ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY …6000038 ABBOTT HOUSE: 8 8: HIGHLAND PARK $11.47:...

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Page 1 ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES BUREAU OF RATE DEVELOPMENT AND ANALYSIS MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016 Building Facility Rate Capital Support Nursing Total Effective Capital Rate ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date 6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $68.28 $124.20 7/1/2016 6000020 ABBINGTON REHAB NURSING CENTE 7 7 ROSELLE $14.60 $49.47 $85.25 $149.32 7/1/2016 7/1/2014 6000038 ABBOTT HOUSE 8 8 HIGHLAND PARK $11.47 $49.04 $55.09 $115.60 7/1/2014 Eligible for Provisional License as SMHRF 6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $93.04 $162.94 7/1/2016 6007959 ALBANY CARE INC 7 7 EVANSTON $15.70 $33.26 $55.95 $104.91 7/1/2014 Eligible for Provisional License as SMHRF 6000103 ALDEN ALMA NELSON MANOR 1 1 ROCKFORD $14.99 $49.65 $85.33 $149.97 7/1/2016 6014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $108.11 $186.29 7/1/2016 6003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $145.19 $224.44 7/1/2016 6013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $19.32 $55.98 $124.99 $200.29 7/1/2016 6007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $120.46 $190.66 7/1/2016 6016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $107.20 $172.10 7/1/2016 6006886 ALDEN ESTATES OF SKOKIE 7 7 SKOKIE $22.33 $55.98 $84.28 $162.59 7/1/2014 6005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.19 $48.50 $129.42 $192.11 7/1/2016 6009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $97.94 $162.04 7/1/2016 6005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $103.52 $168.36 7/1/2016 6014765 ALDEN NORTH SHORE REHAB AND H 7 7 SKOKIE $21.70 $55.98 $92.99 $170.67 7/1/2016 6014500 ALDEN NORTHMOOR REHAB AND HH 6 6 CHICAGO $22.43 $51.87 $111.24 $185.54 7/1/2016 6014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $101.20 $176.66 7/1/2016 6014922 ALDEN ORLAND PARK REHAB AND H 7 7 ORLAND PARK $18.80 $55.98 $108.26 $183.04 7/1/2016 6007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $12.80 $49.65 $95.40 $157.85 7/1/2016 7/1/2014 6001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $104.66 $174.95 7/1/2016 6012645 ALDEN PRINCETON REHAB AND HCC 6 6 CHICAGO $17.33 $51.00 $86.37 $154.70 7/1/2016 6008304 ALDEN TERRACE OF MCHENRY REHA 8 8 MCHENRY $10.10 $43.65 $102.23 $155.98 7/1/2016 6013353 ALDEN TOWN MANOR REHAB AND HC 7 7 CICERO $20.74 $49.73 $96.64 $167.11 7/1/2016 6000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $102.09 $166.14 7/1/2016 6009856 ALDEN WENTWORTH REHAB AND HC 6 6 CHICAGO $17.55 $44.13 $91.73 $153.41 7/1/2016 6003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $9.14 $38.14 $71.92 $119.20 7/1/2016 6004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $73.59 $112.49 7/1/2016 7/1/2014 6000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $11.97 $45.18 $77.07 $134.22 7/1/2016 7/1/2014 6000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $95.30 $158.28 7/1/2016 6000152 ALTON MEM HOSP HATCH SNF UNIT 11 11 ALTON $5.44 $46.71 $78.51 $130.66 7/1/2014 6002778 ALTON REHAB AND NURSING CENTE 11 11 ALTON $11.52 $43.69 $94.17 $149.38 7/1/2016 7/1/2014 6000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $14.37 $50.93 $129.76 $195.06 7/1/2016 7/1/2015 6001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $14.19 $40.82 $104.98 $159.99 7/1/2016 7/1/2015 6001788 ANNA REHAB AND NURSING CENTER 5 5 ANNA $10.12 $40.67 $82.93 $133.72 7/1/2016 6005730 APERION CARE AMBOY 1 1 AMBOY $11.60 $40.92 $105.96 $158.48 7/1/2016 7/1/2014 6001010 APERION CARE BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $80.14 $139.91 7/1/2016 6001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $95.06 $148.38 7/1/2016 6007207 APERION CARE BURBANK 7 7 BURBANK $18.32 $55.98 $133.00 $207.30 7/1/2016 6008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO HEIGHTS $14.05 $43.24 $91.31 $148.60 7/1/2016

Transcript of ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY …6000038 ABBOTT HOUSE: 8 8: HIGHLAND PARK $11.47:...

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    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $68.28 $124.20 7/1/20166000020 ABBINGTON REHAB NURSING CENTE 7 7 ROSELLE $14.60 $49.47 $85.25 $149.32 7/1/2016 7/1/20146000038 ABBOTT HOUSE 8 8 HIGHLAND PARK $11.47 $49.04 $55.09 $115.60 7/1/2014 Eligible for Provisional License as SMHRF6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $93.04 $162.94 7/1/20166007959 ALBANY CARE INC 7 7 EVANSTON $15.70 $33.26 $55.95 $104.91 7/1/2014 Eligible for Provisional License as SMHRF6000103 ALDEN ALMA NELSON MANOR 1 1 ROCKFORD $14.99 $49.65 $85.33 $149.97 7/1/20166014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $108.11 $186.29 7/1/20166003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $145.19 $224.44 7/1/20166013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $19.32 $55.98 $124.99 $200.29 7/1/20166007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $120.46 $190.66 7/1/20166016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $107.20 $172.10 7/1/20166006886 ALDEN ESTATES OF SKOKIE 7 7 SKOKIE $22.33 $55.98 $84.28 $162.59 7/1/20146005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.19 $48.50 $129.42 $192.11 7/1/20166009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $97.94 $162.04 7/1/20166005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $103.52 $168.36 7/1/20166014765 ALDEN NORTH SHORE REHAB AND H 7 7 SKOKIE $21.70 $55.98 $92.99 $170.67 7/1/20166014500 ALDEN NORTHMOOR REHAB AND HH 6 6 CHICAGO $22.43 $51.87 $111.24 $185.54 7/1/20166014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $101.20 $176.66 7/1/20166014922 ALDEN ORLAND PARK REHAB AND H 7 7 ORLAND PARK $18.80 $55.98 $108.26 $183.04 7/1/20166007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $12.80 $49.65 $95.40 $157.85 7/1/2016 7/1/20146001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $104.66 $174.95 7/1/20166012645 ALDEN PRINCETON REHAB AND HCC 6 6 CHICAGO $17.33 $51.00 $86.37 $154.70 7/1/20166008304 ALDEN TERRACE OF MCHENRY REHA 8 8 MCHENRY $10.10 $43.65 $102.23 $155.98 7/1/20166013353 ALDEN TOWN MANOR REHAB AND HC 7 7 CICERO $20.74 $49.73 $96.64 $167.11 7/1/20166000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $102.09 $166.14 7/1/20166009856 ALDEN WENTWORTH REHAB AND HC 6 6 CHICAGO $17.55 $44.13 $91.73 $153.41 7/1/20166003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $9.14 $38.14 $71.92 $119.20 7/1/20166004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $73.59 $112.49 7/1/2016 7/1/20146000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $11.97 $45.18 $77.07 $134.22 7/1/2016 7/1/20146000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $95.30 $158.28 7/1/20166000152 ALTON MEM HOSP HATCH SNF UNIT 11 11 ALTON $5.44 $46.71 $78.51 $130.66 7/1/20146002778 ALTON REHAB AND NURSING CENTE 11 11 ALTON $11.52 $43.69 $94.17 $149.38 7/1/2016 7/1/20146000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $14.37 $50.93 $129.76 $195.06 7/1/2016 7/1/20156001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $14.19 $40.82 $104.98 $159.99 7/1/2016 7/1/20156001788 ANNA REHAB AND NURSING CENTER 5 5 ANNA $10.12 $40.67 $82.93 $133.72 7/1/20166005730 APERION CARE AMBOY 1 1 AMBOY $11.60 $40.92 $105.96 $158.48 7/1/2016 7/1/20146001010 APERION CARE BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $80.14 $139.91 7/1/20166001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $95.06 $148.38 7/1/20166007207 APERION CARE BURBANK 7 7 BURBANK $18.32 $55.98 $133.00 $207.30 7/1/20166008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO HEIGHTS $14.05 $43.24 $91.31 $148.60 7/1/2016

