HB0011sam001 98TH GENERAL ASSEMBLY

Sen. Jacqueline Y. Collins

Filed: 5/8/2013

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 11

2    AMENDMENT NO. ______. Amend House Bill 11 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Nursing Home Care Act is amended by
5changing Section 3-202.05 as follows:
 
6    (210 ILCS 45/3-202.05)
7    Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
8thereafter.
9    (a) For the purpose of computing staff to resident ratios,
10direct care staff shall include:
11        (1) registered nurses;
12        (2) licensed practical nurses;
13        (3) certified nurse assistants;
14        (4) psychiatric services rehabilitation aides;
15        (5) rehabilitation and therapy aides;
16        (6) psychiatric services rehabilitation coordinators;

 

 

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1        (7) assistant directors of nursing;
2        (8) 50% of the Director of Nurses' time; and
3        (9) 30% of the Social Services Directors' time.
4    The Department shall, by rule, allow certain facilities
5subject to 77 Ill. Admin. Code 300.4000 and following (Subpart
6S) to utilize specialized clinical staff, as defined in rules,
7to count towards the staffing ratios.
8    Within 120 days of the effective date of this amendatory
9Act of the 97th General Assembly, the Department shall
10promulgate rules specific to the staffing requirements for
11facilities federally defined as Institutions for Mental
12Disease. These rules shall recognize the unique nature of
13individuals with chronic mental health conditions, shall
14include minimum requirements for specialized clinical staff,
15including clinical social workers, psychiatrists,
16psychologists, and direct care staff set forth in paragraphs
17(4) through (6) and any other specialized staff which may be
18utilized and deemed necessary to count toward staffing ratios.
19    Within 120 days of the effective date of this amendatory
20Act of the 97th General Assembly, the Department shall
21promulgate rules specific to the staffing requirements for
22facilities licensed under the Specialized Mental Health
23Rehabilitation Act. These rules shall recognize the unique
24nature of individuals with chronic mental health conditions,
25shall include minimum requirements for specialized clinical
26staff, including clinical social workers, psychiatrists,

 

 

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1psychologists, and direct care staff set forth in paragraphs
2(4) through (6) and any other specialized staff which may be
3utilized and deemed necessary to count toward staffing ratios.
4    (b) Beginning January 1, 2011, and thereafter, light
5intermediate care shall be staffed at the same staffing ratio
6as intermediate care.
7    (c) Facilities shall notify the Department within 60 days
8after the effective date of this amendatory Act of the 96th
9General Assembly, in a form and manner prescribed by the
10Department, of the staffing ratios in effect on the effective
11date of this amendatory Act of the 96th General Assembly for
12both intermediate and skilled care and the number of residents
13receiving each level of care.
14    (d)(1) Effective July 1, 2010, for each resident needing
15skilled care, a minimum staffing ratio of 2.5 hours of nursing
16and personal care each day must be provided; for each resident
17needing intermediate care, 1.7 hours of nursing and personal
18care each day must be provided.
19    (2) Effective January 1, 2011, the minimum staffing ratios
20shall be increased to 2.7 hours of nursing and personal care
21each day for a resident needing skilled care and 1.9 hours of
22nursing and personal care each day for a resident needing
23intermediate care.
24    (3) Effective January 1, 2012, the minimum staffing ratios
25shall be increased to 3.0 hours of nursing and personal care
26each day for a resident needing skilled care and 2.1 hours of

 

 

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1nursing and personal care each day for a resident needing
2intermediate care.
3    (4) Effective January 1, 2013, the minimum staffing ratios
4shall be increased to 3.4 hours of nursing and personal care
5each day for a resident needing skilled care and 2.3 hours of
6nursing and personal care each day for a resident needing
7intermediate care.
8    (5) Effective January 1, 2014, the minimum staffing ratios
9shall be increased to 3.8 hours of nursing and personal care
10each day for a resident needing skilled care and 2.5 hours of
11nursing and personal care each day for a resident needing
12intermediate care.
13    (e) Ninety days after the effective date of this amendatory
14Act of the 97th General Assembly, a minimum of 25% of nursing
15and personal care time shall be provided by licensed nurses,
16with at least 10% of nursing and personal care time provided by
17registered nurses. These minimum requirements shall remain in
18effect until an acuity based registered nurse requirement is
19promulgated by rule concurrent with the adoption of the
20Resource Utilization Group classification-based payment
21methodology, as provided in Section 5-5.2 of the Illinois
22Public Aid Code. Registered nurses and licensed practical
23nurses employed by a facility in excess of these requirements
24may be used to satisfy the remaining 75% of the nursing and
25personal care time requirements. Notwithstanding this
26subsection, no staffing requirement in statute in effect on the

