Bill Text: IL SB2901 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: 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.

Spectrum: Partisan Bill (Democrat 18-0)

Status: (Introduced - Dead) 2021-05-25 - Added as Co-Sponsor Sen. Omar Aquino [SB2901 Detail]

Download: Illinois-2021-SB2901-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 SB2901 Introduced 5/19/2021, by Sen. Ann Gillespie 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.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 3. The Illinois Administrative Procedure Act is
amended by adding Section 5-45.8 as follows:
(5 ILCS 100/5-45.8 new)
Sec. 5-45.8. Emergency rulemaking; nursing facility
payment rates. To provide for the expeditious and timely
implementation of changes made to Section 5-5.2 of the
Illinois Public Aid Code by this amendatory Act of the 102nd
General Assembly, emergency rules may be adopted in accordance
with Section 5-45 by the Department of Healthcare and Family
Services. The adoption of emergency rules authorized by
Section 5-45 and this Section is deemed to be necessary for the
public interest, safety, and welfare.
This Section is repealed on January 1, 2026.
Section 5. The Nurse Agency Licensing Act is amended by
changing Sections 3 and 14 as follows:
(225 ILCS 510/3) (from Ch. 111, par. 953)
Sec. 3. Definitions. As used in this Act:
(a) "Certified nurse aide" means an individual certified

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

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

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

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Section 10. The Illinois Public Aid Code is amended by
changing Sections 5-5.2, 5-5.4, 5B-2, 5B-4, 5B-5, 5B-8, and
5E-10 as follows:
(305 ILCS 5/5-5.2) (from Ch. 23, par. 5-5.2)
Sec. 5-5.2. Payment.
(a) All nursing facilities that are grouped pursuant to
Section 5-5.1 of this Act shall receive the same rate of
payment for similar services.
(b) It shall be a matter of State policy that the Illinois
Department shall utilize a uniform billing cycle throughout
the State for the long-term care providers.
(b-1) It shall be a matter of State policy that the
Illinois Department shall set nursing facility rates by rule
utilizing an evidence-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.
(c) (Blank). Notwithstanding any other provisions of this
Code, the methodologies for reimbursement of nursing services
as provided under this Article shall no longer be applicable
for bills payable for nursing services rendered on or after a

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

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

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

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

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"2" in any items S1200A through S1200I and also scores in
RUG groups PA1, PA2, BA1, or BA2.
(3) 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.
(e-1) (Blank).
(e-2) (Blank). For dates of services beginning January 1,
2014, the RUG-IV nursing component per diem for a nursing home
shall be the product of the statewide RUG-IV nursing base per
diem rate, the facility average case mix index, and the
regional wage adjustor. Transition rates for services provided
between January 1, 2014 and December 31, 2014 shall be as
follows:
(1) The transition RUG-IV per diem nursing rate for
nursing homes whose rate calculated in this subsection
(e-2) is greater than the nursing component rate in effect
July 1, 2012 shall be paid the sum of:
(A) The nursing component rate in effect July 1,
2012; plus
(B) The difference of the RUG-IV nursing component
per diem calculated for the current quarter minus the
nursing component rate in effect July 1, 2012
multiplied by 0.88.
(2) The transition RUG-IV per diem nursing rate for
nursing homes whose rate calculated in this subsection

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

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components shall be reduced by 1.7%.
(h) Notwithstanding any other provision of this Code, on
and after July 1, 2012, nursing facilities designated by the
Department of Healthcare and Family Services as "Institutions
for Mental Disease" and "Institutions for Mental Disease" that
are facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013 shall have the nursing,
socio-developmental, capital, and support components of their
reimbursement rate effective May 1, 2011 reduced in total by
2.7%.
(i) On and after July 1, 2014, the reimbursement rates for
the support component of the nursing facility rate for
facilities licensed under the Nursing Home Care Act as skilled
or intermediate care facilities shall be the rate in effect on
June 30, 2014 increased by 8.17%.
(j) Notwithstanding any other provision of law, subject to
federal approval, effective July 1, 2019, sufficient funds
shall be allocated for changes to rates for facilities
licensed under the Nursing Home Care Act as skilled nursing
facilities or intermediate care facilities for dates of
services on and after July 1, 2019: (i) to establish, through
December 31, 2021 or upon implementation of the staffing
multiplier payments under paragraph (7) of subsection (d),
whichever is later, a per diem add-on to the direct care per
diem rate not to exceed $70,000,000 annually in the aggregate
taking into account federal matching funds for the purpose of

