Full Text of HB5847 103rd General Assembly
HB5847 103RD GENERAL ASSEMBLY | | | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB5847 Introduced 5/15/2024, by Rep. Anna Moeller - Yolonda Morris SYNOPSIS AS INTRODUCED: | | | Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision concerning payments to nursing facilities, sets forth how to calculate each facility's variable per diem staffing add-on amount beginning October 1, 2024. Increases the per diem maximum amounts paid to facilities based on the STRIVE study. Effective October 1, 2024. |
| |
| | A BILL FOR |
| | | | HB5847 | | LRB103 40684 KTG 73450 b |
|
| 1 | | AN ACT concerning 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 5-5.2 as follows: | 6 | | (305 ILCS 5/5-5.2) | 7 | | Sec. 5-5.2. Payment. | 8 | | (a) All nursing facilities that are grouped pursuant to | 9 | | Section 5-5.1 of this Act shall receive the same rate of | 10 | | payment for similar services. | 11 | | (b) It shall be a matter of State policy that the Illinois | 12 | | Department shall utilize a uniform billing cycle throughout | 13 | | the State for the long-term care providers. | 14 | | (c) (Blank). | 15 | | (c-1) Notwithstanding any other provisions of this Code, | 16 | | the methodologies for reimbursement of nursing services as | 17 | | provided under this Article shall no longer be applicable for | 18 | | bills payable for nursing services rendered on or after a new | 19 | | reimbursement system based on the Patient Driven Payment Model | 20 | | (PDPM) has been fully operationalized, which shall take effect | 21 | | for services provided on or after the implementation of the | 22 | | PDPM reimbursement system begins. For the purposes of Public | 23 | | Act 102-1035 this amendatory Act of the 102nd General |
| | | HB5847 | - 2 - | LRB103 40684 KTG 73450 b |
|
| 1 | | Assembly , the implementation date of the PDPM reimbursement | 2 | | system and all related provisions shall be July 1, 2022 if the | 3 | | following conditions are met: (i) the Centers for Medicare and | 4 | | Medicaid Services has approved corresponding changes in the | 5 | | reimbursement system and bed assessment; and (ii) the | 6 | | Department has filed rules to implement these changes no later | 7 | | than June 1, 2022. Failure of the Department to file rules to | 8 | | implement the changes provided in Public Act 102-1035 this | 9 | | amendatory Act of the 102nd General Assembly no later than | 10 | | June 1, 2022 shall result in the implementation date being | 11 | | delayed to October 1, 2022. | 12 | | (d) The new nursing services reimbursement methodology | 13 | | utilizing the Patient Driven Payment Model, which shall be | 14 | | referred to as the PDPM reimbursement system, taking effect | 15 | | July 1, 2022, upon federal approval by the Centers for | 16 | | Medicare and Medicaid Services, shall be based on the | 17 | | following: | 18 | | (1) The methodology shall be resident-centered, | 19 | | facility-specific, cost-based, and based on guidance from | 20 | | the Centers for Medicare and Medicaid Services. | 21 | | (2) Costs shall be annually rebased and case mix index | 22 | | quarterly updated. The nursing services methodology will | 23 | | be assigned to the Medicaid enrolled residents on record | 24 | | as of 30 days prior to the beginning of the rate period in | 25 | | the Department's Medicaid Management Information System | 26 | | (MMIS) as present on the last day of the second quarter |
| | | HB5847 | - 3 - | LRB103 40684 KTG 73450 b |
|
