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1 | AN ACT concerning public aid.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Administrative Procedure Act is | |||||||||||||||||||
5 | amended by adding Section 5-45.20 as follows: | |||||||||||||||||||
6 | (5 ILCS 100/5-45.20 new) | |||||||||||||||||||
7 | Sec. 5-45.20. Emergency rulemaking; nursing facility | |||||||||||||||||||
8 | payment rates. To provide for the expeditious and timely | |||||||||||||||||||
9 | implementation of changes made to Section 5-5.2 of the | |||||||||||||||||||
10 | Illinois Public Aid Code by this amendatory Act of the 102nd | |||||||||||||||||||
11 | General Assembly, emergency rules implementing such changes | |||||||||||||||||||
12 | may be adopted in accordance with Section 5-45 by the | |||||||||||||||||||
13 | Department of Healthcare and Family Services. The adoption of | |||||||||||||||||||
14 | emergency rules authorized by Section 5-45 and this Section is | |||||||||||||||||||
15 | deemed to be necessary for the public interest, safety, and | |||||||||||||||||||
16 | welfare. This Section is repealed on January 1, 2023. | |||||||||||||||||||
17 | Section 10. The Nurse Agency Licensing Act is amended by | |||||||||||||||||||
18 | changing Sections 3 and 14 as follows:
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19 | (225 ILCS 510/3) (from Ch. 111, par. 953)
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20 | Sec. 3. Definitions. As used in this Act:
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21 | (a) "Certified nurse aide" means an individual certified |
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1 | as defined in
Section 3-206 of the Nursing Home Care Act, | ||||||
2 | Section 3-206 of the ID/DD Community Care Act, or Section | ||||||
3 | 3-206 of the MC/DD Act, as now or hereafter amended.
| ||||||
4 | (b) "Department" means the Department of Labor.
| ||||||
5 | (c) "Director" means the Director of Labor.
| ||||||
6 | (d) "Health care facility" is defined as in Section 3 of | ||||||
7 | the Illinois
Health Facilities Planning Act, as now or | ||||||
8 | hereafter amended.
| ||||||
9 | (e) "Licensee" means any nursing agency which is properly | ||||||
10 | licensed under
this Act.
| ||||||
11 | (f) "Nurse" means a registered nurse or a licensed | ||||||
12 | practical nurse as
defined in the Nurse Practice Act.
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13 | (g) "Nurse agency" means any individual, firm, | ||||||
14 | corporation,
partnership or other legal entity that employs, | ||||||
15 | assigns or refers nurses
or certified nurse aides to a health | ||||||
16 | care facility for a
fee. The term "nurse agency" includes | ||||||
17 | nurses registries. The term "nurse
agency" does not include | ||||||
18 | services provided by home
health agencies licensed and | ||||||
19 | operated under the Home Health, Home Services, and Home | ||||||
20 | Nursing Agency
Licensing Act or a licensed or certified
| ||||||
21 | individual who provides his or her own services as a regular | ||||||
22 | employee of a
health care facility, nor does it apply to a | ||||||
23 | health care facility's
organizing nonsalaried employees to | ||||||
24 | provide services only in that
facility.
| ||||||
25 | (h) "Covenant not to compete" means an agreement between | ||||||
26 | an employer and an employee that restricts such employee from |
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1 | performing: | ||||||
2 | (1) any work for another employer for a specified | ||||||
3 | period of time; | ||||||
4 | (2) any work in a specified geographical area; or | ||||||
5 | (3) work for another employer that is similar to such | ||||||
6 | employee's work for the employer included as a party to | ||||||
7 | the agreement. | ||||||
8 | (Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
| ||||||
9 | (225 ILCS 510/14) (from Ch. 111, par. 964)
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10 | Sec. 14. Minimum Standards. (a) The Department, by rule, | ||||||
11 | shall
establish minimum standards for the operation of nurse | ||||||
12 | agencies. Those
standards shall include, but are not limited | ||||||
13 | to: (1) the maintenance of written
policies and procedures; | ||||||
14 | and (2) the development of personnel policies which
include a | ||||||
15 | personal interview, a reference check, an annual
evaluation of | ||||||
16 | each employee (which may be based in part upon information | ||||||
17 | provided by
health care facilities utilizing nurse agency | ||||||
18 | personnel) and periodic
health examinations.
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19 | (b) Each nurse agency shall have a nurse serving as a | ||||||
20 | manager or
supervisor of all nurses and certified nurses | ||||||
21 | aides.
| ||||||
22 | (c) Each nurse agency shall
ensure that its employees meet | ||||||
23 | the minimum
licensing, training, and orientation standards for
| ||||||
24 | which those employees
are licensed or certified.
| ||||||
25 | (d) A nurse agency shall not employ, assign, or refer for |
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| |||||||
1 | use in an Illinois
health care facility a nurse or certified | ||||||
2 | nurse aide unless certified or
licensed under applicable | ||||||
3 | provisions of State and federal law or regulations.
Each | ||||||
4 | certified nurse aide shall comply with all pertinent
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5 | regulations of the Illinois Department of Public Health | ||||||
6 | relating to the
health and other qualifications of personnel | ||||||
7 | employed in health care facilities.
| ||||||
8 | (e) The Department may adopt rules to monitor the usage of | ||||||
9 | nurse agency services to
determine their impact.
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10 | (f) Nurse agencies are prohibited from requiring, as a | ||||||
11 | condition of
employment, assignment, or referral, that their | ||||||
12 | employees
recruit new employees for the nurse agency from
| ||||||
13 | among the permanent employees of the health care facility to | ||||||
14 | which the
nurse agency employees have been employed,
assigned, | ||||||
15 | or referred,
and the health care facility to which such | ||||||
16 | employees are employed, assigned,
or referred is prohibited | ||||||
17 | from requiring, as a condition of employment,
that their | ||||||
18 | employees recruit new employees from these nurse agency
| ||||||
19 | employees. Violation of this provision is a business offense.
| ||||||
20 | (g) Nurse agencies are prohibited from entering into | ||||||
21 | covenants not to compete with nurses and certified nurse aides | ||||||
22 | who are employed by the agencies. After the effective date of | ||||||
23 | this amendatory Act of the 102nd General Assembly, a covenant | ||||||
24 | not to compete entered into between a nurse agency and a | ||||||
25 | certified nurse aide is illegal and void. | ||||||
26 | (h) Maximum charges. A supplemental healthcare staffing |
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| |||||||
1 | agency must not bill nor receive payments from a health care | ||||||
2 | facility licensed by the State at a rate higher than 130% of | ||||||
3 | the sum of total compensation plus associated payroll taxes | ||||||
4 | for applicable employee classifications. Agencies must submit | ||||||
5 | a confidential report to the Department of Employment Security | ||||||
6 | on a quarterly basis the sum of total compensation plus | ||||||
7 | associated payroll taxes for all applicable employee | ||||||
8 | classifications, and shall separately include in this report | ||||||
9 | the total revenue received from health care facilities | ||||||
10 | licensed by the State for the same period for these employees, | ||||||
11 | thereby enabling the Department's calculation of the ratio of | ||||||
12 | these 2 totals. This ratio shall be used by the Department to | ||||||
13 | determine compliance with this maximum charge provision, and | ||||||
14 | the veracity of the underlying data shall be subject to audit | ||||||
15 | by the Department as well as by the Auditor General. For | ||||||
16 | purposes of this subsection, total compensation shall include, | ||||||
17 | at a minimum, wages defined as hourly rate of pay and shift | ||||||
18 | differential, including weekend shift differential and | ||||||
19 | overtime. | ||||||
20 | The maximum charge must include all charges for | ||||||
21 | administrative fees, contract fees, or other special charges | ||||||
22 | in addition to compensation for the temporary nursing pool | ||||||
23 | personnel supplied to a health care facility. A health care | ||||||
24 | facility that pays for the actual travel and housing costs for | ||||||
25 | supplemental healthcare staffing agency staff working at the | ||||||
26 | facility and that pays these costs to the employee, the |
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1 | agency, or another vendor, is not required to count these | ||||||
2 | costs as total compensation. | ||||||
3 | (Source: P.A. 86-817.)
