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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 SB3006
Introduced 2/4/2010, by Sen. James F. Clayborne, Jr. SYNOPSIS AS INTRODUCED: |
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305 ILCS 5/5-5.4 |
from Ch. 23, par. 5-5.4 |
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Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning standards of payment of skilled
nursing and intermediate care services.
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A BILL FOR
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| AN ACT concerning public aid.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Illinois Public Aid Code is amended by |
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| changing Section 5-5.4 as follows: |
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| (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
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| (Text of Section before amendment by P.A. 96-339 ) |
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| Sec. 5-5.4. Standards of Payment - Department of Healthcare |
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| and Family Services.
The The Department of Healthcare and |
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| Family Services shall develop standards of payment of skilled
|
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| nursing and intermediate care services in facilities providing |
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| such services
under this Article which:
|
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| (1) Provide for the determination of a facility's payment
|
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| for skilled nursing and intermediate care services on a |
15 |
| prospective basis.
The amount of the payment rate for all |
16 |
| nursing facilities certified by the
Department of Public Health |
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| under the Nursing Home Care Act as Intermediate
Care for the |
18 |
| Developmentally Disabled facilities, Long Term Care for Under |
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| Age
22 facilities, Skilled Nursing facilities, or Intermediate |
20 |
| Care facilities
under the
medical assistance program shall be |
21 |
| prospectively established annually on the
basis of historical, |
22 |
| financial, and statistical data reflecting actual costs
from |
23 |
| prior years, which shall be applied to the current rate year |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| and updated
for inflation, except that the capital cost element |
2 |
| for newly constructed
facilities shall be based upon projected |
3 |
| budgets. The annually established
payment rate shall take |
4 |
| effect on July 1 in 1984 and subsequent years. No rate
increase |
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| and no
update for inflation shall be provided on or after July |
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| 1, 1994 and before
July 1, 2010, unless specifically provided |
7 |
| for in this
Section.
The changes made by Public Act 93-841
|
8 |
| extending the duration of the prohibition against a rate |
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| increase or update for inflation are effective retroactive to |
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| July 1, 2004.
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| For facilities licensed by the Department of Public Health |
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| under the Nursing
Home Care Act as Intermediate Care for the |
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| Developmentally Disabled facilities
or Long Term Care for Under |
14 |
| Age 22 facilities, the rates taking effect on July
1, 1998 |
15 |
| shall include an increase of 3%. For facilities licensed by the
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| Department of Public Health under the Nursing Home Care Act as |
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| Skilled Nursing
facilities or Intermediate Care facilities, |
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| the rates taking effect on July 1,
1998 shall include an |
19 |
| increase of 3% plus $1.10 per resident-day, as defined by
the |
20 |
| Department. For facilities licensed by the Department of Public |
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| Health under the Nursing Home Care Act as Intermediate Care |
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| Facilities for the Developmentally Disabled or Long Term Care |
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| for Under Age 22 facilities, the rates taking effect on January |
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| 1, 2006 shall include an increase of 3%.
For facilities |
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| licensed by the Department of Public Health under the Nursing |
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| Home Care Act as Intermediate Care Facilities for the |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| Developmentally Disabled or Long Term Care for Under Age 22 |
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| facilities, the rates taking effect on January 1, 2009 shall |
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| include an increase sufficient to provide a $0.50 per hour wage |
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| increase for non-executive staff.
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| For facilities licensed by the Department of Public Health |
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| under the
Nursing Home Care Act as Intermediate Care for the |
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| Developmentally Disabled
facilities or Long Term Care for Under |
8 |
| Age 22 facilities, the rates taking
effect on July 1, 1999 |
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| shall include an increase of 1.6% plus $3.00 per
resident-day, |
10 |
| as defined by the Department. For facilities licensed by the
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| Department of Public Health under the Nursing Home Care Act as |
12 |
| Skilled Nursing
facilities or Intermediate Care facilities, |
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| the rates taking effect on July 1,
1999 shall include an |
14 |
| increase of 1.6% and, for services provided on or after
October |
15 |
| 1, 1999, shall be increased by $4.00 per resident-day, as |
16 |
| defined by
the Department.
|
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| For facilities licensed by the Department of Public Health |
18 |
| under the
Nursing Home Care Act as Intermediate Care for the |
19 |
| Developmentally Disabled
facilities or Long Term Care for Under |
20 |
| Age 22 facilities, the rates taking
effect on July 1, 2000 |
21 |
| shall include an increase of 2.5% per resident-day,
as defined |
22 |
| by the Department. For facilities licensed by the Department of
|
23 |
| Public Health under the Nursing Home Care Act as Skilled |
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| Nursing facilities or
Intermediate Care facilities, the rates |
25 |
| taking effect on July 1, 2000 shall
include an increase of 2.5% |
26 |
| per resident-day, as defined by the Department.
