Illinois nursing home rate reform plan enacted

SPRINGFIELD, Ill. (WGEM) — Illinois nursing homes will undergo long-awaited rate reform this year. Gov. JB Pritzker on Tuesday signed a bill tying funding for nursing homes to staffing levels and the quality of care provided to seniors.

Nearly 45,000 people in Illinois living in nursing homes rely on Medicaid. These patients represent approximately 70% of Illinois nursing home residents. The Illinois Department of Health and Family Services has been negotiating a patient-based payment model for several years.

Lawmakers and advocates say the law ensures that Illinois will no longer allow facilities to pass profits onto these people. The state will now invest more than $700 million in Medicaid funding for the nursing home industry, simplifying and expanding the current nursing home assessment tax, and providing additional general revenue funds. .

“When the pandemic hit, all the most glaring cracks and flaws in the system were exposed. Enough is enough,” Pritzker said. “We stand together to prevent bad actors from charging more while providing shoddy care to their residents.”

Pritzker said this law will help seniors get the care they deserve. The patient-based payment model is designed to more accurately reflect the clinical care needs of residents and empower nursing home owners. It specifically requires transparency in the financial disclosures of people who operate congregate care facilities.

The law also includes a new pay scale for certified practical nurses to help increase salaries based on years of experience. Pritzker and the bill’s sponsors say this is crucial for black and brown nursing home residents who are more likely to live in understaffed facilities.

Additional funds will be set aside to address increased costs at these facilities due to labor shortages and wage increases. The legislation provides an adjustment of $4 per resident day for nursing homes that serve an above-average percentage of Medicaid clients. Workers could see their wages increase by up to $8 an hour depending on their role and years of working in nursing homes.

“I had the opportunity to hear from nursing home workers who shared what it’s like to be stretched and how transformative this legislation can be,” said Lieutenant Governor Juliana Stratton. “With this bill, we are building a better future for residents and workers with their voices at the forefront.”

HFS will pay all Illinois nursing homes as if fully staffed for the first six months. This plan is separate from a 15-month transition period during which old and new payment models will be combined to help facilities adapt. HFS Director Theresa Eagleson said she is thrilled that nursing home payment reform is becoming a reality in Illinois. Eagleson noted that it was clear changes were needed to ensure nursing home residents received appropriate care.

“This will result in better staffing levels, improved care and better quality of life for so many people and is the result of leadership starting with the Governor and the hard work of the HFS team, together with the associations professional nursing homes and individual nursing homes. owners, advocates and frontline workers,” Eagleson said. “There is now a direct relationship between staffing, quality and funding.”

The plan has been backed by AARP Illinois, the Affordable Assisted Living Coalition, the Illinois Health Care Association, SEIU Healthcare Illinois and LeadingAge Illinois, among other advocacy groups.

“For too long, our seniors and their families have been at the mercy of nursing homes that put profit before quality of care,” said Rep. Anna Moeller (D-Elgin). “These practices must stop. House Bill 246 will help achieve this.

The law is expected to go into effect July 1 pending federal approval. However, that could be delayed until October 1 if the Centers for Medicare and Medicaid Services do not approve corresponding changes to the reimbursement system and bed evaluation for nursing homes.

“This legislation will have an absolutely positive impact on the care and quality of life of tens of thousands of nursing home residents across the state by putting in place accountability measures and tying new funding to quality measures. “Senator Ann Gillespie (D-Arlington Heights) said. “I’m proud of the work that has gone into this legislation and the message it sends – in Illinois nursing homes, we will not tolerate profits being valued over people.”

The plan was passed by both houses with unanimous support in April.

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