 

 

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1effective date of this amendatory Act of the 97th General
2Assembly shall be reduced on account of this subsection. Both
3the 25% licensed nurse requirement and 10% registered nurse
4requirement shall remain in effect until an acuity based
5licensed nurse requirement and registered nurse requirement
6are adopted in administrative rules subsequent to the
7implementation of the Resource Utilization Group
8classification-based payment methodology, as provided in
9Section 5-5.2 of the Illinois Public Aid Code. An acuity based
10licensed nurse requirement and registered nurse requirement
11shall not be made effective before January 1, 2014.
12(Source: P.A. 96-1372, eff. 7-29-10; 96-1504, eff. 1-27-11;
1397-689, eff. 6-14-12.)
 
14    Section 10. The Illinois Public Aid Code is amended by
15changing Sections 5-5.2 and 5-5.4 as follows:
 
16    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
17    Sec. 5-5.2. Payment.
18    (a) All nursing facilities that are grouped pursuant to
19Section 5-5.1 of this Act shall receive the same rate of
20payment for similar services.
21    (b) It shall be a matter of State policy that the Illinois
22Department shall utilize a uniform billing cycle throughout the
23State for the long-term care providers.
24    (c) Notwithstanding any other provisions of this Code, the

 

 

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1methodologies for reimbursement of nursing services as
2provided under this Article shall no longer be applicable for
3bills payable for nursing services rendered on or after a new
4reimbursement system based on the Resource Utilization Groups
5(RUGs) has been fully operationalized, which shall take effect
6for services provided on or after July 1, 2013 January 1, 2014.
7    (d) A new nursing services reimbursement methodology
8utilizing RUGs IV 48 grouper model shall be established and may
9include an Illinois-specific default group, as needed. The new
10RUGs-based nursing services reimbursement methodology shall be
11resident-driven, facility-specific, and cost-based. Costs
12shall be annually rebased and case mix index quarterly updated.
13The methodology shall include regional wage adjustors based on
14the Health Service Areas (HSA) groupings in effect on April 30,
152012. The Department shall assign a case mix index to each
16resident class based on the Centers for Medicare and Medicaid
17Services staff time measurement study utilizing an index
18maximization approach.
19    (e) Notwithstanding any other provision of this Code, the
20Department shall by rule develop a reimbursement methodology
21reflective of the intensity of care and services requirements
22of low need residents in the lowest RUG IV groupers and
23corresponding regulations.
24    (f) Notwithstanding any other provision of this Code, on
25and after July 1, 2012, reimbursement rates associated with the
26nursing or support components of the current nursing facility

 

 

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1rate methodology shall not increase beyond the level effective
2May 1, 2011 until a new reimbursement system based on the RUGs
3IV 48 grouper model has been fully operationalized.
4    (g) Notwithstanding any other provision of this Code, on
5and after July 1, 2012, for facilities not designated by the
6Department of Healthcare and Family Services as "Institutions
7for Mental Disease", rates effective May 1, 2011 shall be
8adjusted as follows:
9        (1) Individual nursing rates for residents classified
10    in RUG IV groups PA1, PA2, BA1, and BA2 during the quarter
11    ending March 31, 2012 shall be reduced by 10%;
12        (2) Individual nursing rates for residents classified
13    in all other RUG IV groups shall be reduced by 1.0%;
14        (3) Facility rates for the capital and support
15    components shall be reduced by 1.7%.
16    (h) Notwithstanding any other provision of this Code, on
17and after July 1, 2012, nursing facilities designated by the
18Department of Healthcare and Family Services as "Institutions
19for Mental Disease" and "Institutions for Mental Disease" that
20are facilities licensed under the Specialized Mental Health
21Rehabilitation Act shall have the nursing,
22socio-developmental, capital, and support components of their
23reimbursement rate effective May 1, 2011 reduced in total by
242.7%.
25(Source: P.A. 96-1530, eff. 2-16-11; 97-689, eff. 6-14-12.)
 

