Provider Notice issued 10/21/2025

Supportive Living Program (SLP) Provider Involuntary Discharge Requirements

This notice serves as a reminder for how Supporting Living Program (SLP) providers should manage resident discharges. A SLP provider can only issue an involuntarily discharge (IVD) to a resident if (a) the resident poses an immediate threat to self or others; (b) the resident needs mental health services to prevent harm to self or others; or (c) the SLP cannot meet the resident's needs with available support services per 89 Ill. Adm. Code 146.255.

1. When a Medicaid resident is temporarily discharged to a nursing home, the 30 payable days for temporary absence (bed hold) starts over upon their readmission. The 30 days is a total 30 days for the entire fiscal year (July 1st-June 30th) from any SLP admission. The SLP cannot issue an involuntary discharge (IVD) notice until after the 30th day is used. Refer to 89 Ill. Adm. Code 146.225 (f) for additional details.

2. If the SLP has documentation in place to show they are unable to care for a resident and the physician corroborates, the SLP can give an immediate notice of discharge. Under emergency discharges, the SLP does not have to keep the resident until an appeal is heard (this could take several months).

• If the decision is overturned at the appeal, the SLP would be required to re-admit the resident upon the availability of an apartment.

3. If a SLP resident is admitted to another setting, such as a nursing home, they give up the right to a 30 day involuntary notice. The resident is considered discharged. The SLP will need to make arrangements for the removal of the former resident’s personal possessions.

4. Upon receipt of the notice of the scheduled hearing date for involuntary discharges (IVDs), the SLP shall submit all documents to be presented at the hearing to the Fair Hearings Section at the address or fax number provided.

5. The SLP must provide hospitalized residents with an IVD notice and appeal information when the decision is made to not re-admit, even when the SLP feels they can no longer meet the resident’s needs.

6. A SLP can share resident information with a SNF/hospital/SLP without written permission from the resident if the resident’s acuity/care needs are the reason for the discharge. If a resident is choosing to be discharged on their own, the SLP must obtain written approval from the resident before sharing any information.

7. A SLP cannot discharge a private pay resident, who has converted to Medicaid, due to exceeding their 25% Medicaid occupancy reserve.

When determining if the resident needs a higher level of care (LOC), ensure the following is reviewed and documented:

1. What behavior or medical needs have changed?

a. When did these changes start?

2. What has been done to assist the resident?

a. Was the resident seen by a physician?

i. If so, when? What was the outcome?

3. Does the physician agree with the resident requiring a higher level of care (LOC)? If yes, why?

4. Document why the SLP cannot meet the needs of the resident.

a. Transfer concerns, safety concerns, increased medication needs, behavioral issues, etc.

Questions regarding this notice may be directed to the SLP inbox at HFS.SLF@illinois.gov .

Laura Phelan, Administrator 
Division of Medical Programs