Ill. Admin. Code tit. 89, § 153.125 - Long Term Care Facility Rate Adjustments
a) Notwithstanding the provisions set forth
in Section 153.100, long term care facility
(SNF/ICF and ICF/MR) rates established on July 1, 1996 shall be increased by
6.8 percent for services
provided on or after January 1, 1997.
b) Notwithstanding the provisions set forth
in Section 153.100, long term care facility (SNF/ICF and ICF/MR) rates and
developmental training rates established on July 1, 1998, for services provided
on or after that date, shall be increased by three percent. For nursing
facilities (SNF/ICF) only, $1.10 shall also be added to the
nursing component of the rate.
c)
Notwithstanding the provisions set forth in Section 153.100, long term care
facility (SNF/ICF and ICF/MR) rates and developmental training rates
established on July 1, 1999, for services provided on or after that date, shall
include:
1) an increase of
1.6 percent for SNF/ICF, ICF/MR
and developmental training rates;
2) an additional increase of $3.00 per resident day for ICF/MR
rates; and
3) an increase of
$10.02 per person, per month for
developmental training rates.
d) Notwithstanding the provisions set forth
in Section 153.100, SNF/ICF rates shall be increased by $4.00 per resident day for
services provided on or after October 1, 1999.
e) Notwithstanding the provisions set forth
in Section 153.100, SNF/ICF, ICF/MR and developmental training rates shall be
increased 2.5 percent per resident day for
services provided on or after July 1, 2000.
f) Notwithstanding the provisions set forth
in Section 153.100, nursing facility (SNF/ICF) rates effective on July 1, 2001
shall be computed using the most recent cost reports on file with the
Department no later than April 1, 2000, updated for inflation to January 1,
2001.
1) The Uniform Building Value shall be
as defined in 89 Ill. Adm. Code
140.570(b)(10),
except that, as of July 1, 2001, the definition of current year is the year
2000.
2) The real estate tax bill
that was due to be paid in 1999 by the nursing facility shall be used in
determination of the capital component of the rate. The real estate tax
component shall be removed from the capital rate if the facility's status
changes so as to be exempt from assessment to pay real estate taxes.
3) 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.
4) All
accounting records and other documentation necessary to support the costs and
other information reported on the cost report to be used in accordance with
rate setting under Section
153.125(f)
shall be kept for a minimum of two years after the Department's final payment
using rates that were based in part on that cost report.
g) Notwithstanding the provisions set forth
in Section 153.100, intermediate care facilities for persons with developmental
disabilities (ICF/MR), including skilled nursing facilities for persons under
22 years of age (MC/DD), shall receive an increase in rates for residential
services equal to a statewide average of
7.85 percent. Residential rates
taking effect March 1, 2001, for services provided on or after that date, shall
include an increase of
11.01 percent to the residential
program rate component and an increase of
3.33 percent to the residential
support rate component, each of which shall be adjusted by the geographical
area adjuster, as defined by the Department of Human Services (DHS).
h) For developmental training services
provided on or after March 1, 2001, for residents of long term care facilities,
rates shall include an increase of
9.05 percent and rates shall be
adjusted by the geographical area adjuster, as defined by DHS.
i) Notwithstanding the provisions set forth
in Section 153.100, daily rates for intermediate care facilities for persons
with developmental disabilities (ICF/MR), including skilled long term care
facilities for persons under 22 years of age (MC/DD), shall be increased by
2.247 percent for services
provided during the period beginning on April 11, 2002, and ending on June 30,
2002.
j) Notwithstanding the
provisions set forth in Section 153.100, daily rates effective on July 1, 2002,
for intermediate care facilities for persons with developmental disabilities
(ICF/MR), including skilled long term care facilities for persons under 22
years of age (MC/DD), shall be reduced to the level of the rates in effect on
April 10, 2002.
k) Notwithstanding
the provisions set forth in Section 153.100, nursing facility (SNF/ICF) rates
effective on July 1, 2002 will be
5.9 percent less than the rates
in effect on June 30, 2002.
l)
Notwithstanding the provisions set forth in Section 153.100, daily rates
effective on July 1, 2003, for intermediate care facilities for persons with
developmental disabilities (ICF/MR), including skilled long term care
facilities for persons under 22 years of age (MC/DD), shall be increased by
3.59 percent.
m) Notwithstanding the provisions set forth
in Section 153.100, developmental training rates effective on July 1, 2003
shall be increased by 4 percent.
n)
Notwithstanding the provisions set forth in Section 153.100, pending the
approvals described in this subsection (n), nursing facility (SNF/ICF) rates
effective July 1, 2004 shall be
3.0 percent greater than the
rates in effect on June 30, 2004. The increase is contingent on approval of
both the payment methodologies required under Article 5A-12 of the Public Aid
Code [305
ILCS 5/5A-12] and the waiver granted under
42 CFR
433.68.
o) Notwithstanding the provisions set forth
in Section 153.100, the "Original Building Base Cost" for nursing facilities
(SNF/ICF) which have been rented continuously from an unrelated party since
prior to January 1, 1978, effective on July 1, 2004, shall be added to the
capital rate calculation using the most recent cost reports on file with the
Department no later than June 30, 2004. The "Original Building Base Cost" as
defined in 89 Ill. Adm. Code
140.570 shall be calculated from
the original lease information that is presently on file with the Department.
