TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 146 SPECIALIZED HEALTH CARE DELIVERY SYSTEMS
SECTION 146.265 RECORDS AND REPORTING REQUIREMENTS
Section 146.265 Records and Reporting Requirements
a) An SLP provider shall develop and maintain confidential written records regarding each resident, which shall include, but are not limited to:
1) The Comprehensive Resident Assessment;
2) The resident contract;
3) The service plan;
4) The quarterly evaluation;
5) Progress notes that shall be used to document decline or improvement in resident status;
6) The resident satisfaction survey;
7) Written documentation of the inquiry to the sex offender databases, including the result of the inquiry; and
8) Documentation of a tuberculosis test administered in accordance with Section 146.220(d).
b) An SLP provider shall develop and maintain confidential written personnel records that shall include, but are not limited to:
1) Job description;
2) Educational preparation and work experience;
3) Current licensure or certification, if applicable;
4) Documentation that employee has received personnel policies and procedures;
5) Documentation of on-going staff training;
6) Documentation of a tuberculosis test administered in accordance with Section 146.235(m); and
7) Results from the health care worker background check conducted in accordance with Section 146.235(l).
c) An SLP provider shall develop and maintain confidential written records regarding each potential resident, which shall include, but are not limited to:
1) Results of the Determination of Need assessment as indicated on the Interagency Certification of Screening (HFS 2536), Screening Verification Form (HFS 3864), or successor form;
2) OBRA-1 Initial Screen;
3) Standardized interview;
4) Specialized mental health evaluation, if indicated;
5) Application for admission to the SLP setting;
6) Documentation that supports the SLP provider's ability to meet the resident's needs.
d) Medication Error Report: The SLP provider shall record, and retain in a facility record, all medication errors identified and reported by staff. Errors shall be recorded on a Department designated form. Any medication error resulting in a hospitalization shall be reported to the resident's physician and to the Department within 24 hours after discovery.
e) Incident Report: Pursuant to Sections 146.295 and 146.305, the SLP shall notify the Department of suspected abuse, neglect or financial exploitation that results in contact with local law enforcement.
f) The SLP provider shall generate and submit to the Department the following reports in a format and medium designated by the Department and with the frequencies as specified:
1) Resident Identification Report, which shall be due monthly. The report shall be in two parts, one for Medicaid-eligible residents and one for private pay residents. Each part shall contain an alphabetical list of residents residing in the SLP setting, including their names, case identification and recipient numbers for Medicaid-eligible residents or Department designated identifying numbers for private pay residents, dates of admission and dates of discharge.
2) Cost Reports, which shall be submitted at any time upon request by the Department or when a significant change occurs in the SLP provider's financial status/solvency, and annually not later than 90 days after the end of the SLP provider's fiscal year. One extension up to 30 days shall be granted for circumstances that will not allow a cost report to be properly completed before the due date of the report. The written extension must be submitted to the Department's Bureau of Long Term Care prior to the original due date. Each enrolled SLP providershall file an annual report with the Department in accordance with the following requirements:
A) All schedules contained in the cost report must be completed with the exception of those schedules specified in the cost report instructions as optional.
B) The cost report is not complete until all required schedules are filed and all inquiries to the provider are satisfactorily resolved.
C) If the cost report is prepared by other than the SLP setting's manager or officer, the certification must be signed by the preparer as well as the officer or manager. The preparer's declaration is based upon all information of which the preparer has any knowledge.
D) All financial data contained in the cost report must be accounted for on the accrual basis of accounting.
E) Copies of all independent audits and reviews performed on the SLP setting by certified public accounting firms shall be provided to the Department with the cost report.
3) Cost Report for Change of Ownership. The new owner or lessee must file a cost report nine months after acquisition (covering the first six months of operation). A change of ownership is dated from the closing of the sale or from the date of the oldest lease agreement between the present incumbents of a lease. The facility must also file a cost report within 90 days after the close of its first complete fiscal year. A change of corporate stock ownership does not constitute a change of ownership.
4) Cost Report for New Facility. A full cost report must be filed within nine months after opening the facility (covering at least the first six months of operation). The facility must also file a cost report within 90 days after the close of its first complete fiscal year.
g) No funds shall be expended by the Department for the maintenance of any resident in an SLP setting that has failed to file an annual cost report.
h) The SLP provider shall retain all records in accordance with provisions of 89 Ill. Adm. Code 140.28. The SLP provider shall provide the Department or its designee with access to financial and other records that pertain to covered services. The SLP provider shall keep fiscal records in accordance with acceptable accounting procedures.
(Source: Amended at 44 Ill. Reg. 2331, effective January 15, 2020)