 

 

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1    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
2    Sec. 5-5.4. Standards of Payment - Department of Healthcare
3and Family Services. The Department of Healthcare and Family
4Services shall develop standards of payment of nursing facility
5and ICF/DD services in facilities providing such services under
6this Article which:
7    (1) Provide for the determination of a facility's payment
8for nursing facility or ICF/DD services on a prospective basis.
9The amount of the payment rate for all nursing facilities
10certified by the Department of Public Health under the ID/DD
11Community Care Act or the Nursing Home Care Act as Intermediate
12Care for the Developmentally Disabled facilities, Long Term
13Care for Under Age 22 facilities, Skilled Nursing facilities,
14or Intermediate Care facilities under the medical assistance
15program shall be prospectively established annually on the
16basis of historical, financial, and statistical data
17reflecting actual costs from prior years, which shall be
18applied to the current rate year and updated for inflation,
19except that the capital cost element for newly constructed
20facilities shall be based upon projected budgets. The annually
21established payment rate shall take effect on July 1 in 1984
22and subsequent years. No rate increase and no update for
23inflation shall be provided on or after July 1, 1994 and before
24January 1, 2014, unless specifically provided for in this
25Section. The changes made by Public Act 93-841 extending the
26duration of the prohibition against a rate increase or update

 

 

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1for inflation are effective retroactive to July 1, 2004.
2    For facilities licensed by the Department of Public Health
3under the Nursing Home Care Act as Intermediate Care for the
4Developmentally Disabled facilities or Long Term Care for Under
5Age 22 facilities, the rates taking effect on July 1, 1998
6shall include an increase of 3%. For facilities licensed by the
7Department of Public Health under the Nursing Home Care Act as
8Skilled Nursing facilities or Intermediate Care facilities,
9the rates taking effect on July 1, 1998 shall include an
10increase of 3% plus $1.10 per resident-day, as defined by the
11Department. For facilities licensed by the Department of Public
12Health under the Nursing Home Care Act as Intermediate Care
13Facilities for the Developmentally Disabled or Long Term Care
14for Under Age 22 facilities, the rates taking effect on January
151, 2006 shall include an increase of 3%. For facilities
16licensed by the Department of Public Health under the Nursing
17Home Care Act as Intermediate Care Facilities for the
18Developmentally Disabled or Long Term Care for Under Age 22
19facilities, the rates taking effect on January 1, 2009 shall
20include an increase sufficient to provide a $0.50 per hour wage
21increase for non-executive staff.
22    For facilities licensed by the Department of Public Health
23under the Nursing Home Care Act as Intermediate Care for the
24Developmentally Disabled facilities or Long Term Care for Under
25Age 22 facilities, the rates taking effect on July 1, 1999
26shall include an increase of 1.6% plus $3.00 per resident-day,

 

 

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1as defined by the Department. For facilities licensed by the
2Department of Public Health under the Nursing Home Care Act as
3Skilled Nursing facilities or Intermediate Care facilities,
4the rates taking effect on July 1, 1999 shall include an
5increase of 1.6% and, for services provided on or after October
61, 1999, shall be increased by $4.00 per resident-day, as
7defined by the Department.
8    For facilities licensed by the Department of Public Health
9under the Nursing Home Care Act as Intermediate Care for the
10Developmentally Disabled facilities or Long Term Care for Under
11Age 22 facilities, the rates taking effect on July 1, 2000
12shall include an increase of 2.5% per resident-day, as defined
13by the Department. For facilities licensed by the Department of
14Public Health under the Nursing Home Care Act as Skilled
15Nursing facilities or Intermediate Care facilities, the rates
16taking effect on July 1, 2000 shall include an increase of 2.5%
17per resident-day, as defined by the Department.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as skilled nursing facilities
20or intermediate care facilities, a new payment methodology must
21be implemented for the nursing component of the rate effective
22July 1, 2003. The Department of Public Aid (now Healthcare and
23Family Services) shall develop the new payment methodology
24using the Minimum Data Set (MDS) as the instrument to collect
25information concerning nursing home resident condition
26necessary to compute the rate. The Department shall develop the