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    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6006852 APERION CARE COLFAX 4 4 COLFAX $11.16 $50.44 $79.00 $140.60 7/1/20166005508 APERION CARE DECATUR 4 4 DECATUR $12.92 $39.00 $86.52 $138.44 7/1/20166002547 APERION CARE DOLTON 7 7 DOLTON $18.79 $49.25 $123.89 $191.93 7/1/20166005847 APERION CARE ELGIN 8 8 ELGIN $11.47 $54.20 $95.72 $161.39 7/1/20166006845 APERION CARE EVANSTON 7 7 EVANSTON $20.53 $48.47 $118.87 $187.87 7/1/20166015333 APERION CARE FOREST PARK 7 7 FOREST PARK $21.70 $48.88 $119.64 $190.22 7/1/2016 7/1/20156000434 APERION CARE GALESBURG 2 2 GALESBURG $13.09 $40.51 $89.25 $142.85 7/1/2016 7/1/20156007280 APERION CARE HIGHWOOD 8 8 HIGHWOOD $19.52 $44.78 $117.81 $182.11 7/1/20166014617 APERION CARE INTERNATIONAL 6 6 CHICAGO $22.20 $48.75 $110.54 $181.49 7/1/20166008650 APERION CARE JACKSONVILLE 3 3 JACKSONVILLE $13.28 $39.56 $87.75 $140.59 7/1/2016 7/1/20156000095 APERION CARE LITCHFIELD 3 3 LITCHFIELD $9.67 $40.08 $87.27 $137.02 7/1/2016 7/1/20146001077 APERION CARE MIDLOTHIAN 7 7 MIDLOTHIAN $14.70 $45.18 $99.13 $159.01 7/1/20166002646 APERION CARE MOLINE 10 10 EAST MOLINE $12.88 $44.26 $89.42 $146.56 7/1/2016 7/1/20146002059 APERION CARE OAK LAWN 7 7 OAK LAWN $16.48 $50.10 $129.87 $196.45 7/1/20166007520 APERION CARE PLUM GROVE 7 7 PALATINE $20.49 $46.83 $120.50 $187.82 7/1/20166008783 APERION CARE SPRING VALLEY 2 2 SPRING VALLEY $7.72 $48.96 $70.79 $127.47 7/1/20166002661 APERION CARE SPRINGFIELD 3 3 SPRINGFIELD $8.12 $42.00 $81.26 $131.38 7/1/20166004204 APERION CARE ST ELMO 5 5 SAINT ELMO $13.10 $42.14 $97.62 $152.86 7/1/2016 7/1/20156006308 APERION CARE TOLUCA 2 2 TOLUCA $8.57 $48.85 $73.68 $131.10 7/1/20166008312 APERION CARE WILMINGTON 9 9 WILMINGTON $14.50 $44.03 $96.66 $155.19 7/1/2016 7/1/20156000384 APOSTOLIC CHRISTIAN HOME 2 2 ROANOKE $14.69 $50.44 $74.97 $140.10 7/1/20166002885 APOSTOLIC CHRISTIAN HOME 2 2 EUREKA $16.41 $49.92 $76.70 $143.03 7/1/2016 7/1/20156000400 APOSTOLIC CHRISTIAN RESTMOR 2 2 MORTON $16.85 $50.44 $69.46 $136.75 7/1/20166000426 APOSTOLIC CHRISTIAN SKYLINES 2 2 PEORIA $13.82 $49.59 $84.75 $148.16 7/1/20166008155 ARBOUR HEALTH CARE CENTER 6 6 CHICAGO $13.16 $44.39 $76.08 $133.63 7/1/20166009823 ARCOLA HEALTH CARE CENTER 4 4 ARCOLA $9.63 $36.01 $78.10 $123.74 7/1/20166014906 ARIA POST ACUTE CARE 7 7 HILLSIDE $21.46 $49.62 $104.30 $175.38 7/1/20166000517 ARTHUR HOME 4 4 ARTHUR $9.51 $47.66 $63.94 $121.11 7/1/20166016729 ASBURY GARDENS NSG AND REHAB 8 8 NORTH AURORA $19.48 $45.20 $96.27 $160.95 7/1/20166008205 ASPEN REHAB AND HEALTH CARE 10 10 SILVIS $12.20 $50.96 $73.79 $136.95 7/1/2016 7/1/20156016273 ASSISI HCC AT CLARE OAKS 7 7 BARTLETT $18.18 $55.98 $95.96 $170.12 7/1/20166006662 ASTORIA PLACE LIVING & REHAB 6 6 CHICAGO $17.76 $56.24 $111.64 $185.64 7/1/20166003834 ATRIUM HEALTH CARE CENTER LTD 6 6 CHICAGO $13.80 $45.27 $90.11 $149.18 7/1/2016 7/1/20156007181 AUBURN REHAB AND HCC 3 3 AUBURN $8.78 $35.60 $74.45 $118.83 7/1/20166014344 AVANTARA LONG GROVE 8 8 LONG GROVE $17.46 $47.61 $124.74 $189.81 7/1/20166009096 AVANTARA PARK RIDGE 7 7 PARK RIDGE $18.89 $55.98 $115.53 $190.40 7/1/20166003214 AVANTI WELLNESS AND REHAB 7 7 NILES $16.75 $49.29 $110.46 $176.50 7/1/20166011340 AVISTON COUNTRYSIDE MANOR 11 11 AVISTON $13.24 $42.38 $78.39 $134.01 7/1/20166000640 BALLARD RESPIRATORY AND REHAB 7 7 DES PLAINES $17.48 $55.82 $158.67 $231.97 7/1/20166000657 BALMORAL NURSING HOME 6 6 CHICAGO $11.01 $32.49 $72.12 $115.62 7/1/2016

