Bill
HB 2910
Illinois HB 2910 ties Medicaid nursing facility per-diem staffing add-ons to the PDPM STRIVE Staffing Ratio, using PBJ data and facility targets to adjust payments.
Status / Sponsor
- Bill: HB 2910
- Short title (in text): not provided; topic: Medicaid nursing facility staffing calculation (PDPM STRIVE)
- Primary sponsor: Rep. Anna Moeller
- Action highlights: Introduced Feb 6, 2025; first reading Feb 6; committee referrals (Rules; Trade/Workforce & Economic Development; Appropriations‑Health & Human Services); read first time Mar 19; Rule 19(a) / re‑referred to Rules Committee Mar 21. Companion: SB 443.
- Conditional: The changes take effect only if House Bill 4907 of the 103rd General Assembly becomes law; effective date is either immediate or the date HB 4907 takes effect, whichever is later.
Purpose / Intent
- To change how the “per diem staffing add‑on” for Medicaid payment to nursing facilities is calculated by tying the staffing percentage to a facility’s PDPM STRIVE Staffing Ratio, using federal staffing reports and a facility‑specific PDPM STRIVE Staffing Target. The intent is to base Medicaid staffing add‑ons on standardized, facility‑level staffing metrics (Payroll Based Journal / Provider Information File) and adjusted case mix.
Key provisions (major points)
- Beginning October 1, 2024 (and with phased definitions on Jan 1, 2025 and Jan 1, 2026), the staffing percentage used to compute the per‑diem staffing add‑on shall be the facility’s PDPM STRIVE Staffing Ratio.
- PDPM STRIVE Staffing Ratio = (Reported Total Nurse Staffing Hours Per Resident Per Day from the most recent federal Provider Information File) ÷ (Facility’s PDPM STRIVE Staffing Target).
- PDPM STRIVE Staffing Target is defined in terms of the facility’s Illinois Adjusted Facility Case‑Mix Hours Per Resident Per Day. The bill supplies formulas to compute:
- Illinois Adjusted Facility Case‑Mix HPRD = (Facility Case‑Mix Total Nurse Staffing HPRD as published federally) × adjustment factor(s) ÷ national reported total nurse HPRD (from State US Averages file). The bill specifies numerical constants (e.g., multipliers such as 3.662 and 3.79, divisors such as 0.82 or 1.36671) that are used in the staged calculations for different effective dates (2024–2026).
- The Department will rely on federal Payroll Based Journal (PBJ) / Provider Information File and State US Averages data to compute reported staffing and targets. The bill directs correction procedures when PBJ data are missing or inaccurate.
- The bill also references establishing a STRIVE staffing fee schedule and how facility values feed into per‑diem add‑on calculations.
Who is affected
- Primary: Nursing facilities/providers participating in Illinois Medicaid (long‑term care providers).
- Secondary: Illinois Department of Healthcare and Family Services (or relevant Medicaid agency) for implementation, auditing, and rulemaking; Medicaid beneficiaries indirectly (through potential changes in facility funding and staffing).
- Financially: Per‑facility Medicaid staffing add‑ons may increase or decrease depending on each facility’s reported staffing relative to its computed target; impacts vary by facility.
Procedural / implementation notes
- The provisions apply only if HB 4907 (103rd Gen. Assembly) becomes law — HB 2910 is explicitly conditional.
- Effective dates in the bill are phased: Oct 1, 2024 (initial tie to PDPM STRIVE), Jan 1, 2025, and Jan 1, 2026 (staged target adjustments and numeric factors). Implementation depends on federal data availability and the Department’s rulemaking and data processes.
- The Department must use federal PBJ/Provider Information File and State US Averages, and correct reported data when errors are verified.
Potential impacts / considerations
- Aligns Medicaid staffing add‑on methodology with federal staffing reporting (PBJ), increasing transparency and consistency.
- Facilities with lower reported staffing relative to their STRIVE target could receive lower staffing add‑ons, creating financial pressure to increase staffing or adjust operations. Conversely, some facilities could see higher payments.
- Relies on accuracy and timeliness of federal PBJ data; administrative burden for facilities and the Department to reconcile and correct data.
- Because the bill is conditional on another statute (HB 4907), its enactment and timing hinge on separate legislation.
Note on bill text inclusion
- The packet includes an unrelated Arizona bill text (wage disclosure / Wage Antidiscrimination Act). That Arizona material appears to be included in error and is not part of the Illinois HB 2910 PDPM STRIVE provisions summarized here.
Compiled from official sources — confirm details with the bill’s official record.
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