DHFS-ALZHEIMER CARE UNIT RATES

Illinois General Assembly - Full Text of HB2550

Select Language

×

The Illinois General Assembly offers the Google Translate™ service for visitor convenience. In no way should it be considered accurate as to the translation of any content herein.

Visitors of the Illinois General Assembly website are encouraged to use other translation services available on the internet.

The English language version is always the official and authoritative version of this website.

NOTE: To return to the original English language version, select the "Show Original" button on the Google Translate™ menu bar at the top of the window.

Choose Language

English

Afrikaans

Albanian

Arabic

Armenian

Azerbaijani

Basque

Bengali

Bosnian

Catalan

Croatian

Czech

Danish

Dutch

Esperanto

Estonian

Filipino

Finnish

French

Galician

Georgian

German

Greek

Gujarati

Haitian Creole

Hausa

Hawaiian

Hebrew

Hindi

Hungarian

Icelandic

Indonesian

Interlingua

Interlingue

Inuktitut

Irish

Italian

Japanese

Javanese

Kannada

Khmer

Korean

Latin

Latvian

Lithuanian

Luxembourgish

Macedonian

Malagasy

Malayalam

Maltese

Maori

Marathi

Myanmar

Nepali

Norwegian

Odia

Pashto

Punjabi

Romanian

Russian

Samoan

Sango

Sanskrit

Sardinian

Sindhi

Sinhala

Slovak

Slovenian

Somali

Southern Sotho

Spanish

Sundanese

Swahili

Swedish

Tamil

Telugu

Thai

Tigrinya

Tonga

Turkish

Ukrainian

Urdu

Vietnamese

Welsh

Xhosa

Yiddish

Yoruba

Zulu

Powered by
Translate

Close

Illinois General Assembly

Top Navigation Bar

Translate

Learn

Select General Assembly

Search the 104th General Assembly

Enter search terms for legislation, members, committees, or schedules.

ILGA.GOV

LEGISLATION & LAWS

Bills & Resolutions

Public Acts

Illinois Compiled Statutes

Illinois Constitution

Search Legislation

Glossary

Guide

Reports & Inquiry

Legislative Reports

Special Reports

FTP Site

Legislator Lookup

Capitol Complex Phone Numbers

Rules & Regulations

Illinois Register

Administrative Rules

Senate

Members

Schedules

Committees

Request for Remote Testimony

Journals

Transcripts

Rules

Audio/Video

FOIA Information

Senate Employment Opportunities

Media Guidelines

House

Members

Schedules

Committees

Submit testimony for House Committees

Journals

Transcripts

Rules

Audio/Video

FOIA Information

House Employment Opportunities

Log In

Mobile Top Bar

Search the 104th General Assembly

Enter keywords to search the Illinois General Assembly website.

Full Text of HB2550

Home

Legislation

Full Text

HB2550 - 104th General Assembly

Bill Status

Full Text

Votes

Witness Slips

Select Menu

Bill Status

Full Text

Votes

Witness Slips

Printer Friendly Version

Introduced

Printer Friendly Version

Introduced

Open PDF

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB2550

Introduced 2/4/2025, by Rep. Natalie A. Manley

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.2

Amends the Medical Assistance Article of the Illinois Public Aid
Code. Provides that beginning January 1, 2026, the rate must be multiplied
by 5 for nursing facilities which have disclosed their status as
Alzheimer's special care units under the requirements of the Alzheimer's
Disease and Related Dementias Special Care Disclosure Act. Requires the
Department of Healthcare and Family Services to update the status for
nursing facilities for rates in effect each January 1.
LRB104 10563 KTG 20639 b

A BILL FOR

HB2550
LRB104 10563 KTG 20639 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 5-5.2 as follows:

6

(305 ILCS 5/5-5.2)
7

Sec. 5-5.2.
Payment.
8

(a) All nursing facilities that are grouped pursuant to
9
Section 5-5.1 of this Act shall receive the same rate of
10
payment for similar services.
11

(b) It shall be a matter of State policy that the Illinois
12
Department shall utilize a uniform billing cycle throughout
13
the State for the long-term care providers.
14

