LONG-TERM CARE RATE LIMIT

Illinois General Assembly - Full Text of HB2429

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB2429

Introduced 2/4/2025, by Rep. Nabeela Syed

SYNOPSIS AS INTRODUCED:

210 ILCS 9/85
210 ILCS 45/2-202

from Ch. 111 1/2, par. 4152-202
210 ILCS 46/2-202
210 ILCS 47/2-202

Amends the Assisted Living and Shared Housing Act, the Nursing Home
Care Act, the MC/DD Act, and the ID/DD Community Care Act. Provides that a
service delivery contract or other contract between a facility and a
resident shall not permit rate increases for a resident's room and board
before the expiration of the residency period specified in the contract.
Provides that, if there is a rate increase for a resident's room and board
provided in a subsequent contract that is greater than the percentage
increase in the consumer price index-u during the preceding residency
period, the facility must provide justification for the increase.
LRB104 08265 BAB 18315 b

A BILL FOR

HB2429
LRB104 08265 BAB 18315 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Assisted Living and Shared Housing Act is
5
amended by changing Section 85 as follows:

6

(210 ILCS 9/85)
7

Sec. 85.
Contract requirements.

8

(a)
No entity may establish, operate, conduct, or maintain
9
an establishment in this State unless a written service
10
delivery contract is executed between the establishment and
11
each resident or resident's representative in accordance with
12
Section 90 and unless the establishment operates in accordance
13
with the terms of the contract. The resident or the resident's
14
representative shall be given a complete copy of the contract
15
and all supporting documents and attachments and any changes
16
whenever changes are made. If the resident does not understand
17
English and if translated documents are not available, the
18
establishment must explain its policies to a responsible
19
relative or friend or another individual who has agreed to
20
communicate the information to the resident.
21

(b) A service delivery contract shall not permit rate
22
increases for a resident's room and board before the
23
expiration of the residency period specified in the contract.

HB2429
- 2 -
LRB104 08265 BAB 18315 b
1
If there is a rate increase for a resident's room and board
2
provided in a subsequent contract that is greater than the
3
percentage increase in the consumer price index-u during the
4
preceding residency period, the establishment must provide
5
justification for the increase.
6

For the purposes of this subsection, "consumer price
7
index-u" means the index published by the Bureau of Labor
8
Statistics of the United States Department of Labor that
9
measures the average change in prices of goods and services
10
purchased by all urban consumers, United States city average,
11
all items, 1982-84 = 100.

12
(Source: P.A. 91-656, eff. 1-1-01.)

13

Section 15.
The Nursing Home Care Act is amended by
14
changing Section 2-202 as follows:

15

(210 ILCS 45/2-202)

(from Ch. 111 1/2, par. 4152-202)
16

Sec. 2-202.
(a) Before a person is admitted to a facility,
17
or at the expiration of the period of previous contract, or
18
when the source of payment for the resident's care changes
19
from private to public funds or from public to private funds, a
20
written contract shall be executed between a licensee and the
21
following in order of priority:

22

(1) the person, or if the person is a minor, his parent
23

or guardian; or

24

(2) the person's guardian, if any, or agent, if any,

HB2429
- 3 -
LRB104 08265 BAB 18315 b
1

as defined in Section 2-3 of the Illinois Power of
2

Attorney Act; or

3

(3) a member of the person's immediate family.
4

An adult person shall be presumed to have the capacity to
5
contract for admission to a long term care facility unless he
6
has been adjudicated a "person with a disability" within the
7
meaning of Section 11a-2 of the Probate Act of 1975, or unless
8
a petition for such an adjudication is pending in a circuit
9
court of Illinois.
10

If there is no guardian, agent or member of the person's
11
immediate family available, able or willing to execute the
12
contract required by this Section and a physician determines
13
that a person is so disabled as to be unable to consent to
14
placement in a facility, or if a person has already been found
15
to be a "person with a disability", but no order has been
16
entered allowing residential placement of the person, that
17
person may be admitted to a facility before the execution of a
18
contract required by this Section; provided that a petition
19
for guardianship or for modification of guardianship is filed
20
within 15 days of the person's admission to a facility, and
21
provided further that such a contract is executed within 10
22
days of the disposition of the petition.
23

No adult shall be admitted to a facility if he objects,
24
orally or in writing, to such admission, except as otherwise
25
provided in Chapters III and IV of the Mental Health and
26
Developmental Disabilities Code or Section 11a-14.1 of the