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    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000731 BARRY COMMUNITY CARE 3 3 BARRY $9.06 $40.29 $69.56 $118.91 7/1/20166008171 BATAVIA REHAB HEALTH CARE CTR 8 8 BATAVIA $12.57 $55.98 $84.54 $153.09 7/1/20166000764 BAYSIDE TERRACE 8 8 WAUKEGAN $10.85 $38.53 $54.39 $103.77 7/1/2014 Eligible for Provisional License as SMHRF6000806 BEECHER MANOR NURSG AND RHB C 9 9 BEECHER $19.71 $53.08 $108.64 $181.43 7/1/20166000822 BELHAVEN NURSING REHAB CTR 6 6 CHICAGO $18.25 $55.98 $134.36 $208.59 7/1/2016 7/1/20156000889 BELLA TERRA MORTON GROVE 7 7 MORTON GROVE $19.84 $49.44 $116.92 $186.20 7/1/20166000848 BELMONT NURSING HOME 6 6 CHICAGO $12.65 $49.57 $56.10 $118.32 7/1/2014 Eligible for Provisional License as SMHRF6000855 BEMENT HEALTH CARE CENTER 4 4 BEMENT $11.34 $41.46 $77.20 $130.00 7/1/2016 7/1/20146005391 BENTON REHAB HEALTH CARE CTR 5 5 BENTON $9.26 $43.31 $68.61 $121.18 7/1/2016 7/1/20146010110 BERKELEY NURSING REHAB CENTER 7 7 OAK PARK $18.15 $55.98 $98.64 $172.77 7/1/2016 7/1/20146000863 BETHALTO CARE 11 11 BETHALTO $9.57 $44.50 $80.81 $134.88 7/1/20166014872 BETHANY REHAB AND HCC 1 1 DEKALB $18.85 $51.52 $82.30 $152.67 7/1/2016 7/1/20146006688 BETHESDA HOME AND RETIREMENT 6 6 CHICAGO $13.46 $55.98 $84.99 $154.43 7/1/20166000962 BIG MEADOWS INC 1 1 SAVANNA $13.91 $48.57 $69.74 $132.22 7/1/2016 7/1/20146000988 BIRCHWOOD PLAZA INC 6 6 CHICAGO $12.71 $39.49 $89.70 $141.90 7/1/20166000996 BLOOMINGTON REHAB AND HCC 4 4 BLOOMINGTON $9.66 $50.44 $95.79 $155.89 7/1/20166001069 BOURBONNAIS TERRACE NH 9 9 BOURBONNAIS $10.27 $34.73 $52.94 $97.94 7/1/2014 Eligible for Provisional License as SMHRF6001101 BREESE NURSING HOME 11 11 BREESE $10.21 $41.54 $68.48 $120.23 7/1/20166001119 BRENTWOOD NORTH HC REHAB CTR 8 8 RIVERWOODS $13.90 $55.98 $124.12 $194.00 7/1/20166001127 BRENTWOOD SUB ACUTE HEALTHCA 7 7 BURBANK $19.23 $51.75 $140.23 $211.21 7/1/20166005474 BRIA OF BELLEVILLE 11 11 BELLEVILLE $14.56 $41.92 $96.96 $153.44 7/1/2016 7/1/20156007983 BRIA OF CAHOKIA 11 11 CAHOKIA $10.50 $38.76 $91.44 $140.70 7/1/20166007991 BRIA OF CHICAGO HEIGHTS 7 7 S CHICAGO HTS $17.19 $40.26 $103.27 $160.72 7/1/2016 7/1/20146000954 BRIA OF FOREST EDGE 6 6 CHICAGO $11.79 $36.89 $104.02 $152.70 7/1/20166003503 BRIA OF GENEVA 8 8 GENEVA $11.25 $55.98 $111.15 $178.38 7/1/20166010086 BRIA OF PALOS HILLS 7 7 PALOS HILLS $14.88 $45.78 $109.10 $169.76 7/1/2016 7/1/20146001283 BRIA OF RIVER OAKS 7 7 BURNHAM $16.05 $36.83 $116.69 $169.57 7/1/2016 7/1/20146009930 BRIA OF WESTMONT 7 7 WESTMONT $12.58 $44.26 $111.85 $168.69 7/1/20166001143 BRIAR PLACE 7 7 INDIAN HEAD PRK $13.86 $44.40 $69.01 $127.27 7/1/20166001168 BRIDGEVIEW HEALTH CARE CENTER 7 7 BRIDGEVIEW $15.05 $45.78 $121.86 $182.69 7/1/20166000353 BRIDGEWAY SENIOR LIVING 7 7 BENSENVILLE $16.52 $55.98 $101.93 $174.43 7/1/2016 7/1/20156001176 BRIGHTVIEW HEALTHCARE REHAB 6 6 CHICAGO $14.61 $52.58 $105.27 $172.46 7/1/2016 7/1/20156002018 BRYN MAWR CARE INC 6 6 CHICAGO $15.01 $32.48 $55.85 $103.34 7/1/2014 Eligible for Provisional License as SMHRF6001242 BUCKINGHAM PAVILION INC 6 6 CHICAGO $14.49 $41.32 $79.31 $135.12 7/1/20166001259 BURGESS SQUARE HEALTHCARE CT 7 7 WESTMONT $11.90 $51.15 $88.77 $151.82 7/1/20166001275 BURGIN MANOR 5 5 OLNEY $11.71 $38.61 $82.25 $132.57 7/1/20166001291 BURNSIDE COMMUNITY HEALTH CTR 4 4 MARSHALL $11.67 $46.84 $75.72 $134.23 7/1/20166001317 CAHOKIA NURSING AND REHAB CTR 11 11 CAHOKIA $14.07 $42.39 $90.56 $147.02 7/1/20166014674 CALHOUN NURSING AND REHAB CTR 3 3 HARDIN $14.40 $39.41 $72.72 $126.53 7/1/20166001333 CALIFORNIA GDNS NUR REHAB CTR 6 6 CHICAGO $15.24 $44.14 $77.52 $136.90 7/1/2016 7/1/2015

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    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6008635 CAMBRIDGE NURSING REHAB CENTE 7 7 SKOKIE $16.85 $50.53 $121.21 $188.59 7/1/20166002489 CAPITOL HLTHCARE AND REHAB CTR 3 3 SPRINGFIELD $9.91 $40.88 $87.09 $137.88 7/1/20166009203 CARBONDALE REHABILITATION AND 5 5 CARBONDALE $9.04 $42.88 $82.01 $133.93 7/1/20166001424 CARE CENTER OF ABINGDON 2 2 ABINGDON $12.34 $43.92 $67.72 $123.98 7/1/2016 7/1/20146009336 CARLINVILLE REHAB AND HLTC 3 3 CARLINVILLE $11.97 $43.24 $76.47 $131.68 7/1/20166001473 CARLYLE HEALTHCARE CENTER INC 11 11 CARLYLE $14.18 $44.61 $85.20 $143.99 7/1/2016 7/1/20146016539 CARMI MANOR 5 5 CARMI $8.87 $43.35 $75.09 $127.31 7/1/20166001507 CARRIER MILLS NURSING REHAB CT 5 5 CARRIER MILLS $12.50 $40.09 $81.56 $134.15 7/1/20166000970 CASEY HEALTH CARE CENTER 4 4 CASEY $10.20 $48.94 $72.78 $131.92 7/1/20166010227 CASEYVILLE NRSG AND REHAB CTR 11 11 CASEYVILLE $13.23 $40.07 $82.49 $135.79 7/1/20166002869 CEDAR RIDGE HEALTH REHAB CTR 11 11 LEBANON $12.66 $46.71 $85.79 $145.16 7/1/20166001523 CENTER HOME HISPANIC ELDERLY 6 6 CHICAGO $15.60 $54.41 $118.96 $188.97 7/1/20166001564 CENTRAL BAPTIST VILLAGE 7 7 NORRIDGE $16.29 $55.98 $84.10 $156.37 7/1/20166001580 CENTRAL NURSING HOME 6 6 CHICAGO $9.44 $27.73 $97.28 $134.45 7/1/20166001598 CENTRAL PLAZA 6 6 CHICAGO $13.51 $44.74 $66.60 $124.85 7/1/2014 Eligible for Provisional License as SMHRF 7/1/20146012355 CENTRALIA MANOR 5 5 CENTRALIA $16.97 $41.30 $86.63 $144.90 7/1/20166008601 CHALET LIVING & REHAB 6 6 CHICAGO $15.94 $55.98 $109.78 $181.70 7/1/20166001630 CHAMPAIGN COUNTY NURSING HOM 4 4 URBANA $16.85 $54.84 $72.33 $144.02 7/1/20166001457 CHAMPAIGN URBANA NURSING REHA 4 4 SAVOY $14.96 $50.44 $90.17 $155.57 7/1/20166001358 CHARLESTON REHAB HEALTH CARE 4 4 CHARLESTON $10.19 $42.27 $84.02 $136.48 7/1/2016 7/1/20156010367 CHATEAU NURSING AND REHAB 7 7 WILLOWBROOK $16.27 $51.15 $117.46 $184.88 7/1/2016 7/1/20146008841 CHESTER REHAB AND NURSING CTR 5 5 CHESTER $10.69 $43.38 $60.24 $114.31 7/1/2016 7/1/20146001697 CHICAGO RIDGE NURSING CENTER 7 7 CHICAGO RIDGE $13.89 $36.49 $80.57 $130.95 7/1/20166001739 CHRISTIAN NURSING HOME 3 3 LINCOLN $16.84 $44.38 $83.25 $144.47 7/1/2016 7/1/20156001770 CISNE REHAB AND HEALTH CENTER 5 5 CISNE $7.72 $43.93 $95.98 $147.63 7/1/20166000277 CITADEL CARE CENTER-ELGIN 8 8 ELGIN $16.04 $55.98 $89.22 $161.24 7/1/20166000269 CITADEL CARE CENTER-KANKAKEE 9 9 KANKAKEE $14.72 $48.06 $92.44 $155.22 7/1/20166006563 CITADEL CARE CENTER-WILMETTE 7 7 WILMETTE $18.26 $55.98 $107.84 $182.08 7/1/20166009948 CITY VIEW MULTICARE CENTER LLC 7 7 CICERO $14.84 $39.14 $91.69 $145.67 7/1/20166016554 CLAREMONT HANOVER PARK 7 7 HANOVER PARK $26.15 $55.98 $128.37 $210.50 7/1/20166005144 CLARIDGE HEALTHCARE CENTER 8 8 LAKE BLUFF $10.83 $40.10 $107.99 $158.92 7/1/20166001796 CLARK MANOR CONVALESCENT CTR 6 6 CHICAGO $16.68 $40.10 $107.14 $163.92 7/1/20166001838 CLAYBERG FULTON CO N CTR 2 2 CUBA $10.69 $55.63 $78.54 $144.86 7/1/2016 7/1/20146001846 CLAYTON RESIDENTAL HOME 6 6 CHICAGO $14.12 $42.80 $66.18 $123.10 7/1/2014 Eligible for Provisional License as SMHRF6001887 CLINTON MANOR LIVING CENTER 11 11 NEW BADEN $11.34 $45.93 $72.52 $129.79 7/1/20166004469 COBDEN REHAB AND NRSG CENTER 5 5 COBDEN $9.87 $39.73 $57.85 $107.45 7/1/20166007496 COLLINSVILLE REHAB HEALTH CARE 11 11 COLLINSVILLE $11.15 $38.29 $84.65 $134.09 7/1/20166001945 COLONIAL HLTHCARE AND REHAB C 2 2 PRINCETON $11.17 $46.28 $93.71 $151.16 7/1/20166001952 COLONIAL MANOR 4 4 DANVILLE $16.24 $50.44 $80.68 $147.36 7/1/20166013106 COLUMBIA REHAB AND NURSING CT 11 11 COLUMBIA $16.05 $46.24 $86.21 $148.50 7/1/2016