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| For facilities licensed by the Department of Public Health |
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| under the
Nursing Home Care Act as skilled nursing facilities |
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| or intermediate care
facilities, a new payment methodology must |
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| be implemented for the nursing
component of the rate effective |
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| July 1, 2003. The Department of Public Aid
(now Healthcare and |
6 |
| Family Services) shall develop the new payment methodology |
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| using the Minimum Data Set
(MDS) as the instrument to collect |
8 |
| information concerning nursing home
resident condition |
9 |
| necessary to compute the rate. The Department
shall develop the |
10 |
| new payment methodology to meet the unique needs of
Illinois |
11 |
| nursing home residents while remaining subject to the |
12 |
| appropriations
provided by the General Assembly.
A transition |
13 |
| period from the payment methodology in effect on June 30, 2003
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| to the payment methodology in effect on July 1, 2003 shall be |
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| provided for a
period not exceeding 3 years and 184 days after |
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| implementation of the new payment
methodology as follows:
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| (A) For a facility that would receive a lower
nursing |
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| component rate per patient day under the new system than |
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| the facility
received
effective on the date immediately |
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| preceding the date that the Department
implements the new |
21 |
| payment methodology, the nursing component rate per |
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| patient
day for the facility
shall be held at
the level in |
23 |
| effect on the date immediately preceding the date that the
|
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| Department implements the new payment methodology until a |
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| higher nursing
component rate of
reimbursement is achieved |
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| by that
facility.
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| (B) For a facility that would receive a higher nursing |
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| component rate per
patient day under the payment |
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| methodology in effect on July 1, 2003 than the
facility |
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| received effective on the date immediately preceding the |
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| date that the
Department implements the new payment |
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| methodology, the nursing component rate
per patient day for |
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| the facility shall be adjusted.
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| (C) Notwithstanding paragraphs (A) and (B), the |
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| nursing component rate per
patient day for the facility |
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| shall be adjusted subject to appropriations
provided by the |
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| General Assembly.
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| For facilities licensed by the Department of Public Health |
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| under the
Nursing Home Care Act as Intermediate Care for the |
14 |
| Developmentally Disabled
facilities or Long Term Care for Under |
15 |
| Age 22 facilities, the rates taking
effect on March 1, 2001 |
16 |
| shall include a statewide increase of 7.85%, as
defined by the |
17 |
| Department.
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| Notwithstanding any other provision of this Section, for |
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| facilities licensed by the Department of Public Health under |
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| the
Nursing Home Care Act as skilled nursing facilities or |
21 |
| intermediate care
facilities, the numerator of the ratio used |
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| by the Department of Healthcare and Family Services to compute |
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| the rate payable under this Section using the Minimum Data Set |
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| (MDS) methodology shall incorporate the following annual |
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| amounts as the additional funds appropriated to the Department |
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| specifically to pay for rates based on the MDS nursing |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| component methodology in excess of the funding in effect on |
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| December 31, 2006: |
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| (i) For rates taking effect January 1, 2007, |
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| $60,000,000. |
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| (ii) For rates taking effect January 1, 2008, |
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| $110,000,000. |
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| (iii) For rates taking effect January 1, 2009, |
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| $194,000,000. |
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| Notwithstanding any other provision of this Section, for |
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| facilities licensed by the Department of Public Health under |
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| the Nursing Home Care Act as skilled nursing facilities or |
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| intermediate care facilities, the support component of the |
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| rates taking effect on January 1, 2008 shall be computed using |
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| the most recent cost reports on file with the Department of |
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| Healthcare and Family Services no later than April 1, 2005, |
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| updated for inflation to January 1, 2006. |
17 |
| For facilities licensed by the Department of Public Health |
18 |
| under the
Nursing Home Care Act as Intermediate Care for the |
19 |
| Developmentally Disabled
facilities or Long Term Care for Under |
20 |
| Age 22 facilities, the rates taking
effect on April 1, 2002 |
21 |
| shall include a statewide increase of 2.0%, as
defined by the |
22 |
| Department.