HB2429
- 4 -
LRB104 08265 BAB 18315 b
1
Probate Act of 1975.
2

If a person has not executed a contract as required by this
3
Section, then such a contract shall be executed on or before
4
July 1, 1981, or within 10 days after the disposition of a
5
petition for guardianship or modification of guardianship that
6
was filed prior to July 1, 1981, whichever is later.
7

Before a licensee enters a contract under this Section, it
8
shall provide the prospective resident and his or her
9
guardian, if any, with written notice of the licensee's policy
10
regarding discharge of a resident whose private funds for
11
payment of care are exhausted.
12

Before a licensee enters into a contract under this
13
Section, it shall provide the resident or prospective resident
14
and his or her guardian, if any, with a copy of the licensee's
15
policy regarding the assignment of Social Security
16
representative payee status as a condition of the contract
17
when the resident's or prospective resident's care is being
18
funded under Title XIX of the Social Security Act and Article V
19
of the Illinois Public Aid Code.
20

(b) A resident shall not be discharged or transferred at
21
the expiration of the term of a contract, except as provided in
22
Sections 3-401 through 3-423.
23

(c) At the time of the resident's admission to the
24
facility, a copy of the contract shall be given to the
25
resident, his guardian, if any, and any other person who
26
executed the contract.

HB2429
- 5 -
LRB104 08265 BAB 18315 b
1

(d) A copy of the contract for a resident who is supported
2
by nonpublic funds other than the resident's own funds shall
3
be made available to the person providing the funds for the
4
resident's support.
5

(e) The original or a copy of the contract shall be
6
maintained in the facility and be made available upon request
7
to representatives of the Department and the Department of
8
Healthcare and Family Services.
9

(f) The contract shall be written in clear and unambiguous
10
language and shall be printed in not less than 12-point type.
11
The general form of the contract shall be prescribed by the
12
Department.
13

(g) The contract shall specify:

14

(1) the term of the contract;

15

(2) the services to be provided under the contract and
16

the charges for the services;

17

(3) the services that may be provided to supplement
18

the contract and the charges for the services;

19

(4) the sources liable for payments due under the
20

contract;

21

(5) the amount of deposit paid; and

22

(6) the rights, duties and obligations of the
23

resident, except that the specification of a resident's
24

rights may be furnished on a separate document which
25

complies with the requirements of Section 2-211.
26

(h) The contract shall designate the name of the

HB2429
- 6 -
LRB104 08265 BAB 18315 b
1
resident's representative, if any. The resident shall provide
2
the facility with a copy of the written agreement between the
3
resident and the resident's representative which authorizes
4
the resident's representative to inspect and copy the
5
resident's records and authorizes the resident's
6
representative to execute the contract on behalf of the
7
resident required by this Section.
8

(i) The contract shall provide that if the resident is
9
compelled by a change in physical or mental health to leave the
10
facility, the contract and all obligations under it shall
11
terminate on 7 days notice. No prior notice of termination of
12
the contract shall be required, however, in the case of a
13
resident's death. The contract shall also provide that in all
14
other situations, a resident may terminate the contract and
15
all obligations under it with 30 days notice. All charges
16
shall be prorated as of the date on which the contract
17
terminates, and, if any payments have been made in advance,
18
the excess shall be refunded to the resident. This provision
19
shall not apply to life-care contracts through which a
20
facility agrees to provide maintenance and care for a resident
21
throughout the remainder of his life nor to continuing-care
22
contracts through which a facility agrees to supplement all
23
available forms of financial support in providing maintenance
24
and care for a resident throughout the remainder of his life.
25

(j) In addition to all other contract specifications
26
contained in this Section admission contracts shall also

HB2429
- 7 -
LRB104 08265 BAB 18315 b
1
specify:

2

(1) whether the facility accepts Medicaid clients;

3

(2) whether the facility requires a deposit of the
4

resident or his family prior to the establishment of
5

Medicaid eligibility;

6

(3) in the event that a deposit is required, a clear
7

and concise statement of the procedure to be followed for
8

the return of such deposit to the resident or the
9

appropriate family member or guardian of the person;

10

(4) that all deposits made to a facility by a
11

resident, or on behalf of a resident, shall be returned by
12

the facility within 30 days of the establishment of
13

Medicaid eligibility, unless such deposits must be drawn
14

upon or encumbered in accordance with Medicaid eligibility
15

requirements established by the Department of Healthcare
16

and Family Services.
17

(k) It shall be a business offense for a facility to
18
knowingly and intentionally both retain a resident's deposit
19
and accept Medicaid payments on behalf of that resident.
20

(l) A contract under this Section shall not permit rate
21
increases for a resident's room and board before the
22
expiration of the residency period specified in the contract.
23
If there is a rate increase for a resident's room and board
24
provided in a subsequent contract that is greater than the
25
percentage increase in the consumer price index-u during the
26
preceding residency period, the facility must provide

HB2429
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LRB104 08265 BAB 18315 b
1
justification for the increase.
2

For the purposes of this subsection, "consumer price
3
index-u" means the index published by the Bureau of Labor
4
Statistics of the United States Department of Labor that
5
measures the average change in prices of goods and services
6
purchased by all urban consumers, United States city average,
7
all items, 1982-84 = 100.

