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the State may be grouped for competitive review purposes consistent | | with appropriations made available for that purpose by the | | Legislature. A nursing facility project that proposes renovation, | | replacement or other actions that will increase Medicaid costs may | | be approved only if appropriations have been made by the | | Legislature expressly for the purpose of meeting those costs, | | except that the department may approve, without a prior | | appropriation for the express purpose, projects to reopen beds | | previously reserved by a nursing facility through a voluntary | | reduction pursuant to section 333, if the annual total of reopened | | beds approved does not exceed 100. |
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| | | Beginning with all applications pending on January 1, 2003, in | | evaluating whether a project will increase MaineCare expenditures | | for a nursing facility for the purposes of this section, the | | department shall: |
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| | | 1.__Square footage.__Allow gross square footage per licensed | | bed of not less than 500 square feet unless the applicant | | specifies a smaller allowance for the project; and |
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| | | 2.__Replacement of equipment.__Exclude the projected | | incremental cost associated with replacement of equipment. |
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| | | Sec. 2. 22 MRSA §1812-C, sub-§6-A, as enacted by PL 1995, c. 670, Pt. | | B, §1 and affected by Pt. D, §5, is amended to read: |
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| | | 6-A. Shared staffing. The department shall permit staff in | nursing facilities to be shared with other levels of | licensed to provide assisted living on the same premises | | as long as there is a clear, documented audit trail and the | | staffing in the nursing facilities remains adequate to meet the | | needs of residents. Staffing to be shared may be based on the | | average number of hours used per week or month within the | | assisted living program. In a facility licensed to provide | | assisted living services under section 7801 in which 2 or more | | staff are required to be awake and on duty during a night shift, | | one of the staff may be shared with a nursing facility located in | | the same building without prior approval from the department, | | subject to the following provisions. |
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| | | A.__Prior notice must be given to the department. |
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| | | B.__The assisted living program shall maintain its state | | minimum staffing ratio, and the nursing facility shall | | maintain its state minimum staffing ratio and its federal | | licensed nurse staffing requirement. |
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| | | C.__The assisted housing program and the nursing facility shall | | each post a notice informing the public that, although |
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