On February 10, 2025, the Oklahoma State Legislature introduced Senate Bill 904, a significant piece of legislation aimed at enhancing the quality of care in nursing facilities across the state. The bill seeks to address ongoing concerns regarding resident outcomes and the overall quality of life for individuals in long-term care settings.

The primary focus of Senate Bill 904 is to implement a quality assurance component within the reimbursement framework for nursing facilities. Under the proposed bill, $5.00 per patient day will be allocated for quality assurance, which nursing facilities can earn by meeting specific performance metrics related to resident-centered outcomes. To fund this initiative, the bill stipulates that $2.00 will be deducted from each facility’s per diem rate, supplemented by an additional $3.00 contribution from the state’s Medicaid Authority. This structure aims to incentivize facilities to improve their performance, as payments for achieving these metrics will be treated as an “add back” to their net reimbursement.

The bill outlines a pay-for-performance model, allowing nursing facilities to earn quarterly payments based on their success in achieving four key long-stay quality measures defined by the Centers for Medicare and Medicaid Services (CMS). This approach not only encourages facilities to enhance their care standards but also aligns financial incentives with the quality of care provided to residents.

Debate surrounding Senate Bill 904 has highlighted concerns about the potential impact on nursing facilities, particularly regarding the financial implications of the per diem deductions. Supporters argue that the bill will lead to improved care and better outcomes for residents, while opponents caution that the financial burden could disproportionately affect smaller facilities, potentially leading to staffing shortages or reduced services.

The implications of this legislation are significant. By tying financial incentives to quality metrics, the bill aims to foster a culture of accountability and improvement within Oklahoma’s nursing facilities. Experts suggest that if successfully implemented, this model could serve as a blueprint for other states grappling with similar challenges in long-term care.

As the legislative process unfolds, stakeholders from various sectors, including healthcare providers, advocacy groups, and policymakers, will closely monitor the bill’s progress. The outcome of Senate Bill 904 could reshape the landscape of long-term care in Oklahoma, with potential ripple effects on resident care standards and facility operations statewide.