| 1 | | preceding the rate period based upon the Assessment | 2 | | Reference Date of the Minimum Data Set (MDS). | 3 | | (3) Regional wage adjustors based on the Health | 4 | | Service Areas (HSA) groupings and adjusters in effect on | 5 | | April 30, 2012 shall be included, except no adjuster shall | 6 | | be lower than 1.06. | 7 | | (4) PDPM nursing case mix indices in effect on March | 8 | | 1, 2022 shall be assigned to each resident class at no less | 9 | | than 0.7858 of the Centers for Medicare and Medicaid | 10 | | Services PDPM unadjusted case mix values, in effect on | 11 | | March 1, 2022. | 12 | | (5) The pool of funds available for distribution by | 13 | | case mix and the base facility rate shall be determined | 14 | | using the formula contained in subsection (d-1). | 15 | | (6) The Department shall establish a variable per diem | 16 | | staffing add-on in accordance with the most recent | 17 | | available federal staffing report, currently the Payroll | 18 | | Based Journal, for the same period of time, and if | 19 | | applicable adjusted for acuity using the same quarter's | 20 | | MDS. The Department shall rely on Payroll Based Journals | 21 | | provided to the Department of Public Health to make a | 22 | | determination of non-submission. If the Department is | 23 | | notified by a facility of missing or inaccurate Payroll | 24 | | Based Journal data or an incorrect calculation of | 25 | | staffing, the Department must make a correction as soon as | 26 | | the error is verified for the applicable quarter. |
| | | HB5847 | - 4 - | LRB103 40684 KTG 73450 b |
|
| 1 | | Beginning October 1, 2024, the staffing percentage | 2 | | used in the calculation of the per diem staffing add-on | 3 | | shall be its PDPM STRIVE Staffing Ratio which equals: its | 4 | | Reported Total Nurse Staffing Hours Per Resident Per Day | 5 | | as published in the most recent federal staffing report | 6 | | (the Provider Information File), divided by the facility's | 7 | | PDPM STRIVE Staffing Target. Each facility's PDPM STRIVE | 8 | | Staffing Target is equal to .82 times the facility's | 9 | | Illinois Adjusted Facility Case-Mix Hours Per Resident Per | 10 | | Day. A facility's Illinois Adjusted Facility Case Mix | 11 | | Hours Per Resident Per Day is equal to its Case-Mix Total | 12 | | Nurse Staffing Hours Per Resident Per Day (as published in | 13 | | the most recent federal staffing report) times 3.662 | 14 | | (which reflects the national resident days-weighted mean | 15 | | Reported Total Nurse Staffing Hours Per Resident Per Day | 16 | | as calculated using the January 2024 federal Provider | 17 | | Information Files), divided by the national resident | 18 | | days-weighted mean Reported Total Nurse Staffing Hours Per | 19 | | Resident Per Day calculated using the most recent federal | 20 | | Provider Information File. Facilities with at least 70% of | 21 | | the staffing indicated by the STRIVE study shall be paid a | 22 | | per diem add-on of $9, increasing by equivalent steps for | 23 | | each whole percentage point until the facilities reach a | 24 | | per diem of $16.52 $14.88 . Facilities with at least 80% of | 25 | | the staffing indicated by the STRIVE study shall be paid a | 26 | | per diem add-on of $16.52 $14.88 , increasing by equivalent |
| | | HB5847 | - 5 - | LRB103 40684 KTG 73450 b |
|
| 1 | | steps for each whole percentage point until the facilities | 2 | | reach a per diem add-on of $25.77 $23.80 . Facilities with | 3 | | at least 92% of the staffing indicated by the STRIVE study | 4 | | shall be paid a per diem add-on of $25.77 $23.80 , | 5 | | increasing by equivalent steps for each whole percentage | 6 | | point until the facilities reach a per diem add-on of | 7 | | $30.98 $29.75 . Facilities with at least 100% of the | 8 | | staffing indicated by the STRIVE study shall be paid a per | 9 | | diem add-on of $30.98 $29.75 , increasing by equivalent | 10 | | steps for each whole percentage point until the facilities | 11 | | reach a per diem add-on of $36.44 $35.70 . Facilities with | 12 | | at least 110% of the staffing indicated by the STRIVE | 13 | | study shall be paid a per diem add-on of $36.44 $35.70 , | 14 | | increasing by equivalent steps for each whole percentage | 15 | | point until the facilities reach a per diem add-on of | 16 | | $38.68. Facilities with at least 125% or higher of the | 17 | | staffing indicated by the STRIVE study shall be paid a per | 18 | | diem add-on of $38.68. No Beginning April 1, 2023, no | 19 | | nursing facility's variable staffing per diem add-on shall | 20 | | be reduced by more than 5% in 2 consecutive quarters. For | 21 | | the quarters beginning July 1, 2022 and October 1, 2022, | 22 | | no facility's variable per diem staffing add-on shall be | 23 | | calculated at a rate lower than 85% of the staffing | 24 | | indicated by the STRIVE study. No facility below 70% of | 25 | | the staffing indicated by the STRIVE study shall receive a | 26 | | variable per diem staffing add-on after December 31, 2022. |
