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92_SB2310 LRB9215823DJmg 1 AN ACT in relation to public aid. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Illinois Public Aid Code is amended by 5 changing Section 5-5.4 as follows: 6 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4) 7 Sec. 5-5.4. Nursing homes; standards of payment; 8 Department of Public Aid. The Department of Public Aid shall 9 develop standards of payment of skilled nursing and 10 intermediate care services in facilities providing such 11 services under this Article which: 12 (1) ProvideProvidesfor the determination of a 13 facility's payment for skilled nursing and intermediate care 14 services on a prospective basis. The amount of the payment 15 rate for all nursing facilities certified under the medical 16 assistance program shall be prospectively established 17 annually on the basis of historical, financial, and 18 statistical data reflecting actual costs from prior years, 19 which shall be applied to the current rate year and updated 20 for inflation, except that the capital cost element for newly 21 constructed facilities shall be based upon projected budgets. 22 The annually established payment rate shall take effect on 23 July 1 in 1984 and subsequent years. Rate increases shall be 24 provided annually thereafter on July 1 in 1984 and on each 25 subsequent July 1 in the following years, except that no rate 26 increase and no update for inflation shall be provided on or 27 after July 1, 1994 and before July 1, 2002, unless 28 specifically provided for in this Section. 29 For facilities licensed by the Department of Public 30 Health under the Nursing Home Care Act as Intermediate Care 31 for the Developmentally Disabled facilities or Long Term Care -2- LRB9215823DJmg 1 for Under Age 22 facilities, the rates taking effect on July 2 1, 1998 shall include an increase of 3%. For facilities 3 licensed by the Department of Public Health under the Nursing 4 Home Care Act as Skilled Nursing facilities or Intermediate 5 Care facilities, the rates taking effect on July 1, 1998 6 shall include an increase of 3% plus $1.10 per resident-day, 7 as defined by the Department. 8 For facilities licensed by the Department of Public 9 Health under the Nursing Home Care Act as Intermediate Care 10 for the Developmentally Disabled facilities or Long Term Care 11 for Under Age 22 facilities, the rates taking effect on July 12 1, 1999 shall include an increase of 1.6% plus $3.00 per 13 resident-day, as defined by the Department. For facilities 14 licensed by the Department of Public Health under the Nursing 15 Home Care Act as Skilled Nursing facilities or Intermediate 16 Care facilities, the rates taking effect on July 1, 1999 17 shall include an increase of 1.6% and, for services provided 18 on or after October 1, 1999, shall be increased by $4.00 per 19 resident-day, as defined by the Department. 20 For facilities licensed by the Department of Public 21 Health under the Nursing Home Care Act as Intermediate Care 22 for the Developmentally Disabled facilities or Long Term Care 23 for Under Age 22 facilities, the rates taking effect on July 24 1, 2000 shall include an increase of 2.5% per resident-day, 25 as defined by the Department. For facilities licensed by the 26 Department of Public Health under the Nursing Home Care Act 27 as Skilled Nursing facilities or Intermediate Care 28 facilities, the rates taking effect on July 1, 2000 shall 29 include an increase of 2.5% per resident-day, as defined by 30 the Department. 31 For facilities licensed by the Department of Public 32 Health under the Nursing Home Care Act as Intermediate Care 33 for the Developmentally Disabled facilities or Long Term Care 34 for Under Age 22 facilities, the rates taking effect on March -3- LRB9215823DJmg 1 1, 2001 shall include a statewide increase of 7.85%, as 2 defined by the Department. 3 For facilities licensed by the Department of Public 4 Health under the Nursing Home Care Act as Intermediate Care 5 for the Developmentally Disabled facilities or Long Term Care 6 for Under Age 22 facilities, the rates taking effect on April 7 1, 2002 shall include a statewide increase of 2.0%, as 8 defined by the Department. 9 For facilities licensed by the Department of Public 10 Health under the Nursing Home Care Act as skilled nursing 11 facilities or intermediate care facilities, the rates taking 12 effect on July 1, 2001, and each subsequent year thereafter, 13 shall be computed using the most recent cost reports on file 14 with the Department of Public Aid no later than April 1, 2000 15 updated for inflation to January 1, 2001. For rates 16 effective July 1, 2001 only, rates shall be the greater of 17 the rate computed for July 1, 2001 or the rate effective on 18 June 30, 2001. 19 Rates established effective each July 1 shall govern 20 payment for services rendered throughout that fiscal year, 21 except that rates established on July 1, 1996 shall be 22 increased by 6.8% for services provided on or after January 23 1, 1997. Such rates will be based upon the rates calculated 24 for the year beginning July 1, 1990, and for subsequent years 25 thereafter until June 30, 2001 shall be based on the facility 26 cost reports for the facility fiscal year ending at any point 27 in time during the previous calendar year, updated to the 28 midpoint of the rate year. The cost report shall be on file 29 with the Department no later than April 1 of the current rate 30 year. Should the cost report not be on file by April 1, the 31 Department shall base the rate on the latest cost report 32 filed by each skilled care facility and intermediate care 33 facility, updated to the midpoint of the current rate year. 34 In determining rates for services rendered on and after July -4- LRB9215823DJmg 1 1, 1985, fixed time shall not be computed at less than zero. 2 The Department shall not make any alterations of regulations 3 which would reduce any component of the Medicaid rate to a 4 level below what that component would have been utilizing in 5 the rate effective on July 1, 1984. 6 (2) Shall take into account the actual costs incurred by 7 facilities in providing services for recipients of skilled 8 nursing and intermediate care services under the medical 9 assistance program. 10 (3) Shall take into account the medical and 11 psycho-social characteristics and needs of the patients. 12 (4) Shall take into account the actual costs incurred by 13 facilities in meeting licensing and certification standards 14 imposed and prescribed by the State of Illinois, any of its 15 political subdivisions or municipalities and by the U.S. 16 Department of Health and Human Services pursuant to Title XIX 17 of the Social Security Act. 18 The Department of Public Aid shall develop precise 19 standards for payments to reimburse nursing facilities for 20 any utilization of appropriate rehabilitative personnel for 21 the provision of rehabilitative services which is authorized 22 by federal regulations, including reimbursement for services 23 provided by qualified therapists or qualified assistants, and 24 which is in accordance with accepted professional practices. 25 Reimbursement also may be made for utilization of other 26 supportive personnel under appropriate supervision. 27 (Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10, 28 eff. 6-11-01; 92-31, eff. 6-28-01; revised 12-13-01.)