| ||||||
4 | Section 15. The Illinois Public Aid Code is amended by | ||||||
5 | changing Sections 5-5.2, 5B-2, 5B-4, 5B-5, 5B-8, 5E-10, and by | ||||||
6 | adding Section 5E-20 as follows:
| ||||||
7 | (305 ILCS 5/5-5.2) (from Ch. 23, par. 5-5.2)
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8 | Sec. 5-5.2. Payment.
| ||||||
9 | (a) All nursing facilities that are grouped pursuant to | ||||||
10 | Section
5-5.1 of this Act shall receive the same rate of | ||||||
11 | payment for similar
services.
| ||||||
12 | (b) It shall be a matter of State policy that the Illinois | ||||||
13 | Department
shall utilize a uniform billing cycle throughout | ||||||
14 | the State for the
long-term care providers.
| ||||||
15 | (b-1) It shall be a matter of State policy that the | ||||||
16 | Department shall set nursing facility rates, by rule, | ||||||
17 | utilizing an evidence-based methodology that rewards | ||||||
18 | appropriate staffing, quality-of-life improvements for nursing | ||||||
19 | facility residents, and the reduction of racial inequities and | ||||||
20 | health disparities for nursing facility residents enrolled in | ||||||
21 | Medicaid. | ||||||
22 | (c) (Blank). Notwithstanding any other provisions of this | ||||||
23 | Code, the methodologies for reimbursement of nursing services | ||||||
24 | as provided under this Article shall no longer be applicable |
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1 | for bills payable for nursing services rendered on or after a | ||||||
2 | new reimbursement system based on the Resource Utilization | ||||||
3 | Groups (RUGs) has been fully operationalized, which shall take | ||||||
4 | effect for services provided on or after January 1, 2014. | ||||||
5 | (d) The new nursing services reimbursement methodology | ||||||
6 | utilizing the Patient Driven Payment Model RUG-IV 48 grouper | ||||||
7 | model , which shall be referred to as the PDPM RUGs | ||||||
8 | reimbursement system, taking effect January 1, 2022, upon | ||||||
9 | federal approval by the Centers for Medicare and Medicaid | ||||||
10 | Services 2014 , shall be based on the following: | ||||||
11 | (1) The methodology shall be resident-centered | ||||||
12 | resident-driven , facility-specific, and based on guidance | ||||||
13 | from the Centers for Medicare and Medicaid Services | ||||||
14 | cost-based . | ||||||
15 | (2) Costs shall be annually rebased and case mix index | ||||||
16 | quarterly updated. The nursing services methodology will | ||||||
17 | be assigned to the Medicaid enrolled residents on record | ||||||
18 | as of 30 days prior to the beginning of the rate period in | ||||||
19 | the Department's Medicaid Management Information System | ||||||
20 | (MMIS) as present on the last day of the second quarter | ||||||
21 | preceding the rate period based upon the Assessment | ||||||
22 | Reference Date of the Minimum Data Set (MDS). | ||||||
23 | (3) Regional wage adjustors based on the Health | ||||||
24 | Service Areas (HSA) groupings and adjusters in effect on | ||||||
25 | January 1, 2022 April 30, 2012 shall be included, except | ||||||
26 | no adjuster shall be lower than 1.0. |
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1 | (4) PDPM nursing case-mix indices in effect on May 1, | ||||||
2 | 2021 Case mix index shall be assigned to each resident | ||||||
3 | class based on the Centers for Medicare and Medicaid | ||||||
4 | Services staff time measurement study called Staff Time | ||||||
5 | and Resource Intensity Verification (STRIVE) in effect on | ||||||
6 | July 1, 2013 , adjusted by a uniform multiplier to achieve | ||||||
7 | the same statewide case mix index value observed for the | ||||||
8 | quarter beginning April 1, 2021 while holding PA1, PA2, | ||||||
9 | BA1, and BB1 resident classes at the level applicable | ||||||
10 | under the RUG-IV payment model prior to January 1, 2022 | ||||||
11 | utilizing an index maximization approach . | ||||||
12 | (5) (Blank). The pool of funds available for | ||||||
13 | distribution by case mix and the base facility rate shall | ||||||
14 | be determined using the formula contained in subsection | ||||||
15 | (d-1). | ||||||
16 | (6) The statewide base rate for dates of service | ||||||
17 | before January 1, 2022 shall be $85.25, and thereafter | ||||||
18 | shall be no less than $90.25. | ||||||
19 | (7) The Department shall establish a variable per diem | ||||||
20 | add-on based on information from the most recent available | ||||||
21 | federal staffing report, currently the Payroll Based | ||||||
22 | Journal, adjusted for acuity if applicable using the same | ||||||
23 | quarter's MDS. The variable per diem add-on shall be paid | ||||||
24 | only to facilities with at least 70% of the staffing | ||||||
25 | indicated by the STRIVE study. For facilities at 70% of | ||||||
26 | the staffing indicated by the STRIVE study, those |
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1 | facilities shall be paid a per diem add-on of $9, | ||||||
2 | increasing by equivalent steps for each whole percentage | ||||||
3 | point of improvement until the facilities reach a per diem | ||||||
4 | of $14.88. For facilities with at least 80% of the | ||||||
5 | staffing indicated by the STRIVE study, those facilities | ||||||
6 | shall be paid a per diem add-on of $14.88, increasing by | ||||||
7 | equivalent steps for each whole percentage point of | ||||||
8 | improvement until the facilities reach a per diem add-on | ||||||
9 | of $23.80. For facilities with at least 92% of the | ||||||
10 | staffing indicated by the STRIVE study, those facilities | ||||||
11 | shall be paid a per diem add-on of $23.80, increasing by | ||||||
12 | equivalent steps for each whole percentage point of | ||||||
13 | improvement until the facilities reach a per diem add-on | ||||||
14 | of $29.75. For facilities with at least 100% of the | ||||||
15 | staffing indicated by the STRIVE study, those facilities | ||||||
16 | shall be paid a per diem add-on of $29.75, increasing by | ||||||
17 | equivalent steps for each whole percentage point of | ||||||
18 | improvement until the facilities reach a per diem add-on | ||||||
19 | of $35.70. For facilities with at least 110% of the | ||||||
20 | staffing indicated by the STRIVE study, those facilities | ||||||
21 | shall be paid a per diem add-on of $35.70, increasing by | ||||||
22 | equivalent steps for each whole percentage point of | ||||||
23 | improvement until the facilities reach a per diem add-on | ||||||
24 | of $38.68. For facilities with 125% of the staffing | ||||||
25 | indicated by the STRIVE study or more, those facilities | ||||||
26 | shall be paid a per diem add-on of $38.68. The Department |
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1 | shall establish, by rule, a limit of not more than a 5 | ||||||
2 | percentage point drop per once-consecutive quarter in the | ||||||
3 | STRIVE percentage used to determine the variable per diem | ||||||
4 | add-on. | ||||||
5 | (d-1) (Blank). Calculation of base year Statewide RUG-IV | ||||||
6 | nursing base per diem rate. | ||||||
