Agencies
Services
Provider Notice issued 08/06/12
Fiscal Year 2013 Long Term Care Provider Assessment
| To: | Long Term Care Providers |
| Date: | August 6, 2014 |
| Re: | Fiscal Year 2013 Long Term Care Provider Assessment |
Pursuant to Public Act 96-1530, long term care providers are to be assessed an amount equal to $6.07 times the number of occupied bed days due and payable each month. An "occupied bed day" is defined as the sum of all beds multiplied by the number of days during the month on which each bed was occupied by a resident, other than a resident for whom Medicare Part A is the primary payer. By law, this assessment cannot be billed or passed on to any resident of a nursing home.
Based on payments made to long term care providers, the department is requiring providers to file the monthly assessment reports and make assessment payments for the reporting periods of October 2011 through March 2012 by September 3, 2012.
Providers will be notified of future reporting and payment requirements once the department analyzes ongoing legislative and budget constraints.
The purpose of this notice is to provide information on the reporting and payment requirements for fiscal year 2013. Please read the enclosed material carefully. The packet should include the following material:
Long Term Care Provider Monthly Assessment Report and Instructions
Six Long Term Care Provider Monthly Assessment Reports (Monthly Assessment Report) for the reporting periods of October 2011 through March 2012 are enclosed. Instructions for completing the report are also enclosed. Additional copies of the report can be found on the Medical Programs Forms Web page.
The Monthly Assessment Report and monthly assessment fee must be postmarked on or before the due date to be considered as received on time.
Failure to pay the monthly assessment on or before the due date will result in the assessment of a 5% penalty. In addition, failure to file the Monthly Assessment Report with payment will result in an additional penalty equal to 25% of the monthly assessment due.
Chart of Important Dates
The chart identifies all the critical due dates for the fiscal year 2013 Long Term Care Provider Assessment Program and should be posted for easy reference.
Please note that this assessment is in addition to the Nursing Home License Fee required under Public Aid Code 305 ILCS 5/5. The due date for the first quarter 2013 fee is September 10, 2012.
If you have any questions regarding the fiscal year 2013 Long Term Care Provider Assessment, please contact the Bureau of Program and Reimbursement Analysis, Assessment Unit, at (217) 524 7110.
Greg Wilson, Chief
Bureau of Program and Reimbursement Analysis
Healthcare and Family Services Long Term Care Provider Monthly Assessment Report Instructions
Who Must File
A long-term care provider, as defined in Public Aid Code 305 ILCS 5/5B-1, is licensed by the Illinois Department of Public Health to operate and maintain a skilled nursing or intermediate long-term care facility or a hospital provider that provides skilled or intermediate long-term care services within the meaning of Title XVIII or XIX of the Social Security Act.
When to File
The Long Term Care Provider Monthly Assessment Report (referred to as the Monthly Assessment Report in this document) must be submitted to the Illinois Department of Healthcare and Family Services (HFS) to report the long term care facility’s occupied beds for each monthly period. Each report should accompany the monthly assessment amount computed on the report.
Completing the Monthly Assessment Report
Facility Information
Please verify that all information is accurate. If the information has changed or is incorrect, please type or write in corrections. The facility's HFS assessment tax identification number should not be changed.
Reporting Period
Mark the appropriate box to indicate if the report is an initial report or corrected report. Fill in the dates for the reporting period for which the occupied bed data is being reported. The reporting period is the preceding third (3) month prior to the month in which the assessment is payable and due.
Example: If the provider assessment report and payment are due for July, the reporting period is April.
Occupied bed days
For reference, a completed Monthly Assessment Report is enclosed and used as an example throughout the instruction
Lines 1 through 4: Report the number of occupied bed days by level of care and reported by primary payment source (i.e., Medicaid, Medicare and other) for the month.
Example: From April 1 through April 30 the number of occupied bed days for skilled nursing facilities (SNF) covered by Medicaid amounted to 400. The occupied bed days covered by Medicare numbered 600 and the days covered by other insurance numbered 300. The number of occupied bed days for the month of April totaled 1,300 days.
From April 1 through April 30 the number of occupied bed days for skilled nursing facilities for pediatrics (SNF/PED) covered by Medicaid amounted to 200.
No occupied bed days were reported as covered by Medicare and the days covered by other insurance amounted to 100. The number of occupied bed days for the month of April totaled 300 days.