  • Page 5

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6001994 COLUMBUS MANOR RES CARE HOME 6 6 CHICAGO $9.11 $31.41 $44.46 $84.98 7/1/2014 Eligible for Provisional License as SMHRF6002026 COMMUNITY CARE CENTER 6 6 CHICAGO $11.77 $39.06 $88.90 $139.73 7/1/20166006175 COMMUNITY NRSG AND REHAB CTR 7 7 NAPERVILLE $15.71 $50.90 $112.05 $178.66 7/1/20166016711 CONCORDIA VILLAGE CARE CENTER 3 3 SPRINGFIELD $16.85 $40.28 $71.25 $128.38 7/1/20166002075 CONTINENTAL NURSING REHAB CTR 6 6 CHICAGO $14.90 $50.31 $96.05 $161.26 7/1/2016 7/1/20156003420 CORNERSTONE REHAB AND HC 2 2 PEORIA HEIGHTS $11.84 $50.44 $81.59 $143.87 7/1/20166015200 COULTERVILLE REHAB AND HCC 5 5 COULTERVILLE $18.18 $43.93 $73.37 $135.48 7/1/20166002141 COUNTRY HEALTH INC 4 4 GIFFORD $26.69 $50.44 $74.64 $151.77 7/1/20166002174 COUNTRYSIDE CARE CENTRE 8 8 AURORA $15.60 $46.13 $105.09 $166.82 7/1/2016 7/1/20146002190 COUNTRYSIDE NRSG AND REHAB CT 7 7 DOLTON $16.11 $41.83 $104.97 $162.91 7/1/20166005631 COUNTRYVIEW CARE CTR OF MACO 2 2 MACOMB $9.68 $47.66 $65.19 $122.53 7/1/2016 7/1/20146003008 COURTYARD HEALTHCARE CENTER 7 7 BERWYN $17.93 $50.15 $103.13 $171.21 7/1/2016 7/1/20146001093 COVENANT HEALTH CARE CENTER 7 7 NORTHBROOK $14.88 $55.98 $98.59 $169.45 7/1/20166002208 COVENANT HEALTH CARE CENTER 8 8 BATAVIA $17.23 $55.98 $97.55 $170.76 7/1/20166011373 COVENTRY LIVING CENTER 1 1 STERLING $14.15 $51.52 $81.26 $146.93 7/1/20166002273 CRESTWOOD TERRACE NURSING CT 7 7 CRESTWOOD $13.11 $35.07 $57.03 $105.21 7/1/20166010136 CROSSROADS CARE CTR WOODSTO 8 8 WOODSTOCK $11.80 $48.90 $106.27 $166.97 7/1/20166002299 CRYSTAL PINES REHAB AND HCC 8 8 CRYSTAL LAKE $15.09 $53.62 $93.55 $162.26 7/1/20166002307 CUMBERLAND REHAB HEALTH CARE 4 4 GREENUP $9.41 $44.13 $86.77 $140.31 7/1/20166002364 DANVILLE CARE CENTER LTD 4 4 DANVILLE $10.98 $46.64 $92.76 $150.38 7/1/20166010342 DAYSTAR NURSING AND REHAB CTR 5 5 CAIRO $11.91 $42.46 $79.77 $134.14 7/1/20166007363 DECATUR MANOR HEALTHCARE 4 4 DECATUR $11.85 $33.69 $55.99 $101.53 7/1/2014 Eligible for Provisional License as SMHRF6003081 DECATUR REHAB HEALTH CARE CTR 4 4 DECATUR $10.04 $50.44 $74.51 $134.99 7/1/2016 7/1/20146015630 DEKALB COUNTY REHAB AND NSG 1 1 DEKALB $16.84 $48.93 $84.42 $150.19 7/1/2016 7/1/20146005276 DIXON REHAB AND HCC 1 1 DIXON $10.26 $45.42 $80.50 $136.18 7/1/20166002521 DOBSON PLAZA NURSING & REHAB 7 7 EVANSTON $15.87 $48.15 $106.85 $170.87 7/1/20166002539 DOCTORS NURSING AND REHAB CTR 5 5 SALEM $13.36 $38.22 $107.76 $159.34 7/1/20166002570 DOUGLAS NURSING AND REHAB CTR 4 4 MATTOON $15.09 $44.20 $87.66 $146.95 7/1/20166002612 DUPAGE CONV 7 7 WHEATON $12.98 $66.81 $100.64 $180.43 7/1/20166002943 DUQUOIN NURSING AND REHAB 5 5 DU QUOIN $12.62 $37.19 $90.20 $140.01 7/1/2016 7/1/20156003222 EAST BANK CENTER LLC 1 1 LOVES PARK $5.37 $48.05 $113.77 $167.19 7/1/20166007025 EASTSIDE HEALTH CARE CENTER 3 3 PITTSFIELD $10.49 $43.90 $90.07 $144.46 7/1/20166009237 EASTVIEW TERRACE 4 4 SULLIVAN $10.96 $44.46 $100.14 $155.56 7/1/2016 7/1/20156002679 EDEN VILLAGE 11 11 GLEN CARBON $12.09 $44.73 $68.00 $124.82 7/1/20166002729 EDWARDSVILLE NRSNG REHAB CTR 11 11 EDWARDSVILLE $12.27 $42.28 $91.26 $145.81 7/1/20166009559 EFFINGHAM REHAB HEALTH CARE C 5 5 EFFINGHAM $8.98 $41.70 $71.30 $121.98 7/1/20166002745 EL PASO HEALTH CARE CENTER 2 2 EL PASO $12.05 $45.14 $84.31 $141.50 7/1/20166003248 ELDORADO REHAB AND HEALTHCAR 5 5 ELDORADO $11.85 $30.18 $60.80 $102.83 7/1/20166002810 ELIZABETH NURSING HOME INC 1 1 ELIZABETH $7.07 $44.08 $70.06 $121.21 7/1/20166010144 ELM BROOK HEALTHCARE AND REHA 7 7 ELMHURST $12.90 $50.63 $110.80 $174.33 7/1/2016