7 | (1) Base rate spending pool shall be: | ||||||
8 | (A) The base year resident days which are | ||||||
9 | calculated by multiplying the number of Medicaid | ||||||
10 | residents in each nursing home as indicated in the MDS | ||||||
11 | data defined in paragraph (4) by 365. | ||||||
12 | (B) Each facility's nursing component per diem in | ||||||
13 | effect on July 1, 2012 shall be multiplied by | ||||||
14 | subsection (A). | ||||||
15 | (C) Thirteen million is added to the product of | ||||||
16 | subparagraph (A) and subparagraph (B) to adjust for | ||||||
17 | the exclusion of nursing homes defined in paragraph | ||||||
18 | (5). | ||||||
19 | (2) For each nursing home with Medicaid residents as | ||||||
20 | indicated by the MDS data defined in paragraph (4), | ||||||
21 | weighted days adjusted for case mix and regional wage | ||||||
22 | adjustment shall be calculated. For each home this | ||||||
23 | calculation is the product of: | ||||||
24 | (A) Base year resident days as calculated in | ||||||
25 | subparagraph (A) of paragraph (1). | ||||||
26 | (B) The nursing home's regional wage adjustor |
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1 | based on the Health Service Areas (HSA) groupings and | ||||||
2 | adjustors in effect on April 30, 2012. | ||||||
3 | (C) Facility weighted case mix which is the number | ||||||
4 | of Medicaid residents as indicated by the MDS data | ||||||
5 | defined in paragraph (4) multiplied by the associated | ||||||
6 | case weight for the RUG-IV 48 grouper model using | ||||||
7 | standard RUG-IV procedures for index maximization. | ||||||
8 | (D) The sum of the products calculated for each | ||||||
9 | nursing home in subparagraphs (A) through (C) above | ||||||
10 | shall be the base year case mix, rate adjusted | ||||||
11 | weighted days. | ||||||
12 | (3) The Statewide RUG-IV nursing base per diem rate: | ||||||
13 | (A) on January 1, 2014 shall be the quotient of the | ||||||
14 | paragraph (1) divided by the sum calculated under | ||||||
15 | subparagraph (D) of paragraph (2); and | ||||||
16 | (B) on and after July 1, 2014, shall be the amount | ||||||
17 | calculated under subparagraph (A) of this paragraph | ||||||
18 | (3) plus $1.76. | ||||||
19 | (4) Minimum Data Set (MDS) comprehensive assessments | ||||||
20 | for Medicaid residents on the last day of the quarter used | ||||||
21 | to establish the base rate. | ||||||
22 | (5) Nursing facilities designated as of July 1, 2012 | ||||||
23 | by the Department as "Institutions for Mental Disease" | ||||||
24 | shall be excluded from all calculations under this | ||||||
25 | subsection. The data from these facilities shall not be | ||||||
26 | used in the computations described in paragraphs (1) |
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1 | through (4) above to establish the base rate. | ||||||
2 | (e) Beginning July 1, 2014 through December 31, 2021 , the | ||||||
3 | Department shall allocate funding in the amount up to | ||||||
4 | $10,000,000 for per diem add-ons to the RUGS methodology for | ||||||
5 | dates of service on and after July 1, 2014: | ||||||
6 | (1) $0.63 for each resident who scores in I4200 | ||||||
7 | Alzheimer's Disease or I4800 non-Alzheimer's Dementia. | ||||||
8 | (2) $2.67 for each resident who scores either a "1" or | ||||||
9 | "2" in any items S1200A through S1200I and also scores in | ||||||
10 | RUG groups PA1, PA2, BA1, or BA2. | ||||||
11 | (3) Beginning on and after January 1, 2022, the | ||||||
12 | Department shall allocate funding, by rule, for per diem | ||||||
13 | add-ons to the PDPM methodology for each resident with a | ||||||
14 | diagnosis of Alzheimer's disease. | ||||||
15 | (e-1) (Blank). | ||||||
16 | (e-2) (Blank). For dates of services beginning January 1, | ||||||
17 | 2014, the RUG-IV nursing component per diem for a nursing home | ||||||
18 | shall be the product of the statewide RUG-IV nursing base per | ||||||
19 | diem rate, the facility average case mix index, and the | ||||||
20 | regional wage adjustor. Transition rates for services provided | ||||||
21 | between January 1, 2014 and December 31, 2014 shall be as | ||||||
22 | follows: | ||||||
23 | (1) The transition RUG-IV per diem nursing rate for | ||||||
24 | nursing homes whose rate calculated in this subsection | ||||||
25 | (e-2) is greater than the nursing component rate in effect | ||||||
26 | July 1, 2012 shall be paid the sum of: |
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| |||||||
1 | (A) The nursing component rate in effect July 1, | ||||||
2 | 2012; plus | ||||||
3 | (B) The difference of the RUG-IV nursing component | ||||||
4 | per diem calculated for the current quarter minus the | ||||||
5 | nursing component rate in effect July 1, 2012 | ||||||
6 | multiplied by 0.88. | ||||||
7 | (2) The transition RUG-IV per diem nursing rate for | ||||||
8 | nursing homes whose rate calculated in this subsection | ||||||
9 | (e-2) is less than the nursing component rate in effect | ||||||
10 | July 1, 2012 shall be paid the sum of: | ||||||
11 | (A) The nursing component rate in effect July 1, | ||||||
12 | 2012; plus | ||||||
13 | (B) The difference of the RUG-IV nursing component | ||||||
14 | per diem calculated for the current quarter minus the | ||||||
15 | nursing component rate in effect July 1, 2012 | ||||||
16 | multiplied by 0.13. | ||||||
17 | (f) Notwithstanding any other provision of this Code, on | ||||||
18 | and after July 1, 2012, reimbursement rates associated with | ||||||
19 | the nursing or support components of the current nursing | ||||||
20 | facility rate methodology shall not increase beyond the level | ||||||
21 | effective May 1, 2011 until a new reimbursement system based | ||||||
22 | on the RUGs IV 48 grouper model has been fully | ||||||
23 | operationalized. | ||||||
24 | (g) Notwithstanding any other provision of this Code, on | ||||||
25 | and after July 1, 2012, for facilities not designated by the | ||||||
26 | Department of Healthcare and Family Services as "Institutions |
| |||||||
| |||||||
1 | for Mental Disease", rates effective May 1, 2011 shall be | ||||||
2 | adjusted as follows: | ||||||
3 | (1) (Blank); Individual nursing rates for residents | ||||||
4 | classified in RUG IV groups PA1, PA2, BA1, and BA2 during | ||||||
5 | the quarter ending March 31, 2012 shall be reduced by 10%; | ||||||
6 | (2) (Blank); Individual nursing rates for residents | ||||||
7 | classified in all other RUG IV groups shall be reduced by | ||||||
8 | 1.0%; | ||||||
9 | (3) Facility rates for the capital and support | ||||||
10 | components shall be reduced by 1.7%. | ||||||
11 | (h) Notwithstanding any other provision of this Code, on | ||||||
12 | and after July 1, 2012, nursing facilities designated by the | ||||||
13 | Department of Healthcare and Family Services as "Institutions | ||||||
14 | for Mental Disease" and "Institutions for Mental Disease" that | ||||||
15 | are facilities licensed under the Specialized Mental Health | ||||||
16 | Rehabilitation Act of 2013 shall have the nursing, | ||||||