| | | HB5847 | - 6 - | LRB103 40684 KTG 73450 b |
|
| 1 | | (7) For dates of services beginning July 1, 2022, the | 2 | | PDPM nursing component per diem for each nursing facility | 3 | | shall be the product of the facility's (i) statewide PDPM | 4 | | nursing base per diem rate, $92.25, adjusted for the | 5 | | facility average PDPM case mix index calculated quarterly | 6 | | and (ii) the regional wage adjuster, and then add the | 7 | | Medicaid access adjustment as defined in (e-3) of this | 8 | | Section. Transition rates for services provided between | 9 | | July 1, 2022 and October 1, 2023 shall be the greater of | 10 | | the PDPM nursing component per diem or: | 11 | | (A) for the quarter beginning July 1, 2022, the | 12 | | RUG-IV nursing component per diem; | 13 | | (B) for the quarter beginning October 1, 2022, the | 14 | | sum of the RUG-IV nursing component per diem | 15 | | multiplied by 0.80 and the PDPM nursing component per | 16 | | diem multiplied by 0.20; | 17 | | (C) for the quarter beginning January 1, 2023, the | 18 | | sum of the RUG-IV nursing component per diem | 19 | | multiplied by 0.60 and the PDPM nursing component per | 20 | | diem multiplied by 0.40; | 21 | | (D) for the quarter beginning April 1, 2023, the | 22 | | sum of the RUG-IV nursing component per diem | 23 | | multiplied by 0.40 and the PDPM nursing component per | 24 | | diem multiplied by 0.60; | 25 | | (E) for the quarter beginning July 1, 2023, the | 26 | | sum of the RUG-IV nursing component per diem |
| | | HB5847 | - 7 - | LRB103 40684 KTG 73450 b |
|
| 1 | | multiplied by 0.20 and the PDPM nursing component per | 2 | | diem multiplied by 0.80; or | 3 | | (F) for the quarter beginning October 1, 2023 and | 4 | | each subsequent quarter, the transition rate shall end | 5 | | and a nursing facility shall be paid 100% of the PDPM | 6 | | nursing component per diem. | 7 | | (d-1) Calculation of base year Statewide RUG-IV nursing | 8 | | base per diem rate. | 9 | | (1) Base rate spending pool shall be: | 10 | | (A) The base year resident days which are | 11 | | calculated by multiplying the number of Medicaid | 12 | | residents in each nursing home as indicated in the MDS | 13 | | data defined in paragraph (4) by 365. | 14 | | (B) Each facility's nursing component per diem in | 15 | | effect on July 1, 2012 shall be multiplied by | 16 | | subsection (A). | 17 | | (C) Thirteen million is added to the product of | 18 | | subparagraph (A) and subparagraph (B) to adjust for | 19 | | the exclusion of nursing homes defined in paragraph | 20 | | (5). | 21 | | (2) For each nursing home with Medicaid residents as | 22 | | indicated by the MDS data defined in paragraph (4), | 23 | | weighted days adjusted for case mix and regional wage | 24 | | adjustment shall be calculated. For each home this | 25 | | calculation is the product of: | 26 | | (A) Base year resident days as calculated in |
| | | HB5847 | - 8 - | LRB103 40684 KTG 73450 b |
|