This original lease information will be used to capitalize the oldest available
lease payment from the unrelated party lease that has been in effect since
prior to January 1, 1978, and continued to be in effect on December 31, 1999.
Before the lease payment is capitalized, a 15 percent portion will be removed
from the oldest available lease payment for movable equipment costs. After the
lease payment is capitalized, a portion of the capitalized amount will be
removed for land cost. The land cost portion is
4.88 percent. The remaining
amount will be the facility's building cost. The construction/acquisition year
for the building will be the date the pre-1978 lease began. The allowable cost
of subsequent improvements to the building will be included in the original
building base cost. The original building base cost will not change due to
sales or leases of the facility after January 1, 1978.
p) Notwithstanding the provisions set forth
in Section 153.100, nursing facility (SNF/ICF) rates effective on January 1,
2005 will be 3.0 percent more than the rates
in effect on December 31, 2004.
q)
Notwithstanding the provisions set forth in Section 153.100, nursing facility
(SNF/ICF) rates shall be increased by the difference between a facility's per
diem property, liability and malpractice insurance costs as reported in the
cost report that was filed with the Department and used to establish rates
effective July 1, 2001, and 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.
r) Notwithstanding
the provisions set forth in Section 153.100, daily rates effective on January
1, 2006 for intermediate care facilities for persons with developmental
disabilities (ICF/MR), including skilled long term care facilities for persons
under 22 years of age (MC/DD), shall be increased by 3 percent.
s) Notwithstanding the provisions set forth
in Section 153.100, developmental training rates for intermediate care
facilities for persons with developmental disabilities (ICF/MR), including
skilled long term care facilities for persons under 22 years of age (MC/DD),
effective on January 1, 2006 shall be increased by 3 percent.
t) Notwithstanding the provisions set forth
in Section 153.100, for facilities that are federally defined as Institutions
for Mental Disease (see Section
145.30), a socio-development
component rate equal to
6.6 % of the nursing component
rate as of January 1, 2006 shall be established and paid effective July 1,
2006. This rate shall become a part of the facility's nursing component of the
Medicaid rate. While this rate may be adjusted by the Department, the rate
shall not be reduced.
u)
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 Healthcare and Family
Services no later than April 1, 2005, updated for inflation to January 1, 2006.
1) Support rates taking effect on January 1,
2008 shall be adjusted based on audits of cost report data in accordance with
89 Ill. Adm. Code 140.582(b) and
140.590. The audited cost report
data will be used to retroactively update the resulting support rate effective
January 1, 2008, after the 45-day appeal period from Section
140.582(b) has
passed.
2) All accounting records
and other documentation necessary to support the costs and other information
reported on the cost report to be used in accordance with rate setting under
this subsection (u) shall be kept for a minimum of two years after the
Department's final payment using rates that were based in part on that cost
report.
v)
Notwithstanding the provisions set forth in Section 153.100, pursuant to Public
Act 95-0744, for services beginning August 1, 2008, the socio-development
component for facilities that are federally defined as Institutions for Mental
Disease (see 89 Ill. Adm. Code 145.30) shall equal 6.6% of the facility's
nursing component rate as of January 1, 2006, multiplied by a factor of
3.53.
w) Notwithstanding the provisions set forth
in Section 153.100, pursuant to Public Act 95-0744, for services beginning
January 1, 2009, the support component for skilled and intermediate care
facilities that was 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,
shall be increased to the amount that would have been derived using standard
Department of Healthcare and Family Services methods, procedures and inflators
described in Sections
140.533,
140.551,
140.553 and
140.561.
x) Notwithstanding the provisions set forth
in Section 153.100, effective November 1, 2010, the program and support
components of the per diem rate for ICF/MR qualifying under 89 Ill. Adm. Code
144.102 shall be adjusted in
accordance with that Section.
y)
Notwithstanding the provisions set forth in Section 153.100, pursuant to Public
Act 96-1530, for services beginning May 1, 2011, the socio-development
component for facilities that are federally defined as Institutions for Mental
Disease (IMD) (see 89 Ill. Adm. Code 145.30) and that are Medicaid certified
will have the nursing component of their rate fully funded using the MDS
methodology and will also receive an increase to their socio-development
component rate. The socio-development component rate increase will be equal to
two-thirds of the difference between the highest nursing rate among the
Medicaid certified IMD facilities and the individual IMD's nursing rate. This
rate change is subject to approval by the Centers for Medicare and Medicaid
Services of the U.S. Department of Health and Human Services.
z) Notwithstanding the provisions set forth
in Section 153.100, effective for services beginning May 1, 2011, facilities
that are federally defined as Institutions for Mental Disease (see 89 Ill. Adm.