17 | socio-developmental, capital, and support components of their | ||||||
18 | reimbursement rate effective May 1, 2011 reduced in total by | ||||||
19 | 2.7%. | ||||||
20 | (i) On and after July 1, 2014, the reimbursement rates for | ||||||
21 | the support component of the nursing facility rate for | ||||||
22 | facilities licensed under the Nursing Home Care Act as skilled | ||||||
23 | or intermediate care facilities shall be the rate in effect on | ||||||
24 | June 30, 2014 increased by 8.17%. | ||||||
25 | (j) Notwithstanding any other provision of law, subject to | ||||||
26 | federal approval, effective July 1, 2019, sufficient funds |
| |||||||
| |||||||
1 | shall be allocated for changes to rates for facilities | ||||||
2 | licensed under the Nursing Home Care Act as skilled nursing | ||||||
3 | facilities or intermediate care facilities for dates of | ||||||
4 | services on and after July 1, 2019: (i) to establish , through | ||||||
5 | December 31, 2021 or upon implementation of the variable per | ||||||
6 | diem add-on for staffing under paragraph (7) of subsection | ||||||
7 | (d), whichever is later, a per diem add-on to the direct care | ||||||
8 | per diem rate not to exceed $70,000,000 annually in the | ||||||
9 | aggregate taking into account federal matching funds for the | ||||||
10 | purpose of addressing the facility's unique staffing needs, | ||||||
11 | adjusted quarterly and distributed by a weighted formula based | ||||||
12 | on Medicaid bed days on the last day of the second quarter | ||||||
13 | preceding the quarter for which the rate is being adjusted . | ||||||
14 | Beginning January 1, 2022, or upon implementation of the | ||||||
15 | variable per diem add-on for staffing under paragraph (7) of | ||||||
16 | subsection (d), whichever is later, the annual $70,000,000 | ||||||
17 | described in the preceding sentence shall be dedicated to the | ||||||
18 | variable per diem add-on for staffing under paragraph (7) of | ||||||
19 | subsection (d) ; and (ii) in an amount not to exceed | ||||||
20 | $170,000,000 annually in the aggregate taking into account | ||||||
21 | federal matching funds to permit the support component of the | ||||||
22 | nursing facility rate to be updated as follows: | ||||||
23 | (1) 80%, or $136,000,000, of the funds shall be used | ||||||
24 | to update each facility's rate in effect on June 30, 2019 | ||||||
25 | using the most recent cost reports on file, which have had | ||||||
26 | a limited review conducted by the Department of Healthcare |
| |||||||
| |||||||
1 | and Family Services and will not hold up enacting the rate | ||||||
2 | increase, with the Department of Healthcare and Family | ||||||
3 | Services and taking into account subsection (i) . | ||||||
4 | (2) After completing the calculation in paragraph (1), | ||||||
5 | any facility whose rate is less than the rate in effect on | ||||||
6 | June 30, 2019 shall have its rate restored to the rate in | ||||||
7 | effect on June 30, 2019 from the 20% of the funds set | ||||||
8 | aside. | ||||||
9 | (3) The remainder of the 20%, or $34,000,000, shall be | ||||||
10 | used to increase each facility's rate by an equal | ||||||
11 | percentage. | ||||||
12 | In order to provide for the expeditious and timely | ||||||
13 | implementation of the provisions of this amendatory Act of the | ||||||
14 | 102nd General Assembly, emergency rules to implement any | ||||||
15 | provision of this amendatory Act of the 102nd General Assembly | ||||||
16 | may be adopted in accordance with this subsection by the | ||||||
17 | agency charged with administering that provision or | ||||||
18 | initiative. The 24-month limitation on the adoption of | ||||||
19 | emergency rules does not apply to rules adopted under this | ||||||
20 | subsection. The adoption of emergency rules authorized by this | ||||||
21 | subsection is deemed to be necessary for the public interest, | ||||||
22 | safety, and welfare. | ||||||
23 | To implement item (i) in this subsection, facilities shall | ||||||
24 | file quarterly reports documenting compliance with its | ||||||
25 | annually approved staffing plan, which shall permit compliance | ||||||
26 | with Section 3-202.05 of the Nursing Home Care Act. A facility |
| |||||||
| |||||||
1 | that fails to meet the benchmarks and dates contained in the | ||||||
2 | plan may have its add-on adjusted in the quarter following the | ||||||
3 | quarterly review. Nothing in this Section shall limit the | ||||||
4 | ability of the facility to appeal a ruling of non-compliance | ||||||
5 | and a subsequent reduction to the add-on. Funds adjusted for | ||||||
6 | noncompliance shall be maintained in the Long-Term Care | ||||||
7 | Provider Fund and accounted for separately. At the end of each | ||||||
8 | fiscal year, these funds shall be made available to facilities | ||||||
9 | for special staffing projects. | ||||||
10 | In order to provide for the expeditious and timely
| ||||||
11 | implementation of the provisions of Public Act 101-10, | ||||||
12 | emergency rules to implement any provision of Public Act | ||||||
13 | 101-10 may be adopted in accordance with this subsection by | ||||||
14 | the agency charged with administering that provision or
| ||||||
15 | initiative. The agency shall simultaneously file emergency | ||||||
16 | rules and permanent rules to ensure that there is no | ||||||
17 | interruption in administrative guidance. The 150-day | ||||||
18 | limitation of the effective period of emergency rules does not | ||||||
19 | apply to rules adopted under this
subsection, and the | ||||||
20 | effective period may continue through
June 30, 2021. The | ||||||
21 | 24-month limitation on the adoption of
emergency rules does | ||||||
22 | not apply to rules adopted under this
subsection. The adoption | ||||||
23 | of emergency rules authorized by this subsection is deemed to | ||||||
24 | be necessary for the public interest, safety, and welfare. | ||||||
25 | (k) During the first quarter of State Fiscal Year 2020, | ||||||
26 | the Department of Healthcare of Family Services must convene a |
| |||||||
| |||||||
1 | technical advisory group consisting of members of all trade | ||||||
2 | associations representing Illinois skilled nursing providers | ||||||
3 | to discuss changes necessary with federal implementation of | ||||||
4 | Medicare's Patient-Driven Payment Model. Implementation of | ||||||
5 | Medicare's Patient-Driven Payment Model shall, by September 1, | ||||||
6 | 2020, end the collection of the MDS data that is necessary to | ||||||
7 | maintain the current RUG-IV Medicaid payment methodology. The | ||||||
8 | technical advisory group must consider a revised reimbursement | ||||||
9 | methodology that takes into account transparency, | ||||||
10 | accountability, actual staffing as reported under the | ||||||
11 | federally required Payroll Based Journal system, changes to | ||||||
12 | the minimum wage, adequacy in coverage of the cost of care, and | ||||||
13 | a quality component that rewards quality improvements. | ||||||
14 | (l) The Department shall establish directed payments to | ||||||
