. The commissioner may review the distribution plan to
6.19ensure that the payment rate adjustment per resident day is used in accordance with this
6.20section. The commissioner may allow for a distribution plan amendment under exceptional
6.21circumstances to be determined at the sole discretion of the commissioner.
6.22(f) By September 1, 2023, a facility must post the distribution plan summary and leave
6.23it posted for a period of at least six months in an area of the facility to which all employees
6.24have access. The posted distribution plan summary must be in the form and manner
6.25determined by the commissioner. The distribution plan summary must include instructions
6.26regarding how to contact the commissioner, or the commissioner's representative, if an
6.27employee believes the employee is covered by paragraph (b) or (c) and has not received the
6.28compensation-related increases described in paragraph (d). The instruction to such employees
6.29must include the email address and telephone number that may be used by the employee to
6.30contact the commissioner's representative. The posted distribution plan summary must
6.31demonstrate how the increase in paragraph (a) received by the nursing facility from July 1,
6.322023, through December 1, 2025, will be used in full to pay the compensation-related costs
6.33in paragraph (d) for employees described in paragraphs (b) and (c).
6.34(g) If the nursing facility expends less on new compensation-related costs than the amount
6.35that was made available by the rate increase in this section for that purpose, the amount of
7.1this rate adjustment must be reduced to equal the amount utilized by the facility for purposes
7.2authorized under this section. If the facility fails to post the distribution plan summary in
7.3its facility as required, fails to submit its distribution plan to the commissioner by the due
7.4date, or uses these funds for unauthorized purposes, these rate increases must be treated as
7.5an overpayment and subsequently recovered.
7.6(h) The commissioner shall not treat payments received under this section as an applicable
7.7credit for purposes of setting total payment rates under Minnesota Statutes, chapter 256R.
7.8EFFECTIVE DATE.This section is effective July 1, 2023, or upon federal approval,
7.9whichever is later. The commissioner of human services shall notify the revisor of statutes
7.10when federal approval is obtained."
7.11Page 155, line 17, delete "6,834,184,000" and insert "6,805,053,000" and delete
7.12"7,252,890,000" and insert "7,242,687,000"
7.13Page 155, line 20, delete "6,825,305,000" and insert "6,796,174,000" and delete
7.14"7,247,928,000" and insert "7,237,725,000"
7.15Page 155, line 29, delete "16,057,000" and insert "16,060,000"
7.16Page 156, line 26, delete "14,120,000" and insert "14,495,000" and delete "21,666,000"
7.17and insert "22,095,000"
7.18Page 159, line 20, delete "$6,476,000" and insert "$6,905,000"
7.19Page 159, line 21, delete "$6,378,000" and insert "$6,807,000"
7.20Page 160, line 28, delete "5,654,567,000" and insert "5,705,130,000" and delete
7.21"6,359,586,000" and insert "6,428,463,000"
7.22Page 163, line 31, delete "160,792,000" and insert "136,592,000"
7.23Page 166, delete lines 9 to 16
7.24Reletter the paragraphs in sequence
7.25Page 172, line 16, delete "169,962,000" and insert "151,485,000" and delete
7.26"177,152,000" and insert "150,810,000"
7.27Page 172, line 27, delete "20,386,000" and insert "18,693,000" and delete "21,164,,000"
7.28and insert "18,693,000"
7.29Page 172, line 32, delete "141,020,000" and insert "125,511,000" and delete
7.30"148,513,000" and insert "125,511,000"
8.1Page 172, line 34, delete "115,920,000" and insert "101,672,000" and delete
8.2"121,726,000" and insert "101,672,000"
8.3Page 173, line 2, delete "78,432,000" and insert "72,490,000" and delete "95,098,000"
8.4and insert "87,455,000"
8.5Renumber the sections in sequence and correct the internal references
8.6Amend the title accordingly