  • Page 6

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6002828 ELMHURST EXTENDED CARE CENTE 7 7 ELMHURST $11.94 $54.24 $96.52 $162.70 7/1/20166002836 ELMS NURSING HOME 2 2 MACOMB $10.38 $52.79 $73.67 $136.84 7/1/20166005961 ELMWOOD NURSING AND REHAB CT 11 11 MARYVILLE $13.40 $41.32 $88.23 $142.95 7/1/20166002844 ELMWOOD TERRACE HEALTHCARE C 8 8 AURORA $11.11 $51.77 $102.98 $165.86 7/1/20166002851 ELSTON NURSING AND REHAB CENT 6 6 CHICAGO $14.24 $50.36 $87.87 $152.47 7/1/20166005425 ENFIELD REHAB HEALTH CARE 5 5 ENFIELD $8.70 $43.93 $82.86 $135.49 7/1/2016 7/1/20146004667 ESTATES OF HYDE PARK 6 6 CHICAGO $13.72 $43.56 $94.75 $152.03 7/1/20166002877 EUNICE C SMITH HOME 11 11 ALTON $5.44 $46.71 $71.63 $123.78 7/1/20166002901 EVENGLOW LODGE 4 4 PONTIAC $13.82 $48.31 $76.03 $138.16 7/1/2016 7/1/20156002133 EVERGREEN NURSING AND REHAB C 5 5 EFFINGHAM $10.62 $38.12 $77.06 $125.80 7/1/20166002950 FAIR HAVENS CHRISTIAN HOME 4 4 DECATUR $12.09 $50.22 $84.54 $146.85 7/1/20166002976 FAIR OAKS HEALTH CARE CENTER 8 8 CRYSTAL LAKE $15.55 $55.98 $110.79 $182.32 7/1/20166002984 FAIR OAKS REHAB AND HCC 1 1 SOUTH BELOIT $13.77 $50.75 $93.80 $158.32 7/1/20166003024 FAIRHAVEN CHRISTIAN RET HOME 1 1 ROCKFORD $16.41 $51.52 $78.82 $146.75 7/1/20166001051 FAIRMONT CARE CENTRE 6 6 CHICAGO $16.22 $49.59 $114.30 $180.11 7/1/20166003040 FAIRVIEW HAVEN NURSING HOME 4 4 FAIRBURY $13.93 $50.44 $58.53 $122.90 7/1/20166003099 FAIRVIEW NURSING CENTER 5 5 DUQUOIN $10.58 $36.15 $72.64 $119.37 7/1/2016 7/1/20156003107 FAITH CARE CENTER 11 11 HIGHLAND $16.84 $46.44 $74.31 $137.59 7/1/20166004824 FARMER CITY REHAB AND HC 4 4 FARMER CITY $10.73 $47.43 $93.70 $151.86 7/1/20166003115 FARMINGTON COUNTRY MANOR 2 2 FARMINGTON $12.37 $49.24 $73.67 $135.28 7/1/2016 7/1/20146003123 FAYETTE COUNTY HOSPITAL NH 5 5 VANDALIA $6.15 $43.93 $64.23 $114.31 7/1/20166001614 FIRESIDE HOUSE OF CENTRALIA 5 5 CENTRALIA $10.38 $40.52 $70.72 $121.62 7/1/20166000939 FLANAGAN REHAB HEALTH CARE 4 4 FLANAGAN $10.95 $50.44 $100.13 $161.52 7/1/20166003172 FLORA GARDENS CARE CENTER 5 5 FLORA $10.68 $41.19 $98.72 $150.59 7/1/2016 7/1/20146003156 FLORA REHAB HEALTH CARE CTR 5 5 FLORA $11.82 $43.93 $83.76 $139.51 7/1/2016 7/1/20146003180 FLORENCE NURSING HOME 8 8 MARENGO $12.61 $49.25 $91.64 $153.50 7/1/2016 7/1/20146003198 FONDULAC REHAB HEALTH CARE CT 2 2 EAST PEORIA $12.22 $50.44 $72.48 $135.14 7/1/20166001135 FOREST CITY REHAB AND NRSG CTR 1 1 ROCKFORD $12.58 $35.60 $74.46 $122.64 7/1/20166000483 FOREST VIEW REHAB NURSING CTR 7 7 ITASCA $14.27 $47.27 $119.41 $180.95 7/1/20166000137 FOSTER HEALTH AND REHAB CENTE 6 6 CHICAGO $14.85 $47.14 $110.15 $172.14 7/1/2016 7/1/20146012413 FRANCISCAN VILLAGE 7 7 LEMONT $13.46 $55.98 $87.05 $156.49 7/1/20166003289 FRANKFORT HEALTHCARE REHAB C 5 5 WEST FRANKFORT $8.80 $40.24 $70.00 $119.04 7/1/20166003297 FRANKFORT TERRACE NURSING CTR 9 9 FRANKFORT $10.80 $38.53 $71.68 $121.01 7/1/20166003305 FRANKLIN GROVE LIVING REHAB 1 1 FRANKLIN GROVE $11.11 $46.91 $77.03 $135.05 7/1/20166003321 FREEBURG CARE CENTER INC 11 11 FREEBURG $11.93 $36.01 $82.53 $130.47 7/1/2016 7/1/20156003388 FRIENDSHIP MANOR 10 10 ROCK ISLAND $13.83 $50.35 $65.89 $130.07 7/1/2016 7/1/20146015895 FRIENDSHIP MANOR HEALTH CARE 5 5 NASHVILLE $10.06 $38.41 $78.32 $126.79 7/1/20166005979 FRIENDSHIP SKILLED NSG REHAB 3 3 CARLINVILLE $10.32 $44.49 $83.99 $138.80 7/1/20166003404 FRIENDSHIP VILLAGE 7 7 SCHAUMBURG $16.97 $55.98 $116.68 $189.63 7/1/2016 7/1/20146003438 GALENA STAUSS NURSING HOME 1 1 GALENA $7.78 $51.11 $72.65 $131.54 7/1/2016

  • Page 7

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6009567 GARDENVIEW MANOR 4 4 DANVILLE $11.95 $37.42 $89.92 $139.29 7/1/2016 12/1/20156000467 GENERATIONS AT APPLEWOOD 7 7 MATTESON $16.08 $49.08 $107.78 $172.94 7/1/20166002067 GENERATIONS AT COLUMBUS PARK 6 6 CHICAGO $17.30 $40.15 $77.09 $134.54 7/1/20166008270 GENERATIONS AT ELMWOOD PARK 7 7 ELMWOOD PARK $18.63 $41.81 $135.06 $195.50 7/1/20166006514 GENERATIONS AT NEIGHBORS 1 1 BYRON $12.40 $48.47 $89.47 $150.34 7/1/2016 7/1/20146006837 GENERATIONS AT OAKTON PAVILLIO 7 7 DES PLAINES $16.40 $39.50 $114.00 $169.90 7/1/20166007793 GENERATIONS AT REGENCY 7 7 NILES $21.04 $48.46 $110.02 $179.52 7/1/20166008130 GENERATIONS AT ROCK ISLAND 10 10 ROCK ISLAND $13.59 $40.61 $86.22 $140.42 7/1/2016 7/1/20146006076 GENESIS SENIOR LIVING ALEDO 10 10 ALEDO $12.09 $47.02 $71.15 $130.26 7/1/20166003552 GIBSON COMMUNITY HOSPITAL ANN 4 4 GIBSON CITY $15.97 $50.44 $60.69 $127.10 7/1/20166003578 GILMAN HEALTHCARE CENTER 4 4 GILMAN $13.97 $44.51 $80.33 $138.81 7/1/20166006191 GLEN BRIDGE NURSING AND REHAB 7 7 NILES $17.36 $45.95 $113.55 $176.86 7/1/2016 7/1/20156003586 GLEN OAKS NURSING REHAB CENTE 7 7 NORTHBROOK $14.22 $44.61 $92.32 $151.15 7/1/20166008833 GLEN SAINT ANDREW LIVING COMM 7 7 NILES $8.74 $55.98 $108.17 $172.89 7/1/20166003610 GLEN VIEW TERRACE NURSING CTR 7 7 GLENVIEW $18.90 $53.28 $110.85 $183.03 7/1/20166003594 GLENCREST HLTHCR AND REHAB CT 6 6 CHICAGO $16.29 $49.38 $121.81 $187.48 7/1/2016 7/1/20156006647 GLENLAKE TERRACE NURSING REHA 8 8 WAUKEGAN $11.79 $42.52 $107.61 $161.92 7/1/20166007918 GLENSHIRE NURSING REHAB CENTR 7 7 RICHTON PARK $18.34 $51.25 $124.72 $194.31 7/1/20166003628 GLENWOOD HEALTHCARE AND REHA 7 7 GLENWOOD $16.72 $48.77 $118.76 $184.25 7/1/20166003636 GOLDEN GOOD SHEPHERD HOME 3 3 GOLDEN $10.43 $43.06 $58.18 $111.67 7/1/20166007637 GOOD SAM PROPHETS RIVERVIEW 1 1 PROPHETSTOWN $12.52 $51.52 $75.35 $139.39 7/1/20166003495 GOOD SAM SOC GENESEO VILLAGE 10 10 GENESEO $14.24 $48.44 $62.27 $124.95 7/1/20166001515 GOOD SAM SOCIETY MT CARROLL 1 1 MT CARROLL $14.24 $48.25 $77.90 $140.39 7/1/20166003677 GOOD SAMARITAN FLANAGAN 4 4 FLANAGAN $12.09 $50.44 $77.11 $139.64 7/1/20166003685 GOOD SAMARITAN HOME OF QUINCY 3 3 QUINCY $16.84 $44.49 $71.29 $132.62 7/1/20166005573 GOOD SAMARITAN PONTIAC 4 4 PONTIAC $10.80 $49.55 $69.04 $129.39 7/1/20166003727 GOTTLIEB MEMORIAL HOSPITAL 7 7 MELROSE PARK $7.85 $55.98 $99.40 $163.23 7/1/20166060524 GRAHAM HOSP EXT CARE FACILITY 2 2 CANTON $8.22 $50.44 $83.13 $141.79 7/1/20166001986 GRANITE NURSING AND REHAB CTR 11 11 GRANITE CITY $17.95 $38.49 $81.16 $137.60 7/1/20166003776 GRASMERE PLACE 6 6 CHICAGO $12.38 $37.00 $53.51 $102.89 7/1/2014 Eligible for Provisional License as SMHRF 7/1/20146015499 GREEK AMERICAN REHAB CARE CTR 7 7 WHEELING $17.26 $53.43 $115.99 $186.68 7/1/20166016570 GREENFIELDS OF GENEVA 8 8 GENEVA $18.18 $55.98 $142.45 $216.61 7/1/20166000202 GREENWOOD CARE 7 7 EVANSTON $15.65 $39.53 $55.16 $110.34 7/1/2014 Eligible for Provisional License as SMHRF6003511 GROSSE POINTE MANOR 7 7 NILES $19.37 $51.62 $106.39 $177.38 7/1/20166000574 GROVE OF FOX VALLEY 8 8 AURORA $15.74 $44.74 $109.82 $170.30 7/1/20166003933 HALLMARK HOUSE NURSING CENTE 2 2 PEKIN $13.16 $49.37 $75.87 $138.40 7/1/20166003974 HAMILTON MEM REHAB AND HCC 5 5 MCLEANSBORO $13.26 $43.93 $70.64 $127.83 7/1/20166004006 HAMMOND HENRY DISTRICT HOSPIT 10 10 GENESEO $16.84 $53.08 $79.06 $148.98 7/1/20166004048 HARBOR CREST HOME INC 1 1 FULTON $5.80 $47.43 $59.28 $112.51 7/1/20166013684 HARMONY NURSING AND REHAB CTR 6 6 CHICAGO $20.50 $51.74 $118.83 $191.07 7/1/2016

