Relating to nursing facility revenue requirements

This bill relates to nursing facility revenue requirements. Beginning January 1, 2026, the bill prohibits the department of inspections, appeals, and licensing (DIAL) from approving a new license or renewing a license for a nursing facility unless the nursing facility spends a certain percentage of the nursing facility’s gross revenue for the immediately preceding calendar year on goods and services directly related to resident care as detailed in the bill, and remits the nursing facility’s gross revenue in excess of 105 percent of its expenditures to DIAL. The bill creates an aging Iowans care fund (fund) and requires DIAL to deposit all moneys received under the bill into the fund. The general assembly may appropriate moneys from the fund as the general assembly deems appropriate. The bill allows a nursing facility to apply with DIAL and the office of the long-term care ombudsman (ombudsman) for a waiver of the bill’s requirements due to an unexpected or exceptional circumstance which prevents the nursing facility from complying with the bill (exceptional circumstances). The bill requires DIAL and the ombudsman to make a determination if exceptional circumstances exist as alleged by the nursing facility. If both DIAL and the ombudsman determine exceptional circumstances exist, DIAL must grant the nursing facility a waiver of the bill’s requirements to the extent the exceptional circumstances prevented the nursing facility’s compliance. If DIAL, the ombudsman, or both, determine that exceptional circumstances do not exist, DIAL shall not grant a waiver to the nursing facility. The bill requires DIAL to adopt rules to implement the bill.