(c) (Blank).
15

(c-1) Notwithstanding any other provisions of this Code,
16
the methodologies for reimbursement of nursing services as
17
provided under this Article shall no longer be applicable for
18
bills payable for nursing services rendered on or after a new
19
reimbursement system based on the Patient Driven Payment Model
20
(PDPM) has been fully operationalized, which shall take effect
21
for services provided on or after the implementation of the
22
PDPM reimbursement system begins. For the purposes of Public
23
Act 102-1035, the implementation date of the PDPM

HB2550
- 2 -
LRB104 10563 KTG 20639 b
1
reimbursement system and all related provisions shall be July
2
1, 2022 if the following conditions are met: (i) the Centers
3
for Medicare and Medicaid Services has approved corresponding
4
changes in the reimbursement system and bed assessment; and
5
(ii) the Department has filed rules to implement these changes
6
no later than June 1, 2022. Failure of the Department to file
7
rules to implement the changes provided in Public Act 102-1035
8
no later than June 1, 2022 shall result in the implementation
9
date being delayed to October 1, 2022.
10

(d) The new nursing services reimbursement methodology
11
utilizing the Patient Driven Payment Model, which shall be
12
referred to as the PDPM reimbursement system, taking effect
13
July 1, 2022, upon federal approval by the Centers for
14
Medicare and Medicaid Services, shall be based on the
15
following:
16

(1) The methodology shall be resident-centered,
17

facility-specific, cost-based, and based on guidance from
18

the Centers for Medicare and Medicaid Services.
19

(2) Costs shall be annually rebased and case mix index
20

quarterly updated. The nursing services methodology will
21

be assigned to the Medicaid enrolled residents on record
22

as of 30 days prior to the beginning of the rate period in
23

the Department's Medicaid Management Information System
24

(MMIS) as present on the last day of the second quarter
25

preceding the rate period based upon the Assessment
26

Reference Date of the Minimum Data Set (MDS).

