Bill Text: IL HB5095 | 2023-2024 | 103rd General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Nursing Home Care Act. Provides that a facility of which only a distinct part is certified to participate in the Medical Assistance Program may refuse to retain as a resident any person who resides in a part of the facility that does not participate in the Medical Assistance Program and who is unable to pay for his or her care in the facility without Medical Assistance only if, in addition to meeting other requirements, in circumstances where the Medicare coverage is ending prior to the full 100-day benefit period, the facility provides notice to the resident and to the resident's representative that the resident's Medicare coverage will likely end in 5 days. Requires the notification to specify that the resident shall not be required to move until these 5 days are up. In cases where the facility is notified in a shorter time frame than 5 days by a managed care organization or the time frame is shorter than 5 days due to inaccurate reporting by an outside entity, requires the facility to provide a minimum of 2 days' notification.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Enrolled) 2024-05-16 - Added as Alternate Chief Co-Sponsor Sen. Lakesia Collins [HB5095 Detail]

Download: Illinois-2023-HB5095-Engrossed.html

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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nursing Home Care Act is amended by
changing Section 3-401.1 as follows:
(210 ILCS 45/3-401.1) (from Ch. 111 1/2, par. 4153-401.1)
Sec. 3-401.1. (a) A facility participating in the Medical
Assistance Program is prohibited from failing or refusing to
retain as a resident any person because he or she is a
recipient of or an applicant for the Medical Assistance
Program.
(a-5) A After the effective date of this amendatory Act of
1997, a facility of which only a distinct part is certified to
participate in the Medical Assistance Program may refuse to
retain as a resident any person who resides in a part of the
facility that does not participate in the Medical Assistance
Program and who is unable to pay for his or her care in the
facility without Medical Assistance only if:
(1) the facility, no later than at the time of
admission and at the time of the resident's contract
renewal, explains to the resident (unless he or she is
incompetent), and to the resident's representative, and to
the person making payment on behalf of the resident for

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the resident's stay, in writing, that the facility may
discharge the resident if the resident is no longer able
to pay for his or her care in the facility without Medical
Assistance;
(2) the resident (unless he or she is incompetent),
the resident's representative, and the person making
payment on behalf of the resident for the resident's stay,
acknowledge in writing that they have received the written
explanation; .
(3) in circumstances where the Medicare coverage is
ending prior to the full 100-day benefit period, the
facility provides notice to the resident and to the
resident's representative that the resident's Medicare
coverage will likely end in 5 days. This notification
shall specify that the resident shall not be required to
move under this Section until these 5 days are up. In cases
where the facility is notified in a shorter time frame
than 5 days by a managed care organization or the time
frame is shorter than 5 days due to inaccurate reporting
by an outside entity, the facility must provide a minimum
of 2 days' notification.
(a-10) For the purposes of this Section, a recipient or
applicant shall be considered a resident in the facility
during any hospital stay totaling 10 days or less following a
hospital admission. The Department of Healthcare and Family
Services shall recoup funds from a facility when, as a result

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