NOTE: Completion of Form 2299, as described below, is OPTIONAL. All of the following actions may be done by entering new data and revising existing data in the MMIS LTC subsystem.
Use Form 2299 to start payment to a nursing home (NH) or a supportive living facility (SLF). For private facilities, use the form for each customer admitted for whom the facility requests reimbursement. For DHS facilities, use the form to report a customer's admission. This starts payment using a computer tape match between HFS and DHS. Complete Form 2299 only when:
Do not complete Form 2299 for spenddown cases, additions, corrections, or discharges.
Illinois Department of Human ServicesJB Pritzker, Governor · Dulce Quintero, Secretary
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