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(305 ILCS 5/5-1.1)
(from Ch. 23, par. 5-1.1)
The terms defined in this Section
shall have the meanings ascribed to them, except when the
context otherwise requires.
(a) "Nursing facility" means a facility, licensed by the Department of Public Health under the Nursing Home Care Act, that provides nursing facility services within the meaning of Title XIX of
the federal Social Security Act.
(b) "Intermediate care facility for persons with developmental disabilities" or "ICF/DD" means a facility, licensed by the Department of Public Health under the ID/DD Community Care Act, that is an intermediate care facility for the mentally retarded within the meaning of Title XIX
of the federal Social Security Act.
(c) "Standard services" means those services required for
the care of all patients in the facility and shall, as a
minimum, include the following: (1) administration; (2)
dietary (standard); (3) housekeeping; (4) laundry and linen;
(5) maintenance of property and equipment, including utilities;
(6) medical records; (7) training of employees; (8) utilization
review; (9) activities services; (10) social services; (11)
disability services; and all other similar services required
by either the laws of the State of Illinois or one of its
political subdivisions or municipalities or by Title XIX of
the Social Security Act.
(d) "Patient services" means those which vary with the
number of personnel; professional and para-professional
skills of the personnel; specialized equipment, and reflect
the intensity of the medical and psycho-social needs of the
patients. Patient services shall as a minimum include:
(1) physical services; (2) nursing services, including
restorative nursing; (3) medical direction and patient care
planning; (4) health related supportive and habilitative
services and all similar services required by either the
laws of the State of Illinois or one of its political
subdivisions or municipalities or by Title XIX of the
Social Security Act.
(e) "Ancillary services" means those services which
require a specific physician's order and defined as under
the medical assistance program as not being routine in
nature for skilled nursing facilities and ICF/DDs.
Such services generally must be authorized prior to delivery
and payment as provided for under the rules of the Department
of Healthcare and Family Services.
(f) "Capital" means the investment in a facility's assets
for both debt and non-debt funds. Non-debt capital is the
difference between an adjusted replacement value of the assets
and the actual amount of debt capital.
(g) "Profit" means the amount which shall accrue to a
facility as a result of its revenues exceeding its expenses
as determined in accordance with generally accepted accounting
(h) "Non-institutional services" means those services provided under
paragraph (f) of Section 3 of the Rehabilitation of Persons with Disabilities Act and those services provided under Section 4.02 of the Illinois Act on the Aging.
(j) "Institutionalized person" means an individual who is an inpatient
in an ICF/DD or nursing facility, or who is an inpatient in
institution receiving a level of care equivalent to that of an ICF/DD or nursing facility, or who is receiving services under
Section 1915(c) of the Social Security Act.
(k) "Institutionalized spouse" means an institutionalized person who is
expected to receive services at the same level of care for at least 30 days
and is married to a spouse who is not an institutionalized person.
(l) "Community spouse" is the spouse of an institutionalized spouse.
(m) "Health Benefits Service Package" means, subject to federal approval, benefits covered by the medical assistance program as determined by the Department by rule for individuals eligible for medical assistance under paragraph 18 of Section 5-2 of this Code.
(n) "Federal poverty level" means the poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services. These guidelines set poverty levels by family size.
(Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15.)