| ||||
| Public Act 103-0691 | ||||
| ||||
AN ACT concerning regulation. | ||||
Be it enacted by the People of the State of Illinois, | ||||
represented in the General Assembly: | ||||
Section 5. The Nursing Home Care Act is amended by | ||||
changing Section 3-401.1 as follows: | ||||
(210 ILCS 45/3-401.1) (from Ch. 111 1/2, par. 4153-401.1) | ||||
Sec. 3-401.1. (a) A facility participating in the Medical | ||||
Assistance Program is prohibited from failing or refusing to | ||||
retain as a resident any person because he or she is a | ||||
recipient of or an applicant for the Medical Assistance | ||||
Program. | ||||
(a-5) A After the effective date of this amendatory Act of | ||||
1997, a facility of which only a distinct part is certified to | ||||
participate in the Medical Assistance Program may refuse to | ||||
retain as a resident any person who resides in a part of the | ||||
facility that does not participate in the Medical Assistance | ||||
Program and who is unable to pay for his or her care in the | ||||
facility without Medical Assistance only if: | ||||
(1) the facility, no later than at the time of | ||||
admission and at the time of the resident's contract | ||||
renewal, explains to the resident (unless he or she is | ||||
incompetent), and to the resident's representative, and to | ||||
the person making payment on behalf of the resident for | ||||
the resident's stay, in writing, that the facility may | ||
discharge the resident if the resident is no longer able | ||
to pay for his or her care in the facility without Medical | ||
Assistance; | ||
(2) the resident (unless he or she is incompetent), | ||
the resident's representative, and the person making | ||
payment on behalf of the resident for the resident's stay, | ||
acknowledge in writing that they have received the written | ||
explanation; . | ||
(3) in circumstances where the Medicare coverage is | ||
ending prior to the full 100-day benefit period, the | ||
facility provides notice to the resident and to the | ||
resident's representative that the resident's Medicare | ||
coverage will likely end in 5 days. This notification | ||
shall specify that the resident shall not be required to | ||
move under this Section until these 5 days are up. In cases | ||
where the facility is notified in a shorter time frame | ||
than 5 days by a managed care organization or the time | ||
frame is shorter than 5 days due to inaccurate reporting | ||
by an outside entity, the facility must provide a minimum | ||
of 2 days' notification. | ||
(a-10) For the purposes of this Section, a recipient or | ||
applicant shall be considered a resident in the facility | ||
during any hospital stay totaling 10 days or less following a | ||
hospital admission. The Department of Healthcare and Family | ||
Services shall recoup funds from a facility when, as a result | ||
of the facility's refusal to readmit a recipient after | ||
hospitalization for 10 days or less, the recipient incurs | ||
hospital bills in an amount greater than the amount that would | ||
have been paid by that Department (formerly the Illinois | ||
Department of Public Aid) for care of the recipient in the | ||
facility. The amount of the recoupment shall be the difference | ||
between the Department of Healthcare and Family Services' | ||
(formerly the Illinois Department of Public Aid's) payment for | ||
hospital care and the amount that Department would have paid | ||
for care in the facility. | ||
(b) A facility which violates this Section shall be guilty | ||
of a business offense and fined not less than $500 nor more | ||
than $1,000 for the first offense and not less than $1,000 nor | ||
more than $5,000 for each subsequent offense. | ||
(Source: P.A. 95-331, eff. 8-21-07.) | ||