Section 146.220  Resident Participation Requirements

a)         The SLF may admit or retain residents whose needs can be met through the services described in Section 146.230.  These persons would typically have a score between 29 and 47 on the Determination of Need (DON) and need assistance in one or more activities of daily living.  These persons must meet the following criteria prior to admission to an SLF:

1)         Be age 22 years or over with a disability (as determined by the Social Security Administration) or elderly (age 65 years or over); and

2)         Be screened by the Department and found to be in need of nursing facility level of care and that SLF placement is appropriate to meet the needs of the individual.  A new screen is not needed for a resident who is transferring between SLFs or comes from a nursing facility with no break in service.  It is the admitting SLF's responsibility to ensure that a screening document is received from the transferring SLF or nursing facility.  Private pay individuals may choose to be admitted into an SLF when the screening assessment does not justify nursing facility level of care; and

3)         Be without a primary or secondary diagnosis of developmental disability or serious and persistent mental illness.  (Developmental disability is defined as a disability which is attributable to mental retardation or a related condition.) The developmental disability or mental illness must be determined by a qualified Department of Human Services screening agent; and

4)         Have name checked against the Illinois Sex Offender Registration website at www.isp.state.il.us and/or the Illinois Department of Corrections registered sex offender database at www.idoc.state.il.us.  Refer to Section 146.215 for facility requirements if a person whose name appears on either registry is admitted to an SLF.

b)         Private pay residents seeking to convert to Medicaid while residing in an SLF shall be screened by the Department using the DON prior to the point of conversion and must be found to be in need of nursing facility level of care before Medicaid payment may be authorized.

c)         Each prospective resident shall have a tuberculin skin test in accordance with the Control of Tuberculosis Code (77 Ill. Adm. Code 696).  The test must be completed no more than 90 days prior to the date of admission to the SLF or the test must be commenced no more than seven days after admission to the SLF.

d)         A Medicaid resident of an SLF shall not participate in the Department on Aging's Community Care Program or the Department of Human Services' Home Services Program.

(Source:  Amended at 30 Ill. Reg. 8845, effective May 1, 2006)