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| | 10300SB3256sam001 | - 2 - | LRB103 39314 RPS 70840 a |
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1 | | Program and who is unable to pay for his or her care in the |
2 | | facility without Medical Assistance only if: |
3 | | (1) the facility, no later than at the time of |
4 | | admission and at the time of the resident's contract |
5 | | renewal, explains to the resident (unless he or she is |
6 | | incompetent), and to the resident's representative, and to |
7 | | the person making payment on behalf of the resident for |
8 | | the resident's stay, in writing, that the facility may |
9 | | discharge the resident if the resident is no longer able |
10 | | to pay for his or her care in the facility without Medical |
11 | | Assistance; |
12 | | (2) the resident (unless he or she is incompetent), |
13 | | the resident's representative, and the person making |
14 | | payment on behalf of the resident for the resident's stay, |
15 | | acknowledge in writing that they have received the written |
16 | | explanation ; . |
17 | | (3) the facility provides notice to the resident and |
18 | | to the resident's representative that the resident's |
19 | | Medicare coverage will likely end in 10 days. This |
20 | | notification shall specify that the resident shall not be |
21 | | required to move under this Section until these 10 days |
22 | | are up. |
23 | | (a-10) For the purposes of this Section, a recipient or |
24 | | applicant shall be considered a resident in the facility |
25 | | during any hospital stay totaling 10 days or less following a |
26 | | hospital admission. The Department of Healthcare and Family |
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| | 10300SB3256sam001 | - 3 - | LRB103 39314 RPS 70840 a |
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1 | | Services shall recoup funds from a facility when, as a result |
2 | | of the facility's refusal to readmit a recipient after |
3 | | hospitalization for 10 days or less, the recipient incurs |
4 | | hospital bills in an amount greater than the amount that would |
5 | | have been paid by that Department (formerly the Illinois |
6 | | Department of Public Aid) for care of the recipient in the |
7 | | facility. The amount of the recoupment shall be the difference |
8 | | between the Department of Healthcare and Family Services' |
9 | | (formerly the Illinois Department of Public Aid's) payment for |
10 | | hospital care and the amount that Department would have paid |
11 | | for care in the facility. |
12 | | (b) A facility which violates this Section shall be guilty |
13 | | of a business offense and fined not less than $500 nor more |
14 | | than $1,000 for the first offense and not less than $1,000 nor |
15 | | more than $5,000 for each subsequent offense. |
16 | | (Source: P.A. 95-331, eff. 8-21-07.)". |