Provider Notice issued 11/26/2025

Calendar Year 2026 Long Term Care Provider Assessment

Pursuant to Public Act 102-1035, long term care providers are to be assessed per occupied bed day in an amount varying with the number of paid Medicaid resident days per annum in the facility with the following schedule of occupied bed tax amounts.  This assessment is due and payable each month.  The tax shall follow the schedule below effective July 1, 2022, and be rebased by the Department at the beginning of each calendar year.

Rate Tier based on number of paid Medicaid resident days per annum 4/1/2024-3/31/2025

a.) $10.67 – 0-5,000 paid Medicaid resident days per annum
b.) $19.20 – 5,001-15,000 paid Medicaid resident days per annum
c.) $22.40 – 15,001-35,000 paid Medicaid resident days per annum
d.) $19.20 – 35,001-55,000 paid Medicaid resident days per annum
e.) $13.86 – 55,001-65,000 paid Medicaid resident days per annum
f.) $10.67 – 65,001+ paid Medicaid resident days per annum
g.) $ 7.00 – Any non-profit nursing facilities without Medicaid certified beds or any nursing facility owned and operated by a county government.

The published Rate Tier by facility can be found here.

An "occupied bed day" is defined as the sum of all beds multiplied by the number of days during the month on which each bed was occupied by a resident, other than a resident for whom Medicare Part A is the primary payer. By law, this assessment cannot be billed or passed on to any resident of a nursing home.

As a reminder, for a resident whose care is covered by the Medicare Medicaid Alignment Initiative (MMAI) demonstration, Medicare Part A is considered the primary payer.  Enrollment of residents into MMAI are not expected to increase the tax burden on any nursing facility as these beds are counted as Medicare beds and will not be charged the per day assessment. 

PLEASE NOTE: HFS will offer Medicare Advantage dual eligible special needs plans (D-SNPs) effective January 1, 2026, as the Centers for Medicare & Medicaid Services (CMS) is requiring states with an MMAI program to convert to the D-SNP model.  Therefore, the Illinois Medicare-Medicaid Alignment Initiative (MMAI) program will end December 31, 2025. All current MMAI members will remain in their MMAI plans until December 31, 2025, unless they have acted to disenroll themselves from the MMAI plans. D-SNP bed days will be counted and assessed the same as MMAI bed days with respect to the Provider Assessment Monthly reporting.

The department has established due dates for providers to file monthly assessment reports and make assessment payments for the reporting periods of October 2025 through September 2026 for assessment periods January 2026 through December 2026.  Providers will be notified of any assessment deadline extensions via the website, and are encouraged to sign up for e-mail notifications regarding extensions of future due dates at this link. 

The purpose of this notice is to provide information on the reporting and payment requirements for the 2026 calendar year monthly occupied bed assessments.  Your facility’s provider notice packet has been mailed via USPS Attn: Chief Financial Officer.  Please read the enclosed material carefully.  The packet should include the following material:

1. Long Term Care Provider Monthly Assessment Report and Instructions

Twelve (12) Long Term Care Provider Monthly Assessment Reports (Monthly Assessment Report) for the reporting periods of October 2025 through September 2026 (January-December 2026 assessment periods) are enclosed. Instructions for completing the report are also enclosed. You will be able to access additional copies of the report at this link. 

In addition, the Department has developed the electronic submission for the Monthly Assessment Report which can be accessed through the HFS MEDI website.

A signed copy of the Monthly Assessment Report must be submitted electronically by email or postmarked on or before the due date to be considered as received on time. A copy of the report must accompany the payment and must be postmarked on or before the due date for the payment to be considered as received on time.

Failure to pay the monthly assessment on or before the due date will result in the assessment of a 5% penalty. In addition, failure to file the Monthly Assessment Report will result in an additional penalty equal to 25% of the monthly assessment due.

2. 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 a monthly assessment must be submitted no less than five (5) business days prior to the assessment due date.

3. Chart of Important Dates

The chart identifies all the critical due dates for the calendar year 2026 Long Term Care Provider Assessment Program and should be posted for easy reference.

If you have any questions regarding the calendar year 2026 Long Term Care Provider Assessment, please contact the Bureau of Rate Development and Analysis, Assessment Unit, at (217) 5247110 or via e-mail at HFS.ProviderAssessmentUnit@illinois.gov.

Kathleen Staley, Bureau Chief
Bureau of Rate Development and Analysis

Illinois Department of Healthcare and Family Services

Calendar Year 2026 LTC Occupied Bed
Provider Assessment (Fund 345)
Chart of Important Dates