15 | improve the quality of care delivered by facilities, | ||||||
16 | including: | ||||||
17 | (1) Incentive payments determined by facility | ||||||
18 | performance on specified quality measures in an initial | ||||||
19 | amount of $70,000,000. Nothing in this Section shall be | ||||||
20 | construed to limit the quality of care directed payments | ||||||
21 | to $70,000,000, and in the case that quality of care has | ||||||
22 | improved across nursing facilities, the Department shall | ||||||
23 | adjust those directed payments accordingly. The quality | ||||||
24 | payment methodology described in this Section must be used | ||||||
25 | for at least the first 2 quarters in calendar year 2022. | ||||||
26 | Beginning with the quarter starting July 1, 2022, the |
| |||||||
| |||||||
1 | Department may add, remove, or change quality metrics and | ||||||
2 | make associated changes to the quality payment methodology | ||||||
3 | as outlined in subparagraph (E). Facilities designated by | ||||||
4 | the Centers for Medicare and Medicaid Services as a | ||||||
5 | special focus facility or a hospital-based nursing home do | ||||||
6 | not qualify for quality payments. | ||||||
7 | (A) Each quality pool must be distributed by | ||||||
8 | assigning a quality weighted score for each nursing | ||||||
9 | home which is calculated by multiplying the nursing | ||||||
10 | home's quality base period Medicaid days by the | ||||||
11 | nursing home's star rating weight in that period. | ||||||
12 | (B) Star rating weights are assigned based on the | ||||||
13 | nursing home's star rating for the LTS quality star | ||||||
14 | rating. "LTS quality star rating" means the long stay | ||||||
15 | quality rating for each nursing facility as assigned | ||||||
16 | by the Centers for Medicare and Medicaid Services | ||||||
17 | under the Five-Star Quality Rating System. The rating | ||||||
18 | is a number ranging from 0 (lowest) to 5 (highest). | ||||||
19 | (i) Zero or one star rating has a weight of 0. | ||||||
20 | (ii) Two star rating has a weight of 0.75. | ||||||
21 | (iii) Three star rating has a weight of 1.5. | ||||||
22 | (iv) Four star rating has a weight of 2.5. | ||||||
23 | (v) Five star rating has a weight of 3.5. | ||||||
24 | (C) Each nursing home's quality weight score is | ||||||
25 | divided by the sum of all quality weight scores for | ||||||
26 | qualifying nursing homes to determine the proportion |
| |||||||
| |||||||
1 | of the quality pool to be paid to the nursing home. | ||||||
2 | (D) The quality pool is no less than $70,000,000 | ||||||
3 | annually or $17,500,000 per quarter. | ||||||
4 | (E) The Department shall review quality metrics | ||||||
5 | used for payment of the quality pool and make | ||||||
6 | recommendations for any associated changes to the | ||||||
7 | methodology for distributing quality pool payments to | ||||||
8 | a quality review committee established by the | ||||||
9 | Department consisting of associations representing | ||||||
10 | long-term care providers, consumer advocates, | ||||||
11 | organizations representing workers of long-term care | ||||||
12 | facilities, and payors. | ||||||
13 | (F) The Department shall disburse quality pool | ||||||
14 | payments from the Long-Term Care Provider Fund on | ||||||
15 | either a monthly or daily basis in amounts | ||||||
16 | proportional to the total quality pool payment | ||||||
17 | determined for the quarter. | ||||||
18 | (G) The Department shall publish any changes in | ||||||
19 | the methodology for distributing quality pool payments | ||||||
20 | prior to the beginning of the measurement period, or | ||||||
21 | quality base period, for any metric added to the | ||||||
22 | distribution's methodology. | ||||||
23 | (2) Payments based on CNA tenure, promotion, and CNA | ||||||
24 | training for the purpose of increasing CNA compensation. | ||||||
25 | It is the intent of this subsection that payments made in | ||||||
26 | accordance with this paragraph be directly incorporated |
| |||||||
| |||||||
1 | into increased compensation for CNAs. As used in this | ||||||
2 | paragraph, "CNA" means a certified nursing assistant as | ||||||
3 | that term is described in Section 3-206 of the Nursing | ||||||
4 | Home Care Act, Section 3-206 of the ID/DD Community Care | ||||||
5 | Act, and Section 3-206 of the MC/DD Act. The Department | ||||||
6 | shall establish, by rule, payments to nursing facilities | ||||||
7 | equal to Medicaid's share of the tenure wage increments | ||||||
8 | specified in this paragraph for all reported CNA employee | ||||||
9 | hours compensated according to a posted schedule | ||||||
10 | consisting of increments at least as large as those | ||||||
11 | specified in this paragraph. The increments are as | ||||||
12 | follows: an additional $1.50 per hour for CNAs with at | ||||||
13 | least one and less than 2 years' experience plus another | ||||||
14 | $1 per hour for each additional year of experience up to a | ||||||
15 | maximum of $6.50 for CNAs with at least 6 years of | ||||||
16 | experience. For purposes of this paragraph, Medicaid's | ||||||
17 | share shall be the ratio determined by paid Medicaid bed | ||||||
18 | days divided by total bed days for the applicable time | ||||||
19 | period used in the calculation. In addition, and additive | ||||||
20 | to any tenure increments paid as specified in this | ||||||
21 | paragraph, the Department shall establish, by rule, | ||||||
22 | payments supporting Medicaid's share of the | ||||||
23 | promotion-based wage increments for CNA employee hours | ||||||
24 | compensated for that promotion with at least a $1.50 | ||||||
25 | hourly increase. Medicaid's share shall be established as | ||||||
26 | it is for the tenure increments described in this |
| |||||||
| |||||||
1 | paragraph. Qualifying promotions shall be defined by the | ||||||
2 | Department in rules for an expected 10-15% subset of CNAs | ||||||
3 | assigned intermediate, specialized, or added roles such as | ||||||
4 | CNA trainers, CNA scheduling 'captains', and CNA | ||||||
5 | specialists for resident conditions like dementia or | ||||||
6 | memory care or behavioral health. | ||||||
7 | (m) In order to provide for the expeditious and timely | ||||||
8 | implementation of the provisions of this amendatory Act of the | ||||||
9 | 102nd General Assembly, emergency rules to implement any | ||||||
10 | provision of this amendatory Act of the 102nd General Assembly | ||||||
11 | may be adopted in accordance with this subsection by the | ||||||
12 | agency charged with administering that provision or | ||||||
13 | initiative. The 24-month limitation on the adoption of | ||||||
14 | emergency rules does not apply to rules adopted under this | ||||||
15 | subsection. The adoption of emergency rules authorized by this | ||||||
16 | subsection is deemed to be necessary for the public interest, | ||||||
17 | safety, and welfare. | ||||||
18 | (Source: P.A. 101-10, eff. 6-5-19; 101-348, eff. 8-9-19; | ||||||
19 | 102-77, eff. 7-9-21; 102-558, eff. 8-20-21.)