 

 

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1new payment methodology to meet the unique needs of Illinois
2nursing home residents while remaining subject to the
3appropriations provided by the General Assembly. A transition
4period from the payment methodology in effect on June 30, 2003
5to the payment methodology in effect on July 1, 2003 shall be
6provided for a period not exceeding 3 years and 184 days after
7implementation 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

 

 

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1    shall be adjusted subject to appropriations provided by the
2    General Assembly.
3    For facilities licensed by the Department of Public Health
4under the Nursing Home Care Act as Intermediate Care for the
5Developmentally Disabled facilities or Long Term Care for Under
6Age 22 facilities, the rates taking effect on March 1, 2001
7shall include a statewide increase of 7.85%, as defined by the
8Department.
9    Notwithstanding any other provision of this Section, for
10facilities licensed by the Department of Public Health under
11the Nursing Home Care Act as skilled nursing facilities or
12intermediate care facilities, except facilities participating
13in the Department's demonstration program pursuant to the
14provisions of Title 77, Part 300, Subpart T of the Illinois
15Administrative Code, the numerator of the ratio used by the
16Department of Healthcare and Family Services to compute the
17rate payable under this Section using the Minimum Data Set
18(MDS) methodology shall incorporate the following annual
19amounts as the additional funds appropriated to the Department
20specifically to pay for rates based on the MDS nursing
21component methodology in excess of the funding in effect on
22December 31, 2006:
23        (i) For rates taking effect January 1, 2007,
24    $60,000,000.
25        (ii) For rates taking effect January 1, 2008,
26    $110,000,000.

 

 

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1        (iii) For rates taking effect January 1, 2009,
2    $194,000,000.
3        (iv) For rates taking effect April 1, 2011, or the
4    first day of the month that begins at least 45 days after
5    the effective date of this amendatory Act of the 96th
6    General Assembly, $416,500,000 or an amount as may be
7    necessary to complete the transition to the MDS methodology
8    for the nursing component of the rate. Increased payments
9    under this item (iv) are not due and payable, however,
10    until (i) the methodologies described in this paragraph are
11    approved by the federal government in an appropriate State
12    Plan amendment and (ii) the assessment imposed by Section
13    5B-2 of this Code is determined to be a permissible tax
14    under Title XIX of the Social Security Act.
15    Notwithstanding any other provision of this Section, for
16facilities licensed by the Department of Public Health under
17the Nursing Home Care Act as skilled nursing facilities or
18intermediate care facilities, the support component of the
19rates taking effect on January 1, 2008 shall be computed using
20the most recent cost reports on file with the Department of
21Healthcare and Family Services no later than April 1, 2005,
22updated for inflation to January 1, 2006.
23    For facilities licensed by the Department of Public Health
24under the Nursing Home Care Act as Intermediate Care for the
25Developmentally Disabled facilities or Long Term Care for Under
26Age 22 facilities, the rates taking effect on April 1, 2002

 

 

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1shall include a statewide increase of 2.0%, as defined by the
2Department. This increase terminates on July 1, 2002; beginning
3July 1, 2002 these rates are reduced to the level of the rates
4in effect on March 31, 2002, as defined by the Department.
5    For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as skilled nursing facilities
7or intermediate care facilities, the rates taking effect on
8July 1, 2001 shall be computed using the most recent cost
9reports on file with the Department of Public Aid no later than
10April 1, 2000, updated for inflation to January 1, 2001. For
11rates effective July 1, 2001 only, rates shall be the greater
12of the rate computed for July 1, 2001 or the rate effective on
13June 30, 2001.
14    Notwithstanding any other provision of this Section, for
15facilities licensed by the Department of Public Health under
16the Nursing Home Care Act as skilled nursing facilities or
17intermediate care facilities, the Illinois Department shall
18determine by rule the rates taking effect on July 1, 2002,
19which shall be 5.9% less than the rates in effect on June 30,
202002.
21    Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, if the payment methodologies
25required under Section 5A-12 and the waiver granted under 42
26CFR 433.68 are approved by the United States Centers for

