Illinois General Assembly - Full Text of HB4085
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Full Text of HB4085  102nd General Assembly

HB4085 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4085

 

Introduced 5/19/2021, by Rep. Anna Moeller

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Illinois Public Aid Code. Provides that it shall be a matter of State policy that the Department of Healthcare and Family Services shall set nursing facility rates by rule utilizing an evidenced-based methodology that rewards appropriate staffing, quality-of-life improvements for nursing facility residents, including the cessation of payments for rooms with 3 or more people residing in them by January 1, 2027, and the reduction of racial inequities and health disparities for nursing facility residents enrolled in Medicaid. Provides that the new nursing services reimbursement methodology taking effect January 1, 2022, upon federal approval, shall utilize the Patient Driven Payment Model (PDPM) (rather than the RUG-IV 48 grouper model). Sets the statewide base rate for dates of service on and after January 1, 2022 at $85.25. Requires the Department to establish, by rule, a multiplier based on information from the Payroll Based Journal. Provides that, beginning on and after January 1, 2022, the Department shall allocate funding, by rule, for per diem add-ons to the PDPM methodology for each resident with a diagnosis of Alzheimer's disease. Contains provisions concerning funds allocated for certain incentive payments to nursing facilities; emergency rules; payments to improve the quality of care delivered by nursing facilities; long-term care provider assessments; and other matters. Amends the Nurse Agency Licensing Act. Prohibits nurse agencies from entering into covenants not to compete with certified nurse aides. Amends the Illinois Administrative Procedure Act. Permits the Department of Healthcare and Family Services to adopt emergency rules. Effective immediately.


LRB102 18527 KTG 26753 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4085LRB102 18527 KTG 26753 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 3. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.8 as follows:
 
6    (5 ILCS 100/5-45.8 new)
7    Sec. 5-45.8. Emergency rulemaking; nursing facility
8payment rates. To provide for the expeditious and timely
9implementation of changes made to Section 5-5.2 of the
10Illinois Public Aid Code by this amendatory Act of the 102nd
11General Assembly, emergency rules may be adopted in accordance
12with Section 5-45 by the Department of Healthcare and Family
13Services. The adoption of emergency rules authorized by
14Section 5-45 and this Section is deemed to be necessary for the
15public interest, safety, and welfare.
16    This Section is repealed on January 1, 2026.
 
17    Section 5. The Nurse Agency Licensing Act is amended by
18changing Sections 3 and 14 as follows:
 
19    (225 ILCS 510/3)  (from Ch. 111, par. 953)
20    Sec. 3. Definitions. As used in this Act:
21    (a) "Certified nurse aide" means an individual certified

 

 

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1as defined in Section 3-206 of the Nursing Home Care Act,
2Section 3-206 of the ID/DD Community Care Act, or Section
33-206 of the MC/DD Act, as now or hereafter amended.
4    (b) "Department" means the Department of Labor.
5    (c) "Director" means the Director of Labor.
6    (d) "Health care facility" is defined as in Section 3 of
7the Illinois Health Facilities Planning Act, as now or
8hereafter amended.
9    (e) "Licensee" means any nursing agency which is properly
10licensed under this Act.
11    (f) "Nurse" means a registered nurse or a licensed
12practical nurse as defined in the Nurse Practice Act.
13    (g) "Nurse agency" means any individual, firm,
14corporation, partnership or other legal entity that employs,
15assigns or refers nurses or certified nurse aides to a health
16care facility for a fee. The term "nurse agency" includes
17nurses registries. The term "nurse agency" does not include
18services provided by home health agencies licensed and
19operated under the Home Health, Home Services, and Home
20Nursing Agency Licensing Act or a licensed or certified
21individual who provides his or her own services as a regular
22employee of a health care facility, nor does it apply to a
23health care facility's organizing nonsalaried employees to
24provide services only in that facility.
25    (h) "Covenant not to compete" means an agreement between
26an employer and an employee that restricts such employee from

 

 

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1performing:
2        (1) any work for another employer for a specified
3    period of time;
4        (2) any work in a specified geographical area; or
5        (3) work for another employer that is similar to such
6    employee's work for the employer included as a party to
7    the agreement.
8(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
 
9    (225 ILCS 510/14)  (from Ch. 111, par. 964)
10    Sec. 14. Minimum Standards. (a) The Department, by rule,
11shall establish minimum standards for the operation of nurse
12agencies. Those standards shall include, but are not limited
13to: (1) the maintenance of written policies and procedures;
14and (2) the development of personnel policies which include a
15personal interview, a reference check, an annual evaluation of
16each employee (which may be based in part upon information
17provided by health care facilities utilizing nurse agency
18personnel) and periodic health examinations.
19    (b) Each nurse agency shall have a nurse serving as a
20manager or supervisor of all nurses and certified nurses
21aides.
22    (c) Each nurse agency shall ensure that its employees meet
23the minimum licensing, training, and orientation standards for
24which those employees are licensed or certified.
25    (d) A nurse agency shall not employ, assign, or refer for

 

 

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1use in an Illinois health care facility a nurse or certified
2nurse aide unless certified or licensed under applicable
3provisions of State and federal law or regulations. Each
4certified nurse aide shall comply with all pertinent
5regulations of the Illinois Department of Public Health
6relating to the health and other qualifications of personnel
7employed in health care facilities.
8    (e) The Department may adopt rules to monitor the usage of
9nurse agency services to determine their impact.
10    (f) Nurse agencies are prohibited from requiring, as a
11condition of employment, assignment, or referral, that their
12employees recruit new employees for the nurse agency from
13among the permanent employees of the health care facility to
14which the nurse agency employees have been employed, assigned,
15or referred, and the health care facility to which such
16employees are employed, assigned, or referred is prohibited
17from requiring, as a condition of employment, that their
18employees recruit new employees from these nurse agency
19employees. Violation of this provision is a business offense.
20    (g) Nurse agencies are prohibited from entering into
21covenants not to compete with certified nurse aides who are
22employed by the agencies. After the effective date of this
23amendatory Act of the 102nd General Assembly, a covenant not
24to compete entered into between a nurse agency and a certified
25nurse aide is illegal and void.
26(Source: P.A. 86-817.)
 

 

 

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1    Section 10. The Illinois Public Aid Code is amended by
2changing Sections 5-5.2, 5-5.4, 5B-2, 5B-4, 5B-5, 5B-8, and
35E-10 as follows:
 
4    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
5    Sec. 5-5.2. Payment.
6    (a) All nursing facilities that are grouped pursuant to
7Section 5-5.1 of this Act shall receive the same rate of
8payment for similar services.
9    (b) It shall be a matter of State policy that the Illinois
10Department shall utilize a uniform billing cycle throughout
11the State for the long-term care providers.
12    (b-1) It shall be a matter of State policy that the
13Illinois Department shall set nursing facility rates by rule
14utilizing an evidence-based methodology that rewards
15appropriate staffing, quality-of-life improvements for nursing
16facility residents, including the cessation of payments for
17rooms with 3 or more people residing in them by January 1,
182027, and the reduction of racial inequities and health
19disparities for nursing facility residents enrolled in
20Medicaid.
21    (c) (Blank). Notwithstanding any other provisions of this
22Code, the methodologies for reimbursement of nursing services
23as provided under this Article shall no longer be applicable
24for bills payable for nursing services rendered on or after a

 

 

