Provider Notice issued 08/05/14

Fiscal Year 2015 Provider Assessment Program

Under Public Aid Code 305 ILCS 5/5E, nursing home providers are taxed an amount of $1.50 for each licensed skilled and/or intermediate care nursing bed day for the calendar quarter in which the tax is due. A "licensed bed day" is defined as the sum of all nursing beds for the number of days during the calendar quarter on which each bed is covered by a license issued to the provider under the Nursing Home Care Act or the Hospital Licensing Act. By law, this tax cannot be billed or passed on to any resident of a nursing home.

The purpose of this notice is to provide information on the reporting and payment requirements for fiscal year 2015. Please read the enclosed material carefully. The packet should include the following material:

First Quarter Tax Calculation Worksheet

A tax calculation worksheet for the first quarter is enclosed. The licensed bed data used to calculate the first quarter tax reflects the facility's licensed nursing beds, on record with the Department, as of July 1, 2014.

If the total licensed nursing beds, reflected on the tax calculation worksheet, is correct, please return the bottom portion of the tax calculation worksheet, along with the first quarter payment, to the address indicated on the calculation worksheet, on or before September 10, 2014. The tax calculation worksheet and first quarter payment must be postmarked by September 10th to be considered as received on time.

If the number of licensed nursing beds is incorrect, please complete the enclosed “Nursing Home Licensed Bed Change Form.” The “Nursing Home Licensed Bed Change Form”, a copy of the IDPH current bed License form, and the revised first quarter installment must be postmarked by September 10th to be considered as received on time. Failure to pay the first quarter installment by September 10th may result in the assessment of a five percent penalty.

Remittance Cards

Remittance cards are enclosed for the second, third and fourth quarters of fiscal year 2015. Each card has the facility's name, address, tax identification number, due date, and the quarterly tax amount owed. To ensure proper crediting of the facility’s account, please be sure to return the remittance card with the quarterly payments. The quarterly payments should be mailed to the address indicated on the remittance card. To be considered as received on time, payments must be postmarked by the due date.

Delay of Payment Instructions

Please read the delay of payment instructions carefully, as incomplete or late requests will not be considered. Included with the delay of payment instructions, is a cash position statement to use when requesting a delay of payment. A cash position statement must be submitted with each delay of payment request. Delay of payment requests for the first quarter must be submitted no later than August 20th.

Chart of Important Dates

The chart identifies all the critical due dates for the fiscal year 2015 Provider Assessment Program and should be posted for easy reference.

If you have any questions regarding the fiscal year 2015 Provider Assessment Program, please feel free to contact the Bureau of Hospital and Provider Services, Assessment Unit, at (217) 524 7110.

Mashelle Rose, Bureau Chief

Bureau of Hospital and Provider Services

Nursing Home Provider

Fiscal Year 2015 Licensed Bed Assessment Program Due Dates

Notes:

Delay of Payment Requests must include:

1. Letter requesting delay of payment

2. Cash Position Statement (Financial data must be less than sixty days old)

3. Loan or extension of credit denial letter (Must be less than ninety days old)

Requests may be sent via facsimile to the Department of Healthcare and Family Services, Bureau of Hospital and Provider Services at (217) 557-3502.

All Incomplete Or Late Requests Will Be Denied