This increase terminates on July 1, 2002;
beginning |
23 |
| July 1, 2002 these rates are reduced to the level of the rates
|
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| in effect on March 31, 2002, as defined by the Department.
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| For facilities licensed by the Department of Public Health |
26 |
| under the
Nursing Home Care Act as skilled nursing facilities |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| or intermediate care
facilities, the rates taking effect on |
2 |
| July 1, 2001 shall be computed using the most recent cost |
3 |
| reports
on file with the Department of Public Aid no later than |
4 |
| April 1, 2000,
updated for inflation to January 1, 2001. For |
5 |
| rates effective July 1, 2001
only, rates shall be the greater |
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| of the rate computed for July 1, 2001
or the rate effective on |
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| June 30, 2001.
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| Notwithstanding any other provision of this Section, for |
9 |
| facilities
licensed by the Department of Public Health under |
10 |
| the Nursing Home Care Act
as skilled nursing facilities or |
11 |
| intermediate care facilities, the Illinois
Department shall |
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| determine by rule the rates taking effect on July 1, 2002,
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| which shall be 5.9% less than the rates in effect on June 30, |
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| 2002.
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| Notwithstanding any other provision of this Section, for |
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| facilities
licensed by the Department of Public Health under |
17 |
| the Nursing Home Care Act as
skilled nursing
facilities or |
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| intermediate care facilities, if the payment methodologies |
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| required under Section 5A-12 and the waiver granted under 42 |
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| CFR 433.68 are approved by the United States Centers for |
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| Medicare and Medicaid Services, the rates taking effect on July |
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| 1, 2004 shall be 3.0% greater than the rates in effect on June |
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| 30, 2004. These rates shall take
effect only upon approval and
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| implementation of the payment methodologies required under |
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| Section 5A-12.
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| Notwithstanding any other provisions of this Section, for |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| facilities licensed by the Department of Public Health under |
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| the Nursing Home Care Act as skilled nursing facilities or |
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| intermediate care facilities, the rates taking effect on |
4 |
| January 1, 2005 shall be 3% more than the rates in effect on |
5 |
| December 31, 2004.
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| Notwithstanding any other provision of this Section, for |
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| facilities licensed by the Department of Public Health under |
8 |
| the Nursing Home Care Act as skilled nursing facilities or |
9 |
| intermediate care facilities, effective January 1, 2009, the |
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| per diem support component of the rates effective on January 1, |
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| 2008, computed using the most recent cost reports on file with |
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| the Department of Healthcare and Family Services no later than |
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| April 1, 2005, updated for inflation to January 1, 2006, shall |
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| be increased to the amount that would have been derived using |
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| standard Department of Healthcare and Family Services methods, |
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| procedures, and inflators. |
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| Notwithstanding any other provisions of this Section, for |
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| facilities licensed by the Department of Public Health under |
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| the Nursing Home Care Act as intermediate care facilities that |
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| are federally defined as Institutions for Mental Disease, a |
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| socio-development component rate equal to 6.6% of the |
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| facility's nursing component rate as of January 1, 2006 shall |
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| be established and paid effective July 1, 2006. The |
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| socio-development component of the rate shall be increased by a |
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| factor of 2.53 on the first day of the month that begins at |
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| least 45 days after January 11, 2008 (the effective date of |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| Public Act 95-707). As of August 1, 2008, the socio-development |
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| component rate shall be equal to 6.6% of the facility's nursing |
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| component rate as of January 1, 2006, multiplied by a factor of |
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| 3.53. The Illinois Department may by rule adjust these |
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| socio-development component rates, but in no case may such |
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| rates be diminished.
|
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| For facilities
licensed
by the
Department of Public Health |
8 |
| under the Nursing Home Care Act as Intermediate
Care for
the |
9 |
| Developmentally Disabled facilities or as long-term care |
10 |
| facilities for
residents under 22 years of age, the rates |
11 |
| taking effect on July 1,
2003 shall
include a statewide |
12 |
| increase of 4%, as defined by the Department.
