Provider Notice issued 01/22/15

Facility Closure – Federal and State Requirements

The Specialized Mental Health Rehabilitation Act of 2013 (210 ILCS 49/)  allows Institution for Mental Disease (IMD) facilities currently licensed and Medicaid-certified as nursing homes, to apply for a three-year provisional license as a Specialized Mental Health Rehabilitation Facility (SMHRF).  Each of these facilities must comply with Federal and State facility closure requirements before a provisional SMHRF license will be issued.

It is the intent of the Illinois Department of Public Health (IDPH) and the Department of Healthcare and Family Services (HFS) to provide information that will assist these facilities to understand the current federal and State facility closure requirements. 

A.  Federal Requirements for Facility Closure

A long term care facility’s withdrawal from the Medicaid certification program constitutes “closure” of the facility under the Patient Protection and Affordable Care Act (pdf), even if no residents are being involuntarily transferred or discharged from the facility.

Federal closure requirements are provided at 42 CFR 483.75 (r), as follows:

• The administrator of the facility must submit written notification of an impending closure to the State Survey Agency (IDPH), the State LTC ombudsman, residents of the facility, and the legal representatives of the residents or other responsible parties;

• The written notification must include a plan for the transfer and adequate relocation of the residents of the facility.  The facility’s plan for transfer and relocation of residents must be approved by the State Medicaid Agency (HFS); and

• The written notification must be submitted at least 60 days prior to the projected date of closure. 

It should be noted that an administrator who fails to comply with the facility closure requirements will be subject to a civil money penalty.

B.  State Requirements for Facility Closure

Each of these facilities must also comply with the closure requirements of the Nursing Home Care Act (210 ILCS 45/), as follows:

• The facility must submit a closure plan to IDPH for approval. The plan must address the process for the safe and orderly transfer of residents. The facility must offer to assist any resident to be transferred or discharged in securing an alternative placement and shall advise the resident on available alternatives;

• The administrator of the facility must give notice of the closure to IDPH, to any resident who must be transferred or discharged, to the resident’s representative, and to a member of the resident’s family where practicable.  The notice must state the proposed date of closing and the reason for closing.  The approved closure plan must be included in the notice. The notice must be given at least 60 days prior to the projected date of closure; 

• The facility must comply with all applicable laws and regulations until the date of closure, including those related to transfer or discharge of residents;

• All cases in administrative hearings must be finalized before the facility closes;

• All outstanding fines assessed under the Nursing Home Care Act and still owed by the facility must be paid prior closure; and 

• The facility must surrender its license to IDPH prior to closing.

Failure by the facility to comply with any of the facility closure requirements may result in the denial of a provisional SMHRF license.  

If you have questions, please contact the IDPH Specialized Mental Health Rehabilitation Facilities at 217-782-2716 or the HFS Bureau of Long Term Care at 217-782-0545.

James M. Parker, Acting Administrator

Division of Medical Programs