Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 140 - MEDICAL PAYMENT › Subpart E - GROUP CARE › Section 140.700 - Discharge of Long Term Care Residents

Current through Register Vol. 48, No. 28, July 12, 2024
a) A nursing 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 or an applicant for the
				Medical Assistance Program. A recipient or applicant shall be considered a
				resident in the nursing facility during any hospital stay totaling ten days or
				less following a hospital admission .
b) If a nursing facility should refuse to
				accept a resident back in the facility after a stay in the hospital of less
				than ten days, the result may be that the resident will thereafter incur
				hospital bills of a greater amount than the nursing facility care would have
				cost. If the Department were to become liable to pay such hospital bills as a
				result of the nursing facility's refusal to take the recipient back into the
				facility, the Department shall recoup its costs for that unnecessary
				hospitalization from the nursing facility. The provider will be required to pay
				the Department the portion of the hospital bill that is in excess of the amount
				that would otherwise have been paid for care in the nursing facility from the
				date on which the nursing facility refused to accept the resident's return. The
				Department will notify the provider of its intent to recoup and opportunity for
				a hearing shall be given pursuant to 89 Ill. Adm. Code 104, Subpart
				C.
c) A nursing facility must
				establish and follow a written policy under which a resident, whose
				hospitalization exceeds ten days or therapeutic leave exceeds the bed reserve
				period specified in Section
				140.523, is
				readmitted to the nursing facility immediately upon the first availability of a
				bed in a semi-private, same sex room if the resident requires the services
				provided by the nursing facility and is eligible for Medicaid certified
				facility services.
d) The nursing
				facility must permit each resident to remain in the nursing facility and not
				transfer or discharge the resident except in specific instances as stated at 77
				Ill. Adm. Code
				300.3300(c)(1)(A) through
				(C).
e) For all Medicaid certified nursing
				facilities, notice of transfer or discharge must be made to any resident 30
				days before the resident is transferred or discharged as mandated by
				42 CFR
				483.12(a)(4)(B). In addition
				to requirements stated at 77 Ill. Adm. Code
				300.3300(e),
				the contents of the notice shall also include requirements under
				42 CFR
				483.12(a)(5).
f) Pursuant to Section 1919(c)(2)(F) of the
				Social Security Act and Section
				140.506,
				a nursing facility that voluntarily withdraws from participation in the Medical
				Assistance Program, but continues to provide nursing facility services, is
				prohibited from using the facility's voluntary withdrawal from participation as
				an acceptable basis for the transfer or discharge of residents of the facility
				who were residing in the facility on the day before the effective date of the
				withdrawal, including those residents who were not entitled to coverage under
				the Medical Assistance Program as of that day.