Sales and Use Tax - Certificates Indicating Multiple Points of Use - Alterations
HB0933 establishes new financial and reporting requirements for Maryland nursing homes, with a focus on how revenue is spent on direct care staff. The bill requires each nursing home to spend at least 75% of its total nursing and residential care revenue on direct care wages and benefits, defined to include nursing, dietary, restorative therapy, and social worker staff. It also requires annual cost reports to the Maryland Department of Health beginning September 1, 2026, with documentation of wage disbursement and any other information the Department requires, signed under penalty of perjury.
The bill also directs the Department of Health to review cost reports and related data from nursing homes participating in the Maryland Medical Assistance Program, including information on revenues allocated to contracted nursing care services and wages for a broad range of direct care and resident-facing staff. The Department must report its findings to the Governor and legislative committees annually from 2025 through 2029. The law takes effect June 1, 2025, and is codified in the Health – General Article as new Sections 16–209 and 16–210.
HB0933 changes Maryland nursing home regulation by imposing a minimum spending threshold for direct care wages and benefits and by creating a new annual cost-reporting and oversight framework. It gives the Maryland Department of Health enforcement authority to respond to noncompliance, including recoupment of certain reimbursement-rate increases, corrective plans, and suspension or termination from the Medicaid program. The bill affects nursing homes, especially those participating in the Maryland Medical Assistance Program, and expands state oversight of staffing-related expenditures and financial reporting.
The bill appears to have been enacted without recorded committee transcript debate or vote detail in the provided materials, so there is no documented floor or committee controversy in the record supplied here. The statutory design suggests a policy emphasis on improving staffing and transparency in nursing homes, which typically aligns with concerns about resident care quality and workforce compensation. Overall, the available context indicates a generally supportive or at least non-contentious legislative outcome, as the bill was approved by the Governor and became Chapter 733.
The main potential point of contention is the 75% revenue-spending mandate, which could be viewed by nursing home operators as a restrictive financial requirement that limits flexibility in how facilities allocate revenue. Facilities may also object to the breadth of the reporting requirements, the Department’s discretion to require additional information, and the enforcement tools available, especially recoupment and program suspension or termination. On the other hand, advocates for residents, workers, and Medicaid oversight would likely support the bill as a way to ensure more funding reaches direct care staff and to improve accountability for public reimbursement dollars.