8
(Source: P.A. 98-104, eff. 7-22-13; 99-143, eff. 7-27-15.)

9

Section 20.
The MC/DD Act is amended by changing Section
10
2-202 as follows:

11

(210 ILCS 46/2-202)
12

Sec. 2-202.
Contract required.

13

(a) Before a person is admitted to a facility, or at the
14
expiration of the period of previous contract, or when the
15
source of payment for the resident's care changes from private
16
to public funds or from public to private funds, a written
17
contract shall be executed between a licensee and the
18
following in order of priority:
19

(1) the person, or if the person is a minor, his parent
20

or guardian; or
21

(2) the person's guardian, if any, or agent, if any,
22

as defined in Section 2-3 of the Illinois Power of
23

Attorney Act; or
24

(3) a member of the person's immediate family.

HB2429
- 9 -
LRB104 08265 BAB 18315 b
1

An adult person shall be presumed to have the capacity to
2
contract for admission to a facility unless he or she has been
3
adjudicated a "disabled person" within the meaning of Section
4
11a-2 of the Probate Act of 1975, or unless a petition for such
5
an adjudication is pending in a circuit court of Illinois.
6

If there is no guardian, agent or member of the person's
7
immediate family available, able or willing to execute the
8
contract required by this Section and a physician determines
9
that a person is so disabled as to be unable to consent to
10
placement in a facility, or if a person has already been found
11
to be a "disabled person", but no order has been entered
12
allowing residential placement of the person, that person may
13
be admitted to a facility before the execution of a contract
14
required by this Section; provided that a petition for
15
guardianship or for modification of guardianship is filed
16
within 15 days of the person's admission to a facility, and
17
provided further that such a contract is executed within 10
18
days of the disposition of the petition.
19

No adult shall be admitted to a facility if he or she
20
objects, orally or in writing, to such admission, except as
21
otherwise provided in Chapters III and IV of the Mental Health
22
and Developmental Disabilities Code or Section 11a-14.1 of the
23
Probate Act of 1975.
24

Before a licensee enters a contract under this Section, it
25
shall provide the prospective resident and his or her
26
guardian, if any, with written notice of the licensee's policy

HB2429
- 10 -
LRB104 08265 BAB 18315 b
1
regarding discharge of a resident whose private funds for
2
payment of care are exhausted.
3

(b) A resident shall not be discharged or transferred at
4
the expiration of the term of a contract, except as provided in
5
Sections 3-401 through 3-423.
6

(c) At the time of the resident's admission to the
7
facility, a copy of the contract shall be given to the
8
resident, his or her guardian, if any, and any other person who
9
executed the contract.
10

(d) A copy of the contract for a resident who is supported
11
by nonpublic funds other than the resident's own funds shall
12
be made available to the person providing the funds for the
13
resident's support.
14

(e) The original or a copy of the contract shall be
15
maintained in the facility and be made available upon request
16
to representatives of the Department and the Department of
17
Healthcare and Family Services.
18

(f) The contract shall be written in clear and unambiguous
19
language and shall be printed in not less than 12-point type.
20
The general form of the contract shall be prescribed by the
21
Department.
22

(g) The contract shall specify:
23

(1) the term of the contract;
24

(2) the services to be provided under the contract and
25

the charges for the services;
26

(3) the services that may be provided to supplement

HB2429
- 11 -
LRB104 08265 BAB 18315 b
1

the contract and the charges for the services;
2

(4) the sources liable for payments due under the
3

contract;
4

(5) the amount of deposit paid; and
5

(6) the rights, duties and obligations of the
6

resident, except that the specification of a resident's
7

rights may be furnished on a separate document which
8

complies with the requirements of Section 2-211.
9

(h) The contract shall designate the name of the
10
resident's representative, if any. The resident shall provide
11
the facility with a copy of the written agreement between the
12
resident and the resident's representative which authorizes
13
the resident's representative to inspect and copy the
14
resident's records and authorizes the resident's
15
representative to execute the contract on behalf of the
16
resident required by this Section.
17

