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Provider Notice Issued 12/23/2021

Date:   December 23, 2021                                                                             

To:      Long Term Care Facilities - Skilled Nursing Facilities (SNF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Specialized Mental Health Rehabilitation Facilities (SMHRF) and Supportive Living Program (SLP) Providers

Re:      Reporting Requirements for Admissions to Long Term Care (LTC) Facilities Effective January 1, 2022

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This Notice is to inform Long Term Care (LTC) providers of the change in reporting requirements regarding a resident's admission to a facility.

LTC providers must continue to electronically submit admissions, discharges, deaths, TPL changes and income changes using the Department's Electronic Data Interchange (EDI) system, Medical Data Interchange (MEDI) or Recipient Eligibility Verification (REV).

Pursuant to Public Act 102-0123 (pdf), effective for new LTC admission requests submitted on and after January 1, 2022, all admissions must be reported within 120 calendar days through the MEDI or REV system vendors as outlined in 89 Ill Adm Code 140.513. The change in the reporting requirement from 45 calendar days to 120 calendar days is not applicable to admission transactions that have been previously submitted and were determined "untimely". 

For an admission transaction to be considered "timely", day one of the 120 calendar day period commences on the later of either:

  • the date the LTC provider receives the required pre-admission screening results (HFS form 2536 "Interagency Certification of Screening Results", HFS form 3864 "Screening Verification", or successor form documenting the level of care screening determination results) from the screening agent; or
  • the admission date entered by the provider. 


Admission transactions submitted "untimely" will be processed using the submittal date in the MEDI or REV system as the assigned admission date. 

If required, supporting documentation for the completed LTC admission transaction shall be submitted through the ABE Partner Portal (preferred) or through the Central Scanning Unit as instructed in the Provider Notice dated 04/29/2021

This notice also serves as a reminder to report changes in the resident's status including, but not limited to, death, discharge, change in patient credit and third party liability (TPL) within the timeframes listed below: 

  • Death of a resident – 15 calendar days
  • Discharge of a resident – 15 calendar days
  • Changes in patient credit – 45 calendar days
  • Third Party Liability (TPL) – 45 calendar days 

All transactions completed through the MEDI or REV systems are assigned a confirmation number also known as the Transaction Audit Number (TAN). This number shall be retained by a facility to verify timely submittal of transactions and for future reference, including audit purposes.

For assistance with the MEDI registration process or making electronic remittance advices available, please submit an inquiry electronically using the "Contact Us" link on the MEDI website or by calling the MEDI Help Desk at 1-800-366-8768. 

Questions regarding this notice may be directed to the Bureau of Long Term Care at 844-528-8444 (toll free).

 

 

Kelly Cunningham, Administrator

Division of Medical Programs   



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Illinois Department of Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director




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