OFFICE OF THE GOVERNOR

Kentucky Department of Veterans' Affairs

(Amendment)

17 KAR 3:020. Maximum charge for room and care at state veterans’ nursing homes.

      RELATES TO: KRS 40.320, 40.325

      STATUTORY AUTHORITY: KRS 40.325(2)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 40.320 identifies the Commonwealth’s duty to provide for the well-being of elderly and disabled veterans within state veterans’ nursing homes. KRS 40.325(2) authorizes the Department of Veterans’ Affairs to promulgate any administrative regulations necessary to operate the homes in compliance with applicable state and federal statutes and regulations. This administrative regulation establishes the maximum monthly resident charge for room and care at state veterans’ nursing homes.

      Section 1. Definitions. (1) "Daily cost of care" means the total annual expenditures on nursing home operations divided by the total number of resident care days provided by the three (3) nursing homes during the course of the fiscal year.

      (2) "Department" means the Kentucky Department of Veterans’ Affairs.

      (3) "Nursing home" means a state veterans’ nursing home operated by the Kentucky Department of Veterans' Affairs.

      (4) "Resident" means a veteran admitted to a state veterans’ nursing home.

      Section 2. Maximum Monthly Resident Charge. (1) The maximum charge for room and care services at a state veterans’ nursing home shall be $3,700[$3,500] per month, which shall include medical and nonmedical services provided by the nursing home.

      (2) Medical services obtained from sources other than the nursing home may result in a charge from the source of care to the resident. These medical services may include:

      (a) X-ray;

      (b) Dental;

      (c) Optometry;

      (d) Hospitalization;

      (e) Ambulance service;

      (f) Hearing aids;

      (g) Podiatry;

      (h) Specialized medications not on the formulary; and

      (i) Specialty care and equipment.

      (3) The maximum monthly charge shall be revised periodically based on changes that occur which affect the nursing homes’ expenditures or sources of income. These changes may include:

      (a) Increases in the daily cost of care prompted by inflation in the cost of goods, services, and labor utilized to provide nursing care;

      (b) Availability of general funds appropriated to the department by the legislature for operation of the three (3) state veterans’ nursing homes; or

      (c) Changes in the per diem allocated by the U.S. Department of Veterans' Affairs.

      (4) If changes are made to the maximum monthly charge, each affected resident shall be notified in writing at least thirty (30) days prior to the change taking effect. The maximum amount shall not be changed without an amendment to this administrative regulation made in accordance with KRS Chapter 13A.

KENNETH R. LUCAS, Commissioner

      APPROVED BY AGENCY: January 11, 2012

      FILED WITH LRC: January 11, 2012 at 2 p.m.

      PUBLIC HEARING AND PUBLIC COMMENT PERIOD A public hearing on this administrative regulation shall be held on February 22, 2012, at 8:30 a.m., at Kentucky Department of Veterans Affairs, 1111B Louisville Road, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing was received by that date, the hearing may be cancelled. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until February 29, 2012. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.

      CONTACT PERSON: Gilda Hill, Executive Director, Office of Kentucky Veterans Centers, Department of Veterans Affairs, 1111B Louisville Road, Frankfort, Kentucky 40601, phone (502) 564-9281, fax (502) 564-4036.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

Contact Person: Gilda Hill

      (1) Provide a brief summary of:

      (a) What this administrative regulation does: This administrative regulation establishes the maximum monthly charge for room and care services at state veterans’ nursing homes. This maximum charge will be applied uniformly in determining a veteran’s ability to pay for nursing home care in accordance with 17 KAR 3:010.

      (b) The necessity of this administrative regulation: This administrative regulation is necessary in order to ensure that facilities operated by the department maintain the financial ability to care for veterans requiring long term, nursing care services.

