89 Ill. Adm. Code 140.562
Nursing Costs
Section 140
Section 140.562 Nursing
Costs
a) The Department reimburses for nursing costs based on
geographic area in which the facility is based, and the level of care the
facility (or distinct part thereof) is licensed to provide. Nursing costs also
include an increment to reimburse for patients requiring skilled care for
differences in support cost areas statistically related to variable patient
conditions. For residents in Skilled Nursing Facilities (SNF) and Intermediate
Care Facilities (ICF), the Department reimburses for nursing costs according to
Sections 140.900 through 140.907; for residents in Skilled Nursing Facilities
for Pediatrics (SNF/PED) or Intermediate Care Facilities for the Medically
Retarded (ICF/MR), the Department reimburses for nursing costs according to
Sections 140.850 through 140.885.
b) For the period July 1, 1986, through December 31, 1986, no
facility's rate of reimbursement for Nursing Services shall be less than 90% of
the rate of reimbursement for Nursing Services that facility received for the
period January 1, 1986, through June 30, 1986.
c) For the period July 1, 1986 through December 31, 1986, the
Department shall perform an additional computation for the rate of
reimbursement for Nursing Services.
1) For intermediate and skilled care facilities, the additional
computation is as follows:
A) Unadjusted nursing rates will be computed according to Section
140.905.
B) The unadjusted nursing rate will be compared to 90 percent of
the previous effective rate for Nursing Services for each facility. The
greater of the two rates will be the "hold harmless" nursing rate.
C) The mean difference between the "hold harmless"
nursing rates and the previous effective nursing rates will be computed for
each HSA area. This difference will be an interim base for the HSA area.
D) The adjusted nursing rate will be the sum of the "hold
harmless" nursing rate and the interim base rate.
2) For intermediate and skilled care facilities for the
developmentally disabled, the additional computation is as follows:
A) Unadjusted nursing rates will be computed according to Section
140.885.
B) The mean difference between the unadjusted nursing rates and
the previous effective nursing rates will be computed for each licensure
group. This difference will be an interim base rate for the licensure group.
C) The adjusted nursing rate will be the sum of the unadjusted
nursing rate and the interim base rate.
d) For the period January 1, 1987 through June 30, 1987, the
nursing rate component for any skilled and intermediate care facility (not
including facilities for the developmentally disabled) will be the higher of
either the rate for the prior rate period (July 1, 1986 through December 31,
1986) or the rate as calculated according to Subpart G.
e) For the period January 1, 1987 through June 30, 1987, the
nursing rate component for facilities for the developmentally disabled will be
the same as for the prior rate period (July 1, 1986 through December 31, 1986).
f) For the period July 1, 1987, through December 31, 1987, the
nursing rate component (updated for wage inflation from January 1, 1987,
through January 1, 1988, as computed in Sections 140.909(b)(1)(A)(iv) and (v)
for long term care facilities for the developmentally disabled will be the same
as for the prior rate period (January 1, 1987, through June 30, 1987).
g) For the period January 1, 1988 through June 30, 1988, the
nursing rate component for facilities for the developmentally disabled will be
the same as for the prior rate period (July 1, 1987 through December 31, 1987).