| 1 | | subparagraph (A) of paragraph (1). | 2 | | (B) The nursing home's regional wage adjustor | 3 | | based on the Health Service Areas (HSA) groupings and | 4 | | adjustors in effect on April 30, 2012. | 5 | | (C) Facility weighted case mix which is the number | 6 | | of Medicaid residents as indicated by the MDS data | 7 | | defined in paragraph (4) multiplied by the associated | 8 | | case weight for the RUG-IV 48 grouper model using | 9 | | standard RUG-IV procedures for index maximization. | 10 | | (D) The sum of the products calculated for each | 11 | | nursing home in subparagraphs (A) through (C) above | 12 | | shall be the base year case mix, rate adjusted | 13 | | weighted days. | 14 | | (3) The Statewide RUG-IV nursing base per diem rate: | 15 | | (A) on January 1, 2014 shall be the quotient of the | 16 | | paragraph (1) divided by the sum calculated under | 17 | | subparagraph (D) of paragraph (2); | 18 | | (B) on and after July 1, 2014 and until July 1, | 19 | | 2022, shall be the amount calculated under | 20 | | subparagraph (A) of this paragraph (3) plus $1.76; and | 21 | | (C) beginning July 1, 2022 and thereafter, $7 | 22 | | shall be added to the amount calculated under | 23 | | subparagraph (B) of this paragraph (3) of this | 24 | | Section. | 25 | | (4) Minimum Data Set (MDS) comprehensive assessments | 26 | | for Medicaid residents on the last day of the quarter used |
| | | HB5847 | - 9 - | LRB103 40684 KTG 73450 b |
|
| 1 | | to establish the base rate. | 2 | | (5) Nursing facilities designated as of July 1, 2012 | 3 | | by the Department as "Institutions for Mental Disease" | 4 | | shall be excluded from all calculations under this | 5 | | subsection. The data from these facilities shall not be | 6 | | used in the computations described in paragraphs (1) | 7 | | through (4) above to establish the base rate. | 8 | | (e) Beginning July 1, 2014, the Department shall allocate | 9 | | funding in the amount up to $10,000,000 for per diem add-ons to | 10 | | the RUGS methodology for dates of service on and after July 1, | 11 | | 2014: | 12 | | (1) $0.63 for each resident who scores in I4200 | 13 | | Alzheimer's Disease or I4800 non-Alzheimer's Dementia. | 14 | | (2) $2.67 for each resident who scores either a "1" or | 15 | | "2" in any items S1200A through S1200I and also scores in | 16 | | RUG groups PA1, PA2, BA1, or BA2. | 17 | | (e-1) (Blank). | 18 | | (e-2) For dates of services beginning January 1, 2014 and | 19 | | ending September 30, 2023, the RUG-IV nursing component per | 20 | | diem for a nursing home shall be the product of the statewide | 21 | | RUG-IV nursing base per diem rate, the facility average case | 22 | | mix index, and the regional wage adjustor. For dates of | 23 | | service beginning July 1, 2022 and ending September 30, 2023, | 24 | | the Medicaid access adjustment described in subsection (e-3) | 25 | | shall be added to the product. | 26 | | (e-3) A Medicaid Access Adjustment of $4 adjusted for the |
| | | HB5847 | - 10 - | LRB103 40684 KTG 73450 b |
|
| 1 | | facility average PDPM case mix index calculated quarterly | 2 | | shall be added to the statewide PDPM nursing per diem for all | 3 | | facilities with annual Medicaid bed days of at least 70% of all | 4 | | occupied bed days adjusted quarterly. For each new calendar | 5 | | year and for the 6-month period beginning July 1, 2022, the | 6 | | percentage of a facility's occupied bed days comprised of | 7 | | Medicaid bed days shall be determined by the Department | 8 | | quarterly. For dates of service beginning January 1, 2023, the | 9 | | Medicaid Access Adjustment shall be increased to $4.75. This | 10 | | subsection shall be inoperative on and after January 1, 2028. | 11 | | (e-4) Subject to federal approval, on and after January 1, | 12 | | 2024, the Department shall increase the rate add-on at | 13 | | paragraph (7) subsection (a) under 89 Ill. Adm. Code 147.335 | 14 | | for ventilator services from $208 per day to $481 per day. | 15 | | Payment is subject to the criteria and requirements under 89 | 16 | | Ill. Adm. Code 147.335. | 17 | | (f) (Blank). | 18 | | (g) Notwithstanding any other provision of this Code, on | 19 | | and after July 1, 2012, for facilities not designated by the | 20 | | Department of Healthcare and Family Services as "Institutions | 21 | | for Mental Disease", rates effective May 1, 2011 shall be | 22 | | adjusted as follows: | 23 | | (1) (Blank); | 24 | | (2) (Blank); | 25 | | (3) Facility rates for the capital and support | 26 | | components shall be reduced by 1.7%. |