Code 145.30) and determined to be Subpart T facilities (see 89 Ill. Adm. Code
145.10) will receive an increase
to their socio-development component rate of $.50 per day, per
resident.
aa) Notwithstanding the
provisions set forth in Section 153.100, effective for services beginning
August 1, 2017, facilities licensed by the Department of Public Health under
the ID/DD Community Care Act [210 ILCS 47 ] as an ID/DD
facility and medically complex for the developmentally disabled facilities
licensed under the MC/DD Act [210 ILCS 46 ] as an MC/DD
facility will receive an increase to their reimbursement rates sufficient to
provide a $0.75 per hour wage increase for
non-executive staff. This increase shall apply to the facility per diem rates
and developmental training rates.
bb) Notwithstanding the provisions set forth
in Section 153.100, effective for services beginning July 1, 2018, facilities
licensed by the Department of Public Health under the ID/DD Community Care Act
[210 ILCS
47 ] or MC/DD Act [210 ILCS 46 ]
will receive an increase to the facility per diem rates and developmental
training rates as follows:
1) Facilities
outside the geographic boundaries of the City of Chicago will receive an
increase to their reimbursement rates sufficient to provide a $0.50 per hour wage increase for
front-line personnel.
2) Facilities
inside the geographic boundaries of the City of Chicago will receive an
increase to their reimbursement rates sufficient to provide a $0.54 per hour wage increase for
front-line personnel.
cc)
Notwithstanding the provisions set forth in Section 153.100, pursuant to
305 ILCS
5/5-5.4(j), effective for services beginning July 1,
2018, the per diem rate will be increased by $21.15 for
facilities with more than 16 beds licensed by the Department of Public Health
under the ID/DD Community Care Act [210 ILCS 47 ]
and located in the Department of Public Health's Planning Area 7-B.
dd) Notwithstanding the provisions set forth
in Section 153.100, facilities licensed by the Department of Public Health
under the ID/DD Community Care Act [210 ILCS 47 ]
or MC/DD Act [210 ILCS 46 ] will receive an
increase to their facility rate:
1) Effective
for dates of services on or after August 1, 2019, the exceptional care per diem
rate in effect on July 30, 2019 shall be increased by
3.5 %, as per 89 Ill. Adm. Code
146.1015(i)(3)(A).
2) Effective June 1, 2020, facilities will
receive an increase to their reimbursement rates sufficient to provide a
$0.26 per hour wage increase for
non-executive staff.
3) Effective
July 1, 2020, facilities will receive an increase to their reimbursement rates
sufficient to provide a $1.00 per hour
wage increase for non-executive staff. Facilities shall use these additional
funds to provide a direct increase to wages for non-executive staff by at least
$0.80 per hour, with priority
given to direct care staff wages.
4) Effective January 1, 2021, facilities will
receive an increase to their reimbursement rates sufficient to provide a
$0.50 per hour wage increase for
non-executive staff. Facilities shall use these additional funds to provide a
direct increase to wages for non-executive staff by at least $0.40 per hour, with priority
given to direct care staff wages.
5) Non-executive staff, for purposes of
subsection (dd), includes but is not limited to direct care staff (direct
support persons (DSPs), front-line supervisors, qualified intellectual
disabilities professionals, and nurses) and non-administrative support
staff.
6) Effective for dates of
services on or after July 1, 2021;
A)
Residential services rates in effect on June 30, 2021 shall be increased by
$0.50 per hour for ICF Aides,
with at least 50% ($0.25 per hour) of those funds to
be provided for a direct increase to all ICF Aides wages, with the remaining
50% ($0.25 per hour) to be used
flexibly for wage increases for ICF Aides and other frontline staff;
and
B) Such rates shall include an
increase sufficient to provide wages for all residential non-executive direct
care staff, excluding ICF Aides, at the federal Department of Labor, Bureau of
Labor Statistics' average wage.
7) Effective for dates of services on or
after January 1, 2022;
A) Residential services
rates in effect on December 31, 2021 shall be increased by $1.00 per hour for ICF Aides,
with at least 50% ($0.50 per hour) of those funds to
be provided for a direct increase to all ICF Aid wages, with the remaining 50%
($0.50 per hour) to be used
flexibly for wage increases for ICF Aides and other frontline staff;
and
B) Such rates shall include an
increase sufficient to provide wages for all residential non-executive direct
care staff, excluding ICF Aides, at the federal Department of Labor, Bureau of
Labor Statistics' average wage.
Notes
Amended at 35 Ill. Reg. 19524, effective December 1, 2011
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