HB2550
- 3 -
LRB104 10563 KTG 20639 b
1

(3) Regional wage adjustors based on the Health
2

Service Areas (HSA) groupings and adjusters in effect on
3

April 30, 2012 shall be included, except no adjuster shall
4

be lower than 1.06.
5

(4) PDPM nursing case mix indices in effect on March
6

1, 2022 shall be assigned to each resident class at no less
7

than 0.7858 of the Centers for Medicare and Medicaid
8

Services PDPM unadjusted case mix values, in effect on
9

March 1, 2022.
10

(5) The pool of funds available for distribution by
11

case mix and the base facility rate shall be determined
12

using the formula contained in subsection (d-1).
13

(6) The Department shall establish a variable per diem
14

staffing add-on in accordance with the most recent
15

available federal staffing report, currently the Payroll
16

Based Journal, for the same period of time, and if
17

applicable adjusted for acuity using the same quarter's
18

MDS. The Department shall rely on Payroll Based Journals
19

provided to the Department of Public Health to make a
20

determination of non-submission. If the Department is
21

notified by a facility of missing or inaccurate Payroll
22

Based Journal data or an incorrect calculation of
23

staffing, the Department must make a correction as soon as
24

the error is verified for the applicable quarter.
25

Beginning October 1, 2024, the staffing percentage
26

used in the calculation of the per diem staffing add-on

HB2550
- 4 -
LRB104 10563 KTG 20639 b
1

shall be its PDPM STRIVE Staffing Ratio which equals: its
2

Reported Total Nurse Staffing Hours Per Resident Per Day
3

as published in the most recent federal staffing report
4

(the Provider Information File), divided by the facility's
5

PDPM STRIVE Staffing Target. Each facility's PDPM STRIVE
6

Staffing Target is equal to .82 times the facility's
7

Illinois Adjusted Facility Case-Mix Hours Per Resident Per
8

Day. A facility's Illinois Adjusted Facility Case Mix
9

Hours Per Resident Per Day is equal to its Case-Mix Total
10

Nurse Staffing Hours Per Resident Per Day (as published in
11

the most recent federal staffing report) times 3.662
12

(which reflects the national resident days-weighted mean
13

Reported Total Nurse Staffing Hours Per Resident Per Day
14

as calculated using the January 2024 federal Provider
15

Information Files), divided by the national resident
16

days-weighted mean Reported Total Nurse Staffing Hours Per
17

Resident Per Day calculated using the most recent federal
18

Provider Information File.
19

(6.5) Beginning July 1, 2024, the paid per diem
20

staffing add-on shall be the paid per diem staffing add-on
21

in effect April 1, 2024. For dates beginning October 1,
22

2024 and through September 30, 2025, the denominator for
23

the staffing percentage shall be the lesser of the
24

facility's PDPM STRIVE Staffing Target and:
25

(A) For the quarter beginning October 1, 2024, the
26

sum of 20% of the facility's PDPM STRIVE Staffing

HB2550
- 5 -
LRB104 10563 KTG 20639 b
1

Target and 80% of the facility's Case-Mix Total Nurse
2

Staffing Hours Per Resident Per Day (as published in
3

the January 2024 federal staffing report).
4

(B) For the quarter beginning January 1, 2025, the
5

sum of 40% of the facility's PDPM STRIVE Staffing
6

Target and 60% of the facility's Case-Mix Total Nurse
7

Staffing Hours Per Resident Per Day (as published in
8

the January 2024 federal staffing report).
9

(C) For the quarter beginning March 1, 2025, the
10

sum of 60% of the facility's PDPM STRIVE Staffing
11

Target and 40% of the facility's Case-Mix Total Nurse
12

Staffing Hours Per Resident Per Day (as published in
13

the January 2024 federal staffing report).
14

(D) For the quarter beginning July 1, 2025, the
15

sum of 80% of the facility's PDPM STRIVE Staffing
16

Target and 20% of the facility's Case-Mix Total Nurse
17

Staffing Hours Per Resident Per Day (as published in
18

the January 2024 federal staffing report).
19

Facilities with at least 70% of the staffing
20

indicated by the STRIVE study shall be paid a per diem
21

add-on of $9, increasing by equivalent steps for each
22

whole percentage point until the facilities reach a per
23

diem of $16.52. Facilities with at least 80% of the
24

staffing indicated by the STRIVE study shall be paid a per
25

diem add-on of $16.52, increasing by equivalent steps for
26

each whole percentage point until the facilities reach a

HB2550
- 6 -
LRB104 10563 KTG 20639 b
1

per diem add-on of $25.77. Facilities with at least 92% of
2

the staffing indicated by the STRIVE study shall be paid a
3

per diem add-on of $25.77, increasing by equivalent steps
4

for each whole percentage point until the facilities reach
5

a per diem add-on of $30.98. Facilities with at least 100%
6

of the staffing indicated by the STRIVE study shall be
7

paid a per diem add-on of $30.98, increasing by equivalent
8

steps for each whole percentage point until the facilities
9

reach a per diem add-on of $36.44. Facilities with at
10

least 110% of the staffing indicated by the STRIVE study
11

shall be paid a per diem add-on of $36.44, increasing by
12

equivalent steps for each whole percentage point until the
13

facilities reach a per diem add-on of $38.68. Facilities
14

with at least 125% or higher of the staffing indicated by
15

the STRIVE study shall be paid a per diem add-on of $38.68.
16

No nursing facility's variable staffing per diem add-on
