Long Term Care

Nursing facilities receive a per diem (a single comprehensive payment per day per resident). The per diem is specific to each facility and is the sum of three separately calculated components – nursing, support and capital.

• Nursing Home Rate Calculation Handbook FY2023 (pdf)

Support and capital rates are set based on information provided by facilities through cost reports submitted to the Department. The nursing component is a function of the health care needs of the facility’s residents, as measured by the Minimum Data Set (MDS) completed by each facility. The MDS-based reimbursement methodology goes into effect January 1, 2007.

• MDS Rules 
  

• Medicaid Rate List for Nursing Facilities, County Nursing Facilities, and SMHRF's Effective April 1, 2024 (pdf) (xls)
• CNA Quarterly Notification Memo (pdf)
• Staffing Add-on and Medicaid Utilization Report for January 1, 2024 (xls) (pdf)
• Nursing Facility Estimated Quality Incentive Payments Listing for April 1, 2024 (pdf) (xls)
• Provider Assessment Rates for Calendar Year 2024 (pdf) (xls)
• Nursing Facility Estimated Quality Incentive Payment Listing for January 1, 2024 (pdf) (xls)

• Archived Medicaid Rate Lists

• Interim Review of the 2022 Nursing Home Payment Reform 2023 (pdf)

• Summary of Initial Participation in Illinois' Nursing Facility CNA Pay Scale Subsidy Program: July-September 2022  (pptx)
  
• CNA Pay Scale Enrollment Form for October 1, 2022 (pdf)
  
• Final Provider Assessment Rates for the Quarter Beginning July 1, 2022 (pdf) (xlsx)
• Estimated Provider Assessment Rates for the Quarter Beginning July 1, 2022  (pdf) (xlsx)
• Quality Incentive Payment Listing
• Overview of Illinois' new nursing facility CNA pay-scale subsidy (June 2022) (pdf)
  
• Rate Reform Methodology FAQs (September 30, 2022) (pdf)
  
• LTC Exchange Site Quick Guide (pdf)
  
• CNA Pay Scale Enrollment Form for July 1, 2022 (pdf)
  
• CNA Pay Scale Enrollment Form for August 1, 2022 (pdf)
  

• July 25, 2022 Nursing Facility Reimbursement Overview Webinar Slides 
  
• July 25, 2022 Nursing Faiclity Reimbursement Overview Webinar Recording 
  
• Medicaid Utilization Percent
• PDPM Weights
  
• STRIVE Targets
• Staffing Per Diem Scale
• Staffing Incentive Calculation
  
• Quality Incentive Calculation Chart
• CNA Wage Pass Through Calculation Chart