Provider Notice issued 09/14/16

Psychiatric Residential Treatment Facility (PRTF) Annual Attestations and Serious Occurrence Reporting

The purpose of this notice is to remind enrolled Division of Alcohol and Substance Abuse (DASA) providers who are licensed as a Psychiatric Residential Treatment Facility (PRTF) regarding compliance with federal regulations related to annual attestations of facility compliance and serious occurrence reporting.

Annual Attestation of Facility Compliance

Consistent with 42 CFR 483.374(a), PRTFs are required on an annual basis to attest, in writing, that the facility is in compliance with requirements set forth in 42 CFR Part 483.  42 CFR Part 483 Subpart G provides for condition of participation for the use of restraint or seclusion in PRTFs providing inpatient psychiatric services for individuals under age 21.

Licensed facility directors are responsible for the completion and submittal of form HFS 2734A in each of the following instances: 1) upon initial enrollment with HFS as a Medicaid provider, 2) annually prior to October 1 of each year, and 3) in the event of a change in the facility director. Completed attestations must be mailed to the Illinois Department of Healthcare and Family Services (HFS) at the following address:

Illinois Department of Healthcare and Family Services

Children’s Behavioral Health Unit

201 S. Grand Avenue East

Springfield, IL 62763

Serious Occurrence Reporting

42 CFR Part 483, requires PRTFs  to report resident “serious occurrences” to HFS and the State’s designated Protection and Advocacy System (Equip for Equality) within one business day following a serious occurrence. Serious occurrences that must be reported include a resident’s death, serious injury to a resident and a resident’s suicide attempt.

PRTFs must complete and submit the HFS Unusual Incident Report Form no later than the close of business on the next business day after a serious occurrence. Instructions for completing the Unusual Incident Report Form (pdf). Unusual Incident Report Forms must be submitted to HFS, consistent with Department policy found on the official Unusual Incident Reporting Form and instructions.

Questions regarding this notice may be directed to the Children’s Behavioral Health Unit at HFS.CBH@illinois.gov or by calling 217-557-1000.

Felicia F. Norwood

Director