Section 146.265  Records and Reporting Requirements

a)         An SLF 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)         Progress notes that shall be used to document any significant involvement with the resident and results of and changes in the service plan;

5)         The resident satisfaction survey; and

6)         Written documentation of the inquiry to the sex offender databases, including the result of the inquiry.

b)         An SLF 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 of annual performance evaluation;

5)         Documentation that employee has received personnel policies and procedures;

6)         Documentation of on-going staff training;

7)         Documentation of a tuberculosis test administered in accordance with Section 146.235(m); and

8)         Results from the health care worker background check conducted in accordance with Section 146.235(l).

c)         The SLF 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)         Personnel Report, which shall be due upon certification and semi-annually thereafter.  The report shall contain a list of all SLF staff listing the names, titles, salaries, and total hours worked during the semi-annual period.  This listing shall include the services to be performed and services outside of the service package.

2)         Resident Identification Report, which shall be due monthly.  The report shall be in two parts, one for Medicaid residents and one for private pay residents.  Each part shall contain an alphabetical list of residents residing in the SLF, including their names, case identification and recipient numbers for Medicaid residents or Department designated identifying numbers for private pay residents, dates of admission and dates of discharge.

3)         Health Care Related Subcontractors and Manager Report, which shall be due upon certification and as changes occur thereafter.

4)         Cost Reports, which shall be submitted at any time upon request by the Department or when a significant change occurs in the SLF's financial status/solvency, and annually not later than 90 days after the end of the SLF'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 SLF shall 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 facility'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 SLF by certified public accounting firms shall be provided to the Department with the cost report.

5)         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.

6)         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.

d)         No funds shall be expended by the Department for the maintenance of any resident in an SLF that has failed to file an annual cost report.

e)         An SLF shall retain all records in accordance with provisions of 89 Ill. Adm. Code 140.28.  The SLF shall provide the Department or its designee with access to financial and other records that pertain to covered services.  The SLF shall keep fiscal records in accordance with acceptable accounting procedures.

(Source:  Amended at 30 Ill. Reg. 8845, effective May 1, 2006)