 

 

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1Medicare and Medicaid Services, the rates taking effect on July
21, 2004 shall be 3.0% greater than the rates in effect on June
330, 2004. These rates shall take effect only upon approval and
4implementation of the payment methodologies required under
5Section 5A-12.
6    Notwithstanding any other provisions of this Section, for
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as skilled nursing facilities or
9intermediate care facilities, the rates taking effect on
10January 1, 2005 shall be 3% more than the rates in effect on
11December 31, 2004.
12    Notwithstanding any other provision of this Section, for
13facilities licensed by the Department of Public Health under
14the Nursing Home Care Act as skilled nursing facilities or
15intermediate care facilities, effective January 1, 2009, the
16per diem support component of the rates effective on January 1,
172008, computed using the most recent cost reports on file with
18the Department of Healthcare and Family Services no later than
19April 1, 2005, updated for inflation to January 1, 2006, shall
20be increased to the amount that would have been derived using
21standard Department of Healthcare and Family Services methods,
22procedures, and inflators.
23    Notwithstanding any other provisions of this Section, for
24facilities licensed by the Department of Public Health under
25the Nursing Home Care Act as intermediate care facilities that
26are federally defined as Institutions for Mental Disease, or

 

 

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1facilities licensed by the Department of Public Health under
2the Specialized Mental Health Rehabilitation Act, a
3socio-development component rate equal to 6.6% of the
4facility's nursing component rate as of January 1, 2006 shall
5be established and paid effective July 1, 2006. The
6socio-development component of the rate shall be increased by a
7factor of 2.53 on the first day of the month that begins at
8least 45 days after January 11, 2008 (the effective date of
9Public Act 95-707). As of August 1, 2008, the socio-development
10component rate shall be equal to 6.6% of the facility's nursing
11component rate as of January 1, 2006, multiplied by a factor of
123.53. For services provided on or after April 1, 2011, or the
13first day of the month that begins at least 45 days after the
14effective date of this amendatory Act of the 96th General
15Assembly, whichever is later, the Illinois Department may by
16rule adjust these socio-development component rates, and may
17use different adjustment methodologies for those facilities
18participating, and those not participating, in the Illinois
19Department's demonstration program pursuant to the provisions
20of Title 77, Part 300, Subpart T of the Illinois Administrative
21Code, but in no case may such rates be diminished below those
22in effect on August 1, 2008.
23    For facilities licensed by the Department of Public Health
24under the Nursing Home Care Act as Intermediate Care for the
25Developmentally Disabled facilities or as long-term care
26facilities for residents under 22 years of age, the rates

 

 

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1taking effect on July 1, 2003 shall include a statewide
2increase of 4%, as defined by the Department.
3    For facilities licensed by the Department of Public Health
4under the Nursing Home Care Act as Intermediate Care for the
5Developmentally Disabled facilities or Long Term Care for Under
6Age 22 facilities, the rates taking effect on the first day of
7the month that begins at least 45 days after the effective date
8of this amendatory Act of the 95th General Assembly shall
9include a statewide increase of 2.5%, as defined by the
10Department.
11    Notwithstanding any other provision of this Section, for
12facilities licensed by the Department of Public Health under
13the Nursing Home Care Act as skilled nursing facilities or
14intermediate care facilities, effective January 1, 2005,
15facility rates shall be increased by the difference between (i)
16a facility's per diem property, liability, and malpractice
17insurance costs as reported in the cost report filed with the
18Department of Public Aid and used to establish rates effective
19July 1, 2001 and (ii) those same costs as reported in the
20facility's 2002 cost report. These costs shall be passed
21through to the facility without caps or limitations, except for
22adjustments required under normal auditing procedures.
23    Rates established effective each July 1 shall govern
24payment for services rendered throughout that fiscal year,
25except that rates established on July 1, 1996 shall be
26increased by 6.8% for services provided on or after January 1,

 

 

