Provider Notice Issued 07/28/2025

This notice provides updated information to Supportive Living Program (SLP) providers regarding the Quality Metrics Process (QMP).

By informational notice dated January 10, 2025, the Department announced the implementation of the QMP pursuant to Public Act 102-0699. The first round of quality metrics was due on March 15, 2025.  The quality metric monitoring program is made up of three metrics:  

1. Staffing hours per resident. The Department will monitor the staffing quality metric on a quarterly basis by calculating the number of direct care staffing hours provided per resident per day using the provider submitted staffing template.

2. Unplanned hospitalizations. The Department will calculate unplanned hospitalizations by using claims data, totaling unplanned hospitalizations and dividing by 1,000 resident days.

3. Emergency room visits. The Department will calculate emergency room visits by using claims data; totaling emergency room visits and dividing by 1,000 resident days.    

Data is reported using the supplied reporting template and must comply with the specific reporting categories as designated within the template. The designated three weeks of data to be reported will be communicated prior to the reporting template due date and will be pre-populated within the published reporting template given to providers. Each template must be uploaded to the HFS SLP web portal in the original format of Excel with completed data. 

The quarterly deadlines for submitting the reporting template to the Department are outlined in the table below:  

SLP providers will receive an automatic reminder email from the portal 15 days and again 5 days prior to the submission due date. These emails are sent directly to the providers based on the addresses provided in the portal. 

Suspension of Add-on Quality Payment

If the SLP does not comply by the required date, the add-on payment will be suspended for the next quarter. HFS will notify the SLP of the suspension in a letter. 

Reinstatement of Add-on Payment

The quality metric add-on payment will only be reinstated in the following quarter after all previously missed and current QM Reporting Templates and verification documents have been submitted to HFS, deemed compliant, and received by the submission deadline noted in the table above. After reinstatement, add-on payments will only be applied prospectively; no retroactive add-on payments will be made. 

Appealing the Add-on Payment Suspension 

Appeals must be submitted via email to HFS.SLP.QMP.Appeals@illinois.gov. The email subject line should include the SLP name, quarter, and year of the add-on payment suspension that is being appealed (e.g., Heritage Health, Quarter 3, 2025).

Additional Guidance 

• For further guidance, refer to the SLP Quarterly Metrics Reporting Guidance, available on the HFS SLP Web Portal. 

• For QM specific reporting and submission questions, please contact ILSLP@MSLC.com.

• For more information on the reporting portal, please refer to the HFS SLP Web Portal Manual.

• Please refer to the SLP QMP webpage to find Frequently Asked Questions (FAQs).

Note:  The CMS Ensuring Access to Medicaid Services (Access rule) final rule mandates federal quality metrics for home and community based services (HCBS) waivers, including the SLP waiver. This rule will take effect in July 2027. It is important that SLPs develop the habit of submitting the metrics on time before the federal rule and associated mandates take effect.

Questions regarding the SLP QMPL should be directed to the Bureau of Long Term Care via email at HFS.SLF@illinois.gov or toll-free at 1-844-528-8444.                      

Laura Phelan, Administrator
Division of Medical Programs