(a) The staffing standards as set forth in § 20-10-1403 are to be construed as nursing facility staffing standards above the 1989 standards established by the Office of Long-Term Care.

(b)

(1) If the Director of the Department of Human Services determines that the reimbursement methodology or available funding is insufficient or unable to pay for the minimum staffing standards under § 20-10-1403, the office, by regulation, may modify the requirements of § 20-10-1403 to ensure minimum staffing funds.

(2) If the Director of the Office of Long-Term Care determines that the minimum staffing standards under § 20-10-1403 or § 20-10-1404 have become insufficient at any time to ensure the health, safety, or welfare of nursing facility residents, by regulation, the office may increase minimum staffing standards or otherwise promulgate regulations to ensure the health, safety, or welfare of the nursing facility residents.

(c) (1) (A) If the Director of the Office of Long-Term Care determines that minimum staffing standards should be increased pursuant to subdivision (b)(2) of this section, the Director of the Office of Long-Term Care shall certify the determination and any proposed regulatory increases to minimum staffing standards to the Director of the Division of Medical Services of the Department of Human Services, who shall notify the Director of the Department of Human Services and the Legislative Council of the determination and whether sufficient appropriated funds exist to fund the costs to be incurred by the proposed changes to the minimum staffing standards.

(B) As used in this subsection, "costs" means direct-care costs as defined in the Centers for Medicare & Medicaid Services Provider Reimbursement Manual as in effect January 12, 2001.

(2) In no event shall minimum staffing standards be increased unless sufficient appropriated funds exist to fund the costs to be incurred by the proposed increases to minimum staffing standards.