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1new reimbursement system based on the Resource Utilization
2Groups (RUGs) has been fully operationalized, which shall take
3effect for services provided on or after January 1, 2014.
4    (d) The new nursing services reimbursement methodology
5utilizing the Patient Driven Payment Model RUG-IV 48 grouper
6model, which shall be referred to as the PDPM RUGs
7reimbursement system, taking effect January 1, 2022, upon
8federal approval by the Centers for Medicare and Medicaid
9Services, 2014, shall be based on the following:
10        (1) The methodology shall be resident-centered
11    resident-driven, facility-specific, and based on guidance
12    from the Centers for Medicare and Medicaid Services
13    cost-based.
14        (2) Costs shall be annually rebased and case mix index
15    quarterly updated. The nursing services methodology will
16    be assigned to the Medicaid enrolled residents on record
17    as of 30 days prior to the beginning of the rate period in
18    the Department's Medicaid Management Information System
19    (MMIS) as present on the last day of the second quarter
20    preceding the rate period based upon the Assessment
21    Reference Date of the Minimum Data Set (MDS).
22        (3) Regional wage adjustors based on the Health
23    Service Areas (HSA) groupings and adjusters in effect on
24    January 1, 2022 April 30, 2012 shall be included.
25        (4) PDPM nursing case-mix indices in effect on May 1,
26    2021 Case mix index shall be assigned to each resident

 

 

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1    class based on the Centers for Medicare and Medicaid
2    Services staff time measurement study called Staff Time
3    And Resource Intensity Verification (STRIVE) in effect on
4    July 1, 2013, adjusted by a uniform multiplier to achieve
5    the same statewide case mix index value observed for the
6    quarter beginning April 1, 2021 while holding PA1, PA2,
7    BA1, and BB1 resident classes at the level applicable
8    under the RUG-IV payment model prior to January 1, 2022.
9    utilizing an index maximization approach.
10        (5) (Blank). The pool of funds available for
11    distribution by case mix and the base facility rate shall
12    be determined using the formula contained in subsection
13    (d-1).
14        (6) The statewide base rate for dates of service on
15    and after January 1, 2022 shall be $85.25.
16        (7) The Department shall establish, by rule, a
17    multiplier based on information from the most recent
18    available federal staffing report, currently the Payroll
19    Based Journal, adjusted for acuity if applicable using the
20    same quarter's MDS. The multiplier may not exceed 1.0
21    unless the nursing facility is at least at 92% of the
22    STRIVE study in effect on May 1, 2021.
23    (d-1) (Blank). Calculation of base year Statewide RUG-IV
24nursing base per diem rate.
25        (1) Base rate spending pool shall be:
26            (A) The base year resident days which are

 

 

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1        calculated by multiplying the number of Medicaid
2        residents in each nursing home as indicated in the MDS
3        data defined in paragraph (4) by 365.
4            (B) Each facility's nursing component per diem in
5        effect on July 1, 2012 shall be multiplied by
6        subsection (A).
7            (C) Thirteen million is added to the product of
8        subparagraph (A) and subparagraph (B) to adjust for
9        the exclusion of nursing homes defined in paragraph
10        (5).
11        (2) For each nursing home with Medicaid residents as
12    indicated by the MDS data defined in paragraph (4),
13    weighted days adjusted for case mix and regional wage
14    adjustment shall be calculated. For each home this
15    calculation is the product of:
16            (A) Base year resident days as calculated in
17        subparagraph (A) of paragraph (1).
18            (B) The nursing home's regional wage adjustor
19        based on the Health Service Areas (HSA) groupings and
20        adjustors in effect on April 30, 2012.
21            (C) Facility weighted case mix which is the number
22        of Medicaid residents as indicated by the MDS data
23        defined in paragraph (4) multiplied by the associated
24        case weight for the RUG-IV 48 grouper model using
25        standard RUG-IV procedures for index maximization.
26            (D) The sum of the products calculated for each

 

 

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1        nursing home in subparagraphs (A) through (C) above
2        shall be the base year case mix, rate adjusted
3        weighted days.
4        (3) The Statewide RUG-IV nursing base per diem rate:
5            (A) on January 1, 2014 shall be the quotient of the
6        paragraph (1) divided by the sum calculated under
7        subparagraph (D) of paragraph (2); and
8            (B) on and after July 1, 2014, shall be the amount
9        calculated under subparagraph (A) of this paragraph
10        (3) plus $1.76.
11        (4) Minimum Data Set (MDS) comprehensive assessments
12    for Medicaid residents on the last day of the quarter used
13    to establish the base rate.
14        (5) Nursing facilities designated as of July 1, 2012
15    by the Department as "Institutions for Mental Disease"
16    shall be excluded from all calculations under this
17    subsection. The data from these facilities shall not be
18    used in the computations described in paragraphs (1)
19    through (4) above to establish the base rate.
20    (e) Beginning July 1, 2014 through December 31, 2021, the
21Department shall allocate funding in the amount up to
22$10,000,000 for per diem add-ons to the RUGS methodology for
23dates of service on and after July 1, 2014:
24        (1) $0.63 for each resident who scores in I4200
25    Alzheimer's Disease or I4800 non-Alzheimer's Dementia.
26        (2) $2.67 for each resident who scores either a "1" or

 

 

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1    "2" in any items S1200A through S1200I and also scores in
2    RUG groups PA1, PA2, BA1, or BA2.
3        (3) Beginning on and after January 1, 2022, the
4    Department shall allocate funding, by rule, for per diem
5    add-ons to the PDPM methodology for each resident with a
6    diagnosis of Alzheimer's disease.
7    (e-1) (Blank).
8    (e-2) (Blank). For dates of services beginning January 1,
92014, the RUG-IV nursing component per diem for a nursing home
10shall be the product of the statewide RUG-IV nursing base per
11diem rate, the facility average case mix index, and the
12regional wage adjustor. Transition rates for services provided
13between January 1, 2014 and December 31, 2014 shall be as
14follows:
15        (1) The transition RUG-IV per diem nursing rate for
16    nursing homes whose rate calculated in this subsection
17    (e-2) is greater than the nursing component rate in effect
18    July 1, 2012 shall be paid the sum of:
19            (A) The nursing component rate in effect July 1,
20        2012; plus
21            (B) The difference of the RUG-IV nursing component
22        per diem calculated for the current quarter minus the
23        nursing component rate in effect July 1, 2012
24        multiplied by 0.88.
25        (2) The transition RUG-IV per diem nursing rate for
26    nursing homes whose rate calculated in this subsection

 

 

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1    (e-2) is less than the nursing component rate in effect
2    July 1, 2012 shall be paid the sum of:
3            (A) The nursing component rate in effect July 1,
4        2012; plus
5            (B) The difference of the RUG-IV nursing component
6        per diem calculated for the current quarter minus the
7        nursing component rate in effect July 1, 2012
8        multiplied by 0.13.
9    (f) Notwithstanding any other provision of this Code, on
10and after July 1, 2012, reimbursement rates associated with
11the nursing or support components of the current nursing
12facility rate methodology shall not increase beyond the level
13effective May 1, 2011 until a new reimbursement system based
14on the RUGs IV 48 grouper model has been fully
15operationalized.
16    (g) Notwithstanding any other provision of this Code, on
17and after July 1, 2012, for facilities not designated by the
18Department of Healthcare and Family Services as "Institutions
19for Mental Disease", rates effective May 1, 2011 shall be
20adjusted as follows:
21        (1) Individual nursing rates for residents classified
22    in RUG IV groups PA1, PA2, BA1, and BA2 during the quarter
23    ending March 31, 2012 shall be reduced by 10%;
24        (2) Individual nursing rates for residents classified
25    in all other RUG IV groups shall be reduced by 1.0%;
26        (3) Facility rates for the capital and support