| | | HB5847 | - 11 - | LRB103 40684 KTG 73450 b |
|
| 1 | | (h) Notwithstanding any other provision of this Code, on | 2 | | and after July 1, 2012, nursing facilities designated by the | 3 | | Department of Healthcare and Family Services as "Institutions | 4 | | for Mental Disease" and "Institutions for Mental Disease" that | 5 | | are facilities licensed under the Specialized Mental Health | 6 | | Rehabilitation Act of 2013 shall have the nursing, | 7 | | socio-developmental, capital, and support components of their | 8 | | reimbursement rate effective May 1, 2011 reduced in total by | 9 | | 2.7%. | 10 | | (i) On and after July 1, 2014, the reimbursement rates for | 11 | | the support component of the nursing facility rate for | 12 | | facilities licensed under the Nursing Home Care Act as skilled | 13 | | or intermediate care facilities shall be the rate in effect on | 14 | | June 30, 2014 increased by 8.17%. | 15 | | (i-1) Subject to federal approval, on and after January 1, | 16 | | 2024, the reimbursement rates for the support component of the | 17 | | nursing facility rate for facilities licensed under the | 18 | | Nursing Home Care Act as skilled or intermediate care | 19 | | facilities shall be the rate in effect on June 30, 2023 | 20 | | increased by 12%. | 21 | | (j) Notwithstanding any other provision of law, subject to | 22 | | federal approval, effective July 1, 2019, sufficient funds | 23 | | shall be allocated for changes to rates for facilities | 24 | | licensed under the Nursing Home Care Act as skilled nursing | 25 | | facilities or intermediate care facilities for dates of | 26 | | services on and after July 1, 2019: (i) to establish, through |
| | | HB5847 | - 12 - | LRB103 40684 KTG 73450 b |
|
| 1 | | June 30, 2022 a per diem add-on to the direct care per diem | 2 | | rate not to exceed $70,000,000 annually in the aggregate | 3 | | taking into account federal matching funds for the purpose of | 4 | | addressing the facility's unique staffing needs, adjusted | 5 | | quarterly and distributed by a weighted formula based on | 6 | | Medicaid bed days on the last day of the second quarter | 7 | | preceding the quarter for which the rate is being adjusted. | 8 | | Beginning July 1, 2022, the annual $70,000,000 described in | 9 | | the preceding sentence shall be dedicated to the variable per | 10 | | diem add-on for staffing under paragraph (6) of subsection | 11 | | (d); and (ii) in an amount not to exceed $170,000,000 annually | 12 | | in the aggregate taking into account federal matching funds to | 13 | | permit the support component of the nursing facility rate to | 14 | | be updated as follows: | 15 | | (1) 80%, or $136,000,000, of the funds shall be used | 16 | | to update each facility's rate in effect on June 30, 2019 | 17 | | using the most recent cost reports on file, which have had | 18 | | a limited review conducted by the Department of Healthcare | 19 | | and Family Services and will not hold up enacting the rate | 20 | | increase, with the Department of Healthcare and Family | 21 | | Services. | 22 | | (2) After completing the calculation in paragraph (1), | 23 | | any facility whose rate is less than the rate in effect on | 24 | | June 30, 2019 shall have its rate restored to the rate in | 25 | | effect on June 30, 2019 from the 20% of the funds set | 26 | | aside. |
| | | HB5847 | - 13 - | LRB103 40684 KTG 73450 b |
|
