Long-Term Care - Illinois General Assembly

offered to facilities to convert multi-bed rooms into single rooms, which would better meet the
expectations of seniors and the disabled. Most are used to living independently and this would
relieve some of the additional stress associated with entering a facility. Several states that have
implemented such incentive programs successfully, including Minnesota.
FULLY IMPLEMENT THE MDS-BASED REIMBURSEMENT SYSTEM
This legislation was implemented July 1, 2003, although the legislature did not provide the
additional funding necessary to accomplish the purpose of the legislation.
We ask for the continued support of the legislature as we move through the rule-making process
and begin the two-year transition to a Medicaid nursing reimbursement system in which the
dollars will more closely follow the needs of the patients.
ENSURE FAIR AND REASONABLE OVERSIGHT OF ALL TYPES OF LONG-TERM CARE FACILITIES
State budget cuts and early retirements have significantly depleted the resources of the Illinois
Department of Public Health, the agency charged with regularly conducting oversight of licensed
long-term care facilities, assisted living establishments, and unlicensed entities. This has
stretched existing staff beyond reasonable limits. Further, the majority of the dollars designed to
establish a survey unit for assisted living and supportive living facilities was eliminated from the
budget approved by the Governor. These situations may result in additional stress to the
oversight system in Illinois.
It is important to ensure that high quality and consistent surveys will be conducted by a team of
well trained surveyors/reviewers that the elderly and disabled have access to licensed entities,
and that unlicensed entities are inspected and, where necessary, closed. This requires the
availability of appropriate human and financial resources.
BE CAUTIOUS ABOUT MEDICAID PROVIDER TAX PROPOSALS
Increasing provider taxes has been advanced as a possible solution to increasing funding for
long-term care. Geriatric facilities currently pay a provider tax of $1.50 per bed per day, and
facilities for the developmentally disabled pay 6% of net revenue (the maximum allowed by
federal law). The dollars raised through these tax programs receive federal match.
Long-term care facilities are the only providers who pay such a tax, although a hospital tax is
currently under consideration.
Last spring, there were some initial discussions about increasing the existing geriatric provider.
Although increasing provider taxes may seem like an easy solution, the legislature and
administration should be cautious about implementing such proposals. The financial condition
of nursing homes is unstable. Significant increases in existing taxes would be very difficult to
manage. Facilities are juggling mortgage payments and food bills, working closely with
creditors to manage their limited resources. Proposals to distribute new tax dollars in an
across-the-board rate adjustment (the usual way of distributing the tax dollars), would be
inconsistent with the provisions of House Bill 5567, which mandates that new dollars be used to
fund the MDS-based nursing reimbursement system.
Bed or provider tax proposals should be analyzed closely. All funds generated by a provider tax
should be earmarked to increase the reimbursement levels of that provider group and, if there is
any general tax increase, providers should be immediately relieved of the provider tax burden.
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