|
13 |
| For facilities licensed by the Department of Public Health |
14 |
| under the
Nursing Home Care Act as Intermediate Care for the |
15 |
| Developmentally Disabled
facilities or Long Term Care for Under |
16 |
| Age 22 facilities, the rates taking
effect on the first day of |
17 |
| the month that begins at least 45 days after the effective date |
18 |
| of this amendatory Act of the 95th General Assembly shall |
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| include a statewide increase of 2.5%, as
defined by the |
20 |
| Department. |
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| Notwithstanding any other provision of this Section, for |
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| facilities licensed by the Department of Public Health under |
23 |
| the Nursing Home Care Act as skilled nursing facilities or |
24 |
| intermediate care facilities, effective January 1, 2005, |
25 |
| facility rates shall be increased by the difference between (i) |
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| a facility's per diem property, liability, and malpractice |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| insurance costs as reported in the cost report filed with the |
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| Department of Public Aid and used to establish rates effective |
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| July 1, 2001 and (ii) those same costs as reported in the |
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| facility's 2002 cost report. These costs shall be passed |
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| through to the facility without caps or limitations, except for |
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| adjustments required under normal auditing procedures.
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| Rates established effective each July 1 shall govern |
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| payment
for services rendered throughout that fiscal year, |
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| except that rates
established on July 1, 1996 shall be |
10 |
| increased by 6.8% for services
provided on or after January 1, |
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| 1997. Such rates will be based
upon the rates calculated for |
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| the year beginning July 1, 1990, and for
subsequent years |
13 |
| thereafter until June 30, 2001 shall be based on the
facility |
14 |
| cost reports
for the facility fiscal year ending at any point |
15 |
| in time during the previous
calendar year, updated to the |
16 |
| midpoint of the rate year. The cost report
shall be on file |
17 |
| with the Department no later than April 1 of the current
rate |
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| year. Should the cost report not be on file by April 1, the |
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| Department
shall base the rate on the latest cost report filed |
20 |
| by each skilled care
facility and intermediate care facility, |
21 |
| updated to the midpoint of the
current rate year. In |
22 |
| determining rates for services rendered on and after
July 1, |
23 |
| 1985, fixed time shall not be computed at less than zero. The
|
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| Department shall not make any alterations of regulations which |
25 |
| would reduce
any component of the Medicaid rate to a level |
26 |
| below what that component would
have been utilizing in the rate |
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SB3006 |
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LRB096 19183 KTG 34574 b |
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| effective on July 1, 1984.
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| (2) Shall take into account the actual costs incurred by |
3 |
| facilities
in providing services for recipients of skilled |
4 |
| nursing and intermediate
care services under the medical |
5 |
| assistance program.
|
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| (3) Shall take into account the medical and psycho-social
|
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| characteristics and needs of the patients.
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| (4) Shall take into account the actual costs incurred by |
9 |
| facilities in
meeting licensing and certification standards |
10 |
| imposed and prescribed by the
State of Illinois, any of its |
11 |
| political subdivisions or municipalities and by
the U.S. |
12 |
| Department of Health and Human Services pursuant to Title XIX |
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| of the
Social Security Act.
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| The Department of Healthcare and Family Services
shall |
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| develop precise standards for
payments to reimburse nursing |
16 |
| facilities for any utilization of
appropriate rehabilitative |
17 |
| personnel for the provision of rehabilitative
services which is |
18 |
| authorized by federal regulations, including
reimbursement for |
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| services provided by qualified therapists or qualified
|
20 |
| assistants, and which is in accordance with accepted |
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| professional
practices. Reimbursement also may be made for |
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| utilization of other
supportive personnel under appropriate |
23 |
| supervision.
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| (Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707, |
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| eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09.) |
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SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| (Text of Section after amendment by P.A. 96-339 ) |
2 |
| Sec. 5-5.4. Standards of Payment - Department of Healthcare |
3 |
| and Family Services.
The The Department of Healthcare and |
4 |
| Family Services shall develop standards of payment of skilled
|
5 |
| nursing and intermediate care services in facilities providing |
6 |
| such services
under this Article which:
|
7 |
| (1) Provide for the determination of a facility's payment
|
8 |
| for skilled nursing and intermediate care services on a |
9 |
| prospective basis.
