Section 24: Report on the provision of continuous skilled nursing care

408 words·~2 min read·/ma/part-i/title-ii/chapter-12c/24

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Section 24. The center, in conjunction with MassHealth, shall prepare a biennial report on the provision of continuous skilled nursing care as defined in 101 CMR 361 and 130 CMR 403.402. The report shall include, but not be limited to:

(i)the number of pediatric patients and the number of adult patients requiring continuous skilled nursing care;

(ii)the average and median number of continuous skilled nursing hours authorized by MassHealth per day, week, month and year for pediatric patients and for adult patients;

(iii)the average and median number of authorized continuous skilled nursing hours actually delivered per day, week, month and year for pediatric patients and for adult patients;

(iv)the total number of continuous skilled nursing hours authorized and actually delivered by MassHealth per month and year for pediatric patients and for adult patients;

(v)the number of nurses providing continuous skilled nursing care to more than 1 patient at a time and, for the patients cared for by those nurses, the aggregate proportion of authorized continuous skilled nursing hours to utilized continuous skilled nursing hours;

(vi)the number of nurses who contract with MassHealth to provide continuous skilled nursing care, the number of nurses who provide continuous skilled nursing care through a home health agency that contracts with MassHealth and whether the total number of nurses providing such care is sufficient to fill all authorized continuous skilled nursing hours;

(vii)a description of the training, experience and education levels of the nurses who contract with MassHealth to provide continuous skilled nursing care; and

(viii)an evaluation of the adequacy of the reimbursement rates for continuous skilled nursing care as established in 101 CMR 350.04(2) and a comparison of those rates against:

(A)the rate paid to nurses who contract directly with MassHealth to provide continuous skilled nursing care;

(B)the portion of the reimbursement rate paid directly as wages to nurses providing continuous skilled nursing care through a home health agency that contracts with MassHealth; and

(C)the median wage rate paid to all nurses in the commonwealth.

Not later than January 1 of each even-numbered year, the report shall be filed with the secretary of health and human services, the clerks of the senate and the house of representatives, the joint committee on health care financing, the joint committee on public health and the senate and house committees on ways and means. The center shall make the report publicly available on its website.