17

shall be reduced by more than 5% in 2 consecutive
18

quarters. For the quarters beginning July 1, 2022 and
19

October 1, 2022, no facility's variable per diem staffing
20

add-on shall be calculated at a rate lower than 85% of the
21

staffing indicated by the STRIVE study. No facility below
22

70% of the staffing indicated by the STRIVE study shall
23

receive a variable per diem staffing add-on after December
24

31, 2022.
25

(7) For dates of services beginning July 1, 2022, the
26

PDPM nursing component per diem for each nursing facility

HB2550
- 7 -
LRB104 10563 KTG 20639 b
1

shall be the product of the facility's (i) statewide PDPM
2

nursing base per diem rate, $92.25, adjusted for the
3

facility average PDPM case mix index calculated quarterly
4

and (ii) the regional wage adjuster, and then add the
5

Medicaid access adjustment as defined in (e-3) of this
6

Section. Transition rates for services provided between
7

July 1, 2022 and October 1, 2023 shall be the greater of
8

the PDPM nursing component per diem or:
9

(A) for the quarter beginning July 1, 2022, the
10

RUG-IV nursing component per diem;
11

(B) for the quarter beginning October 1, 2022, the
12

sum of the RUG-IV nursing component per diem
13

multiplied by 0.80 and the PDPM nursing component per
14

diem multiplied by 0.20;
15

(C) for the quarter beginning January 1, 2023, the
16

sum of the RUG-IV nursing component per diem
17

multiplied by 0.60 and the PDPM nursing component per
18

diem multiplied by 0.40;
19

(D) for the quarter beginning April 1, 2023, the
20

sum of the RUG-IV nursing component per diem
21

multiplied by 0.40 and the PDPM nursing component per
22

diem multiplied by 0.60;
23

(E) for the quarter beginning July 1, 2023, the
24

sum of the RUG-IV nursing component per diem
25

multiplied by 0.20 and the PDPM nursing component per
26

diem multiplied by 0.80; or

HB2550
- 8 -
LRB104 10563 KTG 20639 b
1

(F) for the quarter beginning October 1, 2023 and
2

each subsequent quarter, the transition rate shall end
3

and a nursing facility shall be paid 100% of the PDPM
4

nursing component per diem.
5

(d-1) Calculation of base year Statewide RUG-IV nursing
6
base per diem rate.
7

(1) Base rate spending pool shall be:
8

(A) The base year resident days which are
9

calculated by multiplying the number of Medicaid
10

residents in each nursing home as indicated in the MDS
11

data defined in paragraph (4) by 365.
12

(B) Each facility's nursing component per diem in
13

effect on July 1, 2012 shall be multiplied by
14

subsection (A).
15

(C) Thirteen million is added to the product of
16

subparagraph (A) and subparagraph (B) to adjust for
17

the exclusion of nursing homes defined in paragraph
18

(5).
19

(2) For each nursing home with Medicaid residents as
20

indicated by the MDS data defined in paragraph (4),
21

weighted days adjusted for case mix and regional wage
22

adjustment shall be calculated. For each home this
23

calculation is the product of:
24

(A) Base year resident days as calculated in
25

subparagraph (A) of paragraph (1).
26

(B) The nursing home's regional wage adjustor

HB2550
- 9 -
LRB104 10563 KTG 20639 b
1

based on the Health Service Areas (HSA) groupings and
2

adjustors in effect on April 30, 2012.
3

(C) Facility weighted case mix which is the number
4

of Medicaid residents as indicated by the MDS data
5

defined in paragraph (4) multiplied by the associated
6

case weight for the RUG-IV 48 grouper model using
7

standard RUG-IV procedures for index maximization.
8

(D) The sum of the products calculated for each
9

nursing home in subparagraphs (A) through (C) above
10

shall be the base year case mix, rate adjusted
11

weighted days.
12

(3) The Statewide RUG-IV nursing base per diem rate:
13

(A) on January 1, 2014 shall be the quotient of the
14

paragraph (1) divided by the sum calculated under
15

subparagraph (D) of paragraph (2);
16

(B) on and after July 1, 2014 and until July 1,
17

2022, shall be the amount calculated under
18

subparagraph (A) of this paragraph (3) plus $1.76; and
19

(C) beginning July 1, 2022 and thereafter, $7
20

shall be added to the amount calculated under
21

subparagraph (B) of this paragraph (3) of this
22

Section.
23

(4) Minimum Data Set (MDS) comprehensive assessments
24

for Medicaid residents on the last day of the quarter used
25

to establish the base rate.
26

(5) Nursing facilities designated as of July 1, 2012

HB2550
- 10 -
LRB104 10563 KTG 20639 b
1

by the Department as "Institutions for Mental Disease"
2

shall be excluded from all calculations under this
3

subsection. The data from these facilities shall not be
4

used in the computations described in paragraphs (1)
5

through (4) above to establish the base rate.
6

(e) Beginning July 1, 2014, the Department shall allocate
7
funding in the amount up to $10,000,000 for per diem add-ons to
8
the RUGS methodology for dates of service on and after July 1,
9
2014:
10

(1) $0.63 for each resident who scores in I4200
11

Alzheimer's Disease or I4800 non-Alzheimer's Dementia.
12

Beginning January 1, 2026, the rate must be multiplied by
13

5 for nursing facilities which have disclosed their status
14

as Alzheimer's special care units under the requirements
15

of the Alzheimer's Disease and Related Dementias Special
16

Care Disclosure Act. The Department must update the status
17

for nursing facilities for rates in effect each January 1.