The amount of the payment rate for all |
10 |
| nursing facilities certified by the
Department of Public Health |
11 |
| under the MR/DD Community Care Act or the Nursing Home Care Act |
12 |
| as Intermediate
Care for the Developmentally Disabled |
13 |
| facilities, Long Term Care for Under Age
22 facilities, Skilled |
14 |
| Nursing facilities, or Intermediate Care facilities
under the
|
15 |
| medical assistance program shall be prospectively established |
16 |
| annually on the
basis of historical, financial, and statistical |
17 |
| data reflecting actual costs
from prior years, which shall be |
18 |
| applied to the current rate year and updated
for inflation, |
19 |
| except that the capital cost element for newly constructed
|
20 |
| facilities shall be based upon projected budgets. The annually |
21 |
| established
payment rate shall take effect on July 1 in 1984 |
22 |
| and subsequent years. No rate
increase and no
update for |
23 |
| inflation shall be provided on or after July 1, 1994 and before
|
24 |
| July 1, 2010, unless specifically provided for in this
Section.
|
25 |
| The changes made by Public Act 93-841
extending the duration of |
26 |
| the prohibition against a rate increase or update for inflation |
|
|
|
SB3006 |
- 13 - |
LRB096 19183 KTG 34574 b |
|
|
1 |
| are effective retroactive to July 1, 2004.
|
2 |
| For facilities licensed by the Department of Public Health |
3 |
| under the Nursing
Home Care Act as Intermediate Care for the |
4 |
| Developmentally Disabled facilities
or Long Term Care for Under |
5 |
| Age 22 facilities, the rates taking effect on July
1, 1998 |
6 |
| shall include an increase of 3%. For facilities licensed by the
|
7 |
| Department of Public Health under the Nursing Home Care Act as |
8 |
| Skilled Nursing
facilities or Intermediate Care facilities, |
9 |
| the rates taking effect on July 1,
1998 shall include an |
10 |
| increase of 3% plus $1.10 per resident-day, as defined by
the |
11 |
| Department. For facilities licensed by the Department of Public |
12 |
| Health under the Nursing Home Care Act as Intermediate Care |
13 |
| Facilities for the Developmentally Disabled or Long Term Care |
14 |
| for Under Age 22 facilities, the rates taking effect on January |
15 |
| 1, 2006 shall include an increase of 3%.
For facilities |
16 |
| licensed by the Department of Public Health under the Nursing |
17 |
| Home Care Act as Intermediate Care Facilities for the |
18 |
| Developmentally Disabled or Long Term Care for Under Age 22 |
19 |
| facilities, the rates taking effect on January 1, 2009 shall |
20 |
| include an increase sufficient to provide a $0.50 per hour wage |
21 |
| increase for non-executive staff.
|
22 |
| For facilities licensed by the Department of Public Health |
23 |
| under the
Nursing Home Care Act as Intermediate Care for the |
24 |
| Developmentally Disabled
facilities or Long Term Care for Under |
25 |
| Age 22 facilities, the rates taking
effect on July 1, 1999 |
26 |
| shall include an increase of 1.6% plus $3.00 per
resident-day, |
|
|
|
SB3006 |
- 14 - |
LRB096 19183 KTG 34574 b |
|
|
1 |
| as defined by the Department. For facilities licensed by the
|
2 |
| Department of Public Health under the Nursing Home Care Act as |
3 |
| Skilled Nursing
facilities or Intermediate Care facilities, |
4 |
| the rates taking effect on July 1,
1999 shall include an |
5 |
| increase of 1.6% and, for services provided on or after
October |
6 |
| 1, 1999, shall be increased by $4.00 per resident-day, as |
7 |
| defined by
the Department.
|
8 |
| For facilities licensed by the Department of Public Health |
9 |
| under the
Nursing Home Care Act as Intermediate Care for the |
10 |
| Developmentally Disabled
facilities or Long Term Care for Under |
11 |
| Age 22 facilities, the rates taking
effect on July 1, 2000 |
12 |
| shall include an increase of 2.5% per resident-day,
as defined |
13 |
| by the Department. For facilities licensed by the Department of
|
14 |
| Public Health under the Nursing Home Care Act as Skilled |
15 |
| Nursing facilities or
Intermediate Care facilities, the rates |
16 |
| taking effect on July 1, 2000 shall
include an increase of 2.5% |
17 |
| per resident-day, as defined by the Department.
|
18 |
| For facilities licensed by the Department of Public Health |
19 |
| under the
Nursing Home Care Act as skilled nursing facilities |
20 |
| or intermediate care
facilities, a new payment methodology must |
21 |
| be implemented for the nursing
component of the rate effective |
22 |
| July 1, 2003. The Department of Public Aid
(now Healthcare and |
23 |
| Family Services) shall develop the new payment methodology |
24 |
| using the Minimum Data Set
(MDS) as the instrument to collect |
25 |
| information concerning nursing home
resident condition |
26 |
| necessary to compute the rate. The Department
shall develop the |
|
|
|
SB3006 |
- 15 - |
LRB096 19183 KTG 34574 b |
|
|
1 |
| new payment methodology to meet the unique needs of
Illinois |
2 |
| nursing home residents while remaining subject to the |
3 |
| appropriations
provided by the General Assembly.
