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  • Central Office no longer prints a hard copy of Form 2449 and sends to the FCRC;
  • Form 2449 is available only in Mobius, identified as report #27364051.

Form 2449 is no longer printed at Central Office and sent to the FCRC.  The form is available in Mobius (report #27364051) and may be accessed and revised to document various situations including, but not limited to:

  • authorization of coinsurance payments if a facility notifies the FCRC that a resident is entitled to Medicare-covered skilled nursing facility (SNF) services;
  • discontinuation of Medicare-covered SNF services;
  • changes in patient credit;
  • adjustments for incorrect payments;
  • transfers between facilities;
  • death or discharge from a facility. 

NOTE: The actions listed above are routinely done in the MMIS LTC subsystem rather than by revising Form 2449 in Mobius. Do not complete Form 2449 for changes updated through the LTC EDI system. 


Form referenced:

  • Form 2449

[signed copy on file]

Michelle R.B. Saddler

Secretary, Illinois Department of Human Services

Julie Hamos

Director, Illinois Department of Healthcare and Family Services