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11997. Such rates will be based upon the rates calculated for
2the year beginning July 1, 1990, and for subsequent years
3thereafter until June 30, 2001 shall be based on the facility
4cost reports for the facility fiscal year ending at any point
5in time during the previous calendar year, updated to the
6midpoint of the rate year. The cost report shall be on file
7with the Department no later than April 1 of the current rate
8year. Should the cost report not be on file by April 1, the
9Department shall base the rate on the latest cost report filed
10by each skilled care facility and intermediate care facility,
11updated to the midpoint of the current rate year. In
12determining rates for services rendered on and after July 1,
131985, fixed time shall not be computed at less than zero. The
14Department shall not make any alterations of regulations which
15would reduce any component of the Medicaid rate to a level
16below what that component would have been utilizing in the rate
17effective on July 1, 1984.
18    (2) Shall take into account the actual costs incurred by
19facilities in providing services for recipients of skilled
20nursing and intermediate care services under the medical
21assistance program.
22    (3) Shall take into account the medical and psycho-social
23characteristics and needs of the patients.
24    (4) Shall take into account the actual costs incurred by
25facilities in meeting licensing and certification standards
26imposed and prescribed by the State of Illinois, any of its

 

 

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1political subdivisions or municipalities and by the U.S.
2Department of Health and Human Services pursuant to Title XIX
3of the Social Security Act.
4    The Department of Healthcare and Family Services shall
5develop precise standards for payments to reimburse nursing
6facilities for any utilization of appropriate rehabilitative
7personnel for the provision of rehabilitative services which is
8authorized by federal regulations, including reimbursement for
9services provided by qualified therapists or qualified
10assistants, and which is in accordance with accepted
11professional practices. Reimbursement also may be made for
12utilization of other supportive personnel under appropriate
13supervision.
14    The Department shall develop enhanced payments to offset
15the additional costs incurred by a facility serving exceptional
16need residents and shall allocate at least $8,000,000 of the
17funds collected from the assessment established by Section 5B-2
18of this Code for such payments. For the purpose of this
19Section, "exceptional needs" means, but need not be limited to,
20ventilator care, tracheotomy care, bariatric care, complex
21wound care, and traumatic brain injury care. The enhanced
22payments for exceptional need residents under this paragraph
23are not due and payable, however, until (i) the methodologies
24described in this paragraph are approved by the federal
25government in an appropriate State Plan amendment and (ii) the
26assessment imposed by Section 5B-2 of this Code is determined

 

 

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1to be a permissible tax under Title XIX of the Social Security
2Act.
3    Beginning July 1, 2013, January 1, 2014 the methodologies
4for reimbursement of nursing facility services as provided
5under this Section 5-5.4 shall no longer be applicable for
6services provided on or after July 1, 2013 January 1, 2014.
7    No payment increase under this Section for the MDS
8methodology, exceptional care residents, or the
9socio-development component rate established by Public Act
1096-1530 of the 96th General Assembly and funded by the
11assessment imposed under Section 5B-2 of this Code shall be due
12and payable until after the Department notifies the long-term
13care providers, in writing, that the payment methodologies to
14long-term care providers required under this Section have been
15approved by the Centers for Medicare and Medicaid Services of
16the U.S. Department of Health and Human Services and the
17waivers under 42 CFR 433.68 for the assessment imposed by this
18Section, if necessary, have been granted by the Centers for
19Medicare and Medicaid Services of the U.S. Department of Health
20and Human Services. Upon notification to the Department of
21approval of the payment methodologies required under this
22Section and the waivers granted under 42 CFR 433.68, all
23increased payments otherwise due under this Section prior to
24the date of notification shall be due and payable within 90
25days of the date federal approval is received.
26    On and after July 1, 2012, the Department shall reduce any

 

 

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1rate of reimbursement for services or other payments or alter
2any methodologies authorized by this Code to reduce any rate of
3reimbursement for services or other payments in accordance with
4Section 5-5e.
5(Source: P.A. 96-45, eff. 7-15-09; 96-339, eff. 7-1-10; 96-959,
6eff. 7-1-10; 96-1000, eff. 7-2-10; 96-1530, eff. 2-16-11;
797-10, eff. 6-14-11; 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;
897-584, eff. 8-26-11; 97-689, eff. 6-14-12; 97-813, eff.
97-13-12.)
 
10    Section 99. Effective date. This Act takes effect upon
11becoming law.".