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Provider Notice issued 12/26/2025
- Facilities participating in the CNA Incentive Program that fail to timely submit Payroll Based Journal (PBJ) data will not be paid the CNA incentive payments for the applicable quarter.
- Facilities participating in the CNA Incentive Program who timely submit PBJ data that is ultimately suppressed by the federal Centers for Medicare and Medicaid Services (CMS), will be paid at 90% of their most recent quarter's CNA incentive payment. An additional 10% reduction will be applied to the resulting payment for each sequentially suppressed quarter (90%, 80%, 70%, etc.). All other quarterly program requirements must still be met to receive the reduced payments on appeal.
- Facilities that fail to timely submit PBJ data utilized in the nurse staffing add-on calculation located at 89 Ill. Adm. Code 147.310(c)(3) will receive a staffing percentage of 0% for the quarter
- Facilities who timely submit nurse staffing PBJ data that is ultimately suppressed on the Provider Information File by federal CMS, will be required to submit information on the reason for suppression (facility error or federal audit). Facilities will receive a staffing percentage equal to their most recent quarter's staffing percentage less 10 percentage points, unless the reason for suppression indicates that the percentage of reported hours was overstated by more than 10%, in which case a higher penalty equal to the overstated percentage is justified. An additional reduction of 10 percentage points will be applied to the resulting staffing percentage for each sequentially suppressed quarter.
Appeals Regarding Missing Payroll Based Journal (PBJ) Data
| Date: | December 24, 2025 |
| To: | Long Term Care (LTC) Facilities - Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Supportive Living Program (SLP), Medically Complex for the Developmentally Disabled Facilities (MC/DD) and Specialized Mental Health Rehabilitation Facilities (SMHRF) |
| Re: | Appeals Regarding Missing Payroll Based Journal (PBJ) Data |
This notice is to inform providers of recent changes made to 89 Ill. Adm. Code 140.830 related to appeals regarding missing Payroll Based Journal (PBJ) data.
Certified Nursing Assistant (CNA) Incentive Payments
Nurse Staffing Add-On Payments
The adopted rule amendment was published by the Secretary of State in the Illinois Register on December 19, 2025 (49 Ill. Reg. 16,017 (Dec. 19 2025)).
Questions regarding this notice should be directed to the Bureau of Long Term Care at 1-844-528-8444.
Laura Phelan, Administrator
Division of Medical Programs