Close up image of a caretaker helping older woman walk

Five Illinois-based nursing home groups are suing the state’s Department of Healthcare and Family Services, claiming low reimbursement rates are jeopardizing their ability to provide adequate resident care.

Generations Health Care Network, Carlyle Healthcare Center, St. Vincent’s Home, Clinton Manor Living Center and Extended Care Clinical operate more than 100 facilities statewide. They filed a lawsuit Friday in the U.S. District Court for the Northern District of Illinois, according to Reuters.

In court filings, the operators said reimbursement rates and methodologies violated federal Medicaid requirements.

The Illinois Department of Healthcare and Family Services and Gov. Bruce Rauner’s (R) office did not immediately return Reuters’ requests for comment.

Low-occupancy and reimbursement for Medicare- and Medicaid-related services are pressuring nursing homes nationally, but experts cited said problems are especially bad in Illinois because low reimbursements are combined with lengthy payment delays.

The state has a $9.1 billion backlog of unpaid bills to vendors and service providers. Some nursing facilities reportedly have waited nine months for Medicaid payments.

Chicago’s CC Care filed for Chapter 11 bankruptcy in October, citing “slow, erratic and low Medicaid payments” as having a “disastrous effect” on its nursing homes, and others.