93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB4735


 
Introduced 02/04/04, by Julie Hamos
 
SYNOPSIS AS INTRODUCED:
 		














New Act






20 ILCS 3960/5.4 new






30 ILCS 105/5.625 new









    Creates the Nursing Facility Bed Moratorium and Modernization Act.  Provides that, except as specifically provided, the Health Facilities Planning Board shall deny any request for a permit or exemption for a new nursing facility bed if that license would result in an  increase in the medical assistance reimbursement amount for the purposes of the medical assistance program under Title XIX of the Social Security Act. Provides that any nursing facility that has, for the previous 3 years, provided services to at least 50% of its resident population under the medical assistance program under Title XIX of the Social Security Act is eligible to apply for a Nursing Facility Modernization Grant. Provides that Nursing Facility Modernization Grants shall be available from the Nursing Facility Modernization Fund for capital or one-time capital expenditures, for a maximum of $1,000,000 per nursing facility; provided that grantees shall be required to provide 20% as match toward the total cost of the capital project. Requires the Director of Public Health, in coordination with the Director of Public Aid and the Director of Aging, to submit a report containing analysis of the effect of the nursing facility moratorium and Nursing Facility Modernization Program to the Governor and the General Assembly on January 1, 2006 and on January 1 of each year thereafter. Amends the Illinois Health Facilities Planning Act to provide that no person shall establish, construct, or modify a long term care nursing facility except as authorized under the Nursing Facility Bed Moratorium and Modernization Act.  Amends the State Finance Act to create the  Nursing Facility Modernization Fund. Effective immediately.



















LRB093 19043 AMC 44778 b




















FISCAL NOTE ACT MAY APPLY
















 


 


A BILL FOR









 














HB4735

LRB093 19043 AMC 44778 b









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    AN ACT concerning nursing facilities.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


 
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    Section 1. Short title. This Act may be cited as the 
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Nursing Facility Bed Moratorium and Modernization Act.
 
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    Section 5. Definitions. For the purposes of this Act:
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    "Board" means the Health Facilities Planning Board.
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    "Nursing facility" means (1) a skilled nursing or 
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intermediate long term care facility, whether public or private 
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and whether organized for profit or not-for-profit, that is 
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subject to licensure by the Department of Public Health under 
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the Nursing Home Care Act, including a county nursing home 
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directed and maintained under Section 5-1005 of the Counties 
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Code, and (2) a part of a hospital in which skilled or 
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intermediate long term care services within the meaning of 
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Title XVIII or XIX of the Social Security Act are provided.
 
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    Section 10. Nursing facility bed moratorium. 
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    (a)   In order to create a balanced long term care system 
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with high quality services delivered in the most appropriate 
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manner along a continuum of care, the State of Illinois 
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declares a moratorium on the licensure and medical assistance 
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certification of new nursing facility beds and nursing facility 
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capital expenditures that exceed $1,000,000.  Except as 
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provided in subsection (b) and (c) of this Section, the Health 
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Facilities Planning Board shall deny any request for a permit 
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or exemption for a new nursing facility bed if that license 
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would result in an  increase in the medical assistance 
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reimbursement amount for the purposes of the medical assistance 
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program under Title XIX of the Social Security Act.
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    (b)  A permit or exemption for a new nursing facility bed 
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may be approved pursuant to the Illinois Health Facilities 
 


 