| ||||||
20 | (305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
| ||||||
21 | Sec. 5B-2. Assessment; no local authorization to tax.
| ||||||
22 | (a) For the privilege of engaging in the occupation of | ||||||
23 | long-term care
provider, beginning July 1, 2011 through | ||||||
24 | December 31, 2021, or upon federal approval by the Centers for | ||||||
25 | Medicare and Medicaid Services of the long-term care provider |
| |||||||
| |||||||
1 | assessment described in subsection (a-1), whichever is later, | ||||||
2 | an assessment is imposed upon each long-term care provider in | ||||||
3 | an amount equal to $6.07 times the number of occupied bed days | ||||||
4 | due and payable each month. Notwithstanding any provision of | ||||||
5 | any other Act to the
contrary, this assessment shall be | ||||||
6 | construed as a tax, but shall not be billed or passed on to any | ||||||
7 | resident of a nursing home operated by the nursing home | ||||||
8 | provider.
| ||||||
9 | (a-1) For the privilege of engaging in the occupation of | ||||||
10 | long-term care provider, beginning January 1, 2022, an | ||||||
11 | assessment is imposed upon each long-term care provider in an | ||||||
12 | amount varying with the number of paid Medicaid resident days | ||||||
13 | per annum in the facility with the following initial schedule | ||||||
14 | of occupied bed tax amounts: | ||||||
15 | (1) 0-5,000 Medicaid resident days per annum, $10.67. | ||||||
16 | (2) 5,001-15,000 Medicaid resident days per annum, | ||||||
17 | $19.20. | ||||||
18 | (3) 15,001-35,000 Medicaid resident days per annum, | ||||||
19 | $22.40. | ||||||
20 | (4) 35,001-55,000 Medicaid resident days per annum, | ||||||
21 | $19.20. | ||||||
22 | (5) 55,001-65,000 Medicaid resident days per annum, | ||||||
23 | $13.86. | ||||||
24 | (6) 65,001+ Medicaid resident days per annum, $10.67. | ||||||
25 | (7) Any nonprofit nursing facilities without | ||||||
26 | Medicaid-certified beds, $7 per occupied bed day. |
| |||||||
| |||||||
1 | Notwithstanding any provision of any other Act to the | ||||||
2 | contrary, this assessment shall be construed as a tax but | ||||||
3 | shall not be billed or passed on to any resident of a nursing | ||||||
4 | home operated by the nursing home provider. | ||||||
5 | Each facility's paid Medicaid resident days per annum | ||||||
6 | shall be updated annually for the purpose of determining the | ||||||
7 | appropriate tax rate. | ||||||
8 | Implementation of the assessment described in this | ||||||
9 | subsection shall be subject to federal approval by the Centers | ||||||
10 | for Medicare and Medicaid Services. | ||||||
11 | (b) Nothing in this amendatory Act of 1992 shall be | ||||||
12 | construed to
authorize any home rule unit or other unit of | ||||||
13 | local government to license
for revenue or impose a tax or | ||||||
14 | assessment upon long-term care providers or
the occupation of | ||||||
15 | long-term care provider, or a tax or assessment measured
by | ||||||
16 | the income or earnings or occupied bed days of a long-term care | ||||||
17 | provider.
| ||||||
18 | (c) The assessment imposed by this Section shall not be | ||||||
19 | due and payable, however, until after the Department notifies | ||||||
20 | the long-term care providers, in writing, that the payment | ||||||
21 | methodologies to long-term care providers required under | ||||||
22 | Section 5-5.2 5-5.4 of this Code have been approved by the | ||||||
23 | Centers for Medicare and Medicaid Services of the U.S. | ||||||
24 | Department of Health and Human Services and that the waivers | ||||||
25 | under 42 CFR 433.68 for the assessment imposed by this | ||||||
26 | Section, if necessary, have been granted by the Centers for |
| |||||||
| |||||||
1 | Medicare and Medicaid Services of the U.S. Department of | ||||||
2 | Health and Human Services. | ||||||
3 | (Source: P.A. 96-1530, eff. 2-16-11; 97-10, eff. 6-14-11; | ||||||
4 | 97-584, eff. 8-26-11.)
| ||||||
5 | (305 ILCS 5/5B-4) (from Ch. 23, par. 5B-4)
| ||||||
6 | Sec. 5B-4. Payment of assessment; penalty.
| ||||||
7 | (a) The assessment imposed by Section 5B-2 shall be due | ||||||
8 | and payable monthly, on the last State business day of the | ||||||
9 | month for occupied bed days reported for the preceding third | ||||||
10 | month prior to the month in which the tax is payable and due. A | ||||||
11 | facility that has delayed payment due to the State's failure | ||||||
12 | to reimburse for services rendered may request an extension on | ||||||
13 | the due date for payment pursuant to subsection (b) and shall | ||||||
14 | pay the assessment within 30 days of reimbursement by the | ||||||
15 | Department.
The Illinois Department may provide that county | ||||||
16 | nursing homes directed and
maintained pursuant to Section | ||||||
17 | 5-1005 of the Counties Code may meet their
assessment | ||||||
18 | obligation by certifying to the Illinois Department that | ||||||
19 | county
expenditures have been obligated for the operation of | ||||||
20 | the county nursing
home in an amount at least equal to the | ||||||
21 | amount of the assessment.
| ||||||
22 | (a-5) The Illinois Department shall provide for an | ||||||
23 | electronic submission process for each long-term care facility | ||||||
24 | to report at a minimum the number of occupied bed days of the | ||||||
25 | long-term care facility for the reporting period and other |
| |||||||
| |||||||
1 | reasonable information the Illinois Department requires for | ||||||
2 | the administration of its responsibilities under this Code. | ||||||
3 | Beginning July 1, 2013, a separate electronic submission shall | ||||||
4 | be completed for each long-term care facility in this State | ||||||
5 | operated by a long-term care provider. The Illinois Department | ||||||
6 | shall provide a self-reporting notice of the assessment form | ||||||
7 | that the long-term care facility completes for the required | ||||||
8 | period and submits with its assessment payment to the Illinois | ||||||
9 | Department. To the extent practicable, the Department shall | ||||||
10 | coordinate the assessment reporting requirements with other | ||||||
11 | reporting required of long-term care facilities. | ||||||
12 | (b) The Illinois Department is authorized to establish
| ||||||
13 | delayed payment schedules for long-term care providers that | ||||||
14 | are
unable to make assessment payments when due under this | ||||||
15 | Section
due to financial difficulties, as determined by the | ||||||
16 | Illinois
Department. The Illinois Department may not deny a | ||||||
17 | request for delay of payment of the assessment imposed under | ||||||
18 | this Article if the long-term care provider has not been paid | ||||||
19 | for services provided during the month on which the assessment | ||||||
20 | is levied or the Medicaid managed care organization has not | ||||||
21 | been paid by the State .