A transition |
4 |
| period from the payment methodology in effect on June 30, 2003
|
5 |
| to the payment methodology in effect on July 1, 2003 shall be |
6 |
| provided for a
period not exceeding 3 years and 184 days after |
7 |
| implementation of the new payment
methodology as follows:
|
8 |
| (A) For a facility that would receive a lower
nursing |
9 |
| component rate per patient day under the new system than |
10 |
| the facility
received
effective on the date immediately |
11 |
| preceding the date that the Department
implements the new |
12 |
| payment methodology, the nursing component rate per |
13 |
| patient
day for the facility
shall be held at
the level in |
14 |
| effect on the date immediately preceding the date that the
|
15 |
| Department implements the new payment methodology until a |
16 |
| higher nursing
component rate of
reimbursement is achieved |
17 |
| by that
facility.
|
18 |
| (B) For a facility that would receive a higher nursing |
19 |
| component rate per
patient day under the payment |
20 |
| methodology in effect on July 1, 2003 than the
facility |
21 |
| received effective on the date immediately preceding the |
22 |
| date that the
Department implements the new payment |
23 |
| methodology, the nursing component rate
per patient day for |
24 |
| the facility shall be adjusted.
|
25 |
| (C) Notwithstanding paragraphs (A) and (B), the |
26 |
| nursing component rate per
patient day for the facility |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| shall be adjusted subject to appropriations
provided by the |
2 |
| General Assembly.
|
3 |
| For facilities licensed by the Department of Public Health |
4 |
| under the
Nursing Home Care Act as Intermediate Care for the |
5 |
| Developmentally Disabled
facilities or Long Term Care for Under |
6 |
| Age 22 facilities, the rates taking
effect on March 1, 2001 |
7 |
| shall include a statewide increase of 7.85%, as
defined by the |
8 |
| Department.
|
9 |
| Notwithstanding any other provision of this Section, for |
10 |
| facilities licensed by the Department of Public Health under |
11 |
| the
Nursing Home Care Act as skilled nursing facilities or |
12 |
| intermediate care
facilities, the numerator of the ratio used |
13 |
| by the Department of Healthcare and Family Services to compute |
14 |
| the rate payable under this Section using the Minimum Data Set |
15 |
| (MDS) methodology shall incorporate the following annual |
16 |
| amounts as the additional funds appropriated to the Department |
17 |
| specifically to pay for rates based on the MDS nursing |
18 |
| component methodology in excess of the funding in effect on |
19 |
| December 31, 2006: |
20 |
| (i) For rates taking effect January 1, 2007, |
21 |
| $60,000,000. |
22 |
| (ii) For rates taking effect January 1, 2008, |
23 |
| $110,000,000. |
24 |
| (iii) For rates taking effect January 1, 2009, |
25 |
| $194,000,000. |
26 |
| Notwithstanding any other provision of this Section, for |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| facilities licensed by the Department of Public Health under |
2 |
| the Nursing Home Care Act as skilled nursing facilities or |
3 |
| intermediate care facilities, the support component of the |
4 |
| rates taking effect on January 1, 2008 shall be computed using |
5 |
| the most recent cost reports on file with the Department of |
6 |
| Healthcare and Family Services no later than April 1, 2005, |
7 |
| updated for inflation to January 1, 2006. |
8 |
| For facilities licensed by the Department of Public Health |
9 |
| under the
Nursing Home Care Act as Intermediate Care for the |
10 |
| Developmentally Disabled
facilities or Long Term Care for Under |
11 |
| Age 22 facilities, the rates taking
effect on April 1, 2002 |
12 |
| shall include a statewide increase of 2.0%, as
defined by the |
13 |
| Department.