(i) The contract shall provide that if the resident is
18
compelled by a change in physical or mental health to leave the
19
facility, the contract and all obligations under it shall
20
terminate on 7 days' notice. No prior notice of termination of
21
the contract shall be required, however, in the case of a
22
resident's death. The contract shall also provide that in all
23
other situations, a resident may terminate the contract and
24
all obligations under it with 30 days' notice. All charges
25
shall be prorated as of the date on which the contract
26
terminates, and, if any payments have been made in advance,

HB2429
- 12 -
LRB104 08265 BAB 18315 b
1
the excess shall be refunded to the resident. This provision
2
shall not apply to life care contracts through which a
3
facility agrees to provide maintenance and care for a resident
4
throughout the remainder of his life nor to continuing care
5
contracts through which a facility agrees to supplement all
6
available forms of financial support in providing maintenance
7
and care for a resident throughout the remainder of his or her
8
life.
9

(j) In addition to all other contract specifications
10
contained in this Section admission contracts shall also
11
specify:
12

(1) whether the facility accepts Medicaid clients;
13

(2) whether the facility requires a deposit of the
14

resident or his or her family prior to the establishment
15

of Medicaid eligibility;
16

(3) in the event that a deposit is required, a clear
17

and concise statement of the procedure to be followed for
18

the return of such deposit to the resident or the
19

appropriate family member or guardian of the person; and
20

(4) that all deposits made to a facility by a
21

resident, or on behalf of a resident, shall be returned by
22

the facility within 30 days of the establishment of
23

Medicaid eligibility, unless such deposits must be drawn
24

upon or encumbered in accordance with Medicaid eligibility
25

requirements established by the Department of Healthcare
26

and Family Services.

HB2429
- 13 -
LRB104 08265 BAB 18315 b
1

(k) It shall be a business offense for a facility to
2
knowingly and intentionally both retain a resident's deposit
3
and accept Medicaid payments on behalf of that resident.
4

(l) A contract under this Section shall not permit rate
5
increases for a resident's room and board before the
6
expiration of the residency period specified in the contract.
7
If there is a rate increase for a resident's room and board
8
provided in a subsequent contract that is greater than the
9
percentage increase in the consumer price index-u during the
10
preceding residency period, the facility must provide
11
justification for the increase.
12

For the purposes of this subsection, "consumer price
13
index-u" means the index published by the Bureau of Labor
14
Statistics of the United States Department of Labor that
15
measures the average change in prices of goods and services
16
purchased by all urban consumers, United States city average,
17
all items, 1982-84 = 100.

18
(Source: P.A. 99-180, eff. 7-29-15.)

19

Section 25.
The ID/DD Community Care Act is amended by
20
changing Section 2-202 as follows:

21

(210 ILCS 47/2-202)
22

Sec. 2-202.
Contract required.

23

(a) Before a person is admitted to a facility, or at the
24
expiration of the period of previous contract, or when the

HB2429
- 14 -
LRB104 08265 BAB 18315 b
1
source of payment for the resident's care changes from private
2
to public funds or from public to private funds, a written
3
contract shall be executed between a licensee and the
4
following in order of priority:
5

(1) the person, or if the person is a minor, his parent
6

or guardian; or
7

(2) the person's guardian, if any, or agent, if any,
8

as defined in Section 2-3 of the Illinois Power of
9

Attorney Act; or
10

(3) a member of the person's immediate family.
11

An adult person shall be presumed to have the capacity to
12
contract for admission to a long term care facility unless he
13
or she has been adjudicated a "person with a disability"
14
within the meaning of Section 11a-2 of the Probate Act of 1975,
15
or unless a petition for such an adjudication is pending in a
16
circuit court of Illinois.
17

If there is no guardian, agent or member of the person's
18
immediate family available, able or willing to execute the
19
contract required by this Section and a physician determines
20
that a person is so disabled as to be unable to consent to
21
placement in a facility, or if a person has already been found
22
to be a "person with a disability", but no order has been
23
entered allowing residential placement of the person, that
24
person may be admitted to a facility before the execution of a
25
contract required by this Section; provided that a petition
26
for guardianship or for modification of guardianship is filed

HB2429
- 15 -
LRB104 08265 BAB 18315 b
1
within 15 days of the person's admission to a facility, and
2
provided further that such a contract is executed within 10
3
days of the disposition of the petition.
4

No adult shall be admitted to a facility if he or she
5
objects, orally or in writing, to such admission, except as
6
otherwise provided in Chapters III and IV of the Mental Health
7
and Developmental Disabilities Code or Section 11a-14.1 of the
8
Probate Act of 1975.
9