  • Page 8

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6004089 HAVANA HEALTH CARE CENTER 3 3 HAVANA $12.00 $41.19 $78.25 $131.44 7/1/20166015317 HAWTHORNE INN OF DANVILLE 4 4 DANVILLE $15.75 $41.96 $78.24 $135.95 7/1/20166009310 HEARTHSTONE MANOR 8 8 WOODSTOCK $14.54 $55.98 $62.32 $132.84 7/1/2016 7/1/20146013437 HEARTLAND CHRISTIAN VILLAGE 4 4 NEOGA $14.24 $46.85 $75.17 $136.26 7/1/20166004121 HEARTLAND MANOR INC 4 4 CASEY $10.83 $49.76 $56.41 $117.00 7/1/20166011597 HEARTLAND OF CANTON 2 2 CANTON $14.56 $49.02 $85.39 $148.97 7/1/20166000301 HEARTLAND OF CHAMPAIGN 4 4 CHAMPAIGN $11.11 $50.44 $77.54 $139.09 7/1/20166000285 HEARTLAND OF DECATUR 4 4 DECATUR $15.59 $47.67 $82.97 $146.23 7/1/20166003446 HEARTLAND OF GALESBURG 2 2 GALESBURG $17.02 $50.44 $68.52 $135.98 7/1/20166011613 HEARTLAND OF HENRY 2 2 HENRY $14.85 $48.47 $70.87 $134.19 7/1/20166005649 HEARTLAND OF MACOMB 2 2 MACOMB $15.73 $50.44 $76.24 $142.41 7/1/20166006233 HEARTLAND OF MOLINE 10 10 MOLINE $14.50 $48.19 $91.09 $153.78 7/1/20166000244 HEARTLAND OF NORMAL 4 4 NORMAL $14.04 $50.44 $63.98 $128.46 7/1/20166011571 HEARTLAND OF PAXTON 4 4 PAXTON $16.13 $49.50 $80.12 $145.75 7/1/20166000293 HEARTLAND OF PEORIA 2 2 PEORIA $14.35 $49.03 $75.85 $139.23 7/1/20166008056 HEARTLAND OF RIVERVIEW 2 2 EAST PEORIA $16.76 $50.44 $95.21 $162.41 7/1/20166004139 HEATHER HEALTH CARE CENTER 7 7 HARVEY $18.28 $49.69 $81.54 $149.51 7/1/2016 7/1/20146000814 HEDDINGTON OAKS 2 2 WEST PEORIA $16.84 $50.22 $67.25 $134.31 7/1/2016 9/25/20136004147 HEIGHTS HLTHCARE AND REHAB CT 2 2 PEORIA HEIGHTS $12.45 $48.20 $81.75 $142.40 7/1/2016 7/1/20156006704 HELIA HEALTHCARE OF BELLEVILLE 11 11 BELLEVILLE $9.81 $46.71 $109.83 $166.35 7/1/20166016091 HELIA HEALTHCARE OF BENTON 5 5 BENTON $3.66 $43.93 $67.97 $115.56 7/1/20166003800 HELIA HEALTHCARE OF CHAMPAIGN 4 4 CHAMPAIGN $9.27 $44.00 $61.77 $115.04 7/1/20166005870 HELIA HEALTHCARE OF ENERGY 5 5 ENERGY $7.78 $36.52 $65.97 $110.27 7/1/20166004493 HELIA HEALTHCARE OF GREENVILLE 5 11 GREENVILLE $5.08 $44.33 $69.15 $118.56 7/1/20166006910 HELIA HEALTHCARE OF OLNEY 5 5 OLNEY $9.36 $26.23 $68.93 $104.52 7/1/20166003255 HELIA SOUTHBELT HEALTHCARE 11 11 BELLEVILLE $11.59 $43.65 $82.79 $138.03 7/1/20166012066 HENDERSON CO RETIREMENT CENT 2 2 STRONGHURST $12.85 $45.59 $73.17 $131.61 7/1/20166003917 HENRY AND JANE VONDERLIETH CTR 3 3 MT PULASKI $11.67 $44.49 $79.95 $136.11 7/1/20166000756 HERITAGE HEALTH 3 3 JACKSONVILLE $13.79 $44.49 $86.56 $144.84 7/1/20166000780 HERITAGE HEALTH BEARDSTOWN 3 3 BEARDSTOWN $11.88 $44.49 $78.30 $134.67 7/1/20166004261 HERITAGE HEALTH BLOOMINGTON 4 4 BLOOMINGTON $18.46 $50.44 $91.71 $160.61 7/1/20166000723 HERITAGE HEALTH CARLINVILLE 3 3 CARLINVILLE $12.89 $43.01 $83.66 $139.56 7/1/20166007199 HERITAGE HEALTH CHILLICOTHE 2 2 CHILLICOTHE $13.90 $50.41 $88.63 $152.94 7/1/2016 7/1/20146002083 HERITAGE HEALTH DWIGHT 4 4 DWIGHT $15.32 $50.32 $88.65 $154.29 7/1/20166005920 HERITAGE HEALTH EL PASO 2 2 EL PASO $16.72 $50.44 $89.65 $156.81 7/1/20166006902 HERITAGE HEALTH ELGIN 8 8 ELGIN $14.27 $55.33 $116.85 $186.45 7/1/2016 7/1/20146003560 HERITAGE HEALTH GIBSON CITY 4 4 GIBSON CITY $13.82 $50.40 $68.59 $132.81 7/1/2016 7/1/20156000681 HERITAGE HEALTH GILLESPIE 3 3 GILLESPIE $12.41 $43.33 $81.06 $136.80 7/1/20166004592 HERITAGE HEALTH HOOPESTON 4 4 HOOPESTON $17.99 $47.75 $75.27 $141.01 7/1/20166000699 HERITAGE HEALTH LITCHFIELD 3 3 LITCHFIELD $13.64 $44.41 $84.10 $142.15 7/1/2016