This increase terminates on July 1, 2002;
beginning |
14 |
| July 1, 2002 these rates are reduced to the level of the rates
|
15 |
| in effect on March 31, 2002, as defined by the Department.
|
16 |
| For facilities licensed by the Department of Public Health |
17 |
| under the
Nursing Home Care Act as skilled nursing facilities |
18 |
| or intermediate care
facilities, the rates taking effect on |
19 |
| July 1, 2001 shall be computed using the most recent cost |
20 |
| reports
on file with the Department of Public Aid no later than |
21 |
| April 1, 2000,
updated for inflation to January 1, 2001. For |
22 |
| rates effective July 1, 2001
only, rates shall be the greater |
23 |
| of the rate computed for July 1, 2001
or the rate effective on |
24 |
| June 30, 2001.
|
25 |
| Notwithstanding any other provision of this Section, for |
26 |
| facilities
licensed by the Department of Public Health under |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| the Nursing Home Care Act
as skilled nursing facilities or |
2 |
| intermediate care facilities, the Illinois
Department shall |
3 |
| determine by rule the rates taking effect on July 1, 2002,
|
4 |
| which shall be 5.9% less than the rates in effect on June 30, |
5 |
| 2002.
|
6 |
| Notwithstanding any other provision of this Section, for |
7 |
| facilities
licensed by the Department of Public Health under |
8 |
| the Nursing Home Care Act as
skilled nursing
facilities or |
9 |
| intermediate care facilities, if the payment methodologies |
10 |
| required under Section 5A-12 and the waiver granted under 42 |
11 |
| CFR 433.68 are approved by the United States Centers for |
12 |
| Medicare and Medicaid Services, the rates taking effect on July |
13 |
| 1, 2004 shall be 3.0% greater than the rates in effect on June |
14 |
| 30, 2004. These rates shall take
effect only upon approval and
|
15 |
| implementation of the payment methodologies required under |
16 |
| Section 5A-12.
|
17 |
| Notwithstanding any other provisions of this Section, for |
18 |
| facilities licensed by the Department of Public Health under |
19 |
| the Nursing Home Care Act as skilled nursing facilities or |
20 |
| intermediate care facilities, the rates taking effect on |
21 |
| January 1, 2005 shall be 3% more than the rates in effect on |
22 |
| December 31, 2004.
|
23 |
| Notwithstanding any other provision of this Section, for |
24 |
| facilities licensed by the Department of Public Health under |
25 |
| the Nursing Home Care Act as skilled nursing facilities or |
26 |
| intermediate care facilities, effective January 1, 2009, the |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| per diem support component of the rates effective on January 1, |
2 |
| 2008, computed using the most recent cost reports on file with |
3 |
| the Department of Healthcare and Family Services no later than |
4 |
| April 1, 2005, updated for inflation to January 1, 2006, shall |
5 |
| be increased to the amount that would have been derived using |
6 |
| standard Department of Healthcare and Family Services methods, |
7 |
| procedures, and inflators. |
8 |
| Notwithstanding any other provisions of this Section, for |
9 |
| facilities licensed by the Department of Public Health under |
10 |
| the Nursing Home Care Act as intermediate care facilities that |
11 |
| are federally defined as Institutions for Mental Disease, a |
12 |
| socio-development component rate equal to 6.6% of the |
13 |
| facility's nursing component rate as of January 1, 2006 shall |
14 |
| be established and paid effective July 1, 2006. The |
15 |
| socio-development component of the rate shall be increased by a |
16 |
| factor of 2.53 on the first day of the month that begins at |
17 |
| least 45 days after January 11, 2008 (the effective date of |
18 |
| Public Act 95-707). As of August 1, 2008, the socio-development |
19 |
| component rate shall be equal to 6.6% of the facility's nursing |
20 |
| component rate as of January 1, 2006, multiplied by a factor of |
21 |
| 3.53. The Illinois Department may by rule adjust these |
22 |
| socio-development component rates, but in no case may such |
23 |
| rates be diminished.
|
24 |
| For facilities
licensed
by the
Department of Public Health |
25 |
| under the Nursing Home Care Act as Intermediate
Care for
the |
26 |
| Developmentally Disabled facilities or as long-term care |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
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|
1 |
| facilities for
residents under 22 years of age, the rates |
2 |
| taking effect on July 1,
2003 shall
include a statewide |
3 |
| increase of 4%, as defined by the Department.