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Planning Act to address an extreme hardship in a particular 
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county that, together with all contiguous Illinois counties, 
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has fewer nursing facility beds per 1,000 elderly than the 
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number that is 10% higher than the national average of nursing 
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facility beds per 1,000 elderly individuals.  For the purposes 
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of this Section, the national average of nursing facility beds 
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shall be based on the most recent data that can be supplied by 
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the federal Centers for Medicare and Medicaid Services.
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    (c)  The Board shall not approve any permit or exemption for 
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construction, alteration, reconstruction, renovation, 
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modernization, or improvement of any portion of a nursing 
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facility if the construction project adds any nursing facility 
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beds and if the capital expenditure, as defined in the Illinois 
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Health Facilities Planning Act, exceeds $1,000,000, unless:
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        (1) the construction project has been approved for a 
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    Nursing Facility Modernization Grant under Section 15 of 
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    this Act;
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        (2) the construction costs are not added to the 
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    facility's appraised value for purposes of calculating any 
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    portion of a nursing facility rate for reimbursement under 
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    the medical
assistance program;
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        (3) the project is necessary, for existing nursing 
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    facility beds within the facility; to correct violations of 
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    State or federal law, or to repair or replace a portion of 
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    the facility that was damaged by fire, lightning, 
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    groundshifts, or other such hazards, including 
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    environmental hazards;
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        (4) the facility has submitted to the Board written 
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    documentation evidencing that the facility has commenced 
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    construction prior to January 1, 2004 relating to the 
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    construction project.  For purposes of this subsection, a 
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    facility has "commenced construction" if all of the 
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    following conditions were met:  architectural drawings were 
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    developed; construction contracts were awarded; a timely 
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    construction schedule was developed, stipulating dates for 
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    beginning and completing construction; and all zoning and 
 


 









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    building permits were applied for;
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        (5) the construction project pertains only to 
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    non-clinical service areas, as defined in the Illinois 
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    Health Facilities Planning Act; or
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        (6) the project is being proposed by a licensed nursing 
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    facility that is not certified to participate in the 
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    medical assistance program and will not result in new 
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    certified beds.
 
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    Section 15. Nursing facility modernization program. 
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    (a)  Any nursing facility that has, for the previous 3 
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years, provided services to at least 50% of its resident 
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population under the medical assistance program under Title XIX 
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of the Social Security Act is eligible to apply for a Nursing 
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Facility Modernization Grant.
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    (b)  Nursing Facility Modernization Grants shall be 
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available for the construction, alteration, reconstruction, 
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renovation, modernization, or improvement of existing nursing 
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facility beds or areas within a nursing facility for any or a 
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combination of any of the following uses:
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        (1)  Conversion of a portion of or all nursing facility 
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    beds to an assisted living establishment as defined in the 
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    Assisted Living and Shared Housing Act or to a supported 
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    living facility as provided pursuant to Section 5-5.01a of 
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    the Public Aid Code.
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        (2)  Conversion of shared nursing facility bedrooms to 
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    private, single-bed rooms.
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        (3)  Provision of any alternatives to nursing facility 
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    care, which, for purposes of this Section, means those 
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    services included in the program of home and 
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    community-based waiver services for seniors under the 
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    medical assistance program under Title XIX of the Security 
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    Act, including, but not limited to, adult day services or 
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    respite care living space within a nursing facility.
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    (c)  Construction projects for conversion or modernization 
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    of existing nursing facilities shall not have the effect of:
 


 









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        (1) diminishing or reducing the quality of services 
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    available to nursing facility residents; or
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        (2) forcing any nursing facility resident to 
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    involuntarily accept home or community-based services in 
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    lieu of nursing facility services; or
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        (3) diminishing or reducing the supply of long-term 
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    care services in any community below the level of need.
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    (d)  Grants may not be used to expand a current building, 
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    except (i) for additional space required to accommodate related 
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    supportive services, such as dining rooms, kitchen and 
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    recreation areas, or other community use areas; or
(ii)  if the 
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    facility demonstrates that new construction is more cost 
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    effective than the conversion of existing space.
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    (e)  Notwithstanding any local ordinance related to 
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    development, planning, or zoning to the contrary, the 
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    conversion, modernization, or reuse of a nursing facility that 
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    closes or that curtails, reduces, or changes operations shall 
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    be considered a conforming use permitted under local law, 
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    provided that the facility is converted to another long-term 
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    care service.
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    (f)  Conversions or modernization pursuant to this Act are 
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    exempt from the requirements of the Health Facilities Planning 
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    Act.
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    (g)  Subject to available appropriations, Nursing Facility 
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    Modernization Grants shall be available from the Nursing 
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    Facility Modernization Fund, a special fund hereby created in 
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    the State treasury, for capital or one-time capital 
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    expenditures, for a maximum of $1,000,000 per nursing facility; 
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    provided that grantees shall be required to provide 20% as 
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    match toward the total cost of the capital project.  Any 
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    application for a Nursing Facility Modernization Grant shall 
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    include the total budget that will be necessary, including 
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    State and federal funding, for services to operate the program 
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    once the capital project is completed, and shall specify the 
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    number of existing nursing facility beds that the nursing 
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    facility provider agrees to de-license.  In distribution of the 
 


