This amendment adds $46.7 million the second year from the general fund and $46.7 million in nongeneral funds and one position to provide an increased payment add-on roughly equivalent to $15 per day in fiscal year 2022. Language directs the Department of Medical Assistance Services to work with appropriate nursing facility stakeholders and the Medicaid CCC Plus managed care organizations to develop a unified, value-based purchasing program that includes enhanced funding for facilities that meet or exceed performance and/or improvement thresholds as developed, reported, and consistently measured by DMAS in cooperation with participating facilities. Priority areas targeted for improvement would be adequate staffing levels and avoidance of negative care events, such as hospital admissions and emergency department visits, among others. The value-based purchasing program would be implemented on July 1, 2022. Funding for the additional position can be accommodated within the agency's existing administrative budget based on turnover and vacancy savings and the reallocation of funding for this program.