HB6603 93RD GENERAL ASSEMBLY

LRB093 15228 DRJ 47299 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB6603

Introduced 02/09/04, by Dan Reitz

SYNOPSIS AS INTRODUCED:

20 ILCS 3960/5.4 new
20 ILCS 3960/5.4a new
20 ILCS 3960/5.4b new
20 ILCS 3960/5.4c new
20 ILCS 3960/5.4d new
305 ILCS 5/5-5.4c new

Amends the Illinois Health Facilities Planning Act and the Illinois Public Aid Code. Directs the Department of Public Health to implement a program for voluntary closure or partial closure of nursing homes. Requires implementation of the program by August 15, 2005. Under the Medicaid program, provides for a planned closure rate adjustment in the Medicaid reimbursement rates otherwise payable to a nursing home. Allows a nursing home to assign a planned closure rate adjustment to one or more other nursing homes.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning health facilities.

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

Section 5. The Illinois Health Facilities Planning Act is amended by adding Sections 5.4, 5.4a, 5.4b, 5.4c, and 5.4d as follows:

(20 ILCS 3960/5.4 new)

Sec. 5.4. Definitions. In this Section through Section 5.4d:

"Closure" means the cessation of operations of a nursing facility and delicensure and decertification of all beds within a nursing facility.

"Closure plan" means a plan to close a nursing facility and reallocate a portion of the resulting savings to provide planned closure rate adjustments at other facilities.

"Commencement of closure" means the date on which residents of a nursing facility and their designated representatives are notified of a planned closure of the facility as part of an approved closure plan.

"Completion of closure" means the date on which the final resident of a nursing facility designated for closure in an approved closure plan is discharged from the facility.

"Nursing facility" or "facility" means a facility subject to licensure under the Nursing Home Care Act, including a county nursing home directed and maintained under Section 5-1005 of the Counties Code.

"Partial closure" means the delicensure and decertification of a portion of the beds within a nursing facility.

"Planned closure rate adjustment" means an increase in a nursing facility's operating rates resulting from a planned closure or a planned partial closure of another facility, as provided in Section 5-5.4c of the Illinois Public Aid Code.

"Region" means a State development region designated by the Agency.

(20 ILCS 3960/5.4a new)

Sec. 5.4a. Program for planned closure. By August 15, 2005, the Agency, in cooperation with the Department of Public Aid, shall implement and announce a program for closure or partial closure of nursing facilities. Names and identifying information provided in response to the announcement shall remain private unless approved, according to the timelines established in the plan. The announcement must specify the following:

(1) The criteria in Section 5.4c that will be used by the Agency to approve or reject an application for planned closure.

(2) The information that must accompany an application for planned closure.

(20 ILCS 3960/5.4b new)

Sec. 5.4b. Approval of application for planned closure.

(a) Between August 15, 2005, and June 30, 2006, the Agency may approve planned closures of up to 5,000 nursing facility beds, less the number of beds delicensed in facilities during the same time period without approved closure plans or that have notified the Agency of their intent to close without an approved closure plan.

(b) To be considered for approval, an application for planned closure must address the criteria listed in Section 5.4c and must also include all of the following:

(1) A description of the proposed closure plan, which must include identification of the facility or facilities to receive a planned closure rate adjustment.

(2) The proposed timetable for any proposed closure, including the proposed dates for announcement of the closure to residents of the facility, commencement of closure, and completion of closure.

(3) If available, the proposed relocation plan for current residents of any facility designated for closure. If a relocation plan is not available, the application must include a statement agreeing to develop a relocation plan.

(4) A description of the relationship between the nursing facility that is proposed for closure and the nursing facility or facilities proposed to receive the planned closure rate adjustment. If these facilities are not under common ownership, the applicant must provide copies of any contracts, purchase agreements, or other documents establishing a relationship or proposed relationship.