| ||||||
22 | (c) If a long-term care provider fails to pay the full
| ||||||
23 | amount of an assessment payment when due (including any | ||||||
24 | extensions
granted under subsection (b)), there shall, unless | ||||||
25 | waived by the
Illinois Department for reasonable cause, be | ||||||
26 | added to the
assessment imposed by Section 5B-2 a
penalty |
| |||||||
| |||||||
1 | assessment equal to the lesser of (i) 5% of the amount of
the | ||||||
2 | assessment payment not paid on or before the due date plus 5% | ||||||
3 | of the
portion thereof remaining unpaid on the last day of each | ||||||
4 | month
thereafter or (ii) 100% of the assessment payment amount | ||||||
5 | not paid on or
before the due date. For purposes of this | ||||||
6 | subsection, payments
will be credited first to unpaid | ||||||
7 | assessment payment amounts (rather than
to penalty or | ||||||
8 | interest), beginning with the most delinquent assessment | ||||||
9 | payments. Payment cycles of longer than 60 days shall be one | ||||||
10 | factor the Director takes into account in granting a waiver | ||||||
11 | under this Section.
| ||||||
12 | (c-5) If a long-term care facility fails to file its | ||||||
13 | assessment bill with payment, there shall, unless waived by | ||||||
14 | the Illinois Department for reasonable cause, be added to the | ||||||
15 | assessment due a penalty assessment equal to 25% of the | ||||||
16 | assessment due. After July 1, 2013, no penalty shall be | ||||||
17 | assessed under this Section if the Illinois Department does | ||||||
18 | not provide a process for the electronic submission of the | ||||||
19 | information required by subsection (a-5). | ||||||
20 | (d) Nothing in this amendatory Act of 1993 shall be | ||||||
21 | construed to prevent
the Illinois Department from collecting | ||||||
22 | all amounts due under this Article
pursuant to an assessment | ||||||
23 | imposed before the effective date of this amendatory
Act of | ||||||
24 | 1993.
| ||||||
25 | (e) Nothing in this amendatory Act of the 96th General | ||||||
26 | Assembly shall be construed to prevent
the Illinois Department |
| |||||||
| |||||||
1 | from collecting all amounts due under this Code
pursuant to an | ||||||
2 | assessment, tax, fee, or penalty imposed before the effective | ||||||
3 | date of this amendatory
Act of the 96th General Assembly. | ||||||
4 | (f) No installment of the assessment imposed by Section | ||||||
5 | 5B-2 shall be due and payable until after the Department | ||||||
6 | notifies the long-term care providers, in writing, that the | ||||||
7 | payment methodologies to long-term care providers required | ||||||
8 | under Section 5-5.2 5-5.4 of this Code have been approved by | ||||||
9 | the Centers for Medicare and Medicaid Services of the U.S. | ||||||
10 | Department of Health and Human Services and the waivers under | ||||||
11 | 42 CFR 433.68 for the assessment imposed by this Section, if | ||||||
12 | necessary, have been granted by the Centers for Medicare and | ||||||
13 | Medicaid Services of the U.S. Department of Health and Human | ||||||
14 | Services. Upon notification to the Department of approval of | ||||||
15 | the payment methodologies required under Section 5-5.2 5-5.4 | ||||||
16 | of this Code and the waivers granted under 42 CFR 433.68, all | ||||||
17 | installments otherwise due under Section 5B-4 prior to the | ||||||
18 | date of notification shall be due and payable to the | ||||||
19 | Department upon written direction from the Department within | ||||||
20 | 90 days after issuance by the Comptroller of the payments | ||||||
21 | required under Section 5-5.2 5-5.4 of this Code. | ||||||
22 | (Source: P.A. 100-501, eff. 6-1-18; 101-649, eff. 7-7-20.)
| ||||||
23 | (305 ILCS 5/5B-5) (from Ch. 23, par. 5B-5)
| ||||||
24 | Sec. 5B-5. Annual reporting; penalty; maintenance of | ||||||
25 | records.
|
| |||||||
| |||||||
1 | (a) After December 31 of each year, and on or before
March | ||||||
2 | 31 of the succeeding year, every long-term care provider | ||||||
3 | subject to
assessment under this Article shall file a report | ||||||
4 | with the Illinois
Department. The report shall be in a form and | ||||||
5 | manner prescribed by the Illinois Department and shall state | ||||||
6 | the revenue received by the long-term care provider, reported | ||||||
7 | in such categories as may be required by the Illinois | ||||||
8 | Department, and other reasonable information the Illinois | ||||||
9 | Department requires for the administration of its | ||||||
10 | responsibilities under this Code.
| ||||||
11 | (b) If a long-term care provider operates or maintains
| ||||||
12 | more than one long-term care facility in this State, the | ||||||
13 | provider
may not file a single return covering all those | ||||||
14 | long-term care
facilities, but shall file a separate return | ||||||
15 | for each
long-term care facility and shall compute and pay the | ||||||
16 | assessment
for each long-term care facility separately.
| ||||||
17 | (c) Notwithstanding any other provision in this Article, | ||||||
18 | in
the case of a person who ceases to operate or maintain a | ||||||
19 | long-term
care facility in respect of which the person is | ||||||
20 | subject to
assessment under this Article as a long-term care | ||||||
21 | provider, the person shall file a final, amended return with | ||||||
22 | the Illinois
Department not more than 90 days after the | ||||||
23 | cessation reflecting
the adjustment and shall pay with the | ||||||
24 | final return the
assessment for the year as so adjusted (to the | ||||||
25 | extent not
previously paid). If a person fails to file a final | ||||||
26 | amended return on a timely basis, there shall, unless waived |
| |||||||
| |||||||
1 | by the Illinois Department for reasonable cause, be added to | ||||||
2 | the assessment due a penalty assessment equal to 25% of the | ||||||
3 | assessment due.
| ||||||
4 | (d) Notwithstanding any other provision of this Article, a
| ||||||
5 | provider who commences operating or maintaining a long-term | ||||||
6 | care
facility that was under a prior ownership and remained | ||||||
7 | licensed by the Department of Public Health shall notify the | ||||||
8 | Illinois Department of any the change in ownership regardless | ||||||
9 | of percentage, and shall be responsible to immediately pay any | ||||||
10 | prior amounts owed by the facility. In addition, within 90 | ||||||
11 | days after the effective date of this amendatory Act of the | ||||||
12 | 102nd General Assembly, all providers operating or maintaining | ||||||
13 | a long-term care facility shall notify the Illinois Department | ||||||
14 | of all individual owners and any individuals or organizations | ||||||
15 | that are part of a limited liability company with ownership of | ||||||
16 | that facility and the percentage ownership of each owner. This | ||||||
17 | ownership reporting requirement does not include individual | ||||||
18 | shareholders in a publicly held corporation.
| ||||||
19 | (e) The Department shall develop a procedure for sharing | ||||||
20 | with a potential buyer of a facility information regarding | ||||||
21 | outstanding assessments and penalties owed by that facility.
| ||||||
22 | (f) In the case of a long-term care provider existing as a
| ||||||
23 | corporation or legal entity other than an individual, the | ||||||
24 | return
filed by it shall be signed by its president, | ||||||
25 | vice-president,
secretary, or treasurer or by its properly | ||||||
26 | authorized agent.