|
4 |
| For facilities licensed by the Department of Public Health |
5 |
| under the
Nursing Home Care Act as Intermediate Care for the |
6 |
| Developmentally Disabled
facilities or Long Term Care for Under |
7 |
| Age 22 facilities, the rates taking
effect on the first day of |
8 |
| the month that begins at least 45 days after the effective date |
9 |
| of this amendatory Act of the 95th General Assembly shall |
10 |
| include a statewide increase of 2.5%, as
defined by the |
11 |
| Department. |
12 |
| Notwithstanding any other provision of this Section, for |
13 |
| facilities licensed by the Department of Public Health under |
14 |
| the Nursing Home Care Act as skilled nursing facilities or |
15 |
| intermediate care facilities, effective January 1, 2005, |
16 |
| facility rates shall be increased by the difference between (i) |
17 |
| a facility's per diem property, liability, and malpractice |
18 |
| insurance costs as reported in the cost report filed with the |
19 |
| Department of Public Aid and used to establish rates effective |
20 |
| July 1, 2001 and (ii) those same costs as reported in the |
21 |
| facility's 2002 cost report. These costs shall be passed |
22 |
| through to the facility without caps or limitations, except for |
23 |
| adjustments required under normal auditing procedures.
|
24 |
| Rates established effective each July 1 shall govern |
25 |
| payment
for services rendered throughout that fiscal year, |
26 |
| except that rates
established on July 1, 1996 shall be |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| increased by 6.8% for services
provided on or after January 1, |
2 |
| 1997. Such rates will be based
upon the rates calculated for |
3 |
| the year beginning July 1, 1990, and for
subsequent years |
4 |
| thereafter until June 30, 2001 shall be based on the
facility |
5 |
| cost reports
for the facility fiscal year ending at any point |
6 |
| in time during the previous
calendar year, updated to the |
7 |
| midpoint of the rate year. The cost report
shall be on file |
8 |
| with the Department no later than April 1 of the current
rate |
9 |
| year. Should the cost report not be on file by April 1, the |
10 |
| Department
shall base the rate on the latest cost report filed |
11 |
| by each skilled care
facility and intermediate care facility, |
12 |
| updated to the midpoint of the
current rate year. In |
13 |
| determining rates for services rendered on and after
July 1, |
14 |
| 1985, fixed time shall not be computed at less than zero. The
|
15 |
| Department shall not make any alterations of regulations which |
16 |
| would reduce
any component of the Medicaid rate to a level |
17 |
| below what that component would
have been utilizing in the rate |
18 |
| effective on July 1, 1984.
|
19 |
| (2) Shall take into account the actual costs incurred by |
20 |
| facilities
in providing services for recipients of skilled |
21 |
| nursing and intermediate
care services under the medical |
22 |
| assistance program.
|
23 |
| (3) Shall take into account the medical and psycho-social
|
24 |
| characteristics and needs of the patients.
|
25 |
| (4) Shall take into account the actual costs incurred by |
26 |
| facilities in
meeting licensing and certification standards |
|
|
|
SB3006 |
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LRB096 19183 KTG 34574 b |
|
|
1 |
| imposed and prescribed by the
State of Illinois, any of its |
2 |
| political subdivisions or municipalities and by
the U.S. |
3 |
| Department of Health and Human Services pursuant to Title XIX |
4 |
| of the
Social Security Act.
|
5 |
| The Department of Healthcare and Family Services
shall |
6 |
| develop precise standards for
payments to reimburse nursing |
7 |
| facilities for any utilization of
appropriate rehabilitative |
8 |
| personnel for the provision of rehabilitative
services which is |
9 |
| authorized by federal regulations, including
reimbursement for |
10 |
| services provided by qualified therapists or qualified
|
11 |
| assistants, and which is in accordance with accepted |
12 |
| professional
practices. Reimbursement also may be made for |
13 |
| utilization of other
supportive personnel under appropriate |
14 |
| supervision.
|
15 |
| (Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707, |
16 |
| eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09; |
17 |
| 96-339, eff. 7-1-10; revised 10-23-09.)
|
18 |
| Section 95. No acceleration or delay. Where this Act makes |
19 |
| changes in a statute that is represented in this Act by text |
20 |
| that is not yet or no longer in effect (for example, a Section |
21 |
| represented by multiple versions), the use of that text does |
22 |
| not accelerate or delay the taking effect of (i) the changes |
23 |
| made by this Act or (ii) provisions derived from any other |
24 |
| Public Act.
|