State of Illinois
92nd General Assembly
Legislation

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92_SB2310

 
                                               LRB9215823DJmg

 1        AN ACT in relation to public aid.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Illinois  Public Aid Code is amended by
 5    changing Section 5-5.4 as follows:

 6        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 7        Sec.  5-5.4.  Nursing  homes;   standards   of   payment;
 8    Department of Public Aid.  The Department of Public Aid shall
 9    develop   standards   of   payment  of  skilled  nursing  and
10    intermediate  care  services  in  facilities  providing  such
11    services under this Article which:
12        (1)  Provide  Provides  for  the   determination   of   a
13    facility's  payment for skilled nursing and intermediate care
14    services on a prospective basis.  The amount of  the  payment
15    rate  for  all nursing facilities certified under the medical
16    assistance  program  shall   be   prospectively   established
17    annually   on   the   basis  of  historical,  financial,  and
18    statistical data reflecting actual costs  from  prior  years,
19    which  shall  be applied to the current rate year and updated
20    for inflation, except that the capital cost element for newly
21    constructed facilities shall be based upon projected budgets.
22    The annually established payment rate shall  take  effect  on
23    July 1 in 1984 and subsequent years.  Rate increases shall be
24    provided  annually  thereafter  on July 1 in 1984 and on each
25    subsequent July 1 in the following years, except that no rate
26    increase and no update for inflation shall be provided on  or
27    after   July   1,  1994  and  before  July  1,  2002,  unless
28    specifically provided for in this Section.
29        For facilities  licensed  by  the  Department  of  Public
30    Health  under  the Nursing Home Care Act as Intermediate Care
31    for the Developmentally Disabled facilities or Long Term Care
 
                            -2-                LRB9215823DJmg
 1    for Under Age 22 facilities, the rates taking effect on  July
 2    1,  1998  shall  include  an  increase of 3%.  For facilities
 3    licensed by the Department of Public Health under the Nursing
 4    Home Care Act as Skilled Nursing facilities  or  Intermediate
 5    Care  facilities,  the  rates  taking  effect on July 1, 1998
 6    shall include an increase of 3% plus $1.10 per  resident-day,
 7    as defined by the Department.
 8        For  facilities  licensed  by  the  Department  of Public
 9    Health under the Nursing Home Care Act as  Intermediate  Care
10    for the Developmentally Disabled facilities or Long Term Care
11    for  Under Age 22 facilities, the rates taking effect on July
12    1, 1999 shall include an increase  of  1.6%  plus  $3.00  per
13    resident-day,  as  defined by the Department.  For facilities
14    licensed by the Department of Public Health under the Nursing
15    Home Care Act as Skilled Nursing facilities  or  Intermediate
16    Care  facilities,  the  rates  taking  effect on July 1, 1999
17    shall include an increase of 1.6% and, for services  provided
18    on  or after October 1, 1999, shall be increased by $4.00 per
19    resident-day, as defined by the Department.
20        For facilities  licensed  by  the  Department  of  Public
21    Health  under  the Nursing Home Care Act as Intermediate Care
22    for the Developmentally Disabled facilities or Long Term Care
23    for Under Age 22 facilities, the rates taking effect on  July
24    1,  2000  shall include an increase of 2.5% per resident-day,
25    as defined by the Department.  For facilities licensed by the
26    Department of Public Health under the Nursing Home  Care  Act
27    as   Skilled   Nursing   facilities   or   Intermediate  Care
28    facilities, the rates taking effect on  July  1,  2000  shall
29    include  an  increase of 2.5% per resident-day, as defined by
30    the Department.
31        For facilities  licensed  by  the  Department  of  Public
32    Health  under  the Nursing Home Care Act as Intermediate Care
33    for the Developmentally Disabled facilities or Long Term Care
34    for Under Age 22 facilities, the rates taking effect on March
 
                            -3-                LRB9215823DJmg
 1    1, 2001 shall include  a  statewide  increase  of  7.85%,  as
 2    defined by the Department.
 3        For  facilities  licensed  by  the  Department  of Public
 4    Health under the Nursing Home Care Act as  Intermediate  Care
 5    for the Developmentally Disabled facilities or Long Term Care
 6    for Under Age 22 facilities, the rates taking effect on April
 7    1,  2002  shall  include  a  statewide  increase  of 2.0%, as
 8    defined by the Department.
 9        For facilities  licensed  by  the  Department  of  Public
10    Health  under  the  Nursing  Home Care Act as skilled nursing
11    facilities or intermediate care facilities, the rates  taking
12    effect  on July 1, 2001, and each subsequent year thereafter,
13    shall be computed using the most recent cost reports on  file
14    with the Department of Public Aid no later than April 1, 2000
15    updated   for  inflation  to  January  1,  2001.   For  rates
16    effective July 1, 2001 only, rates shall be  the  greater  of
17    the  rate  computed for July 1, 2001 or the rate effective on
18    June 30, 2001.
19        Rates established effective  each  July  1  shall  govern
20    payment  for  services  rendered throughout that fiscal year,
21    except that rates  established  on  July  1,  1996  shall  be
22    increased  by  6.8% for services provided on or after January
23    1, 1997.  Such rates will be based upon the rates  calculated
24    for the year beginning July 1, 1990, and for subsequent years
25    thereafter until June 30, 2001 shall be based on the facility
26    cost reports for the facility fiscal year ending at any point
27    in  time  during  the  previous calendar year, updated to the
28    midpoint of the rate year.  The cost report shall be on  file
29    with the Department no later than April 1 of the current rate
30    year.   Should the cost report not be on file by April 1, the
31    Department shall base the rate  on  the  latest  cost  report
32    filed  by  each  skilled  care facility and intermediate care
33    facility, updated to the midpoint of the current  rate  year.
34    In  determining rates for services rendered on and after July
 
                            -4-                LRB9215823DJmg
 1    1, 1985, fixed time shall not be computed at less than  zero.
 2    The  Department shall not make any alterations of regulations
 3    which would reduce any component of the Medicaid  rate  to  a
 4    level  below what that component would have been utilizing in
 5    the rate effective on July 1, 1984.
 6        (2)  Shall take into account the actual costs incurred by
 7    facilities in providing services for  recipients  of  skilled
 8    nursing  and  intermediate  care  services  under the medical
 9    assistance program.
10        (3)  Shall   take   into   account   the   medical    and
11    psycho-social characteristics and needs of the patients.
12        (4)  Shall take into account the actual costs incurred by
13    facilities  in  meeting licensing and certification standards
14    imposed and prescribed by the State of Illinois, any  of  its
15    political  subdivisions  or  municipalities  and  by the U.S.
16    Department of Health and Human Services pursuant to Title XIX
17    of the Social Security Act.
18        The  Department  of  Public  Aid  shall  develop  precise
19    standards for payments to reimburse  nursing  facilities  for
20    any  utilization  of appropriate rehabilitative personnel for
21    the provision of rehabilitative services which is  authorized
22    by  federal regulations, including reimbursement for services
23    provided by qualified therapists or qualified assistants, and
24    which is in accordance with accepted professional  practices.
25    Reimbursement  also  may  be  made  for  utilization of other
26    supportive personnel under appropriate supervision.
27    (Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
28    eff. 6-11-01; 92-31, eff. 6-28-01; revised 12-13-01.)

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