(5) Documentation, in a format approved by the Agency and the Department of Public Aid, that all of the nursing facilities receiving a planned closure rate adjustment under the plan have accepted joint and several liability for recovery of overpayments for the facilities designated for closure under the plan.

(20 ILCS 3960/5.4c new)

Sec. 5.4c. Criteria for review of application for planned closure. In reviewing and approving an application for planned closure of a nursing facility, the Agency shall consider criteria that include, but need not be limited to, the following:

(1) Improved quality of care and quality of life for consumers of nursing facility services.

(2) Closure of a nursing facility that has a poor physical plant.

(3) The existence of excess nursing facility beds, measured in terms of beds per thousand persons aged 65 or older. The excess must be measured in reference to one of the following:

(A) The region in which the facility is located.

(B) The region in which the facility is located and all contiguous regions.

(C) The facility's service area. A facility must indicate in its application for planned closure the service area that the facility believes is appropriate for this measurement.

(4) Low-occupancy rates, provided that the unoccupied beds are not the result of a personnel shortage. In analyzing occupancy rates, the Agency shall examine waiting lists in the applicant facility and at facilities in the surrounding area, as determined under item (3) of this Section.

(5) Proposed usage of moneys available from a planned closure rate adjustment for care-related purposes.

(6) Innovative use planned for the closed facility's physical plant.

(7) Evidence that the proposal serves the interests of the State.

(8) Evidence of other factors that affect the viability of the facility, including excessive nursing pool costs.

(20 ILCS 3960/5.4d new)

Sec. 5.4d. Time for approval; duration of approval.

(a) The Agency, in consultation with the Department of Public Aid, shall approve or disapprove an application for planned closure of a nursing facility within 30 days after receiving the application.

(b) Approval of a planned closure expires 18 months after approval by the Agency, unless commencement of closure has begun.

Section 10. The Illinois Public Aid Code is amended by adding Section 5-5.4c as follows:

(305 ILCS 5/5-5.4c new)

Sec. 5-5.4c. Planned closure rate adjustment; assignment.

(a) A facility or facilities reimbursed with a closure plan approved by the Department of Public Health under Sections 5.4 through 5.4d of the Illinois Health Facilities Planning Act may assign a planned closure rate adjustment (i) to another facility or facilities that are not closing or (ii) in the case of a partial closure, to the facility undertaking the partial closure. A facility may also elect to have a planned closure rate adjustment shared equally by the 5 nursing facilities with the lowest total operating payment rates in the region in which the facility that is closing is located. The planned closure rate adjustment must be calculated under subsection (b).

A facility that delicenses beds without a closure plan, or whose closure plan is not approved by the Department of Public Health, is not eligible to assign a planned closure rate adjustment under this Section unless:

(1) the facility is delicensing 5 or fewer beds or less than 6% of the facility's total licensed bed capacity, whichever is greater;

(2) the facility is located in a county in the top 3 quartiles of beds per 1,000 persons aged 65 or older; and

(3) the facility has not delicensed beds in the prior 3 months.

A facility that meets the criteria set forth in items (1) through (3) is eligible to assign the amount calculated under subsection (b) to itself.

If a facility is delicensing the greater of 6 or more beds or 6% percent or more of its total licensed bed capacity and does not have an approved closure plan or is not eligible for the adjustment under this Section, the Department of Public Aid shall calculate the amount the facility would have been eligible to assign under this Section and shall use this amount to provide equal rate adjustments to the 5 nursing facilities with the lowest total operating payment rates in the region in which the facility that delicensed beds is located.

(b) The Department of Public Aid shall calculate the amount of the planned closure rate adjustment available under subsection (a) according to rules adopted by the Department.

(c) An applicant may use the planned closure rate adjustment to allow for a property payment for a new nursing facility or an addition to an existing nursing facility or as an operating payment rate adjustment.

(d) A facility that has received a planned closure rate adjustment may reassign it to another facility that is under the same ownership at any time within 3 years after the effective date of the adjustment. The amount of the adjustment shall be computed according to subsection (b).