|
| |||||||
| |||||||
1 | (g) If a long-term care provider fails to file its return
| ||||||
2 | on or before the due date of the return,
there shall, unless | ||||||
3 | waived by the Illinois Department for
reasonable cause, be | ||||||
4 | added to the assessment imposed by Section
5B-2 a penalty | ||||||
5 | assessment equal to 25%
of the assessment imposed for the | ||||||
6 | year. After July 1, 2013, no penalty shall be assessed if the | ||||||
7 | Illinois Department has not established a process for the | ||||||
8 | electronic submission of information.
| ||||||
9 | (h) Every long-term care provider subject to assessment
| ||||||
10 | under this Article shall keep records and books that will
| ||||||
11 | permit the determination of occupied bed days on a calendar | ||||||
12 | year
basis. All such books and records shall be kept in the | ||||||
13 | English
language and shall, at all times during business hours | ||||||
14 | of the
day, be subject to inspection by the Illinois | ||||||
15 | Department or its
duly authorized agents and employees.
| ||||||
16 | (i) The Illinois Department shall establish a process for | ||||||
17 | long-term care providers to electronically submit all | ||||||
18 | information required by this Section no later than July 1, | ||||||
19 | 2013. | ||||||
20 | (Source: P.A. 96-1530, eff. 2-16-11; 97-403, eff. 1-1-12; | ||||||
21 | 97-813, eff. 7-13-12.)
| ||||||
22 | (305 ILCS 5/5B-8) (from Ch. 23, par. 5B-8)
| ||||||
23 | Sec. 5B-8. Long-Term Care Provider Fund.
| ||||||
24 | (a) There is created in the State Treasury the Long-Term
| ||||||
25 | Care Provider Fund. Interest earned by the Fund shall be
|
| |||||||
| |||||||
1 | credited to the Fund. The Fund shall not be used to replace any
| ||||||
2 | moneys appropriated to the Medicaid program by the General | ||||||
3 | Assembly.
| ||||||
4 | (b) The Fund is created for the purpose of receiving and
| ||||||
5 | disbursing moneys in accordance with this Article. | ||||||
6 | Disbursements
from the Fund shall be made only as follows:
| ||||||
7 | (1) For payments to nursing
facilities, including | ||||||
8 | county nursing facilities but excluding
State-operated | ||||||
9 | facilities, under Title XIX of the Social Security
Act and | ||||||
10 | Article V of this Code.
| ||||||
11 | (1.5) For payments to managed care organizations as | ||||||
12 | defined in Section 5-30.1 of this Code.
| ||||||
13 | (2) For the reimbursement of moneys collected by the
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14 | Illinois Department through error or mistake.
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15 | (3) For payment of administrative expenses incurred by | ||||||
16 | the
Illinois Department or its agent in performing the | ||||||
17 | activities
authorized by this Article.
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18 | (3.5) For reimbursement of expenses incurred by | ||||||
19 | long-term care facilities, and payment of administrative | ||||||
20 | expenses incurred by the Department of Public Health, in | ||||||
21 | relation to the conduct and analysis of background checks | ||||||
22 | for identified offenders under the Nursing Home Care Act.
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23 | (4) For payments of any amounts that are reimbursable | ||||||
24 | to the
federal government for payments from this Fund that | ||||||
25 | are required
to be paid by State warrant.
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26 | (5) For making transfers to the General Obligation |
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1 | Bond
Retirement and Interest Fund, as those transfers are | ||||||
2 | authorized
in the proceedings authorizing debt under the | ||||||
3 | Short Term Borrowing Act,
but transfers made under this | ||||||
4 | paragraph (5) shall not exceed the
principal amount of | ||||||
5 | debt issued in anticipation of the receipt by
the State of | ||||||
6 | moneys to be deposited into the Fund.
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7 | (6) For making transfers, at the direction of the | ||||||
8 | Director of the Governor's Office of Management and Budget | ||||||
9 | during each fiscal year beginning on or after July 1, | ||||||
10 | 2011, to other State funds in an annual amount of | ||||||
11 | $20,000,000 of the tax collected pursuant to this Article | ||||||
12 | for the purpose of enforcement of nursing home standards, | ||||||
13 | support of the ombudsman program, and efforts to expand | ||||||
14 | home and community-based services. No transfer under this | ||||||
15 | paragraph shall occur until (i) the payment methodologies | ||||||
16 | created by Public Act 96-1530 under Section 5-5.4 of this | ||||||
17 | Code have been approved by the Centers for Medicare and | ||||||
18 | Medicaid Services of the U.S. Department of Health and | ||||||
19 | Human Services and (ii) the assessment imposed by Section | ||||||
20 | 5B-2 of this Code is determined to be a permissible tax | ||||||
21 | under Title XIX of the Social Security Act. | ||||||
22 | Disbursements from the Fund, other than transfers made | ||||||
23 | pursuant to paragraphs (5) and (6) of this subsection, shall | ||||||
24 | be by
warrants drawn by the State Comptroller upon receipt of | ||||||
25 | vouchers
duly executed and certified by the Illinois | ||||||
26 | Department.
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1 | (c) The Fund shall consist of the following:
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2 | (1) All moneys collected or received by the Illinois
| ||||||
3 | Department from the long-term care provider assessment | ||||||
4 | imposed by
this Article.
| ||||||
5 | (2) All federal matching funds received by the | ||||||
6 | Illinois
Department as a result of expenditures made from | ||||||
7 | the Fund by the Illinois
Department that are attributable | ||||||
8 | to moneys deposited in the Fund .
| ||||||
9 | (3) Any interest or penalty levied in conjunction with | ||||||
10 | the
administration of this Article.
| ||||||
11 | (4) (Blank).
| ||||||
12 | (5) All other monies received for the Fund from any | ||||||
13 | other source,
including interest earned thereon.
| ||||||
14 | (Source: P.A. 96-1530, eff. 2-16-11; 97-584, eff. 8-26-11.)
| ||||||
15 | (305 ILCS 5/5E-10)
| ||||||
16 | Sec. 5E-10. Fee. Through December 31, 2021 or upon federal | ||||||
17 | approval by the Centers for Medicare and Medicaid Services of | ||||||
18 | the long-term care provider assessment described in subsection | ||||||
19 | (a-1) of Section 5B-2 of this Code, whichever is later, every | ||||||
20 | Every nursing home provider shall pay to the Illinois
| ||||||
21 | Department, on or before September 10, December 10, March 10, | ||||||
22 | and June 10, a
fee in the amount of $1.50 for each licensed | ||||||
23 | nursing bed day for the calendar
quarter in which the payment | ||||||
24 | is due. This fee shall not be billed or passed on
to any | ||||||
25 | resident of a nursing home operated by the nursing home |
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1 | provider. All
fees received by the Illinois Department under | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
2 | this Section shall be deposited
into the Long-Term Care | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 | Provider Fund. This Section 5E-10 is repealed on December 31, | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4 | 2023.
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5 | (Source: P.A. 88-88; 89-21, eff. 7-1-95.)
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6 | (305 ILCS 5/5E-20 new) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
7 | Sec. 5E-20. Repealer. This Article 5E is repealed on July | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
8 | 1, 2024.
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