18

(2) $2.67 for each resident who scores either a "1" or
19

"2" in any items S1200A through S1200I and also scores in
20

RUG groups PA1, PA2, BA1, or BA2.
21

(e-1) (Blank).
22

(e-2) For dates of services beginning January 1, 2014 and
23
ending September 30, 2023, the RUG-IV nursing component per
24
diem for a nursing home shall be the product of the statewide
25
RUG-IV nursing base per diem rate, the facility average case
26
mix index, and the regional wage adjustor. For dates of

HB2550
- 11 -
LRB104 10563 KTG 20639 b
1
service beginning July 1, 2022 and ending September 30, 2023,
2
the Medicaid access adjustment described in subsection (e-3)
3
shall be added to the product.
4

(e-3) A Medicaid Access Adjustment of $4 adjusted for the
5
facility average PDPM case mix index calculated quarterly
6
shall be added to the statewide PDPM nursing per diem for all
7
facilities with annual Medicaid bed days of at least 70% of all
8
occupied bed days adjusted quarterly. For each new calendar
9
year and for the 6-month period beginning July 1, 2022, the
10
percentage of a facility's occupied bed days comprised of
11
Medicaid bed days shall be determined by the Department
12
quarterly. For dates of service beginning January 1, 2023, the
13
Medicaid Access Adjustment shall be increased to $4.75. This
14
subsection shall be inoperative on and after January 1, 2028.
15

(e-4) Subject to federal approval, on and after January 1,
16
2024, the Department shall increase the rate add-on at
17
paragraph (7) subsection (a) under 89 Ill. Adm. Code 147.335
18
for ventilator services from $208 per day to $481 per day.
19
Payment is subject to the criteria and requirements under 89
20
Ill. Adm. Code 147.335.
21

(f) (Blank).
22

(g) Notwithstanding any other provision of this Code, on
23
and after July 1, 2012, for facilities not designated by the
24
Department of Healthcare and Family Services as "Institutions
25
for Mental Disease", rates effective May 1, 2011 shall be
26
adjusted as follows:

HB2550
- 12 -
LRB104 10563 KTG 20639 b
1

(1) (Blank);
2

(2) (Blank);
3

(3) Facility rates for the capital and support
4

components shall be reduced by 1.7%.
5

(h) Notwithstanding any other provision of this Code, on
6
and after July 1, 2012, nursing facilities designated by the
7
Department of Healthcare and Family Services as "Institutions
8
for Mental Disease" and "Institutions for Mental Disease" that
9
are facilities licensed under the Specialized Mental Health
10
Rehabilitation Act of 2013 shall have the nursing,
11
socio-developmental, capital, and support components of their
12
reimbursement rate effective May 1, 2011 reduced in total by
13
2.7%.
14

(i) On and after July 1, 2014, the reimbursement rates for
15
the support component of the nursing facility rate for
16
facilities licensed under the Nursing Home Care Act as skilled
17
or intermediate care facilities shall be the rate in effect on
18
June 30, 2014 increased by 8.17%.
19

(i-1) Subject to federal approval, on and after January 1,
20
2024, the reimbursement rates for the support component of the
21
nursing facility rate for facilities licensed under the
22
Nursing Home Care Act as skilled or intermediate care
23
facilities shall be the rate in effect on June 30, 2023
24
increased by 12%.
25

(j) Notwithstanding any other provision of law, subject to
26
federal approval, effective July 1, 2019, sufficient funds

HB2550
- 13 -
LRB104 10563 KTG 20639 b
1
shall be allocated for changes to rates for facilities
2
licensed under the Nursing Home Care Act as skilled nursing
3
facilities or intermediate care facilities for dates of
4
services on and after July 1, 2019: (i) to establish, through
5
June 30, 2022 a per diem add-on to the direct care per diem
6
rate not to exceed $70,000,000 annually in the aggregate
7
taking into account federal matching funds for the purpose of
8
addressing the facility's unique staffing needs, adjusted
9
quarterly and distributed by a weighted formula based on
10
Medicaid bed days on the last day of the second quarter
11
preceding the quarter for which the rate is being adjusted.
12
Beginning July 1, 2022, the annual $70,000,000 described in
13
the preceding sentence shall be dedicated to the variable per
14
diem add-on for staffing under paragraph (6) of subsection
15
(d); and (ii) in an amount not to exceed $170,000,000 annually
16
in the aggregate taking into account federal matching funds to
17
permit the support component of the nursing facility rate to
18
be updated as follows:
19