Before a licensee enters a contract under this Section, it
10
shall provide the prospective resident and his or her
11
guardian, if any, with written notice of the licensee's policy
12
regarding discharge of a resident whose private funds for
13
payment of care are exhausted.
14

(b) A resident shall not be discharged or transferred at
15
the expiration of the term of a contract, except as provided in
16
Sections 3-401 through 3-423.
17

(c) At the time of the resident's admission to the
18
facility, a copy of the contract shall be given to the
19
resident, his or her guardian, if any, and any other person who
20
executed the contract.
21

(d) A copy of the contract for a resident who is supported
22
by nonpublic funds other than the resident's own funds shall
23
be made available to the person providing the funds for the
24
resident's support.
25

(e) The original or a copy of the contract shall be
26
maintained in the facility and be made available upon request

HB2429
- 16 -
LRB104 08265 BAB 18315 b
1
to representatives of the Department and the Department of
2
Healthcare and Family Services.
3

(f) The contract shall be written in clear and unambiguous
4
language and shall be printed in not less than 12-point type.
5
The general form of the contract shall be prescribed by the
6
Department.
7

(g) The contract shall specify:
8

(1) the term of the contract;
9

(2) the services to be provided under the contract and
10

the charges for the services;
11

(3) the services that may be provided to supplement
12

the contract and the charges for the services;
13

(4) the sources liable for payments due under the
14

contract;
15

(5) the amount of deposit paid; and
16

(6) the rights, duties and obligations of the
17

resident, except that the specification of a resident's
18

rights may be furnished on a separate document which
19

complies with the requirements of Section 2-211.
20

(h) The contract shall designate the name of the
21
resident's representative, if any. The resident shall provide
22
the facility with a copy of the written agreement between the
23
resident and the resident's representative which authorizes
24
the resident's representative to inspect and copy the
25
resident's records and authorizes the resident's
26
representative to execute the contract on behalf of the

HB2429
- 17 -
LRB104 08265 BAB 18315 b
1
resident required by this Section.
2

(i) The contract shall provide that if the resident is
3
compelled by a change in physical or mental health to leave the
4
facility, the contract and all obligations under it shall
5
terminate on 7 days' notice. No prior notice of termination of
6
the contract shall be required, however, in the case of a
7
resident's death. The contract shall also provide that in all
8
other situations, a resident may terminate the contract and
9
all obligations under it with 30 days' notice. All charges
10
shall be prorated as of the date on which the contract
11
terminates, and, if any payments have been made in advance,
12
the excess shall be refunded to the resident. This provision
13
shall not apply to life care contracts through which a
14
facility agrees to provide maintenance and care for a resident
15
throughout the remainder of his life nor to continuing care
16
contracts through which a facility agrees to supplement all
17
available forms of financial support in providing maintenance
18
and care for a resident throughout the remainder of his or her
19
life.
20

(j) In addition to all other contract specifications
21
contained in this Section admission contracts shall also
22
specify:
23

(1) whether the facility accepts Medicaid clients;
24

(2) whether the facility requires a deposit of the
25

resident or his or her family prior to the establishment
26

of Medicaid eligibility;

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1

(3) in the event that a deposit is required, a clear
2

and concise statement of the procedure to be followed for
3

the return of such deposit to the resident or the
4

appropriate family member or guardian of the person;
5

(4) that all deposits made to a facility by a
6

resident, or on behalf of a resident, shall be returned by
7

the facility within 30 days of the establishment of
8

Medicaid eligibility, unless such deposits must be drawn
9

upon or encumbered in accordance with Medicaid eligibility
10

requirements established by the Department of Healthcare
11

and Family Services.
12

(k) It shall be a business offense for a facility to
13
knowingly and intentionally both retain a resident's deposit
14
and accept Medicaid payments on behalf of that resident.
15

(l) A contract under this Section shall not permit rate
16
increases for a resident's room and board before the
17
expiration of the residency period specified in the contract.
18
If there is a rate increase for a resident's room and board
19
provided in a subsequent contract that is greater than the
20
percentage increase in the consumer price index-u during the
21
preceding residency period, the facility must provide
22
justification for the increase.
23

For the purposes of this subsection, "consumer price
24
index-u" means the index published by the Bureau of Labor
25
Statistics of the United States Department of Labor that
26
measures the average change in prices of goods and services

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purchased by all urban consumers, United States city average,
2
all items, 1982-84 = 100.

3
(Source: P.A. 99-143, eff. 7-27-15.)

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