 









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    grants, the following factors shall be considered:
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        (1)  the bed need in the area in which the facility is 
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    located; and

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        (2) The extent to which the conversion or modernization 
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    results in the reduction of licensed nursing facility beds 
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    in an area with excess beds.
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The application and grant process, including rules and 
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    regulations for the Nursing Facility Modernization Program, 
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    shall be promulgated by the Director of Public Health, in 
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    coordination with the Director of Public Aid and the Director 
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    of Aging.
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    (h)  Any nursing facility receiving a grant pursuant to the 
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    Nursing Facility Modernization Program shall reduce the number 
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    of licensed nursing facility beds by an amount equal to or 
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    greater than the number of beds being constructed or modernized 
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    for one or more of the permitted uses pursuant to subsection 
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    (b).
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    (i)  Any nursing facility receiving a grant pursuant to the 
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    Nursing Facility Modernization Program shall agree, for a 
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    minimum of 10 years after the date that the grant is awarded, 
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    to maintain a minimum of 50% of its occupancy for residents 
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    eligible for services under the medical assistance program 
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    under Title XIX of the Social Security Act.  In the event the 
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    nursing facility provider or its successor in interest ceases 
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    to comply with the requirement set forth in this subsection, 
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    the provider shall refund to the Nursing Facility Modernization 
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    Fund, on an amortized basis, the amount of the grant.
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    (j) Any nursing facility receiving a grant pursuant to the 
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    Nursing Facility Modernization Program shall not segregate 
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    residents receiving nursing facility services under the 
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    medical assistance program under Title XIX of the Social 
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    Security Act in an area, section, or portion of the nursing 
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    facility and shall not relocate a resident within the nursing 
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    facility solely due to a change in payment status from private 
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    payment to government subsidy.

 
 


 









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    Section 20. Reporting. The Director of Public Health, in 
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coordination with the Director of Public Aid and the Director 
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of Aging, shall implement mechanisms to monitor and analyze the 
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effect of the nursing facility moratorium and Nursing Facility 
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Modernization Program, including documenting and verifying the 
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savings to the Medicaid program attributable to this Act.   A 
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report containing the analysis shall be submitted to the 
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Governor and the General Assembly on January 1, 2006 and on 
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January 1 of each year thereafter.
 
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    Section 90. The Illinois Health Facilities Planning Act is 
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amended  by adding Section 5.4 as follows:
 
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    (20 ILCS 3960/5.4  new)
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    Sec. 5.4. Nursing Facility Bed Moratorium and 
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Modernization Act. After the effective date of this amendatory 
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Act of the 93rd General Assembly, no person shall establish, 
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construct, or modify a long term care nursing facility except 
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as authorized under the Nursing Facility Bed Moratorium and 
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Modernization Act.
 
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    Section 95. The State Finance Act is amended by adding 
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Section
5.625 as follows:


 
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    (30 ILCS 105/5.625 new)


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    Sec. 5.625. The Nursing Facility Modernization Fund.

 

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    Section 99. Effective date. This Act takes effect upon 
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becoming law.