Provider Notice issued 07/08/09

To:  Nursing Facility Administrator

Date: July 8, 2009

Re:  Request for Number of Medicaid-eligible Nursing Facility Residents Receiving Motorized Wheelchairs

As required by the United States District Court in Jackson v. Maram, No. 04-C-174 (N.D. Ill.), Medicaid-eligible nursing facility residents must be provided with motorized wheelchairs when medically necessary.  Nursing facilities that serve Medicaid-eligible individuals are responsible for ensuring that these residents are properly evaluated, assessed and provided with motorized wheelchairs.                                                                                

To further comply with the above referenced consent decree, the department is required to annually contact Medical Assistance Program enrolled nursing facilities to determine how many Medicaid-eligible residents have received custom or non-custom motorized wheelchairs.  Therefore, the department is again requesting a list of Medicaid-eligible residents for whom a custom motorized wheelchair was applied for through the department, approved and provided to the resident or for whom a non-custom motorized wheelchair was provided by the facility.  You do not need to include residents whose names were submitted as the result of the department’s previous request for resident names.

To assist facilities in complying with the department’s request, complete the attached form with the name and RIN of any resident that received a custom or non-custom motorized wheelchair.  If no residents have received a custom or non-custom motorized wheelchair, check the appropriate box on the form.  An authorized facility representative must sign the form.  In addition to the facility administrator, this could include the director of nursing, rehabilitation nurse or therapy department staff.  This person will also serve as a contact if department staff has questions about the completed form.  

Do not submit:

•  copies of evaluations completed on residents in your facility;
• names of residents who came into the facility with their own motorized wheelchair;
• names of residents paying privately;
• names of residents for whom a motorized wheelchair has been ordered, but not received; or
• names of residents previously submitted on a list to the department during past requests.

The completed form must be returned to the department no less than 15 days from the date of this notice.  You may fax it to 217-524-7114 or mail to:

Department of Healthcare and Family Services

Bureau of Long Term Care
201 South Grand Avenue East
Springfield, IL  62763

If you have any questions, contact the Bureau of Long Term Care at 217-524-7245.

Theresa A. Eagleson, Administrator

Division of Medical Programs

List of Medicaid-Eligible Residents With Custom or Non-Custom Motorized Wheelchairs Form (pdf)