  • Page 9

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6004253 HERITAGE HEALTH MENDOTA 2 2 MENDOTA $11.94 $50.01 $94.47 $156.42 7/1/20166005367 HERITAGE HEALTH MINONK 2 2 MINONK $15.84 $50.44 $96.30 $162.58 7/1/2016 7/1/20156010128 HERITAGE HEALTH MOUNT ZION 4 4 MOUNT ZION $16.56 $49.83 $80.41 $146.80 7/1/20166004287 HERITAGE HEALTH MT STERLING 3 3 MOUNT STERLING $13.68 $44.49 $78.34 $136.51 7/1/2016 7/1/20156008510 HERITAGE HEALTH NORMAL 4 4 NORMAL $16.29 $49.94 $82.79 $149.02 7/1/20166000707 HERITAGE HEALTH PANA 3 3 PANA $13.23 $41.85 $95.39 $150.47 7/1/20166004303 HERITAGE HEALTH PERU 2 2 PERU $15.13 $48.38 $84.16 $147.67 7/1/20166002125 HERITAGE HEALTH ROBINSON 5 5 ROBINSON $13.41 $43.93 $70.49 $127.83 7/1/20166004279 HERITAGE HEALTH SPRINGFIELD 3 3 SPRINGFIELD $15.52 $44.49 $91.91 $151.92 7/1/2016 7/1/20156000715 HERITAGE HEALTH STAUNTON 3 3 STAUNTON $12.01 $44.49 $73.72 $130.22 7/1/2016 7/1/20146004311 HERITAGE HEALTH STREATOR 2 2 STREATOR $16.57 $49.16 $89.53 $155.26 7/1/2016 7/1/20156004337 HERITAGE SQUARE 1 1 DIXON $9.07 $50.53 $91.59 $151.19 7/1/20166003362 HERRIN REHAB AND NRSG CENTER 5 5 HERRIN $9.00 $37.53 $82.10 $128.63 7/1/2016 7/1/20156004352 HICKORY NURSING PAVILION INC 7 7 HICKORY HILLS $15.52 $49.25 $78.72 $143.49 7/1/20166016687 HICKORY POINT CHRISTIAN VILL 4 4 FORSYTH $16.85 $46.11 $91.02 $153.98 7/1/20166001663 HIGHLAND HEALTH CARE CENTER 11 11 HIGHLAND $9.69 $46.52 $86.80 $143.01 7/1/20166000392 HIGHLAND OAKS 8 8 ELGIN $14.39 $55.98 $82.18 $152.55 7/1/20166004402 HILLCREST HOME 10 10 GENESEO $14.69 $46.04 $68.80 $129.53 7/1/20166004410 HILLCREST RETIREMENT VILG LTD 8 8 ROUND LAKE $12.53 $46.74 $100.27 $159.54 7/1/2016 7/1/20146004428 HILLSBORO REHAB AND HLTC 3 3 HILLSBORO $11.14 $42.63 $77.08 $130.85 7/1/20166004451 HILLSIDE REHAB AND CARE CENTER 9 9 YORKVILLE $6.68 $47.72 $89.03 $143.43 7/1/20166004477 HILLTOP SKILLED NURSING REHAB 4 4 CHARLESTON $11.49 $35.29 $92.44 $139.22 7/1/20166004485 HILLVIEW HEALTH CARE CENTER 5 5 VIENNA $8.72 $37.65 $61.95 $108.32 7/1/20166004501 HITZ MEMORIAL HOME 11 11 ALHAMBRA $11.23 $46.71 $76.02 $133.96 7/1/20166004550 HOLY FAMILY VILLA 7 7 PALOS PARK $18.18 $55.98 $74.56 $148.72 7/1/20166006761 HOPE CREEK CARE CENTER 10 10 EAST MOLINE $16.85 $50.35 $70.56 $137.76 7/1/20166004212 ILLINI HERITAGE REHAB AND HC 4 4 CHAMPAIGN $9.69 $41.99 $96.64 $148.32 7/1/20166013023 ILLINI RESTORATIVE CARE 10 10 SILVIS $15.55 $51.52 $70.21 $137.28 7/1/20166004675 ILLINOIS KNIGHTS TEMPLAR HOME 4 4 PAXTON $11.67 $50.44 $73.56 $135.67 7/1/20166012579 IMBODEN CREEK LIVING CENTER 4 4 DECATUR $15.52 $50.44 $63.29 $129.25 7/1/20166001028 INTEGRITY HC OF GODFREY 11 11 GODFREY $12.12 $46.71 $116.87 $175.70 7/1/20166007116 INTEGRITY HC OF SMITHTON 11 11 SMITHTON $10.57 $46.71 $57.47 $114.75 7/1/20166009534 INTEGRITY HC OF WOOD RIVER 11 11 WOOD RIVER $14.15 $46.71 $81.24 $142.10 7/1/2016 7/1/20146004790 IROQUOIS RESIDENT HOME 4 4 WATSEKA $11.67 $50.44 $67.42 $129.53 7/1/20166004832 JACKSON SQUARE SKILLED NURSING 6 6 CHICAGO $16.82 $48.78 $101.25 $166.85 7/1/2016 7/1/20146004840 JACKSONVILLE SKILLED NRSG REH 3 3 JACKSONVILLE $11.62 $38.22 $95.84 $145.68 7/1/2016 7/1/20156004899 JENNINGS TERRACE 8 8 AURORA $9.69 $45.20 $71.55 $126.44 7/1/20166013312 JERSEYVILLE MANOR 3 3 JERSEYVILLE $16.12 $40.75 $84.74 $141.61 7/1/20166004907 JERSEYVILLE NSG AND REHAB CTR 3 3 JERSEYVILLE $16.22 $43.79 $86.37 $146.38 7/1/20166004964 JOLIET TERRACE NURSING CTR 9 9 JOLIET $10.57 $37.90 $56.78 $105.25 7/1/2016

  • Page 10

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6005433 JONESBORO REHAB HEALTH CARE 5 5 JONESBORO $9.58 $43.92 $87.59 $141.09 7/1/20166004972 KANKAKEE TERRACE NURSING CTR 9 9 BOURBONNAIS $12.04 $38.02 $57.85 $107.91 7/1/2014 Eligible for Provisional License as SMHRF6006126 KENSINGTON PLACE NRSG REHAB 6 6 CHICAGO $14.06 $45.30 $105.18 $164.54 7/1/20166005011 KEWANEE CARE HOME 10 10 KEWANEE $12.85 $44.88 $88.04 $145.77 7/1/20166005060 KNOX COUNTY NURSING HOME 2 2 KNOXVILLE $14.24 $51.77 $68.62 $134.63 7/1/20166005128 LAHARPE DAVIER HEALTH CARE 3 3 LA HARPE $9.69 $44.23 $81.40 $135.32 7/1/20166009807 LAKE PARK CENTER 8 8 WAUKEGAN $9.38 $32.88 $56.94 $99.20 7/1/2014 Eligible for Provisional License as SMHRF6005177 LAKE SHORE HEALTHCARE REHAB 6 6 CHICAGO $14.60 $49.20 $115.25 $179.05 7/1/2016 7/1/20146005169 LAKEFRONT NURSING & REHAB CEN 6 6 CHICAGO $13.50 $47.53 $88.67 $149.70 7/1/20166005185 LAKELAND REHAB AND HCC 5 5 EFFINGHAM $11.81 $42.62 $76.14 $130.57 7/1/20166005227 LAKEVIEW REHAB NURSING CENTER 6 6 CHICAGO $13.51 $54.89 $123.49 $191.89 7/1/20166005235 LAKEWOOD NURSING AND REHAB CT 9 9 PLAINFIELD $18.85 $49.99 $116.46 $185.30 7/1/20166005250 LASALLE COUNTY NURSING HOME 2 2 OTTAWA $13.40 $54.60 $76.16 $144.16 7/1/2016 7/1/20156001044 LEBANON CARE CENTER 11 11 LEBANON $11.01 $37.58 $83.99 $132.58 7/1/20166005284 LEE MANOR NURSING HM 7 7 DES PLAINES $16.88 $44.33 $118.21 $179.42 7/1/20166014492 LEMONT NURSING AND REHAB CTR 7 7 LEMONT $21.17 $50.59 $115.91 $187.67 7/1/20166005292 LENA LIVING CENTER 1 1 LENA $9.76 $47.56 $72.06 $129.38 7/1/2016 7/1/20146012157 LEROY MANOR 4 4 LEROY $15.43 $45.75 $76.65 $137.83 7/1/20166005300 LEWIS MEMORIAL 3 3 SPRINGFIELD $16.84 $44.49 $83.18 $144.51 7/1/2016 7/1/20156011993 LEXINGTON HEALTH CARE CENTER O 7 7 BLOOMINGDALE $18.25 $51.26 $109.96 $179.47 7/1/20166005318 LEXINGTON HEALTH CARE CTR INC 7 7 LOMBARD $15.73 $49.10 $112.89 $177.72 7/1/20166012967 LEXINGTON HEALTH CARE OF CHICA 7 7 CHICAGO RIDGE $21.14 $48.71 $109.12 $178.97 7/1/20166013098 LEXINGTON OF ELMHURST 7 7 ELMHURST $17.03 $51.93 $119.17 $188.13 7/1/20166013361 LEXINGTON OF LAGRANGE 7 7 LA GRANGE $23.21 $53.46 $120.90 $197.57 7/1/20166014138 LEXINGTON OF LAKE ZURICH 8 8 LAKE ZURICH $17.94 $50.32 $102.30 $170.56 7/1/20166014682 LEXINGTON OF ORLAND PARK 7 7 ORLAND PARK $21.06 $47.43 $114.16 $182.65 7/1/20166012553 LEXINGTON OF SCHAUMBURG 7 7 SCHAUMBURG $21.18 $49.62 $103.56 $174.36 7/1/20166012975 LEXINGTON OF STREAMWOOD 7 7 STREAMWOOD $21.20 $50.66 $108.53 $180.39 7/1/20166014369 LEXINGTON OF WHEELING 7 7 OTHER $20.99 $50.62 $107.49 $179.10 7/1/20166005359 LIBERTYVILLE MANOR EXT CARE 8 8 LIBERTYVILLE $12.08 $55.55 $58.92 $126.55 7/1/20166005375 LIEBERMAN CENTER FOR HEALTH 7 7 SKOKIE $14.88 $56.24 $100.44 $171.56 7/1/2016 7/1/20146005563 LITTLE SISTERS OF THE POOR 6 6 CHICAGO $10.11 $55.98 $75.49 $141.58 7/1/20166005599 LUTHERAN CARE CTR 5 5 ALTAMONT $12.16 $43.93 $68.24 $124.33 7/1/20166005607 LUTHERAN HOME FOR THE AGED 7 7 ARLINGTON HGTS $18.18 $55.98 $82.06 $156.22 7/1/2016 7/1/20146005615 LUTHERAN HOME INC 2 2 PEORIA $12.52 $50.44 $61.01 $123.97 7/1/20166005623 LYDIA HEALTHCARE 7 7 ROBBINS $15.40 $38.27 $57.09 $110.76 7/1/2014 Eligible for Provisional License as SMHRF6016885 MANOR COURT OF CARBONDALE 5 5 CARBONDALE $16.84 $38.89 $81.37 $137.10 7/1/20166015879 MANOR COURT OF CLINTON 4 4 CLINTON $17.98 $46.11 $86.99 $151.08 7/1/20166016133 MANOR COURT OF FREEPORT 1 1 FREEPORT $17.96 $51.52 $71.21 $140.69 7/1/20166013189 MANOR COURT OF MARYVILLE 11 11 MARYVILLE $13.47 $44.96 $82.98 $141.41 7/1/2016