| 1 | | (3) The remainder of the 20%, or $34,000,000, shall be | 2 | | used to increase each facility's rate by an equal | 3 | | percentage. | 4 | | (k) During the first quarter of State Fiscal Year 2020, | 5 | | the Department of Healthcare of Family Services must convene a | 6 | | technical advisory group consisting of members of all trade | 7 | | associations representing Illinois skilled nursing providers | 8 | | to discuss changes necessary with federal implementation of | 9 | | Medicare's Patient-Driven Payment Model. Implementation of | 10 | | Medicare's Patient-Driven Payment Model shall, by September 1, | 11 | | 2020, end the collection of the MDS data that is necessary to | 12 | | maintain the current RUG-IV Medicaid payment methodology. The | 13 | | technical advisory group must consider a revised reimbursement | 14 | | methodology that takes into account transparency, | 15 | | accountability, actual staffing as reported under the | 16 | | federally required Payroll Based Journal system, changes to | 17 | | the minimum wage, adequacy in coverage of the cost of care, and | 18 | | a quality component that rewards quality improvements. | 19 | | (l) The Department shall establish per diem add-on | 20 | | payments to improve the quality of care delivered by | 21 | | facilities, including: | 22 | | (1) Incentive payments determined by facility | 23 | | performance on specified quality measures in an initial | 24 | | amount of $70,000,000. Nothing in this subsection shall be | 25 | | construed to limit the quality of care payments in the | 26 | | aggregate statewide to $70,000,000, and, if quality of |
| | | HB5847 | - 14 - | LRB103 40684 KTG 73450 b |
|
| 1 | | care has improved across nursing facilities, the | 2 | | Department shall adjust those add-on payments accordingly. | 3 | | The quality payment methodology described in this | 4 | | subsection must be used for at least State Fiscal Year | 5 | | 2023. Beginning with the quarter starting July 1, 2023, | 6 | | the Department may add, remove, or change quality metrics | 7 | | and make associated changes to the quality payment | 8 | | methodology as outlined in subparagraph (E). Facilities | 9 | | designated by the Centers for Medicare and Medicaid | 10 | | Services as a special focus facility or a hospital-based | 11 | | nursing home do not qualify for quality payments. | 12 | | (A) Each quality pool must be distributed by | 13 | | assigning a quality weighted score for each nursing | 14 | | home which is calculated by multiplying the nursing | 15 | | home's quality base period Medicaid days by the | 16 | | nursing home's star rating weight in that period. | 17 | | (B) Star rating weights are assigned based on the | 18 | | nursing home's star rating for the LTS quality star | 19 | | rating. As used in this subparagraph, "LTS quality | 20 | | star rating" means the long-term stay quality rating | 21 | | for each nursing facility, as assigned by the Centers | 22 | | for Medicare and Medicaid Services under the Five-Star | 23 | | Quality Rating System. The rating is a number ranging | 24 | | from 0 (lowest) to 5 (highest). | 25 | | (i) Zero-star or one-star rating has a weight | 26 | | of 0. |
| | | HB5847 | - 15 - | LRB103 40684 KTG 73450 b |
|
| 1 | | (ii) Two-star rating has a weight of 0.75. | 2 | | (iii) Three-star rating has a weight of 1.5. | 3 | | (iv) Four-star rating has a weight of 2.5. | 4 | | (v) Five-star rating has a weight of 3.5. | 5 | | (C) Each nursing home's quality weight score is | 6 | | divided by the sum of all quality weight scores for | 7 | | qualifying nursing homes to determine the proportion | 8 | | of the quality pool to be paid to the nursing home. | 9 | | (D) The quality pool is no less than $70,000,000 | 10 | | annually or $17,500,000 per quarter. The Department | 11 | | shall publish on its website the estimated payments | 12 | | and the associated weights for each facility 45 days | 13 | | prior to when the initial payments for the quarter are | 14 | | to be paid. The Department shall assign each facility | 15 | | the most recent and applicable quarter's STAR value | 16 | | unless the facility notifies the Department within 15 | 17 | | days of an issue and the facility provides reasonable | 18 | | evidence demonstrating its timely compliance with | 19 | | federal data submission requirements for the quarter | 20 | | of record. If such evidence cannot be provided to the | 21 | | Department, the STAR rating assigned to the facility | 22 | | shall be reduced by one from the prior quarter. | 23 | | (E) The Department shall review quality metrics | 24 | | used for payment of the quality pool and make | 25 | | recommendations for any associated changes to the | 26 | | methodology for distributing quality pool payments in |