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

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

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

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

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

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

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

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Developmentally Disabled facilities or Long Term Care for
Under Age 22 facilities, the rates taking effect on July 1,
1999 shall include an increase of 1.6% plus $3.00 per
resident-day, as defined by the Department. For facilities
licensed by the Department of Public Health under the Nursing
Home Care Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking effect on July 1, 1999 shall
include an increase of 1.6% and, for services provided on or
after October 1, 1999, shall be increased by $4.00 per
resident-day, as defined by the Department.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as Intermediate Care for the
Developmentally Disabled facilities or Long Term Care for
Under Age 22 facilities, the rates taking effect on July 1,
2000 shall include an increase of 2.5% per resident-day, as
defined by the Department. For facilities licensed by the
Department of Public Health under the Nursing Home Care Act as
Skilled Nursing facilities or Intermediate Care facilities,
the rates taking effect on July 1, 2000 shall include an
increase of 2.5% per resident-day, as defined by the
Department.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as skilled nursing facilities
or intermediate care facilities, a new payment methodology
must be implemented for the nursing component of the rate
effective July 1, 2003. The Department of Public Aid (now

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

SB2901 - 22 - LRB102 18526 KTG 26752 b
date that the Department implements the new payment
methodology, the nursing component rate per patient day
for the facility shall be adjusted.
(C) Notwithstanding paragraphs (A) and (B), the
nursing component rate per patient day for the facility
shall be adjusted subject to appropriations provided by
the General Assembly.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as Intermediate Care for the
Developmentally Disabled facilities or Long Term Care for
Under Age 22 facilities, the rates taking effect on March 1,
2001 shall include a statewide increase of 7.85%, as defined
by the Department.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, except facilities participating
in the Department's demonstration program pursuant to the
provisions of Title 77, Part 300, Subpart T of the Illinois
Administrative Code, the numerator of the ratio used by the
Department of Healthcare and Family Services to compute the
rate payable under this Section using the Minimum Data Set
(MDS) methodology shall incorporate the following annual
amounts as the additional funds appropriated to the Department
specifically to pay for rates based on the MDS nursing
component methodology in excess of the funding in effect on

SB2901 - 23 - LRB102 18526 KTG 26752 b
December 31, 2006:
(i) For rates taking effect January 1, 2007,
$60,000,000.
(ii) For rates taking effect January 1, 2008,
$110,000,000.
(iii) For rates taking effect January 1, 2009,
$194,000,000.
(iv) For rates taking effect April 1, 2011, or the
first day of the month that begins at least 45 days after
the effective date of this amendatory Act of the 96th
General Assembly, $416,500,000 or an amount as may be
necessary to complete the transition to the MDS
methodology for the nursing component of the rate.
Increased payments under this item (iv) are not due and
payable, however, until (i) the methodologies described in
this paragraph are approved by the federal government in
an appropriate State Plan amendment and (ii) the
assessment imposed by Section 5B-2 of this Code is
determined to be a permissible tax under Title XIX of the
Social Security Act.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, the support component of the
rates taking effect on January 1, 2008 shall be computed using
the most recent cost reports on file with the Department of

SB2901 - 24 - LRB102 18526 KTG 26752 b
Healthcare and Family Services no later than April 1, 2005,
updated for inflation to January 1, 2006.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as Intermediate Care for the
Developmentally Disabled facilities or Long Term Care for
Under Age 22 facilities, the rates taking effect on April 1,
2002 shall include a statewide increase of 2.0%, as defined by
the Department. This increase terminates on July 1, 2002;
beginning July 1, 2002 these rates are reduced to the level of
the rates in effect on March 31, 2002, as defined by the
Department.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as skilled nursing facilities
or intermediate care facilities, the rates taking effect on
July 1, 2001 shall be computed using the most recent cost
reports on file with the Department of Public Aid no later than
April 1, 2000, updated for inflation to January 1, 2001. For
rates effective July 1, 2001 only, rates shall be the greater
of the rate computed for July 1, 2001 or the rate effective on
June 30, 2001.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, the Illinois Department shall
determine by rule the rates taking effect on July 1, 2002,
which shall be 5.9% less than the rates in effect on June 30,

SB2901 - 25 - LRB102 18526 KTG 26752 b
2002.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, if the payment methodologies
required under Section 5A-12 and the waiver granted under 42
CFR 433.68 are approved by the United States Centers for
Medicare and Medicaid Services, the rates taking effect on
July 1, 2004 shall be 3.0% greater than the rates in effect on
June 30, 2004. These rates shall take effect only upon
approval and implementation of the payment methodologies
required under Section 5A-12.
Notwithstanding any other provisions of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, the rates taking effect on
January 1, 2005 shall be 3% more than the rates in effect on
December 31, 2004.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, effective January 1, 2009, the
per diem support component of the rates effective on January
1, 2008, computed using the most recent cost reports on file
with the Department of Healthcare and Family Services no later
than April 1, 2005, updated for inflation to January 1, 2006,

SB2901 - 26 - LRB102 18526 KTG 26752 b
shall be increased to the amount that would have been derived
using standard Department of Healthcare and Family Services
methods, procedures, and inflators.
Notwithstanding any other provisions of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as intermediate care facilities that
are federally defined as Institutions for Mental Disease, or
facilities licensed by the Department of Public Health under
the Specialized Mental Health Rehabilitation Act of 2013, a
socio-development component rate equal to 6.6% of the
facility's nursing component rate as of January 1, 2006 shall
be established and paid effective July 1, 2006. The
socio-development component of the rate shall be increased by
a factor of 2.53 on the first day of the month that begins at
least 45 days after January 11, 2008 (the effective date of
Public Act 95-707). As of August 1, 2008, the
socio-development component rate shall be equal to 6.6% of the
facility's nursing component rate as of January 1, 2006,
multiplied by a factor of 3.53. For services provided on or
after April 1, 2011, or the first day of the month that begins
at least 45 days after the effective date of this amendatory
Act of the 96th General Assembly, whichever is later, the
Illinois Department may by rule adjust these socio-development
component rates, and may use different adjustment
methodologies for those facilities participating, and those
not participating, in the Illinois Department's demonstration

SB2901 - 27 - LRB102 18526 KTG 26752 b
program pursuant to the provisions of Title 77, Part 300,
Subpart T of the Illinois Administrative Code, but in no case
may such rates be diminished below those in effect on August 1,
2008.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as Intermediate Care for the
Developmentally Disabled facilities or as long-term care
facilities for residents under 22 years of age, the rates
taking effect on July 1, 2003 shall include a statewide
increase of 4%, as defined by the Department.
For facilities licensed by the Department of Public Health
under the Nursing Home Care Act as Intermediate Care for the
Developmentally Disabled facilities or Long Term Care for
Under Age 22 facilities, the rates taking effect on the first
day of the month that begins at least 45 days after the
effective date of this amendatory Act of the 95th General
Assembly shall include a statewide increase of 2.5%, as
defined by the Department.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, effective January 1, 2005,
facility rates shall be increased by the difference between
(i) a facility's per diem property, liability, and malpractice
insurance costs as reported in the cost report filed with the
Department of Public Aid and used to establish rates effective

SB2901 - 28 - LRB102 18526 KTG 26752 b
July 1, 2001 and (ii) those same costs as reported in the
facility's 2002 cost report. These costs shall be passed
through to the facility without caps or limitations, except
for adjustments required under normal auditing procedures.
Rates established effective each July 1 shall govern
payment for services rendered throughout that fiscal year,
except that rates established on July 1, 1996 shall be
increased by 6.8% for services provided on or after January 1,
1997. Such rates will be based upon the rates calculated for
the year beginning July 1, 1990, and for subsequent years
thereafter until June 30, 2001 shall be based on the facility
cost reports for the facility fiscal year ending at any point
in time during the previous calendar year, updated to the
midpoint of the rate year. The cost report shall be on file
with the Department no later than April 1 of the current rate
year. Should the cost report not be on file by April 1, the
Department shall base the rate on the latest cost report filed
by each skilled care facility and intermediate care facility,
updated to the midpoint of the current rate year. In
determining rates for services rendered on and after July 1,
1985, fixed time shall not be computed at less than zero. The
Department shall not make any alterations of regulations which
would reduce any component of the Medicaid rate to a level
below what that component would have been utilizing in the
rate effective on July 1, 1984.
(2) Shall take into account the actual costs incurred by

SB2901 - 29 - LRB102 18526 KTG 26752 b
facilities in providing services for recipients of skilled
nursing and intermediate care services under the medical
assistance program.
(3) Shall take into account the medical and psycho-social
characteristics and needs of the patients.
(4) Shall take into account the actual costs incurred by
facilities in meeting licensing and certification standards
imposed and prescribed by the State of Illinois, any of its
political subdivisions or municipalities and by the U.S.
Department of Health and Human Services pursuant to Title XIX
of the Social Security Act.
The Department of Healthcare and Family Services shall
develop precise standards for payments to reimburse nursing
facilities for any utilization of appropriate rehabilitative
personnel for the provision of rehabilitative services which
is authorized by federal regulations, including reimbursement
for services provided by qualified therapists or qualified
assistants, and which is in accordance with accepted
professional practices. Reimbursement also may be made for
utilization of other supportive personnel under appropriate
supervision.
The Department shall develop enhanced payments to offset
the additional costs incurred by a facility serving
exceptional need residents and shall allocate at least
$4,000,000 of the funds collected from the assessment
established by Section 5B-2 of this Code for such payments.

SB2901 - 30 - LRB102 18526 KTG 26752 b
For the purpose of this Section, "exceptional needs" means,
but need not be limited to, ventilator care and traumatic
brain injury care. The enhanced payments for exceptional need
residents under this paragraph are not due and payable,
however, until (i) the methodologies described in this
paragraph are approved by the federal government in an
appropriate State Plan amendment and (ii) the assessment
imposed by Section 5B-2 of this Code is determined to be a
permissible tax under Title XIX of the Social Security Act.
Beginning January 1, 2014 the methodologies for
reimbursement of nursing facility services as provided under
this Section 5-5.4 shall no longer be applicable for services
provided on or after January 1, 2014.
No payment increase under this Section for the MDS
methodology, exceptional care residents, or the
socio-development component rate established by Public Act
96-1530 of the 96th General Assembly and funded by the
assessment imposed under Section 5B-2 of this Code shall be
due and payable until after the Department notifies the
long-term care providers, in writing, that the payment
methodologies to long-term care providers required under this
Section have been approved by the Centers for Medicare and
Medicaid Services of the U.S. Department of Health and Human
Services and the waivers under 42 CFR 433.68 for the
assessment imposed by this Section, if necessary, have been
granted by the Centers for Medicare and Medicaid Services of

SB2901 - 31 - LRB102 18526 KTG 26752 b
the U.S. Department of Health and Human Services. Upon
notification to the Department of approval of the payment
methodologies required under this Section and the waivers
granted under 42 CFR 433.68, all increased payments otherwise
due under this Section prior to the date of notification shall
be due and payable within 90 days of the date federal approval
is received.
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate
of reimbursement for services or other payments in accordance
with Section 5-5e.
For facilities licensed by the Department of Public Health
under the ID/DD Community Care Act as ID/DD Facilities and
under the MC/DD Act as MC/DD Facilities, subject to federal
approval, the rates taking effect for services delivered on or
after August 1, 2019 shall be increased by 3.5% over the rates
in effect on June 30, 2019. The Department shall adopt rules,
including emergency rules under subsection (ii) of Section
5-45 of the Illinois Administrative Procedure Act, to
implement the provisions of this Section, including wage
increases for direct care staff.
For facilities licensed by the Department of Public Health
under the ID/DD Community Care Act as ID/DD Facilities and
under the MC/DD Act as MC/DD Facilities, subject to federal
approval, the rates taking effect on the latter of the

SB2901 - 32 - LRB102 18526 KTG 26752 b
approval date of the State Plan Amendment for these facilities
or the Waiver Amendment for the home and community-based
services settings shall include an increase sufficient to
provide a $0.26 per hour wage increase to the base wage for
non-executive staff. The Department shall adopt rules,
including emergency rules as authorized by Section 5-45 of the
Illinois Administrative Procedure Act, to implement the
provisions of this Section, including wage increases for
direct care staff.
For facilities licensed by the Department of Public Health
under the ID/DD Community Care Act as ID/DD Facilities and
under the MC/DD Act as MC/DD Facilities, subject to federal
approval of the State Plan Amendment and the Waiver Amendment
for the home and community-based services settings, the rates
taking effect for the services delivered on or after July 1,
2020 shall include an increase sufficient to provide a $1.00
per hour wage increase for non-executive staff. For services
delivered on or after January 1, 2021, subject to federal
approval of the State Plan Amendment and the Waiver Amendment
for the home and community-based services settings, shall
include an increase sufficient to provide a $0.50 per hour
increase for non-executive staff. The Department shall adopt
rules, including emergency rules as authorized by Section 5-45
of the Illinois Administrative Procedure Act, to implement the
provisions of this Section, including wage increases for
direct care staff.

SB2901 - 33 - LRB102 18526 KTG 26752 b
(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
101-10, eff. 6-5-19; 101-636, eff. 6-10-20.)
(305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
Sec. 5B-2. Assessment; no local authorization to tax.
(a) For the privilege of engaging in the occupation of
long-term care provider, beginning July 1, 2011 through
December 31, 2021, or upon federal approval by the Centers for
Medicare and Medicaid Services of the long-term care provider
assessment described in subsection (a-1), whichever is later,
an assessment is imposed upon each long-term care provider in
an amount equal to $6.07 times the number of occupied bed days
due and payable each month. Notwithstanding any provision of
any other Act to the contrary, this assessment shall be
construed as a tax, but shall not be billed or passed on to any
resident of a nursing home operated by the nursing home
provider.
(a-1) For the privilege of engaging in the occupation of
long-term care provider, beginning January 1, 2022, an
assessment is imposed upon each long-term care provider in an
amount equal to $17 times the number of occupied bed days due
and payable each month. Notwithstanding any provision of any
other Act to the contrary, this assessment shall be construed
as a tax, but shall not be billed or passed on to any resident
of a nursing home operated by the nursing home provider.
Implementation of the assessment described in this subsection

SB2901 - 34 - LRB102 18526 KTG 26752 b
shall be subject to federal approval by the Centers for
Medicare and Medicaid Services.
(a-2) Every 6 months the Department shall calculate the
payments to nursing facilities under Section 5-5.2. If the
State share of those payments for the 6-month period
calculated exceeds the average nursing rate payment per
resident in effect on June 30, 2019, the Department may
increase the assessment described in subsection (a-1) for the
next 6 months to an amount that will generate the State share
sufficient to cover the increased cost, as long as the revenue
generated from the assessment does not exceed the federal cap
as established by the Centers for Medicare and Medicaid
Services. The Department shall notify each facility subject to
the assessment of the adjusted rate at least 30 days prior to
the date upon which the new rate takes effect and any new rate
imposed on the facilities shall take effect at the start of the
6-month period that begins 6 months after the period used to
calculate the new rate.
(b) Nothing in this amendatory Act of 1992 shall be
construed to authorize any home rule unit or other unit of
local government to license for revenue or impose a tax or
assessment upon long-term care providers or the occupation of
long-term care provider, or a tax or assessment measured by
the income or earnings or occupied bed days of a long-term care
provider.
(c) The assessment imposed by this Section shall not be

SB2901 - 35 - LRB102 18526 KTG 26752 b
due and payable, however, until after the Department notifies
the long-term care providers, in writing, that the payment
methodologies to long-term care providers required under
Section 5-5.4 of this Code have been approved by the Centers
for Medicare and Medicaid Services of the U.S. Department of
Health and Human Services and that the waivers under 42 CFR
433.68 for the assessment imposed by this Section, if
necessary, have been granted by the Centers for Medicare and
Medicaid Services of the U.S. Department of Health and Human
Services.
(Source: P.A. 96-1530, eff. 2-16-11; 97-10, eff. 6-14-11;
97-584, eff. 8-26-11.)
(305 ILCS 5/5B-4) (from Ch. 23, par. 5B-4)
Sec. 5B-4. Payment of assessment; penalty.
(a) The assessment imposed by Section 5B-2 shall be due
and payable monthly, on the last State business day of the
month for occupied bed days reported for the preceding third
month prior to the month in which the tax is payable and due. A
facility that has delayed payment due to the State's failure
to reimburse for services rendered may request an extension on
the due date for payment pursuant to subsection (b) and shall
pay the assessment within 30 days of reimbursement by the
Department. The Illinois Department may provide that county
nursing homes directed and maintained pursuant to Section
5-1005 of the Counties Code may meet their assessment

SB2901 - 36 - LRB102 18526 KTG 26752 b
obligation by certifying to the Illinois Department that
county expenditures have been obligated for the operation of
the county nursing home in an amount at least equal to the
amount of the assessment.
(a-5) The Illinois Department shall provide for an
electronic submission process for each long-term care facility
to report at a minimum the number of occupied bed days of the
long-term care facility for the reporting period and other
reasonable information the Illinois Department requires for
the administration of its responsibilities under this Code.
Beginning July 1, 2013, a separate electronic submission shall
be completed for each long-term care facility in this State
operated by a long-term care provider. The Illinois Department
shall provide a self-reporting notice of the assessment form
that the long-term care facility completes for the required
period and submits with its assessment payment to the Illinois
Department. To the extent practicable, the Department shall
coordinate the assessment reporting requirements with other
reporting required of long-term care facilities.
(b) The Illinois Department is authorized to establish
delayed payment schedules for long-term care providers that
are unable to make assessment payments when due under this
Section due to financial difficulties, as determined by the
Illinois Department. The Illinois Department may not deny a
request for delay of payment of the assessment imposed under
this Article if the long-term care provider has not been paid

SB2901 - 37 - LRB102 18526 KTG 26752 b
for services provided during the month on which the assessment
is levied or the Medicaid managed care organization has not
been paid by the State.
(c) If a long-term care provider fails to pay the full
amount of an assessment payment when due (including any
extensions granted under subsection (b)), there shall, unless
waived by the Illinois Department for reasonable cause, be
added to the assessment imposed by Section 5B-2 a penalty
assessment equal to the lesser of (i) 5% of the amount of the
assessment payment not paid on or before the due date plus 5%
of the portion thereof remaining unpaid on the last day of each
month thereafter or (ii) 100% of the assessment payment amount
not paid on or before the due date. For purposes of this
subsection, payments will be credited first to unpaid
assessment payment amounts (rather than to penalty or
interest), beginning with the most delinquent assessment
payments. Payment cycles of longer than 60 days shall be one
factor the Director takes into account in granting a waiver
under this Section.
(c-5) If a long-term care facility fails to file its
assessment bill with payment, there shall, unless waived by
the Illinois Department for reasonable cause, be added to the
assessment due a penalty assessment equal to 25% of the
assessment due. After July 1, 2013, no penalty shall be
assessed under this Section if the Illinois Department does
not provide a process for the electronic submission of the

SB2901 - 38 - LRB102 18526 KTG 26752 b
information required by subsection (a-5).
(d) Nothing in this amendatory Act of 1993 shall be
construed to prevent the Illinois Department from collecting
all amounts due under this Article pursuant to an assessment
imposed before the effective date of this amendatory Act of
1993.
(e) Nothing in this amendatory Act of the 96th General
Assembly shall be construed to prevent the Illinois Department
from collecting all amounts due under this Code pursuant to an
assessment, tax, fee, or penalty imposed before the effective
date of this amendatory Act of the 96th General Assembly.
(f) No installment of the assessment imposed by Section
5B-2 shall be due and payable until after the Department
notifies the long-term care providers, in writing, that the
payment methodologies to long-term care providers required
under Section 5-5.2 5-5.4 of this Code have been approved by
the Centers for Medicare and Medicaid Services of the U.S.
Department of Health and Human Services and the waivers under
42 CFR 433.68 for the assessment imposed by this Section, if
necessary, have been granted by the Centers for Medicare and
Medicaid Services of the U.S. Department of Health and Human
Services. Upon notification to the Department of approval of
the payment methodologies required under Section 5-5.2 5-5.4
of this Code and the waivers granted under 42 CFR 433.68, all
installments otherwise due under Section 5B-4 prior to the
date of notification shall be due and payable to the

SB2901 - 39 - LRB102 18526 KTG 26752 b
Department upon written direction from the Department within
90 days after issuance by the Comptroller of the payments
required under Section 5-5.2 5-5.4 of this Code.
(Source: P.A. 100-501, eff. 6-1-18; 101-649, eff. 7-7-20.)
(305 ILCS 5/5B-5) (from Ch. 23, par. 5B-5)
Sec. 5B-5. Annual reporting; penalty; maintenance of
records.
(a) After December 31 of each year, and on or before March
31 of the succeeding year, every long-term care provider
subject to assessment under this Article shall file a report
with the Illinois Department. The report shall be in a form and
manner prescribed by the Illinois Department and shall state
the revenue received by the long-term care provider, reported
in such categories as may be required by the Illinois
Department, and other reasonable information the Illinois
Department requires for the administration of its
responsibilities under this Code.
(b) If a long-term care provider operates or maintains
more than one long-term care facility in this State, the
provider may not file a single return covering all those
long-term care facilities, but shall file a separate return
for each long-term care facility and shall compute and pay the
assessment for each long-term care facility separately.
(c) Notwithstanding any other provision in this Article,
in the case of a person who ceases to operate or maintain a

SB2901 - 40 - LRB102 18526 KTG 26752 b
long-term care facility in respect of which the person is
subject to assessment under this Article as a long-term care
provider, the person shall file a final, amended return with
the Illinois Department not more than 90 days after the
cessation reflecting the adjustment and shall pay with the
final return the assessment for the year as so adjusted (to the
extent not previously paid). If a person fails to file a final
amended return on a timely basis, there shall, unless waived
by the Illinois Department for reasonable cause, be added to
the assessment due a penalty assessment equal to 25% of the
assessment due.
(d) Notwithstanding any other provision of this Article, a
provider who commences operating or maintaining a long-term
care facility that was under a prior ownership and remained
licensed by the Department of Public Health shall notify the
Illinois Department of any the change in ownership regardless
of percentage, and shall be responsible to immediately pay any
prior amounts owed by the facility. In addition, within 90
days after the effective date of this amendatory Act of the
102nd General Assembly, all providers operating or maintaining
a long-term care facility shall notify the Illinois Department
of all owners of that facility and the percentage ownership of
each owner.
(e) The Department shall develop a procedure for sharing
with a potential buyer of a facility information regarding
outstanding assessments and penalties owed by that facility.

SB2901 - 41 - LRB102 18526 KTG 26752 b
(f) In the case of a long-term care provider existing as a
corporation or legal entity other than an individual, the
return filed by it shall be signed by its president,
vice-president, secretary, or treasurer or by its properly
authorized agent.
(g) If a long-term care provider fails to file its return
on or before the due date of the return, there shall, unless
waived by the Illinois Department for reasonable cause, be
added to the assessment imposed by Section 5B-2 a penalty
assessment equal to 25% of the assessment imposed for the
year. After July 1, 2013, no penalty shall be assessed if the
Illinois Department has not established a process for the
electronic submission of information.
(h) Every long-term care provider subject to assessment
under this Article shall keep records and books that will
permit the determination of occupied bed days on a calendar
year basis. All such books and records shall be kept in the
English language and shall, at all times during business hours
of the day, be subject to inspection by the Illinois
Department or its duly authorized agents and employees.
(i) The Illinois Department shall establish a process for
long-term care providers to electronically submit all
information required by this Section no later than July 1,
2013.
(Source: P.A. 96-1530, eff. 2-16-11; 97-403, eff. 1-1-12;
97-813, eff. 7-13-12.)

SB2901 - 42 - LRB102 18526 KTG 26752 b
(305 ILCS 5/5B-8) (from Ch. 23, par. 5B-8)
Sec. 5B-8. Long-Term Care Provider Fund.
(a) There is created in the State Treasury the Long-Term
Care Provider Fund. Interest earned by the Fund shall be
credited to the Fund. The Fund shall not be used to replace any
moneys appropriated to the Medicaid program by the General
Assembly.
(b) The Fund is created for the purpose of receiving and
disbursing moneys in accordance with this Article.
Disbursements from the Fund shall be made only as follows:
(1) For payments to nursing facilities, including
county nursing facilities but excluding State-operated
facilities, under Title XIX of the Social Security Act and
Article V of this Code.
(1.5) For payments to managed care organizations as
defined in Section 5-30.1 of this Code.
(2) For the reimbursement of moneys collected by the
Illinois Department through error or mistake.
(3) For payment of administrative expenses incurred by
the Illinois Department or its agent in performing the
activities authorized by this Article.
(3.5) For reimbursement of expenses incurred by
long-term care facilities, and payment of administrative
expenses incurred by the Department of Public Health, in
relation to the conduct and analysis of background checks

SB2901 - 43 - LRB102 18526 KTG 26752 b
for identified offenders under the Nursing Home Care Act.
(4) For payments of any amounts that are reimbursable
to the federal government for payments from this Fund that
are required to be paid by State warrant.
(5) For making transfers to the General Obligation
Bond Retirement and Interest Fund, as those transfers are
authorized in the proceedings authorizing debt under the
Short Term Borrowing Act, but transfers made under this
paragraph (5) shall not exceed the principal amount of
debt issued in anticipation of the receipt by the State of
moneys to be deposited into the Fund.
(6) For making transfers, at the direction of the
Director of the Governor's Office of Management and Budget
during each fiscal year beginning on or after July 1,
2011, to other State funds in an annual amount of
$20,000,000 of the tax collected pursuant to this Article
for the purpose of enforcement of nursing home standards,
support of the ombudsman program, and efforts to expand
home and community-based services. No transfer under this
paragraph shall occur until (i) the payment methodologies
created by Public Act 96-1530 under Section 5-5.4 of this
Code have been approved by the Centers for Medicare and
Medicaid Services of the U.S. Department of Health and
Human Services and (ii) the assessment imposed by Section
5B-2 of this Code is determined to be a permissible tax
under Title XIX of the Social Security Act.

SB2901 - 44 - LRB102 18526 KTG 26752 b
(7) For making transfers, at the direction of the
Director of the Governor's Office of Management and Budget
during each fiscal year beginning on or after January 1,
2022, to the Healthcare Provider Relief Fund in an annual
amount of $49,000,000 of the tax collected pursuant to
this Article for the purpose of enforcement of nursing
home standards, payments for other long-term care
priorities of the Department, including payments to
managed care organizations, and efforts to expand home and
community-based services. For the 6-month period during
State Fiscal Year 2022, on and after January 1, 2022
through June 30, 2022, the amount listed above shall be
prorated to an amount of 1/12th per month.
Disbursements from the Fund, other than transfers made
pursuant to paragraphs (5) and (6) of this subsection, shall
be by warrants drawn by the State Comptroller upon receipt of
vouchers duly executed and certified by the Illinois
Department.
(c) The Fund shall consist of the following:
(1) All moneys collected or received by the Illinois
Department from the long-term care provider assessment
imposed by this Article.
(2) All federal matching funds received by the
Illinois Department as a result of expenditures made from
the Fund by the Illinois Department that are attributable
to moneys deposited in the Fund.

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(3) Any interest or penalty levied in conjunction with
the administration of this Article.
(4) (Blank).
(5) All other monies received for the Fund from any
other source, including interest earned thereon.
(Source: P.A. 96-1530, eff. 2-16-11; 97-584, eff. 8-26-11.)
(305 ILCS 5/5E-10)
Sec. 5E-10. Fee. Through December 31, 2021 or upon federal
approval by the Centers for Medicare and Medicaid Services of
the long-term care provider assessment described in subsection
(a-1) of Section 5B-2 of this Code, whichever is later, every
Every nursing home provider shall pay to the Illinois
Department, on or before September 10, December 10, March 10,
and June 10, a fee in the amount of $1.50 for each licensed
nursing bed day for the calendar quarter in which the payment
is due. This fee shall not be billed or passed on to any
resident of a nursing home operated by the nursing home
provider. All fees received by the Illinois Department under
this Section shall be deposited into the Long-Term Care
Provider Fund.
(Source: P.A. 88-88; 89-21, eff. 7-1-95.)
Section 99. Effective date. This Act takes effect upon
becoming law.
SB2901 - 46 - LRB102 18526 KTG 26752 b
INDEX
Statutes amended in order of appearance