 

 

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1    components shall be reduced by 1.7%.
2    (h) Notwithstanding any other provision of this Code, on
3and after July 1, 2012, nursing facilities designated by the
4Department of Healthcare and Family Services as "Institutions
5for Mental Disease" and "Institutions for Mental Disease" that
6are facilities licensed under the Specialized Mental Health
7Rehabilitation Act of 2013 shall have the nursing,
8socio-developmental, capital, and support components of their
9reimbursement rate effective May 1, 2011 reduced in total by
102.7%.
11    (i) On and after July 1, 2014, the reimbursement rates for
12the support component of the nursing facility rate for
13facilities licensed under the Nursing Home Care Act as skilled
14or intermediate care facilities shall be the rate in effect on
15June 30, 2014 increased by 8.17%.
16    (j) Notwithstanding any other provision of law, subject to
17federal approval, effective July 1, 2019, sufficient funds
18shall be allocated for changes to rates for facilities
19licensed under the Nursing Home Care Act as skilled nursing
20facilities or intermediate care facilities for dates of
21services on and after July 1, 2019: (i) to establish, through
22December 31, 2021 or upon implementation of the staffing
23multiplier payments under paragraph (7) of subsection (d),
24whichever is later, a per diem add-on to the direct care per
25diem rate not to exceed $70,000,000 annually in the aggregate
26taking into account federal matching funds for the purpose of

 

 

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1addressing the facility's unique staffing needs, adjusted
2quarterly and distributed by a weighted formula based on
3Medicaid bed days on the last day of the second quarter
4preceding the quarter for which the rate is being adjusted.
5Beginning January 1, 2022, or upon implementation of the
6staffing multiplier payments under paragraph (7) of subsection
7(d), whichever is later, the annual $70,000,000 described in
8the preceding sentence shall be dedicated to the staffing
9multiplier payments under paragraph (7) of subsection (d); and
10(ii) in an amount not to exceed $170,000,000 annually in the
11aggregate taking into account federal matching funds to permit
12the support component of the nursing facility rate to be
13updated as follows:
14        (1) 80%, or $136,000,000, of the funds shall be used
15    to update each facility's rate in effect on June 30, 2019
16    using the most recent cost reports on file, which have had
17    a limited review conducted by the Department of Healthcare
18    and Family Services and will not hold up enacting the rate
19    increase, with the Department of Healthcare and Family
20    Services and taking into account subsection (i).
21        (2) After completing the calculation in paragraph (1),
22    any facility whose rate is less than the rate in effect on
23    June 30, 2019 shall have its rate restored to the rate in
24    effect on June 30, 2019 from the 20% of the funds set
25    aside.
26        (3) The remainder of the 20%, or $34,000,000, shall be

 

 

HB4085- 14 -LRB102 18527 KTG 26753 b

1    used to increase each facility's rate by an equal
2    percentage.
3    In order to provide for the expeditious and timely
4implementation of the provisions of this amendatory Act of the
5102nd General Assembly, emergency rules to implement any
6provision of this amendatory Act of the 102nd General Assembly
7may be adopted in accordance with this subsection by the
8agency charged with administering that provision or
9initiative. The 24-month limitation on the adoption of
10emergency rules does not apply to rules adopted under this
11subsection. The adoption of emergency rules authorized by this
12subsection is deemed to be necessary for the public interest,
13safety, and welfare.
14    To implement item (i) in this subsection, facilities shall
15file quarterly reports documenting compliance with its
16annually approved staffing plan, which shall permit compliance
17with Section 3-202.05 of the Nursing Home Care Act. A facility
18that fails to meet the benchmarks and dates contained in the
19plan may have its add-on adjusted in the quarter following the
20quarterly review. Nothing in this Section shall limit the
21ability of the facility to appeal a ruling of non-compliance
22and a subsequent reduction to the add-on. Funds adjusted for
23noncompliance shall be maintained in the Long-Term Care
24Provider Fund and accounted for separately. At the end of each
25fiscal year, these funds shall be made available to facilities
26for special staffing projects.

 

 

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1    In order to provide for the expeditious and timely
2implementation of the provisions of this amendatory Act of the
3101st General Assembly, emergency rules to implement any
4provision of this amendatory Act of the 101st General Assembly
5may be adopted in accordance with this subsection by the
6agency charged with administering that provision or
7initiative. The agency shall simultaneously file emergency
8rules and permanent rules to ensure that there is no
9interruption in administrative guidance. The 150-day
10limitation of the effective period of emergency rules does not
11apply to rules adopted under this subsection, and the
12effective period may continue through June 30, 2021. The
1324-month limitation on the adoption of emergency rules does
14not apply to rules adopted under this subsection. The adoption
15of emergency rules authorized by this subsection is deemed to
16be necessary for the public interest, safety, and welfare.
17    (k) (j) During the first quarter of State Fiscal Year
182020, the Department of Healthcare of Family Services must
19convene a technical advisory group consisting of members of
20all trade associations representing Illinois skilled nursing
21providers to discuss changes necessary with federal
22implementation of Medicare's Patient-Driven Payment Model.
23Implementation of Medicare's Patient-Driven Payment Model
24shall, by September 1, 2020, end the collection of the MDS data
25that is necessary to maintain the current RUG-IV Medicaid
26payment methodology. The technical advisory group must

 

 

HB4085- 16 -LRB102 18527 KTG 26753 b

1consider a revised reimbursement methodology that takes into
2account transparency, accountability, actual staffing as
3reported under the federally required Payroll Based Journal
4system, changes to the minimum wage, adequacy in coverage of
5the cost of care, and a quality component that rewards quality
6improvements.
7    (l) The Department shall establish, by rule, payments to
8improve the quality of care delivered by facilities,
9including:
10        (1) Incentive payments determined by facility
11    performance on specified quality measures, including, but
12    not limited to, the consistent assignment of staff and
13    staff retention.
14        (2) Incentive payments for infection control and
15    facility modifications in support of a transition to the
16    cessation of payment for facility rooms in which 3 or more
17    people reside by January 1, 2027.
18        (3) Payments based on CNA tenure, professional
19    development, and wage thresholds for the purpose of
20    increasing CNA compensation. It is the intent of this
21    subsection that payments made in accordance with this
22    paragraph be directly incorporated into increased
23    compensation for CNAs. For purposes of this paragraph,
24    "CNA" means certified nurse aide.
25    (m) The Department shall utilize any federal monies
26allocated for nursing facilities under the American Rescue

 

 

HB4085- 17 -LRB102 18527 KTG 26753 b

1Plan Act of 2021 or any other similar COVID-response funds for
2payments to enhance the quality of life of facility residents
3or to support workforce development initiatives for nursing
4facility staff.
5(Source: P.A. 101-10, eff. 6-5-19; 101-348, eff. 8-9-19;
6revised 9-18-19.)
 
7    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
8    Sec. 5-5.4. Standards of Payment - Department of
9Healthcare and Family Services. The Department of Healthcare
10and Family Services shall develop standards of payment of
11nursing facility and ICF/DD services in facilities providing
12such services under this Article which:
13    (1) Provide for the determination of a facility's payment
14for nursing facility or ICF/DD services on a prospective
15basis. The amount of the payment rate for all nursing
16facilities certified by the Department of Public Health under
17the ID/DD Community Care Act or the Nursing Home Care Act as
18Intermediate Care for the Developmentally Disabled facilities,
19Long Term Care for Under Age 22 facilities, Skilled Nursing
20facilities, or Intermediate Care facilities under the medical
21assistance program shall be prospectively established annually
22on the basis of historical, financial, and statistical data
23reflecting actual costs from prior years, which shall be
24applied to the current rate year and updated for inflation,
25except that the capital cost element for newly constructed

 

 

HB4085- 18 -LRB102 18527 KTG 26753 b

1facilities shall be based upon projected budgets. The annually
2established payment rate shall take effect on July 1 in 1984
3and subsequent years. No rate increase and no update for
4inflation shall be provided on or after July 1, 1994, unless
5specifically provided for in this Section. The changes made by
6Public Act 93-841 extending the duration of the prohibition
7against a rate increase or update for inflation are effective
8retroactive to July 1, 2004.
9    For facilities licensed by the Department of Public Health
10under the Nursing Home Care Act as Intermediate Care for the
11Developmentally Disabled facilities or Long Term Care for
12Under Age 22 facilities, the rates taking effect on July 1,
131998 shall include an increase of 3%. For facilities licensed
14by the Department of Public Health under the Nursing Home Care
15Act as Skilled Nursing facilities or Intermediate Care
16facilities, the rates taking effect on July 1, 1998 shall
17include an increase of 3% plus $1.10 per resident-day, as
18defined by the Department. For facilities licensed by the
19Department of Public Health under the Nursing Home Care Act as
20Intermediate Care Facilities for the Developmentally Disabled
21or Long Term Care for Under Age 22 facilities, the rates taking
22effect on January 1, 2006 shall include an increase of 3%. For
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as Intermediate Care Facilities for
25the Developmentally Disabled or Long Term Care for Under Age
2622 facilities, the rates taking effect on January 1, 2009

 

 

HB4085- 19 -LRB102 18527 KTG 26753 b

1shall include an increase sufficient to provide a $0.50 per
2hour wage increase for non-executive staff. For facilities
3licensed by the Department of Public Health under the ID/DD
4Community Care Act as ID/DD Facilities the rates taking effect
5within 30 days after July 6, 2017 (the effective date of Public
6Act 100-23) shall include an increase sufficient to provide a
7$0.75 per hour wage increase for non-executive staff. The
8Department shall adopt rules, including emergency rules under
9subsection (y) of Section 5-45 of the Illinois Administrative
10Procedure Act, to implement the provisions of this paragraph.
11For facilities licensed by the Department of Public Health
12under the ID/DD Community Care Act as ID/DD Facilities and
13under the MC/DD Act as MC/DD Facilities, the rates taking
14effect within 30 days after the effective date of this
15amendatory Act of the 100th General Assembly shall include an
16increase sufficient to provide a $0.50 per hour wage increase
17for non-executive front-line personnel, including, but not
18limited to, direct support persons, aides, front-line
19supervisors, qualified intellectual disabilities
20professionals, nurses, and non-administrative support staff.
21The Department shall adopt rules, including emergency rules
22under subsection (bb) of Section 5-45 of the Illinois
23Administrative Procedure Act, to implement the provisions of
24this paragraph.
25    For facilities licensed by the Department of Public Health
26under the Nursing Home Care Act as Intermediate Care for the

 

 

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1Developmentally Disabled facilities or Long Term Care for
2Under Age 22 facilities, the rates taking effect on July 1,
31999 shall include an increase of 1.6% plus $3.00 per
4resident-day, as defined by the Department. For facilities
5licensed by the Department of Public Health under the Nursing
6Home Care Act as Skilled Nursing facilities or Intermediate
7Care facilities, the rates taking effect on July 1, 1999 shall
8include an increase of 1.6% and, for services provided on or
9after October 1, 1999, shall be increased by $4.00 per
10resident-day, as defined by the Department.
11    For facilities licensed by the Department of Public Health
12under the Nursing Home Care Act as Intermediate Care for the
13Developmentally Disabled facilities or Long Term Care for
14Under Age 22 facilities, the rates taking effect on July 1,
152000 shall include an increase of 2.5% per resident-day, as
16defined by the Department. For facilities licensed by the
17Department of Public Health under the Nursing Home Care Act as
18Skilled Nursing facilities or Intermediate Care facilities,
19the rates taking effect on July 1, 2000 shall include an
20increase of 2.5% per resident-day, as defined by the
21Department.
22    For facilities licensed by the Department of Public Health
23under the Nursing Home Care Act as skilled nursing facilities
24or intermediate care facilities, a new payment methodology
25must be implemented for the nursing component of the rate
26effective July 1, 2003. The Department of Public Aid (now

 

 

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1Healthcare and Family Services) shall develop the new payment
2methodology using the Minimum Data Set (MDS) as the instrument
3to collect information concerning nursing home resident
4condition necessary to compute the rate. The Department shall
5develop the new payment methodology to meet the unique needs
6of Illinois nursing home residents while remaining subject to
7the appropriations provided by the General Assembly. A
8transition period from the payment methodology in effect on
9June 30, 2003 to the payment methodology in effect on July 1,
102003 shall be provided for a period not exceeding 3 years and
11184 days after implementation of the new payment methodology
12as follows:
13        (A) For a facility that would receive a lower nursing
14    component rate per patient day under the new system than
15    the facility received effective on the date immediately
16    preceding the date that the Department implements the new
17    payment methodology, the nursing component rate per
18    patient day for the facility shall be held at the level in
19    effect on the date immediately preceding the date that the
20    Department implements the new payment methodology until a
21    higher nursing component rate of reimbursement is achieved
22    by that facility.
23        (B) For a facility that would receive a higher nursing
24    component rate per patient day under the payment
25    methodology in effect on July 1, 2003 than the facility
26    received effective on the date immediately preceding the

 

 

HB4085- 22 -LRB102 18527 KTG 26753 b

1    date that the Department implements the new payment
2    methodology, the nursing component rate per patient day
3    for the facility shall be adjusted.
4        (C) Notwithstanding paragraphs (A) and (B), the
5    nursing component rate per patient day for the facility
6    shall be adjusted subject to appropriations provided by
7    the General Assembly.
8    For facilities licensed by the Department of Public Health
9under the Nursing Home Care Act as Intermediate Care for the
10Developmentally Disabled facilities or Long Term Care for
11Under Age 22 facilities, the rates taking effect on March 1,
122001 shall include a statewide increase of 7.85%, as defined
13by the Department.
14    Notwithstanding any other provision of this Section, for
15facilities licensed by the Department of Public Health under
16the Nursing Home Care Act as skilled nursing facilities or
17intermediate care facilities, except facilities participating
18in the Department's demonstration program pursuant to the
19provisions of Title 77, Part 300, Subpart T of the Illinois
20Administrative Code, the numerator of the ratio used by the
21Department of Healthcare and Family Services to compute the
22rate payable under this Section using the Minimum Data Set
23(MDS) methodology shall incorporate the following annual
24amounts as the additional funds appropriated to the Department
25specifically to pay for rates based on the MDS nursing
26component methodology in excess of the funding in effect on

 

 

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1December 31, 2006:
2        (i) For rates taking effect January 1, 2007,
3    $60,000,000.
4        (ii) For rates taking effect January 1, 2008,
5    $110,000,000.
6        (iii) For rates taking effect January 1, 2009,
7    $194,000,000.
8        (iv) For rates taking effect April 1, 2011, or the
9    first day of the month that begins at least 45 days after
10    the effective date of this amendatory Act of the 96th
11    General Assembly, $416,500,000 or an amount as may be
12    necessary to complete the transition to the MDS
13    methodology for the nursing component of the rate.
14    Increased payments under this item (iv) are not due and
15    payable, however, until (i) the methodologies described in
16    this paragraph are approved by the federal government in
17    an appropriate State Plan amendment and (ii) the
18    assessment imposed by Section 5B-2 of this Code is
19    determined to be a permissible tax under Title XIX of the
20    Social Security Act.
21    Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, the support component of the
25rates taking effect on January 1, 2008 shall be computed using
26the most recent cost reports on file with the Department of

 

 

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1Healthcare and Family Services no later than April 1, 2005,
2updated for inflation to January 1, 2006.
3    For facilities licensed by the Department of Public Health
4under the Nursing Home Care Act as Intermediate Care for the
5Developmentally Disabled facilities or Long Term Care for
6Under Age 22 facilities, the rates taking effect on April 1,
72002 shall include a statewide increase of 2.0%, as defined by
8the Department. This increase terminates on July 1, 2002;
9beginning July 1, 2002 these rates are reduced to the level of
10the rates in effect on March 31, 2002, as defined by the
11Department.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as skilled nursing facilities
14or intermediate care facilities, the rates taking effect on
15July 1, 2001 shall be computed using the most recent cost
16reports on file with the Department of Public Aid no later than
17April 1, 2000, updated for inflation to January 1, 2001. For
18rates effective July 1, 2001 only, rates shall be the greater
19of the rate computed for July 1, 2001 or the rate effective on
20June 30, 2001.
21    Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, the Illinois Department shall
25determine by rule the rates taking effect on July 1, 2002,
26which shall be 5.9% less than the rates in effect on June 30,

 

 

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12002.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, if the payment methodologies
6required under Section 5A-12 and the waiver granted under 42
7CFR 433.68 are approved by the United States Centers for
8Medicare and Medicaid Services, the rates taking effect on
9July 1, 2004 shall be 3.0% greater than the rates in effect on
10June 30, 2004. These rates shall take effect only upon
11approval and implementation of the payment methodologies
12required under Section 5A-12.
13    Notwithstanding any other provisions of this Section, for
14facilities licensed by the Department of Public Health under
15the Nursing Home Care Act as skilled nursing facilities or
16intermediate care facilities, the rates taking effect on
17January 1, 2005 shall be 3% more than the rates in effect on
18December 31, 2004.
19    Notwithstanding any other provision of this Section, for
20facilities licensed by the Department of Public Health under
21the Nursing Home Care Act as skilled nursing facilities or
22intermediate care facilities, effective January 1, 2009, the
23per diem support component of the rates effective on January
241, 2008, computed using the most recent cost reports on file
25with the Department of Healthcare and Family Services no later
26than April 1, 2005, updated for inflation to January 1, 2006,

 

 

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1shall be increased to the amount that would have been derived
2using standard Department of Healthcare and Family Services
3methods, procedures, and inflators.
4    Notwithstanding any other provisions of this Section, for
5facilities licensed by the Department of Public Health under
6the Nursing Home Care Act as intermediate care facilities that
7are federally defined as Institutions for Mental Disease, or
8facilities licensed by the Department of Public Health under
9the Specialized Mental Health Rehabilitation Act of 2013, a
10socio-development component rate equal to 6.6% of the
11facility's nursing component rate as of January 1, 2006 shall
12be established and paid effective July 1, 2006. The
13socio-development component of the rate shall be increased by
14a factor of 2.53 on the first day of the month that begins at
15least 45 days after January 11, 2008 (the effective date of
16Public Act 95-707). As of August 1, 2008, the
17socio-development component rate shall be equal to 6.6% of the
18facility's nursing component rate as of January 1, 2006,
19multiplied by a factor of 3.53. For services provided on or
20after April 1, 2011, or the first day of the month that begins
21at least 45 days after the effective date of this amendatory
22Act of the 96th General Assembly, whichever is later, the
23Illinois Department may by rule adjust these socio-development
24component rates, and may use different adjustment
25methodologies for those facilities participating, and those
26not participating, in the Illinois Department's demonstration

 

 

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1program pursuant to the provisions of Title 77, Part 300,
2Subpart T of the Illinois Administrative Code, but in no case
3may such rates be diminished below those in effect on August 1,
42008.
5    For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as Intermediate Care for the
7Developmentally Disabled facilities or as long-term care
8facilities for residents under 22 years of age, the rates
9taking effect on July 1, 2003 shall include a statewide
10increase of 4%, as defined by the Department.
11    For facilities licensed by the Department of Public Health
12under the Nursing Home Care Act as Intermediate Care for the
13Developmentally Disabled facilities or Long Term Care for
14Under Age 22 facilities, the rates taking effect on the first
15day of the month that begins at least 45 days after the
16effective date of this amendatory Act of the 95th General
17Assembly shall include a statewide increase of 2.5%, as
18defined by the Department.
19    Notwithstanding any other provision of this Section, for
20facilities licensed by the Department of Public Health under
21the Nursing Home Care Act as skilled nursing facilities or
22intermediate care facilities, effective January 1, 2005,
23facility rates shall be increased by the difference between
24(i) a facility's per diem property, liability, and malpractice
25insurance costs as reported in the cost report filed with the
26Department of Public Aid and used to establish rates effective

 

 

HB4085- 28 -LRB102 18527 KTG 26753 b

1July 1, 2001 and (ii) those same costs as reported in the
2facility's 2002 cost report. These costs shall be passed
3through to the facility without caps or limitations, except
4for adjustments required under normal auditing procedures.
5    Rates established effective each July 1 shall govern
6payment for services rendered throughout that fiscal year,
7except that rates established on July 1, 1996 shall be
8increased by 6.8% for services provided on or after January 1,
91997. Such rates will be based upon the rates calculated for
10the year beginning July 1, 1990, and for subsequent years
11thereafter until June 30, 2001 shall be based on the facility
12cost reports for the facility fiscal year ending at any point
13in time during the previous calendar year, updated to the
14midpoint of the rate year. The cost report shall be on file
15with the Department no later than April 1 of the current rate
16year. Should the cost report not be on file by April 1, the
17Department shall base the rate on the latest cost report filed
18by each skilled care facility and intermediate care facility,
19updated to the midpoint of the current rate year. In
20determining rates for services rendered on and after July 1,
211985, fixed time shall not be computed at less than zero. The
22Department shall not make any alterations of regulations which
23would reduce any component of the Medicaid rate to a level
24below what that component would have been utilizing in the
25rate effective on July 1, 1984.
26    (2) Shall take into account the actual costs incurred by

 

 

HB4085- 29 -LRB102 18527 KTG 26753 b

1facilities in providing services for recipients of skilled
2nursing and intermediate care services under the medical
3assistance program.
4    (3) Shall take into account the medical and psycho-social
5characteristics and needs of the patients.
6    (4) Shall take into account the actual costs incurred by
7facilities in meeting licensing and certification standards
8imposed and prescribed by the State of Illinois, any of its
9political subdivisions or municipalities and by the U.S.
10Department of Health and Human Services pursuant to Title XIX
11of the Social Security Act.
12    The Department of Healthcare and Family Services shall
13develop precise standards for payments to reimburse nursing
14facilities for any utilization of appropriate rehabilitative
15personnel for the provision of rehabilitative services which
16is authorized by federal regulations, including reimbursement
17for services provided by qualified therapists or qualified
18assistants, and which is in accordance with accepted
19professional practices. Reimbursement also may be made for
20utilization of other supportive personnel under appropriate
21supervision.
22    The Department shall develop enhanced payments to offset
23the additional costs incurred by a facility serving
24exceptional need residents and shall allocate at least
25$4,000,000 of the funds collected from the assessment
26established by Section 5B-2 of this Code for such payments.

 

 

HB4085- 30 -LRB102 18527 KTG 26753 b

1For the purpose of this Section, "exceptional needs" means,
2but need not be limited to, ventilator care and traumatic
3brain injury care. The enhanced payments for exceptional need
4residents under this paragraph are not due and payable,
5however, until (i) the methodologies described in this
6paragraph are approved by the federal government in an
7appropriate State Plan amendment and (ii) the assessment
8imposed by Section 5B-2 of this Code is determined to be a
9permissible tax under Title XIX of the Social Security Act.
10    Beginning January 1, 2014 the methodologies for
11reimbursement of nursing facility services as provided under
12this Section 5-5.4 shall no longer be applicable for services
13provided on or after January 1, 2014.
14    No payment increase under this Section for the MDS
15methodology, exceptional care residents, or the
16socio-development component rate established by Public Act
1796-1530 of the 96th General Assembly and funded by the
18assessment imposed under Section 5B-2 of this Code shall be
19due and payable until after the Department notifies the
20long-term care providers, in writing, that the payment
21methodologies to long-term care providers required under this
22Section have been approved by the Centers for Medicare and
23Medicaid Services of the U.S. Department of Health and Human
24Services and the waivers under 42 CFR 433.68 for the
25assessment imposed by this Section, if necessary, have been
26granted by the Centers for Medicare and Medicaid Services of

 

 

HB4085- 31 -LRB102 18527 KTG 26753 b

1the U.S. Department of Health and Human Services. Upon
2notification to the Department of approval of the payment
3methodologies required under this Section and the waivers
4granted under 42 CFR 433.68, all increased payments otherwise
5due under this Section prior to the date of notification shall
6be due and payable within 90 days of the date federal approval
7is received.
8    On and after July 1, 2012, the Department shall reduce any
9rate of reimbursement for services or other payments or alter
10any methodologies authorized by this Code to reduce any rate
11of reimbursement for services or other payments in accordance
12with Section 5-5e.
13    For facilities licensed by the Department of Public Health
14under the ID/DD Community Care Act as ID/DD Facilities and
15under the MC/DD Act as MC/DD Facilities, subject to federal
16approval, the rates taking effect for services delivered on or
17after August 1, 2019 shall be increased by 3.5% over the rates
18in effect on June 30, 2019. The Department shall adopt rules,
19including emergency rules under subsection (ii) of Section
205-45 of the Illinois Administrative Procedure Act, to
21implement the provisions of this Section, including wage
22increases for direct care staff.
23    For facilities licensed by the Department of Public Health
24under the ID/DD Community Care Act as ID/DD Facilities and
25under the MC/DD Act as MC/DD Facilities, subject to federal
26approval, the rates taking effect on the latter of the

 

 

HB4085- 32 -LRB102 18527 KTG 26753 b

1approval date of the State Plan Amendment for these facilities
2or the Waiver Amendment for the home and community-based
3services settings shall include an increase sufficient to
4provide a $0.26 per hour wage increase to the base wage for
5non-executive staff. The Department shall adopt rules,
6including emergency rules as authorized by Section 5-45 of the
7Illinois Administrative Procedure Act, to implement the
8provisions of this Section, including wage increases for
9direct care staff.
10    For facilities licensed by the Department of Public Health
11under the ID/DD Community Care Act as ID/DD Facilities and
12under the MC/DD Act as MC/DD Facilities, subject to federal
13approval of the State Plan Amendment and the Waiver Amendment
14for the home and community-based services settings, the rates
15taking effect for the services delivered on or after July 1,
162020 shall include an increase sufficient to provide a $1.00
17per hour wage increase for non-executive staff. For services
18delivered on or after January 1, 2021, subject to federal
19approval of the State Plan Amendment and the Waiver Amendment
20for the home and community-based services settings, shall
21include an increase sufficient to provide a $0.50 per hour
22increase for non-executive staff. The Department shall adopt
23rules, including emergency rules as authorized by Section 5-45
24of the Illinois Administrative Procedure Act, to implement the
25provisions of this Section, including wage increases for
26direct care staff.

 

 

HB4085- 33 -LRB102 18527 KTG 26753 b

1(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
2101-10, eff. 6-5-19; 101-636, eff. 6-10-20.)
 
3    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
4    Sec. 5B-2. Assessment; no local authorization to tax.
5    (a) For the privilege of engaging in the occupation of
6long-term care provider, beginning July 1, 2011 through
7December 31, 2021, or upon federal approval by the Centers for
8Medicare and Medicaid Services of the long-term care provider
9assessment described in subsection (a-1), whichever is later,
10an assessment is imposed upon each long-term care provider in
11an amount equal to $6.07 times the number of occupied bed days
12due and payable each month. Notwithstanding any provision of
13any other Act to the contrary, this assessment shall be
14construed as a tax, but shall not be billed or passed on to any
15resident of a nursing home operated by the nursing home
16provider.
17    (a-1) For the privilege of engaging in the occupation of
18long-term care provider, beginning January 1, 2022, an
19assessment is imposed upon each long-term care provider in an
20amount equal to $17 times the number of occupied bed days due
21and payable each month. Notwithstanding any provision of any
22other Act to the contrary, this assessment shall be construed
23as a tax, but shall not be billed or passed on to any resident
24of a nursing home operated by the nursing home provider.
25Implementation of the assessment described in this subsection

 

 

HB4085- 34 -LRB102 18527 KTG 26753 b

1shall be subject to federal approval by the Centers for
2Medicare and Medicaid Services.
3    (a-2) Every 6 months the Department shall calculate the
4payments to nursing facilities under Section 5-5.2. If the
5State share of those payments for the 6-month period
6calculated exceeds the average nursing rate payment per
7resident in effect on June 30, 2019, the Department may
8increase the assessment described in subsection (a-1) for the
9next 6 months to an amount that will generate the State share
10sufficient to cover the increased cost, as long as the revenue
11generated from the assessment does not exceed the federal cap
12as established by the Centers for Medicare and Medicaid
13Services. The Department shall notify each facility subject to
14the assessment of the adjusted rate at least 30 days prior to
15the date upon which the new rate takes effect and any new rate
16imposed on the facilities shall take effect at the start of the
176-month period that begins 6 months after the period used to
18calculate the new rate.
19    (b) Nothing in this amendatory Act of 1992 shall be
20construed to authorize any home rule unit or other unit of
21local government to license for revenue or impose a tax or
22assessment upon long-term care providers or the occupation of
23long-term care provider, or a tax or assessment measured by
24the income or earnings or occupied bed days of a long-term care
25provider.
26    (c) The assessment imposed by this Section shall not be

 

 

HB4085- 35 -LRB102 18527 KTG 26753 b

1due and payable, however, until after the Department notifies
2the long-term care providers, in writing, that the payment
3methodologies to long-term care providers required under
4Section 5-5.4 of this Code have been approved by the Centers
5for Medicare and Medicaid Services of the U.S. Department of
6Health and Human Services and that the waivers under 42 CFR
7433.68 for the assessment imposed by this Section, if
8necessary, have been granted by the Centers for Medicare and
9Medicaid Services of the U.S. Department of Health and Human
10Services.
11(Source: P.A. 96-1530, eff. 2-16-11; 97-10, eff. 6-14-11;
1297-584, eff. 8-26-11.)
 
13    (305 ILCS 5/5B-4)  (from Ch. 23, par. 5B-4)
14    Sec. 5B-4. Payment of assessment; penalty.
15    (a) The assessment imposed by Section 5B-2 shall be due
16and payable monthly, on the last State business day of the
17month for occupied bed days reported for the preceding third
18month prior to the month in which the tax is payable and due. A
19facility that has delayed payment due to the State's failure
20to reimburse for services rendered may request an extension on
21the due date for payment pursuant to subsection (b) and shall
22pay the assessment within 30 days of reimbursement by the
23Department. The Illinois Department may provide that county
24nursing homes directed and maintained pursuant to Section
255-1005 of the Counties Code may meet their assessment

 

 

HB4085- 36 -LRB102 18527 KTG 26753 b

1obligation by certifying to the Illinois Department that
2county expenditures have been obligated for the operation of
3the county nursing home in an amount at least equal to the
4amount of the assessment.
5    (a-5) The Illinois Department shall provide for an
6electronic submission process for each long-term care facility
7to report at a minimum the number of occupied bed days of the
8long-term care facility for the reporting period and other
9reasonable information the Illinois Department requires for
10the administration of its responsibilities under this Code.
11Beginning July 1, 2013, a separate electronic submission shall
12be completed for each long-term care facility in this State
13operated by a long-term care provider. The Illinois Department
14shall provide a self-reporting notice of the assessment form
15that the long-term care facility completes for the required
16period and submits with its assessment payment to the Illinois
17Department. To the extent practicable, the Department shall
18coordinate the assessment reporting requirements with other
19reporting required of long-term care facilities.
20    (b) The Illinois Department is authorized to establish
21delayed payment schedules for long-term care providers that
22are unable to make assessment payments when due under this
23Section due to financial difficulties, as determined by the
24Illinois Department. The Illinois Department may not deny a
25request for delay of payment of the assessment imposed under
26this Article if the long-term care provider has not been paid

 

 

HB4085- 37 -LRB102 18527 KTG 26753 b

1for services provided during the month on which the assessment
2is levied or the Medicaid managed care organization has not
3been paid by the State.
4    (c) If a long-term care provider fails to pay the full
5amount of an assessment payment when due (including any
6extensions granted under subsection (b)), there shall, unless
7waived by the Illinois Department for reasonable cause, be
8added to the assessment imposed by Section 5B-2 a penalty
9assessment equal to the lesser of (i) 5% of the amount of the
10assessment payment not paid on or before the due date plus 5%
11of the portion thereof remaining unpaid on the last day of each
12month thereafter or (ii) 100% of the assessment payment amount
13not paid on or before the due date. For purposes of this
14subsection, payments will be credited first to unpaid
15assessment payment amounts (rather than to penalty or
16interest), beginning with the most delinquent assessment
17payments. Payment cycles of longer than 60 days shall be one
18factor the Director takes into account in granting a waiver
19under this Section.
20    (c-5) If a long-term care facility fails to file its
21assessment bill with payment, there shall, unless waived by
22the Illinois Department for reasonable cause, be added to the
23assessment due a penalty assessment equal to 25% of the
24assessment due. After July 1, 2013, no penalty shall be
25assessed under this Section if the Illinois Department does
26not provide a process for the electronic submission of the

 

 

HB4085- 38 -LRB102 18527 KTG 26753 b

1information required by subsection (a-5).
2    (d) Nothing in this amendatory Act of 1993 shall be
3construed to prevent the Illinois Department from collecting
4all amounts due under this Article pursuant to an assessment
5imposed before the effective date of this amendatory Act of
61993.
7    (e) Nothing in this amendatory Act of the 96th General
8Assembly shall be construed to prevent the Illinois Department
9from collecting all amounts due under this Code pursuant to an
10assessment, tax, fee, or penalty imposed before the effective
11date of this amendatory Act of the 96th General Assembly.
12    (f) No installment of the assessment imposed by Section
135B-2 shall be due and payable until after the Department
14notifies the long-term care providers, in writing, that the
15payment methodologies to long-term care providers required
16under Section 5-5.2 5-5.4 of this Code have been approved by
17the Centers for Medicare and Medicaid Services of the U.S.
18Department of Health and Human Services and the waivers under
1942 CFR 433.68 for the assessment imposed by this Section, if
20necessary, have been granted by the Centers for Medicare and
21Medicaid Services of the U.S. Department of Health and Human
22Services. Upon notification to the Department of approval of
23the payment methodologies required under Section 5-5.2 5-5.4
24of this Code and the waivers granted under 42 CFR 433.68, all
25installments otherwise due under Section 5B-4 prior to the
26date of notification shall be due and payable to the

 

 

HB4085- 39 -LRB102 18527 KTG 26753 b

1Department upon written direction from the Department within
290 days after issuance by the Comptroller of the payments
3required under Section 5-5.2 5-5.4 of this Code.
4(Source: P.A. 100-501, eff. 6-1-18; 101-649, eff. 7-7-20.)
 
5    (305 ILCS 5/5B-5)  (from Ch. 23, par. 5B-5)
6    Sec. 5B-5. Annual reporting; penalty; maintenance of
7records.
8    (a) After December 31 of each year, and on or before March
931 of the succeeding year, every long-term care provider
10subject to assessment under this Article shall file a report
11with the Illinois Department. The report shall be in a form and
12manner prescribed by the Illinois Department and shall state
13the revenue received by the long-term care provider, reported
14in such categories as may be required by the Illinois
15Department, and other reasonable information the Illinois
16Department requires for the administration of its
17responsibilities under this Code.
18    (b) If a long-term care provider operates or maintains
19more than one long-term care facility in this State, the
20provider may not file a single return covering all those
21long-term care facilities, but shall file a separate return
22for each long-term care facility and shall compute and pay the
23assessment for each long-term care facility separately.
24    (c) Notwithstanding any other provision in this Article,
25in the case of a person who ceases to operate or maintain a

 

 

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1long-term care facility in respect of which the person is
2subject to assessment under this Article as a long-term care
3provider, the person shall file a final, amended return with
4the Illinois Department not more than 90 days after the
5cessation reflecting the adjustment and shall pay with the
6final return the assessment for the year as so adjusted (to the
7extent not previously paid). If a person fails to file a final
8amended return on a timely basis, there shall, unless waived
9by the Illinois Department for reasonable cause, be added to
10the assessment due a penalty assessment equal to 25% of the
11assessment due.
12    (d) Notwithstanding any other provision of this Article, a
13provider who commences operating or maintaining a long-term
14care facility that was under a prior ownership and remained
15licensed by the Department of Public Health shall notify the
16Illinois Department of any the change in ownership regardless
17of percentage, and shall be responsible to immediately pay any
18prior amounts owed by the facility. In addition, within 90
19days after the effective date of this amendatory Act of the
20102nd General Assembly, all providers operating or maintaining
21a long-term care facility shall notify the Illinois Department
22of all owners of that facility and the percentage ownership of
23each owner.
24    (e) The Department shall develop a procedure for sharing
25with a potential buyer of a facility information regarding
26outstanding assessments and penalties owed by that facility.

 

 

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1    (f) In the case of a long-term care provider existing as a
2corporation or legal entity other than an individual, the
3return filed by it shall be signed by its president,
4vice-president, secretary, or treasurer or by its properly
5authorized agent.
6    (g) If a long-term care provider fails to file its return
7on or before the due date of the return, there shall, unless
8waived by the Illinois Department for reasonable cause, be
9added to the assessment imposed by Section 5B-2 a penalty
10assessment equal to 25% of the assessment imposed for the
11year. After July 1, 2013, no penalty shall be assessed if the
12Illinois Department has not established a process for the
13electronic submission of information.
14    (h) Every long-term care provider subject to assessment
15under this Article shall keep records and books that will
16permit the determination of occupied bed days on a calendar
17year basis. All such books and records shall be kept in the
18English language and shall, at all times during business hours
19of the day, be subject to inspection by the Illinois
20Department or its duly authorized agents and employees.
21    (i) The Illinois Department shall establish a process for
22long-term care providers to electronically submit all
23information required by this Section no later than July 1,
242013.
25(Source: P.A. 96-1530, eff. 2-16-11; 97-403, eff. 1-1-12;
2697-813, eff. 7-13-12.)
 

 

 

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1    (305 ILCS 5/5B-8)  (from Ch. 23, par. 5B-8)
2    Sec. 5B-8. Long-Term Care Provider Fund.
3    (a) There is created in the State Treasury the Long-Term
4Care Provider Fund. Interest earned by the Fund shall be
5credited to the Fund. The Fund shall not be used to replace any
6moneys appropriated to the Medicaid program by the General
7Assembly.
8    (b) The Fund is created for the purpose of receiving and
9disbursing moneys in accordance with this Article.
10Disbursements from the Fund shall be made only as follows:
11        (1) For payments to nursing facilities, including
12    county nursing facilities but excluding State-operated
13    facilities, under Title XIX of the Social Security Act and
14    Article V of this Code.
15        (1.5) For payments to managed care organizations as
16    defined in Section 5-30.1 of this Code.
17        (2) For the reimbursement of moneys collected by the
18    Illinois Department through error or mistake.
19        (3) For payment of administrative expenses incurred by
20    the Illinois Department or its agent in performing the
21    activities authorized by this Article.
22        (3.5) For reimbursement of expenses incurred by
23    long-term care facilities, and payment of administrative
24    expenses incurred by the Department of Public Health, in
25    relation to the conduct and analysis of background checks

 

 

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1    for identified offenders under the Nursing Home Care Act.
2        (4) For payments of any amounts that are reimbursable
3    to the federal government for payments from this Fund that
4    are required to be paid by State warrant.
5        (5) For making transfers to the General Obligation
6    Bond Retirement and Interest Fund, as those transfers are
7    authorized in the proceedings authorizing debt under the
8    Short Term Borrowing Act, but transfers made under this
9    paragraph (5) shall not exceed the principal amount of
10    debt issued in anticipation of the receipt by the State of
11    moneys to be deposited into the Fund.
12        (6) For making transfers, at the direction of the
13    Director of the Governor's Office of Management and Budget
14    during each fiscal year beginning on or after July 1,
15    2011, to other State funds in an annual amount of
16    $20,000,000 of the tax collected pursuant to this Article
17    for the purpose of enforcement of nursing home standards,
18    support of the ombudsman program, and efforts to expand
19    home and community-based services. No transfer under this
20    paragraph shall occur until (i) the payment methodologies
21    created by Public Act 96-1530 under Section 5-5.4 of this
22    Code have been approved by the Centers for Medicare and
23    Medicaid Services of the U.S. Department of Health and
24    Human Services and (ii) the assessment imposed by Section
25    5B-2 of this Code is determined to be a permissible tax
26    under Title XIX of the Social Security Act.

 

 

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1        (7) For making transfers, at the direction of the
2    Director of the Governor's Office of Management and Budget
3    during each fiscal year beginning on or after January 1,
4    2022, to the Healthcare Provider Relief Fund in an annual
5    amount of $49,000,000 of the tax collected pursuant to
6    this Article for the purpose of enforcement of nursing
7    home standards, payments for other long-term care
8    priorities of the Department, including payments to
9    managed care organizations, and efforts to expand home and
10    community-based services. For the 6-month period during
11    State Fiscal Year 2022, on and after January 1, 2022
12    through June 30, 2022, the amount listed above shall be
13    prorated to an amount of 1/12th per month.
14    Disbursements from the Fund, other than transfers made
15pursuant to paragraphs (5) and (6) of this subsection, shall
16be by warrants drawn by the State Comptroller upon receipt of
17vouchers duly executed and certified by the Illinois
18Department.
19    (c) The Fund shall consist of the following:
20        (1) All moneys collected or received by the Illinois
21    Department from the long-term care provider assessment
22    imposed by this Article.
23        (2) All federal matching funds received by the
24    Illinois Department as a result of expenditures made from
25    the Fund by the Illinois Department that are attributable
26    to moneys deposited in the Fund.

 

 

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1        (3) Any interest or penalty levied in conjunction with
2    the administration of this Article.
3        (4) (Blank).
4        (5) All other monies received for the Fund from any
5    other source, including interest earned thereon.
6(Source: P.A. 96-1530, eff. 2-16-11; 97-584, eff. 8-26-11.)
 
7    (305 ILCS 5/5E-10)
8    Sec. 5E-10. Fee. Through December 31, 2021 or upon federal
9approval by the Centers for Medicare and Medicaid Services of
10the long-term care provider assessment described in subsection
11(a-1) of Section 5B-2 of this Code, whichever is later, every
12Every nursing home provider shall pay to the Illinois
13Department, on or before September 10, December 10, March 10,
14and June 10, a fee in the amount of $1.50 for each licensed
15nursing bed day for the calendar quarter in which the payment
16is due. This fee shall not be billed or passed on to any
17resident of a nursing home operated by the nursing home
18provider. All fees received by the Illinois Department under
19this Section shall be deposited into the Long-Term Care
20Provider Fund.
21(Source: P.A. 88-88; 89-21, eff. 7-1-95.)
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    5 ILCS 100/5-45.8 new
4    225 ILCS 510/3from Ch. 111, par. 953
5    225 ILCS 510/14from Ch. 111, par. 964
6    305 ILCS 5/5-5.2from Ch. 23, par. 5-5.2
7    305 ILCS 5/5-5.4from Ch. 23, par. 5-5.4
8    305 ILCS 5/5B-2from Ch. 23, par. 5B-2
9    305 ILCS 5/5B-4from Ch. 23, par. 5B-4
10    305 ILCS 5/5B-5from Ch. 23, par. 5B-5
11    305 ILCS 5/5B-8from Ch. 23, par. 5B-8
12    305 ILCS 5/5E-10