(1) 80%, or $136,000,000, of the funds shall be used
20

to update each facility's rate in effect on June 30, 2019
21

using the most recent cost reports on file, which have had
22

a limited review conducted by the Department of Healthcare
23

and Family Services and will not hold up enacting the rate
24

increase, with the Department of Healthcare and Family
25

Services.
26

(2) After completing the calculation in paragraph (1),

HB2550
- 14 -
LRB104 10563 KTG 20639 b
1

any facility whose rate is less than the rate in effect on
2

June 30, 2019 shall have its rate restored to the rate in
3

effect on June 30, 2019 from the 20% of the funds set
4

aside.
5

(3) The remainder of the 20%, or $34,000,000, shall be
6

used to increase each facility's rate by an equal
7

percentage.
8

(k) During the first quarter of State Fiscal Year 2020,
9
the Department of Healthcare of Family Services must convene a
10
technical advisory group consisting of members of all trade
11
associations representing Illinois skilled nursing providers
12
to discuss changes necessary with federal implementation of
13
Medicare's Patient-Driven Payment Model. Implementation of
14
Medicare's Patient-Driven Payment Model shall, by September 1,
15
2020, end the collection of the MDS data that is necessary to
16
maintain the current RUG-IV Medicaid payment methodology. The
17
technical advisory group must consider a revised reimbursement
18
methodology that takes into account transparency,
19
accountability, actual staffing as reported under the
20
federally required Payroll Based Journal system, changes to
21
the minimum wage, adequacy in coverage of the cost of care, and
22
a quality component that rewards quality improvements.
23

(l) The Department shall establish per diem add-on
24
payments to improve the quality of care delivered by
25
facilities, including:
26

(1) Incentive payments determined by facility

HB2550
- 15 -
LRB104 10563 KTG 20639 b
1

performance on specified quality measures in an initial
2

amount of $70,000,000. Nothing in this subsection shall be
3

construed to limit the quality of care payments in the
4

aggregate statewide to $70,000,000, and, if quality of
5

care has improved across nursing facilities, the
6

Department shall adjust those add-on payments accordingly.
7

The quality payment methodology described in this
8

subsection must be used for at least State Fiscal Year
9

2023. Beginning with the quarter starting July 1, 2023,
10

the Department may add, remove, or change quality metrics
11

and make associated changes to the quality payment
12

methodology as outlined in subparagraph (E). Facilities
13

designated by the Centers for Medicare and Medicaid
14

Services as a special focus facility or a hospital-based
15

nursing home do not qualify for quality payments.
16

(A) Each quality pool must be distributed by
17

assigning a quality weighted score for each nursing
18

home which is calculated by multiplying the nursing
19

home's quality base period Medicaid days by the
20

nursing home's star rating weight in that period.
21

(B) Star rating weights are assigned based on the
22

nursing home's star rating for the LTS quality star
23

rating. As used in this subparagraph, "LTS quality
24

star rating" means the long-term stay quality rating
25

for each nursing facility, as assigned by the Centers
26

for Medicare and Medicaid Services under the Five-Star

HB2550
- 16 -
LRB104 10563 KTG 20639 b
1

Quality Rating System. The rating is a number ranging
2

from 0 (lowest) to 5 (highest).
3

(i) Zero-star or one-star rating has a weight
4

of 0.
5

(ii) Two-star rating has a weight of 0.75.
6

(iii) Three-star rating has a weight of 1.5.
7

(iv) Four-star rating has a weight of 2.5.
8

(v) Five-star rating has a weight of 3.5.
9

(C) Each nursing home's quality weight score is
10

divided by the sum of all quality weight scores for
11

qualifying nursing homes to determine the proportion
12

of the quality pool to be paid to the nursing home.
13

(D) The quality pool is no less than $70,000,000
14

annually or $17,500,000 per quarter. The Department
15

shall publish on its website the estimated payments
16

and the associated weights for each facility 45 days
17

prior to when the initial payments for the quarter are
18

to be paid. The Department shall assign each facility
19

the most recent and applicable quarter's STAR value
20

unless the facility notifies the Department within 15
21

days of an issue and the facility provides reasonable
22

evidence demonstrating its timely compliance with
23

federal data submission requirements for the quarter
24

of record. If such evidence cannot be provided to the
25

Department, the STAR rating assigned to the facility
26

shall be reduced by one from the prior quarter.