      (c) How this administrative regulation conforms to the content of the authorizing statutes: KRS 40.325(2) authorizes the Department of Veterans’ Affairs to promulgate any administrative regulations necessary to operate the homes in compliance with applicable state and federal statutes and regulations. This administrative regulation establishes the maximum charge for room and care services within the state veterans’ nursing homes.

      (d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: This administrative regulation will assist in the effective administration of the statutes by establishing a standardized monthly resident charge throughout the state veterans’ nursing homes.

      (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

      (a) How the amendment will change this existing administrative regulation: This amendment increases the maximum monthly charge to residents from $3500 to $3700.

      (b) The necessity of the amendment to this administrative regulation: It is a regulatory requirement to amend this regulation any time the maximum amount charged is changed. The substantive reason for this change relates to this agency’s current budget and the need to increase the monthly charge in order to ensure skilled nursing care services may be properly funded.

      (c) How the amendment conforms to the content of the authorizing statutes: This amendment complies with the letter of 17 KAR 3:020, requiring an amendment for any change in the monthly rate, and with KRS 40.325(2) which authorizes the Department of Veterans’ Affairs to promulgate any administrative regulations necessary to operate the homes in compliance with applicable state and federal statutes and regulations. This administrative regulation establishes the maximum charge for room and care services within the state veterans’ nursing homes and the amendment legally increases the maximum charge.

      (d) How the amendment will assist in the effective administration of the statutes: This amendment implements the mission of the Kentucky Department of Veterans Affairs as that mission relates to the operation of state veterans’ nursing homes, establishing a uniform maximum charge for residents.

      (3) List the type and number of individuals, businesses, organizations or state and local government affected by this administrative regulation: There are three state-operated facilities affected by this administrative regulation. This administrative regulation primarily affects the 125 veteran residents of department facilities who have the resources to pay the maximum charge for their care.

      (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change if it is an amendment, including:

      (a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: No action will be required on the part of our veteran residents. Staff members of the three state veterans’ nursing homes will be required to update literature and computer systems to reflect the $3,700 per month maximum monthly charge established by this amendment.

      (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): The costs of complying with this administrative regulation will be an additional $200 per month for the 125 residents who pay the current maximum charge of $3,500 per month.

      (c) As a result of compliance, what benefits will accrue to the entities identified in question (3); This administrative regulation will ensure that state operated facilities have sufficient revenues to maintain the high quality of care that is currently provided to all residents regardless of income.

      (5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:

      (a) Initially: Minimal

      (b) On a continuing basis: Minimal

      (6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: Agency funds. The facilities operated by the department will be required to change the charge rates in their billing and record keeping systems.

      (7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation: This administrative regulation increases the maximum charge rate for the three state veterans’ nursing homes. This increase is necessary in order to continue the provision of long term nursing home care at current levels. No increase in funding will be required to implement this administrative regulation because functions of billing and financial recording keeping for state-operated facilities are already in place.

      (8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees: This administrative regulation establishes fees by codifying the existing departmental policy for determining the maximum monthly room and care charge for the state veterans’ nursing homes. Fees are increased by $200 per month for the 125 residents who pay the current maximum charge of $3,700 per month.

      (9) TIERING: Is tiering applied? No tiering was applied in this administrative regulation, as the maximum monthly charge at the three state veterans’ nursing homes is applied uniformly to all veterans in determining their ability to pay for nursing home care in accordance with 17 KAR 3:010.

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

      1. Does this administrative regulation relate to any program, service, or requirements of a state or local government (including cities, counties, fire departments, or school districts)? Yes.

      2. What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? Kentucky Department of Veterans Affairs

      3. Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation. KRS 40.325(2).

      4. Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.

      (a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? $150,000

      (b)How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? $300,000

      (c) How much will it cost to administer this program for the first year? The administrative body through compliance with this administrative regulation incurs no new costs.

      (d) How much will it cost to administer this program for subsequent years? The administrative body through compliance with this administrative regulation incurs no new costs.

      Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.

      Revenues (+/-):

      Expenditures (+/-):

      Other Explanation: