Bill Text: IL SB3006 | 2009-2010 | 96th General Assembly | Introduced


Bill Title: Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning standards of payment of skilled nursing and intermediate care services.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2010-02-04 - Referred to Assignments [SB3006 Detail]

Download: Illinois-2009-SB3006-Introduced.html


96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB3006

Introduced 2/4/2010, by Sen. James F. Clayborne, Jr.

SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4

Amends the Illinois Public Aid Code. Makes a technical change in a Section concerning standards of payment of skilled nursing and intermediate care services.
LRB096 19183 KTG 34574 b

A BILL FOR

SB3006 LRB096 19183 KTG 34574 b
1 AN ACT concerning public aid.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Public Aid Code is amended by
5 changing Section 5-5.4 as follows:
6 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
7 (Text of Section before amendment by P.A. 96-339)
8 Sec. 5-5.4. Standards of Payment - Department of Healthcare
9 and Family Services. The The Department of Healthcare and
10 Family Services shall develop standards of payment of skilled
11 nursing and intermediate care services in facilities providing
12 such services under this Article which:
13 (1) Provide for the determination of a facility's payment
14 for skilled nursing and intermediate care services on a
15 prospective basis. The amount of the payment rate for all
16 nursing facilities certified by the Department of Public Health
17 under the Nursing Home Care Act as Intermediate Care for the
18 Developmentally Disabled facilities, Long Term Care for Under
19 Age 22 facilities, Skilled Nursing facilities, or Intermediate
20 Care facilities under the medical assistance program shall be
21 prospectively established annually on the basis of historical,
22 financial, and statistical data reflecting actual costs from
23 prior years, which shall be applied to the current rate year

SB3006 - 2 - LRB096 19183 KTG 34574 b
1 and updated for inflation, except that the capital cost element
2 for newly constructed facilities shall be based upon projected
3 budgets. The annually established payment rate shall take
4 effect on July 1 in 1984 and subsequent years. No rate increase
5 and no update for inflation shall be provided on or after July
6 1, 1994 and before July 1, 2010, unless specifically provided
7 for in this Section. The changes made by Public Act 93-841
8 extending the duration of the prohibition against a rate
9 increase or update for inflation are effective retroactive to
10 July 1, 2004.
11 For facilities licensed by the Department of Public Health
12 under the Nursing Home Care Act as Intermediate Care for the
13 Developmentally Disabled facilities or Long Term Care for Under
14 Age 22 facilities, the rates taking effect on July 1, 1998
15 shall include an increase of 3%. For facilities licensed by the
16 Department of Public Health under the Nursing Home Care Act as
17 Skilled Nursing facilities or Intermediate Care facilities,
18 the rates taking effect on July 1, 1998 shall include an
19 increase of 3% plus $1.10 per resident-day, as defined by the
20 Department. For facilities licensed by the Department of Public
21 Health under the Nursing Home Care Act as Intermediate Care
22 Facilities for the Developmentally Disabled or Long Term Care
23 for Under Age 22 facilities, the rates taking effect on January
24 1, 2006 shall include an increase of 3%. For facilities
25 licensed by the Department of Public Health under the Nursing
26 Home Care Act as Intermediate Care Facilities for the

SB3006 - 3 - LRB096 19183 KTG 34574 b
1 Developmentally Disabled or Long Term Care for Under Age 22
2 facilities, the rates taking effect on January 1, 2009 shall
3 include an increase sufficient to provide a $0.50 per hour wage
4 increase for non-executive staff.
5 For facilities licensed by the Department of Public Health
6 under the Nursing Home Care Act as Intermediate Care for the
7 Developmentally Disabled facilities or Long Term Care for Under
8 Age 22 facilities, the rates taking effect on July 1, 1999
9 shall include an increase of 1.6% plus $3.00 per resident-day,
10 as defined by the Department. For facilities licensed by the
11 Department of Public Health under the Nursing Home Care Act as
12 Skilled Nursing facilities or Intermediate Care facilities,
13 the rates taking effect on July 1, 1999 shall include an
14 increase of 1.6% and, for services provided on or after October
15 1, 1999, shall be increased by $4.00 per resident-day, as
16 defined by the Department.
17 For facilities licensed by the Department of Public Health
18 under the Nursing Home Care Act as Intermediate Care for the
19 Developmentally Disabled facilities or Long Term Care for Under
20 Age 22 facilities, the rates taking effect on July 1, 2000
21 shall include an increase of 2.5% per resident-day, as defined
22 by the Department. For facilities licensed by the Department of
23 Public Health under the Nursing Home Care Act as Skilled
24 Nursing facilities or Intermediate Care facilities, the rates
25 taking effect on July 1, 2000 shall include an increase of 2.5%
26 per resident-day, as defined by the Department.

SB3006 - 4 - LRB096 19183 KTG 34574 b
1 For facilities licensed by the Department of Public Health
2 under the Nursing Home Care Act as skilled nursing facilities
3 or intermediate care facilities, a new payment methodology must
4 be implemented for the nursing component of the rate effective
5 July 1, 2003. The Department of Public Aid (now Healthcare and
6 Family Services) shall develop the new payment methodology
7 using the Minimum Data Set (MDS) as the instrument to collect
8 information concerning nursing home resident condition
9 necessary to compute the rate. The Department shall develop the
10 new payment methodology to meet the unique needs of Illinois
11 nursing home residents while remaining subject to the
12 appropriations provided by the General Assembly. A transition
13 period from the payment methodology in effect on June 30, 2003
14 to the payment methodology in effect on July 1, 2003 shall be
15 provided for a period not exceeding 3 years and 184 days after
16 implementation of the new payment methodology as follows:
17 (A) For a facility that would receive a lower nursing
18 component rate per patient day under the new system than
19 the facility received effective on the date immediately
20 preceding the date that the Department implements the new
21 payment methodology, the nursing component rate per
22 patient day for the facility shall be held at the level in
23 effect on the date immediately preceding the date that the
24 Department implements the new payment methodology until a
25 higher nursing component rate of reimbursement is achieved
26 by that facility.

SB3006 - 5 - LRB096 19183 KTG 34574 b
1 (B) For a facility that would receive a higher nursing
2 component rate per patient day under the payment
3 methodology in effect on July 1, 2003 than the facility
4 received effective on the date immediately preceding the
5 date that the Department implements the new payment
6 methodology, the nursing component rate per patient day for
7 the facility shall be adjusted.
8 (C) Notwithstanding paragraphs (A) and (B), the
9 nursing component rate per patient day for the facility
10 shall be adjusted subject to appropriations provided by the
11 General Assembly.
12 For facilities licensed by the Department of Public Health
13 under the Nursing Home Care Act as Intermediate Care for the
14 Developmentally Disabled facilities or Long Term Care for Under
15 Age 22 facilities, the rates taking effect on March 1, 2001
16 shall include a statewide increase of 7.85%, as defined by the
17 Department.
18 Notwithstanding any other provision of this Section, for
19 facilities licensed by the Department of Public Health under
20 the Nursing Home Care Act as skilled nursing facilities or
21 intermediate care facilities, the numerator of the ratio used
22 by the Department of Healthcare and Family Services to compute
23 the rate payable under this Section using the Minimum Data Set
24 (MDS) methodology shall incorporate the following annual
25 amounts as the additional funds appropriated to the Department
26 specifically to pay for rates based on the MDS nursing

SB3006 - 6 - LRB096 19183 KTG 34574 b
1 component methodology in excess of the funding in effect on
2 December 31, 2006:
3 (i) For rates taking effect January 1, 2007,
4 $60,000,000.
5 (ii) For rates taking effect January 1, 2008,
6 $110,000,000.
7 (iii) For rates taking effect January 1, 2009,
8 $194,000,000.
9 Notwithstanding any other provision of this Section, for
10 facilities licensed by the Department of Public Health under
11 the Nursing Home Care Act as skilled nursing facilities or
12 intermediate care facilities, the support component of the
13 rates taking effect on January 1, 2008 shall be computed using
14 the most recent cost reports on file with the Department of
15 Healthcare and Family Services no later than April 1, 2005,
16 updated for inflation to January 1, 2006.
17 For facilities licensed by the Department of Public Health
18 under the Nursing Home Care Act as Intermediate Care for the
19 Developmentally Disabled facilities or Long Term Care for Under
20 Age 22 facilities, the rates taking effect on April 1, 2002
21 shall include a statewide increase of 2.0%, as defined by the
22 Department. This increase terminates on July 1, 2002; beginning
23 July 1, 2002 these rates are reduced to the level of the rates
24 in effect on March 31, 2002, as defined by the Department.
25 For facilities licensed by the Department of Public Health
26 under the Nursing Home Care Act as skilled nursing facilities

SB3006 - 7 - LRB096 19183 KTG 34574 b
1 or intermediate care facilities, the rates taking effect on
2 July 1, 2001 shall be computed using the most recent cost
3 reports on file with the Department of Public Aid no later than
4 April 1, 2000, updated for inflation to January 1, 2001. For
5 rates effective July 1, 2001 only, rates shall be the greater
6 of the rate computed for July 1, 2001 or the rate effective on
7 June 30, 2001.
8 Notwithstanding any other provision of this Section, for
9 facilities licensed by the Department of Public Health under
10 the Nursing Home Care Act as skilled nursing facilities or
11 intermediate care facilities, the Illinois Department shall
12 determine by rule the rates taking effect on July 1, 2002,
13 which shall be 5.9% less than the rates in effect on June 30,
14 2002.
15 Notwithstanding any other provision of this Section, for
16 facilities licensed by the Department of Public Health under
17 the Nursing Home Care Act as skilled nursing facilities or
18 intermediate care facilities, if the payment methodologies
19 required under Section 5A-12 and the waiver granted under 42
20 CFR 433.68 are approved by the United States Centers for
21 Medicare and Medicaid Services, the rates taking effect on July
22 1, 2004 shall be 3.0% greater than the rates in effect on June
23 30, 2004. These rates shall take effect only upon approval and
24 implementation of the payment methodologies required under
25 Section 5A-12.
26 Notwithstanding any other provisions of this Section, for

SB3006 - 8 - LRB096 19183 KTG 34574 b
1 facilities licensed by the Department of Public Health under
2 the Nursing Home Care Act as skilled nursing facilities or
3 intermediate care facilities, the rates taking effect on
4 January 1, 2005 shall be 3% more than the rates in effect on
5 December 31, 2004.
6 Notwithstanding any other provision of this Section, for
7 facilities licensed by the Department of Public Health under
8 the Nursing Home Care Act as skilled nursing facilities or
9 intermediate care facilities, effective January 1, 2009, the
10 per diem support component of the rates effective on January 1,
11 2008, computed using the most recent cost reports on file with
12 the Department of Healthcare and Family Services no later than
13 April 1, 2005, updated for inflation to January 1, 2006, shall
14 be increased to the amount that would have been derived using
15 standard Department of Healthcare and Family Services methods,
16 procedures, and inflators.
17 Notwithstanding any other provisions of this Section, for
18 facilities licensed by the Department of Public Health under
19 the Nursing Home Care Act as intermediate care facilities that
20 are federally defined as Institutions for Mental Disease, a
21 socio-development component rate equal to 6.6% of the
22 facility's nursing component rate as of January 1, 2006 shall
23 be established and paid effective July 1, 2006. The
24 socio-development component of the rate shall be increased by a
25 factor of 2.53 on the first day of the month that begins at
26 least 45 days after January 11, 2008 (the effective date of

SB3006 - 9 - LRB096 19183 KTG 34574 b
1 Public Act 95-707). As of August 1, 2008, the socio-development
2 component rate shall be equal to 6.6% of the facility's nursing
3 component rate as of January 1, 2006, multiplied by a factor of
4 3.53. The Illinois Department may by rule adjust these
5 socio-development component rates, but in no case may such
6 rates be diminished.
7 For facilities licensed by the Department of Public Health
8 under the Nursing Home Care Act as Intermediate Care for the
9 Developmentally Disabled facilities or as long-term care
10 facilities for residents under 22 years of age, the rates
11 taking effect on July 1, 2003 shall include a statewide
12 increase of 4%, as defined by the Department.
13 For facilities licensed by the Department of Public Health
14 under the Nursing Home Care Act as Intermediate Care for the
15 Developmentally Disabled facilities or Long Term Care for Under
16 Age 22 facilities, the rates taking effect on the first day of
17 the month that begins at least 45 days after the effective date
18 of this amendatory Act of the 95th General Assembly shall
19 include a statewide increase of 2.5%, as defined by the
20 Department.
21 Notwithstanding any other provision of this Section, for
22 facilities licensed by the Department of Public Health under
23 the Nursing Home Care Act as skilled nursing facilities or
24 intermediate care facilities, effective January 1, 2005,
25 facility rates shall be increased by the difference between (i)
26 a facility's per diem property, liability, and malpractice

SB3006 - 10 - LRB096 19183 KTG 34574 b
1 insurance costs as reported in the cost report filed with the
2 Department of Public Aid and used to establish rates effective
3 July 1, 2001 and (ii) those same costs as reported in the
4 facility's 2002 cost report. These costs shall be passed
5 through to the facility without caps or limitations, except for
6 adjustments required under normal auditing procedures.
7 Rates established effective each July 1 shall govern
8 payment for services rendered throughout that fiscal year,
9 except that rates established on July 1, 1996 shall be
10 increased by 6.8% for services provided on or after January 1,
11 1997. Such rates will be based upon the rates calculated for
12 the year beginning July 1, 1990, and for subsequent years
13 thereafter until June 30, 2001 shall be based on the facility
14 cost reports for the facility fiscal year ending at any point
15 in time during the previous calendar year, updated to the
16 midpoint of the rate year. The cost report shall be on file
17 with the Department no later than April 1 of the current rate
18 year. Should the cost report not be on file by April 1, the
19 Department shall base the rate on the latest cost report filed
20 by each skilled care facility and intermediate care facility,
21 updated to the midpoint of the current rate year. In
22 determining rates for services rendered on and after July 1,
23 1985, fixed time shall not be computed at less than zero. The
24 Department shall not make any alterations of regulations which
25 would reduce any component of the Medicaid rate to a level
26 below what that component would have been utilizing in the rate

SB3006 - 11 - LRB096 19183 KTG 34574 b
1 effective on July 1, 1984.
2 (2) Shall take into account the actual costs incurred by
3 facilities in providing services for recipients of skilled
4 nursing and intermediate care services under the medical
5 assistance program.
6 (3) Shall take into account the medical and psycho-social
7 characteristics and needs of the patients.
8 (4) Shall take into account the actual costs incurred by
9 facilities in meeting licensing and certification standards
10 imposed and prescribed by the State of Illinois, any of its
11 political subdivisions or municipalities and by the U.S.
12 Department of Health and Human Services pursuant to Title XIX
13 of the Social Security Act.
14 The Department of Healthcare and Family Services shall
15 develop precise standards for payments to reimburse nursing
16 facilities for any utilization of appropriate rehabilitative
17 personnel for the provision of rehabilitative services which is
18 authorized by federal regulations, including reimbursement for
19 services provided by qualified therapists or qualified
20 assistants, and which is in accordance with accepted
21 professional practices. Reimbursement also may be made for
22 utilization of other supportive personnel under appropriate
23 supervision.
24 (Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
25 eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09.)

SB3006 - 12 - LRB096 19183 KTG 34574 b
1 (Text of Section after amendment by P.A. 96-339)
2 Sec. 5-5.4. Standards of Payment - Department of Healthcare
3 and Family Services. The The Department of Healthcare and
4 Family Services shall develop standards of payment of skilled
5 nursing and intermediate care services in facilities providing
6 such services under this Article which:
7 (1) Provide for the determination of a facility's payment
8 for skilled nursing and intermediate care services on a
9 prospective basis. The amount of the payment rate for all
10 nursing facilities certified by the Department of Public Health
11 under the MR/DD Community Care Act or the Nursing Home Care Act
12 as Intermediate Care for the Developmentally Disabled
13 facilities, Long Term Care for Under Age 22 facilities, Skilled
14 Nursing facilities, or Intermediate Care facilities under the
15 medical assistance program shall be prospectively established
16 annually on the basis of historical, financial, and statistical
17 data reflecting actual costs from prior years, which shall be
18 applied to the current rate year and updated for inflation,
19 except that the capital cost element for newly constructed
20 facilities shall be based upon projected budgets. The annually
21 established payment rate shall take effect on July 1 in 1984
22 and subsequent years. No rate increase and no update for
23 inflation shall be provided on or after July 1, 1994 and before
24 July 1, 2010, unless specifically provided for in this Section.
25 The changes made by Public Act 93-841 extending the duration of
26 the prohibition against a rate increase or update for inflation

SB3006 - 13 - LRB096 19183 KTG 34574 b
1 are effective retroactive to July 1, 2004.
2 For facilities licensed by the Department of Public Health
3 under the Nursing Home Care Act as Intermediate Care for the
4 Developmentally Disabled facilities or Long Term Care for Under
5 Age 22 facilities, the rates taking effect on July 1, 1998
6 shall include an increase of 3%. For facilities licensed by the
7 Department of Public Health under the Nursing Home Care Act as
8 Skilled Nursing facilities or Intermediate Care facilities,
9 the rates taking effect on July 1, 1998 shall include an
10 increase of 3% plus $1.10 per resident-day, as defined by the
11 Department. For facilities licensed by the Department of Public
12 Health under the Nursing Home Care Act as Intermediate Care
13 Facilities for the Developmentally Disabled or Long Term Care
14 for Under Age 22 facilities, the rates taking effect on January
15 1, 2006 shall include an increase of 3%. For facilities
16 licensed by the Department of Public Health under the Nursing
17 Home Care Act as Intermediate Care Facilities for the
18 Developmentally Disabled or Long Term Care for Under Age 22
19 facilities, the rates taking effect on January 1, 2009 shall
20 include an increase sufficient to provide a $0.50 per hour wage
21 increase for non-executive staff.
22 For facilities licensed by the Department of Public Health
23 under the Nursing Home Care Act as Intermediate Care for the
24 Developmentally Disabled facilities or Long Term Care for Under
25 Age 22 facilities, the rates taking effect on July 1, 1999
26 shall include an increase of 1.6% plus $3.00 per resident-day,

SB3006 - 14 - LRB096 19183 KTG 34574 b
1 as defined by the Department. For facilities licensed by the
2 Department of Public Health under the Nursing Home Care Act as
3 Skilled Nursing facilities or Intermediate Care facilities,
4 the rates taking effect on July 1, 1999 shall include an
5 increase of 1.6% and, for services provided on or after October
6 1, 1999, shall be increased by $4.00 per resident-day, as
7 defined by the Department.
8 For facilities licensed by the Department of Public Health
9 under the Nursing Home Care Act as Intermediate Care for the
10 Developmentally Disabled facilities or Long Term Care for Under
11 Age 22 facilities, the rates taking effect on July 1, 2000
12 shall include an increase of 2.5% per resident-day, as defined
13 by the Department. For facilities licensed by the Department of
14 Public Health under the Nursing Home Care Act as Skilled
15 Nursing facilities or Intermediate Care facilities, the rates
16 taking effect on July 1, 2000 shall include an increase of 2.5%
17 per resident-day, as defined by the Department.
18 For facilities licensed by the Department of Public Health
19 under the Nursing Home Care Act as skilled nursing facilities
20 or intermediate care facilities, a new payment methodology must
21 be implemented for the nursing component of the rate effective
22 July 1, 2003. The Department of Public Aid (now Healthcare and
23 Family Services) shall develop the new payment methodology
24 using the Minimum Data Set (MDS) as the instrument to collect
25 information concerning nursing home resident condition
26 necessary to compute the rate. The Department shall develop the

SB3006 - 15 - LRB096 19183 KTG 34574 b
1 new payment methodology to meet the unique needs of Illinois
2 nursing home residents while remaining subject to the
3 appropriations provided by the General Assembly. A transition
4 period from the payment methodology in effect on June 30, 2003
5 to the payment methodology in effect on July 1, 2003 shall be
6 provided for a period not exceeding 3 years and 184 days after
7 implementation of the new payment methodology as follows:
8 (A) For a facility that would receive a lower nursing
9 component rate per patient day under the new system than
10 the facility received effective on the date immediately
11 preceding the date that the Department implements the new
12 payment methodology, the nursing component rate per
13 patient day for the facility shall be held at the level in
14 effect on the date immediately preceding the date that the
15 Department implements the new payment methodology until a
16 higher nursing component rate of reimbursement is achieved
17 by that facility.
18 (B) For a facility that would receive a higher nursing
19 component rate per patient day under the payment
20 methodology in effect on July 1, 2003 than the facility
21 received effective on the date immediately preceding the
22 date that the Department implements the new payment
23 methodology, the nursing component rate per patient day for
24 the facility shall be adjusted.
25 (C) Notwithstanding paragraphs (A) and (B), the
26 nursing component rate per patient day for the facility

SB3006 - 16 - LRB096 19183 KTG 34574 b
1 shall be adjusted subject to appropriations provided by the
2 General Assembly.
3 For facilities licensed by the Department of Public Health
4 under the Nursing Home Care Act as Intermediate Care for the
5 Developmentally Disabled facilities or Long Term Care for Under
6 Age 22 facilities, the rates taking effect on March 1, 2001
7 shall include a statewide increase of 7.85%, as defined by the
8 Department.
9 Notwithstanding any other provision of this Section, for
10 facilities licensed by the Department of Public Health under
11 the Nursing Home Care Act as skilled nursing facilities or
12 intermediate care facilities, the numerator of the ratio used
13 by the Department of Healthcare and Family Services to compute
14 the rate payable under this Section using the Minimum Data Set
15 (MDS) methodology shall incorporate the following annual
16 amounts as the additional funds appropriated to the Department
17 specifically to pay for rates based on the MDS nursing
18 component methodology in excess of the funding in effect on
19 December 31, 2006:
20 (i) For rates taking effect January 1, 2007,
21 $60,000,000.
22 (ii) For rates taking effect January 1, 2008,
23 $110,000,000.
24 (iii) For rates taking effect January 1, 2009,
25 $194,000,000.
26 Notwithstanding any other provision of this Section, for

SB3006 - 17 - LRB096 19183 KTG 34574 b
1 facilities licensed by the Department of Public Health under
2 the Nursing Home Care Act as skilled nursing facilities or
3 intermediate care facilities, the support component of the
4 rates taking effect on January 1, 2008 shall be computed using
5 the most recent cost reports on file with the Department of
6 Healthcare and Family Services no later than April 1, 2005,
7 updated for inflation to January 1, 2006.
8 For facilities licensed by the Department of Public Health
9 under the Nursing Home Care Act as Intermediate Care for the
10 Developmentally Disabled facilities or Long Term Care for Under
11 Age 22 facilities, the rates taking effect on April 1, 2002
12 shall include a statewide increase of 2.0%, as defined by the
13 Department. This increase terminates on July 1, 2002; beginning
14 July 1, 2002 these rates are reduced to the level of the rates
15 in effect on March 31, 2002, as defined by the Department.
16 For facilities licensed by the Department of Public Health
17 under the Nursing Home Care Act as skilled nursing facilities
18 or intermediate care facilities, the rates taking effect on
19 July 1, 2001 shall be computed using the most recent cost
20 reports on file with the Department of Public Aid no later than
21 April 1, 2000, updated for inflation to January 1, 2001. For
22 rates effective July 1, 2001 only, rates shall be the greater
23 of the rate computed for July 1, 2001 or the rate effective on
24 June 30, 2001.
25 Notwithstanding any other provision of this Section, for
26 facilities licensed by the Department of Public Health under

SB3006 - 18 - LRB096 19183 KTG 34574 b
1 the Nursing Home Care Act as skilled nursing facilities or
2 intermediate care facilities, the Illinois Department shall
3 determine by rule the rates taking effect on July 1, 2002,
4 which shall be 5.9% less than the rates in effect on June 30,
5 2002.
6 Notwithstanding any other provision of this Section, for
7 facilities licensed by the Department of Public Health under
8 the Nursing Home Care Act as skilled nursing facilities or
9 intermediate care facilities, if the payment methodologies
10 required under Section 5A-12 and the waiver granted under 42
11 CFR 433.68 are approved by the United States Centers for
12 Medicare and Medicaid Services, the rates taking effect on July
13 1, 2004 shall be 3.0% greater than the rates in effect on June
14 30, 2004. These rates shall take effect only upon approval and
15 implementation of the payment methodologies required under
16 Section 5A-12.
17 Notwithstanding any other provisions of this Section, for
18 facilities licensed by the Department of Public Health under
19 the Nursing Home Care Act as skilled nursing facilities or
20 intermediate care facilities, the rates taking effect on
21 January 1, 2005 shall be 3% more than the rates in effect on
22 December 31, 2004.
23 Notwithstanding any other provision of this Section, for
24 facilities licensed by the Department of Public Health under
25 the Nursing Home Care Act as skilled nursing facilities or
26 intermediate care facilities, effective January 1, 2009, the

SB3006 - 19 - LRB096 19183 KTG 34574 b
1 per diem support component of the rates effective on January 1,
2 2008, computed using the most recent cost reports on file with
3 the Department of Healthcare and Family Services no later than
4 April 1, 2005, updated for inflation to January 1, 2006, shall
5 be increased to the amount that would have been derived using
6 standard Department of Healthcare and Family Services methods,
7 procedures, and inflators.
8 Notwithstanding any other provisions of this Section, for
9 facilities licensed by the Department of Public Health under
10 the Nursing Home Care Act as intermediate care facilities that
11 are federally defined as Institutions for Mental Disease, a
12 socio-development component rate equal to 6.6% of the
13 facility's nursing component rate as of January 1, 2006 shall
14 be established and paid effective July 1, 2006. The
15 socio-development component of the rate shall be increased by a
16 factor of 2.53 on the first day of the month that begins at
17 least 45 days after January 11, 2008 (the effective date of
18 Public Act 95-707). As of August 1, 2008, the socio-development
19 component rate shall be equal to 6.6% of the facility's nursing
20 component rate as of January 1, 2006, multiplied by a factor of
21 3.53. The Illinois Department may by rule adjust these
22 socio-development component rates, but in no case may such
23 rates be diminished.
24 For facilities licensed by the Department of Public Health
25 under the Nursing Home Care Act as Intermediate Care for the
26 Developmentally Disabled facilities or as long-term care

SB3006 - 20 - LRB096 19183 KTG 34574 b
1 facilities for residents under 22 years of age, the rates
2 taking effect on July 1, 2003 shall include a statewide
3 increase of 4%, as defined by the Department.
4 For facilities licensed by the Department of Public Health
5 under the Nursing Home Care Act as Intermediate Care for the
6 Developmentally Disabled facilities or Long Term Care for Under
7 Age 22 facilities, the rates taking effect on the first day of
8 the month that begins at least 45 days after the effective date
9 of this amendatory Act of the 95th General Assembly shall
10 include a statewide increase of 2.5%, as defined by the
11 Department.
12 Notwithstanding any other provision of this Section, for
13 facilities licensed by the Department of Public Health under
14 the Nursing Home Care Act as skilled nursing facilities or
15 intermediate care facilities, effective January 1, 2005,
16 facility rates shall be increased by the difference between (i)
17 a facility's per diem property, liability, and malpractice
18 insurance costs as reported in the cost report filed with the
19 Department of Public Aid and used to establish rates effective
20 July 1, 2001 and (ii) those same costs as reported in the
21 facility's 2002 cost report. These costs shall be passed
22 through to the facility without caps or limitations, except for
23 adjustments required under normal auditing procedures.
24 Rates established effective each July 1 shall govern
25 payment for services rendered throughout that fiscal year,
26 except that rates established on July 1, 1996 shall be

SB3006 - 21 - LRB096 19183 KTG 34574 b
1 increased by 6.8% for services provided on or after January 1,
2 1997. Such rates will be based upon the rates calculated for
3 the year beginning July 1, 1990, and for subsequent years
4 thereafter until June 30, 2001 shall be based on the facility
5 cost reports for the facility fiscal year ending at any point
6 in time during the previous calendar year, updated to the
7 midpoint of the rate year. The cost report shall be on file
8 with the Department no later than April 1 of the current rate
9 year. Should the cost report not be on file by April 1, the
10 Department shall base the rate on the latest cost report filed
11 by each skilled care facility and intermediate care facility,
12 updated to the midpoint of the current rate year. In
13 determining rates for services rendered on and after July 1,
14 1985, fixed time shall not be computed at less than zero. The
15 Department shall not make any alterations of regulations which
16 would reduce any component of the Medicaid rate to a level
17 below what that component would have been utilizing in the rate
18 effective on July 1, 1984.
19 (2) Shall take into account the actual costs incurred by
20 facilities in providing services for recipients of skilled
21 nursing and intermediate care services under the medical
22 assistance program.
23 (3) Shall take into account the medical and psycho-social
24 characteristics and needs of the patients.
25 (4) Shall take into account the actual costs incurred by
26 facilities in meeting licensing and certification standards

SB3006 - 22 - LRB096 19183 KTG 34574 b
1 imposed and prescribed by the State of Illinois, any of its
2 political subdivisions or municipalities and by the U.S.
3 Department of Health and Human Services pursuant to Title XIX
4 of the Social Security Act.
5 The Department of Healthcare and Family Services shall
6 develop precise standards for payments to reimburse nursing
7 facilities for any utilization of appropriate rehabilitative
8 personnel for the provision of rehabilitative services which is
9 authorized by federal regulations, including reimbursement for
10 services provided by qualified therapists or qualified
11 assistants, and which is in accordance with accepted
12 professional practices. Reimbursement also may be made for
13 utilization of other supportive personnel under appropriate
14 supervision.
15 (Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 95-707,
16 eff. 1-11-08; 95-744, eff. 7-18-08; 96-45, eff. 7-15-09;
17 96-339, eff. 7-1-10; revised 10-23-09.)
18 Section 95. No acceleration or delay. Where this Act makes
19 changes in a statute that is represented in this Act by text
20 that is not yet or no longer in effect (for example, a Section
21 represented by multiple versions), the use of that text does
22 not accelerate or delay the taking effect of (i) the changes
23 made by this Act or (ii) provisions derived from any other
24 Public Act.
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