Legislature approves incentives to increase nursing home staff

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By PETER HANCOCK

Illinois Capitol News

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SPRINGFIELD — A bill that would inject more than $700 million a year into Medicaid-funded nursing homes to increase staffing and improve quality of care was unanimously approved by the Illinois House on Thursday, a day after authorizing the Senate.

He will head to Governor JB Pritzker, who welcomed his passing in a statement after the House vote.

Illinois has long been home to some of the most understaffed nursing homes in the nation, a problem that has been magnified by the COVID-19 pandemic.

The Illinois Department of Public Health estimates nearly 8,000 nursing home residents and 100 staff members have died from the disease since the pandemic began. That’s about 24% of all COVID-19 deaths recorded in Illinois on Wednesday.

Officials with the Department of Health and Family Services, which administers Medicaid, said much of this was due to understaffing and poor quality of care at Medicaid-funded facilities, especially those that serve patients. low-income residents and people of color, where residents are often housed together.


        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

“Imagine in the year or two before COVID, and if we had known it was coming, if we would have considered resident safety, room overcrowding and staff as pressing issues,” he said. department deputy director Andy Allison told a legislative committee. in October. “We’ve lost – it’s hard for me – thousands of people in our care homes. I don’t think there’s anyone in the country who wouldn’t have said at that time, c “is urgent. And I think the fact is that nothing has changed, except now we know how bad it can be.”

Since around the time the pandemic hit, the Department of Health and Family Services has been working on a new funding model that would reward nursing homes for increased staffing and provide additional funding to increase salaries of certified practical nurses, the people who provide the most direct day-to-day care to residents.

This new system, known as the patient-centric payment model, has been the subject of intense negotiations over the past two years between state agencies, seniors’ advocates and the home industry. of nursing.

But House Majority Leader Greg Harris, a Democrat from Chicago, announced Wednesday morning that a deal had finally been reached, and it was passed unanimously by the Senate later that evening.

“This is a big win, and it will bring a lot more accountability to the long-term care industry,” Harris said at a Statehouse press conference.

Most of the funding for the plan, estimated at $515 million, would come from an increase in the bed tax that the state levies on nursing facilities to generate money that is then used to levy additional federal Medicaid matching funds.

Of that amount, $360 million would be used as incentive payments for nursing homes to increase their workforce to or above certain target levels.

These incentive payments would begin when a facility reaches 75% of their goal and gradually increase with each percentage point increase a facility achieves, up to a maximum of $38.68 per patient day.

Another $85 million would be used to subsidize annual salary increases for CNAs based on their years of experience. These would start with a raise of $1.50 per hour for those with one year of experience, increasing annually to a maximum of $6.50 per hour for those with at least six years of experience. of experience.

Another $70 million would be used to reward facilities that demonstrate improvement in certain quality measures.

The bill also plans to spend $202 million in combined state and federal funds to increase the basic reimbursement rate per day that the state pays to nursing homes by $7, bringing it to $92.25 per day. resident day, plus an additional $4 per day for facilities serving an above-average percentage of Medicaid patients.

Additionally, the bill would require nursing facility owners to annually report the names of all individuals and organizations with an interest in the facility, a change prompted by the growing number of fund-owned facilities. private equity, a trend that some studies have suggested is linked to lower quality care.

A provision the care home industry negotiated into the bill is an 18-month transition period during which all facilities would be reimbursed as if they were at 85% of their staffing target.

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