HB2550
- 17 -
LRB104 10563 KTG 20639 b
1

(E) The Department shall review quality metrics
2

used for payment of the quality pool and make
3

recommendations for any associated changes to the
4

methodology for distributing quality pool payments in
5

consultation with associations representing long-term
6

care providers, consumer advocates, organizations
7

representing workers of long-term care facilities, and
8

payors. The Department may establish, by rule, changes
9

to the methodology for distributing quality pool
10

payments.
11

(F) The Department shall disburse quality pool
12

payments from the Long-Term Care Provider Fund on a
13

monthly basis in amounts proportional to the total
14

quality pool payment determined for the quarter.
15

(G) The Department shall publish any changes in
16

the methodology for distributing quality pool payments
17

prior to the beginning of the measurement period or
18

quality base period for any metric added to the
19

distribution's methodology.
20

(2) Payments based on CNA tenure, promotion, and CNA
21

training for the purpose of increasing CNA compensation.
22

It is the intent of this subsection that payments made in
23

accordance with this paragraph be directly incorporated
24

into increased compensation for CNAs. As used in this
25

paragraph, "CNA" means a certified nursing assistant as
26

that term is described in Section 3-206 of the Nursing

HB2550
- 18 -
LRB104 10563 KTG 20639 b
1

Home Care Act, Section 3-206 of the ID/DD Community Care
2

Act, and Section 3-206 of the MC/DD Act. The Department
3

shall establish, by rule, payments to nursing facilities
4

equal to Medicaid's share of the tenure wage increments
5

specified in this paragraph for all reported CNA employee
6

hours compensated according to a posted schedule
7

consisting of increments at least as large as those
8

specified in this paragraph. The increments are as
9

follows: an additional $1.50 per hour for CNAs with at
10

least one and less than 2 years' experience plus another
11

$1 per hour for each additional year of experience up to a
12

maximum of $6.50 for CNAs with at least 6 years of
13

experience. For purposes of this paragraph, Medicaid's
14

share shall be the ratio determined by paid Medicaid bed
15

days divided by total bed days for the applicable time
16

period used in the calculation. In addition, and additive
17

to any tenure increments paid as specified in this
18

paragraph, the Department shall establish, by rule,
19

payments supporting Medicaid's share of the
20

promotion-based wage increments for CNA employee hours
21

compensated for that promotion with at least a $1.50
22

hourly increase. Medicaid's share shall be established as
23

it is for the tenure increments described in this
24

paragraph. Qualifying promotions shall be defined by the
25

Department in rules for an expected 10-15% subset of CNAs
26

assigned intermediate, specialized, or added roles such as

HB2550
- 19 -
LRB104 10563 KTG 20639 b
1

CNA trainers, CNA scheduling "captains", and CNA
2

specialists for resident conditions like dementia or
3

memory care or behavioral health.
4

(m) The Department shall work with nursing facility
5
industry representatives to design policies and procedures to
6
permit facilities to address the integrity of data from
7
federal reporting sites used by the Department in setting
8
facility rates.
9
(Source: P.A. 102-77, eff. 7-9-21; 102-558, eff. 8-20-21;
10
102-1035, eff. 5-31-22; 102-1118, eff. 1-18-23; 103-102,
11
Article 40, Section 40-5, eff. 1-1-24; 103-102, Article 50,
12
Section 50-5, eff. 1-1-24; 103-593, eff. 6-7-24; 103-605, eff.
13
7-1-24.)

Footer

Disclaimer

This site is maintained for the Illinois General Assembly by the
Legislative Information System, 705 Stratton Building, Springfield, Illinois 62706.

Contact ILGA Webmaster

ILGA.gov uses cookies to ensure you get the best experience on our website. By continuing to browse ILGA.gov you consent to our use of cookies.
Read About Cookies

ILGA.GOV

2026 ILGA.gov | All Rights Reserved |
ADA

|
Disclaimers
|
Learn

This site is maintained for the Illinois General Assembly by the
Legislative Information System, 705 Stratton Building, Springfield, Illinois 62706.
Contact ILGA Webmaster

ILGA.gov uses cookies to ensure you get the best experience on our website. By continuing to browse ILGA.gov you consent to our use of cookies.
Read About Cookies

ILGA.GOV

2026 ILGA.gov | All Rights Reserved |
ADA

|
Disclaimers
|
Learn