Column 5 and Line 5:
Column 5 represents the total number of occupied bed days for each level of care (Rows 1 through 4). Line 5 represents the sum of occupied bed days by payment source (Columns 2 through 4). Column 5, Line 5 represents the total occupied bed days for the month.
Example: The total number of SNF occupied bed days for all payers is 1,300. The total number of SNF/PED occupied bed days for all payers is 300. The sum of all occupied bed days for the month, 1,600, is entered in Column 5, Line 5.
Assessment Calculation
Lines 6 - 10: Once the total number of bed days has been calculated, subtract the total number of Medicare occupied beds on Line 7 from Line 6 in order to find the net occupied beds on Line 8. Multiply Line 8 by $6.07 in order to calculate the total monthly assessment amount due on Line 10. This is the total assessment amount, rounded to the nearest dollar, due by the payment due date
Example: Subtract the 600 Medicare occupied beds on Line 7 from the 1,600 total occupied beds on Line 6 in order to compute the net occupied beds total, 1,000 beds. Multiply 1,000 beds by $6.07, which equals the assessment amount due, $6,070 on Line 10.
Payment information: Indicate if the payment is enclosed with the Monthly Assessment Report and the check number.
Certification statement: Complete the certification statement with a signature by the provider officer or administrator. The assessment report must be signed by the long-term care provider's president, vice-president, secretary, treasurer or its properly authorized agent. The signature verifies by written declaration (and under penalties of perjury) that the signing officer has personally examined the assessment report and that the report is true, correct, and complete. The fact that an individual's name is signed to a report is prima facie evidence that the individual is authorized to sign the report on behalf of the provider.
Submission of Monthly Assessment Report and Payment
The monthly assessment amount due must be submitted with the Monthly Assessment Report on or before the due date to the following address:
Illinois Department of Healthcare and Family Services
Bureau of Fiscal Operations
P.O. Box 19491
Springfield, Illinois 62794-9491
Penalty for Late Filing
Payments and reports postmarked on or before the due date will be considered as received on time. If you fail to file the assessment report on or before the due date, a penalty will be assessed equal to 25% of the assessment due for the month.
Penalty for underpayment of assessment
Failure to pay the full assessment amount on or before the due date will result in an additional penalty equal to 5% of the amount of the assessment not paid on the due date, plus 5% of the portion remaining unpaid on the last day of each month thereafter. The total amount of penalty applied will not exceed 100% of the installment amount not paid on or before the original due date.
Correcting Provider Monthly Assessment Reports
Provider correction(s)
An amended assessment report must be filed within thirty (30) calendar days of the original report due date. The amended report must be accompanied by a letter identifying the changes and the justification for the amended report.
There may be instances that you discover an error after the assessment report has been filed. The error may be in information contained in the report that affects the provider’s assessment liability. If a corrected report is filed, please check the corrected report box on the assessment report. Any additional amounts due to the Department should be enclosed with the corrected report. Any credits may be deducted from the provider’s next monthly installment. Penalties may be applied to the amount underpaid due to a filing error. Corrected reports should be sent to:
Illinois Department of Healthcare and Family Services
Bureau of Program and Reimbursement Analysis
201 South Grand Avenue East
Springfield, Illinois 62763-0001.
Department of Healthcare and Family Services correction(s)
There may be instances when the Department will discover an error in the assessment report that has been filed. For example, there may be an error in arithmetic, entries on the wrong lines, or through an audit the Department may not have received the proper information required to substantiate certain items that enter into the computation of the assessment liability. If there are additional amounts due, the Department will notify the provider. Penalties may be applied to the amount underpaid due to a filing error.
Reconsideration of Adjusted Assessment
If the Department, through an audit conducted by the Department or its agent, changes the assessment liability of a long-term care provider, the long-term care provider may request a review or reconsideration of the adjusted assessment within thirty (30) days of the Department's notification of the change in assessment liability. Requests for reconsideration of the assessment adjustment shall not be considered if such requests are not postmarked on or before the end of the thirty (30) day review period. Penalties may be applied to the amount underpaid due to a filing error.
Maintaining Records
Every long-term provider subject to an assessment must keep records and books that will substantiate any information required on the assessment report. These records must be maintained for a period of not less than three (3) years after the assessment report is filed, and must be available for inspection by duly authorized agents and employees of the Department at all times during business hours of the day.
If You Need Additional Assistance
If you have questions about the assessment report, please call the Bureau of Program and Reimbursement Analysis at (217) 524-7110.