| | | HB5847 | - 16 - | LRB103 40684 KTG 73450 b |
|
| 1 | | consultation with associations representing long-term | 2 | | care providers, consumer advocates, organizations | 3 | | representing workers of long-term care facilities, and | 4 | | payors. The Department may establish, by rule, changes | 5 | | to the methodology for distributing quality pool | 6 | | payments. | 7 | | (F) The Department shall disburse quality pool | 8 | | payments from the Long-Term Care Provider Fund on a | 9 | | monthly basis in amounts proportional to the total | 10 | | quality pool payment determined for the quarter. | 11 | | (G) The Department shall publish any changes in | 12 | | the methodology for distributing quality pool payments | 13 | | prior to the beginning of the measurement period or | 14 | | quality base period for any metric added to the | 15 | | distribution's methodology. | 16 | | (2) Payments based on CNA tenure, promotion, and CNA | 17 | | training for the purpose of increasing CNA compensation. | 18 | | It is the intent of this subsection that payments made in | 19 | | accordance with this paragraph be directly incorporated | 20 | | into increased compensation for CNAs. As used in this | 21 | | paragraph, "CNA" means a certified nursing assistant as | 22 | | that term is described in Section 3-206 of the Nursing | 23 | | Home Care Act, Section 3-206 of the ID/DD Community Care | 24 | | Act, and Section 3-206 of the MC/DD Act. The Department | 25 | | shall establish, by rule, payments to nursing facilities | 26 | | equal to Medicaid's share of the tenure wage increments |
| | | HB5847 | - 17 - | LRB103 40684 KTG 73450 b |
|
| 1 | | specified in this paragraph for all reported CNA employee | 2 | | hours compensated according to a posted schedule | 3 | | consisting of increments at least as large as those | 4 | | specified in this paragraph. The increments are as | 5 | | follows: an additional $1.50 per hour for CNAs with at | 6 | | least one and less than 2 years' experience plus another | 7 | | $1 per hour for each additional year of experience up to a | 8 | | maximum of $6.50 for CNAs with at least 6 years of | 9 | | experience. For purposes of this paragraph, Medicaid's | 10 | | share shall be the ratio determined by paid Medicaid bed | 11 | | days divided by total bed days for the applicable time | 12 | | period used in the calculation. In addition, and additive | 13 | | to any tenure increments paid as specified in this | 14 | | paragraph, the Department shall establish, by rule, | 15 | | payments supporting Medicaid's share of the | 16 | | promotion-based wage increments for CNA employee hours | 17 | | compensated for that promotion with at least a $1.50 | 18 | | hourly increase. Medicaid's share shall be established as | 19 | | it is for the tenure increments described in this | 20 | | paragraph. Qualifying promotions shall be defined by the | 21 | | Department in rules for an expected 10-15% subset of CNAs | 22 | | assigned intermediate, specialized, or added roles such as | 23 | | CNA trainers, CNA scheduling "captains", and CNA | 24 | | specialists for resident conditions like dementia or | 25 | | memory care or behavioral health. | 26 | | (m) The Department shall work with nursing facility |
| | | HB5847 | - 18 - | LRB103 40684 KTG 73450 b |
|
| 1 | | industry representatives to design policies and procedures to | 2 | | permit facilities to address the integrity of data from | 3 | | federal reporting sites used by the Department in setting | 4 | | facility rates. | 5 | | (Source: P.A. 102-77, eff. 7-9-21; 102-558, eff. 8-20-21; | 6 | | 102-1035, eff. 5-31-22; 102-1118, eff. 1-18-23; 103-102, | 7 | | Article 40, Section 40-5, eff. 1-1-24; 103-102, Article 50, | 8 | | Section 50-5, eff. 1-1-24; revised 12-15-23.) | 9 | | Section 99. Effective date. This Act takes effect October | 10 | | 1, 2024. |
|