  • Page 11

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6016190 MANOR COURT OF PEORIA 2 2 PEORIA $20.79 $46.11 $80.54 $147.44 7/1/20166015887 MANOR COURT OF PERU 2 2 PERU $17.87 $46.11 $75.96 $139.94 7/1/20166015861 MANOR COURT OF PRINCETON 2 2 PRINCTON $17.87 $46.11 $75.48 $139.46 7/1/2016 7/1/20146000228 MANORCARE OF ARLINGTON HEIGHT 7 7 ARLINGTON HEIGH $18.32 $55.98 $105.09 $179.39 7/1/20166012686 MANORCARE OF ELK GROVE VILLAG 7 7 ELK GROVE VLG $21.58 $53.57 $100.55 $175.70 7/1/20166006332 MANORCARE OF HINSDALE 7 7 HINSDALE $11.08 $55.98 $96.99 $164.05 7/1/20166012611 MANORCARE OF HOMEWOOD 7 7 HOMEWOOD $21.11 $53.81 $110.52 $185.44 7/1/20166010482 MANORCARE OF LIBERTYVILLE 8 8 LIBERTYVILLE $16.43 $55.40 $109.56 $181.39 7/1/20166000251 MANORCARE OF NAPERVILLE 7 7 NAPERVILLE $14.95 $55.98 $111.13 $182.06 7/1/20166015168 MANORCARE OF NORTHBROOK 7 7 NORTHBROOK $21.70 $53.30 $101.24 $176.24 7/1/20166000236 MANORCARE OF OAK LAWN EAST 7 7 OAK LAWN $19.76 $54.32 $113.92 $188.00 7/1/20166000343 MANORCARE OF OAK LAWN WEST 7 7 OAK LAWN $17.75 $55.08 $104.60 $177.43 7/1/20166010912 MANORCARE OF PALOS HTS EAST 7 7 PALOS HEIGHTS $21.54 $53.48 $99.85 $174.87 7/1/20166014534 MANORCARE OF PALOS HTS WEST 7 7 PALOS HEIGHTS $23.37 $55.98 $105.21 $184.56 7/1/20166000327 MANORCARE OF ROLLING MEADOWS 7 7 ROLLING MEADOWS $19.67 $52.27 $93.74 $165.68 7/1/20166011589 MANORCARE OF SOUTH HOLLAND 7 7 SOUTH HOLLAND $21.20 $54.26 $111.70 $187.16 7/1/20166000335 MANORCARE OF WESTMONT 7 7 WESTMONT $17.31 $55.98 $102.21 $175.50 7/1/20166005706 MAPLE CREST CARE CENTRE 1 1 BELVIDERE $13.70 $46.96 $101.82 $162.48 7/1/2016 7/1/20146005722 MAPLE LAWN HEALTH CENTER 2 2 EUREKA $12.09 $50.44 $61.30 $123.83 7/1/20166005748 MAR KA NURSING HOME 11 11 MASCOUTAH $10.11 $43.42 $78.90 $132.43 7/1/20166005755 MARGARET MANOR 6 6 CHICAGO $13.00 $49.03 $45.45 $107.48 7/1/2015 Eligible for Provisional License as SMHRF 7/1/20156005763 MARGARET MANOR NORTH 6 6 CHICAGO $11.51 $42.94 $54.24 $108.69 7/1/2015 Eligible for Provisional License as SMHRF 7/1/20156005797 MARIGOLD REHABILITATION HCC 2 2 GALESBURG $11.91 $46.74 $71.71 $130.36 7/1/20166003230 MARION REHAB AND NRSG CENTER 5 5 MARION $15.03 $41.60 $77.96 $134.59 7/1/20166011688 MASON CITY AREA NURSING HOME 3 3 MASON CITY $12.52 $44.49 $78.86 $135.87 7/1/20166004691 MASON POINT 4 4 SULLIVAN $9.37 $50.44 $79.43 $139.24 7/1/20166005888 MATTOON REHAB AND HCC 4 4 MATTOON $10.99 $48.76 $75.37 $135.12 7/1/20166005896 MAYFIELD CARE CENTER INC 6 6 CHICAGO $12.93 $49.50 $122.02 $184.45 7/1/2016 7/1/20156005938 MCKINLEY COURT 4 4 DECATUR $14.32 $47.72 $94.15 $156.19 7/1/2016 7/1/20146005946 MCLEAN COUNTY NURSING HOME 4 4 NORMAL $9.51 $54.49 $65.50 $129.50 7/1/20166005417 MCLEANSBORO REHAB HEALTH CAR 5 5 MCLEANSBORO $9.24 $43.93 $88.12 $141.29 7/1/20166005953 MEADOW MANOR SKILLED NRSG RE 3 3 TAYLORVILLE $10.26 $39.30 $85.58 $135.14 7/1/20166013120 MEADOWBROOK MANOR 9 9 BOLINGBROOK $17.07 $46.15 $119.63 $182.85 7/1/20166014518 MEADOWBROOK MANOR NAPERVILL 7 7 NAPERVILLE $18.61 $48.91 $109.93 $177.45 7/1/20166016281 MEADOWBROOK MANOR OF LAGRAN 7 7 LA GRANGE $16.22 $44.69 $119.34 $180.25 7/1/20166005987 MEADOWOOD 5 5 GRAYVILLE $9.03 $28.31 $64.69 $102.03 7/1/20166006001 MEADOWS MENNONITE 4 4 CHENOA $14.69 $49.26 $87.52 $151.47 7/1/2016 7/1/20156006019 MEDINA NURSING CENTER INC 1 1 DURAND $14.27 $48.91 $83.07 $146.25 7/1/20166006035 MEMORIAL CARE CENTER 11 11 BELLEVILLE $6.15 $46.71 $109.22 $162.08 7/1/20166006050 MENDOTA LUTHERAN HOME 2 2 MENDOTA $12.09 $49.20 $81.68 $142.97 7/1/2016

  • Page 12

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6016737 MERCY CIRCLE 6 6 CHICAGO $18.18 $45.20 $94.20 $157.58 7/1/20166015697 MERCY HARVARD HOSPITAL CR CTR 8 8 HARVARD $10.15 $55.98 $90.05 $156.18 7/1/20166015812 MERIDIAN VILLAGE CARE CENTER 11 11 GLEN CARBON $16.85 $46.71 $74.91 $138.47 7/1/20166006118 METROPOLIS REHAB AND HCC 5 5 METROPOLIS $16.62 $43.74 $62.44 $122.80 7/1/20166006134 MID AMERICA CARE CENTER 6 6 CHICAGO $15.40 $47.51 $91.30 $154.21 7/1/20166003826 MIDWAY NEUROLOGICAL REHAB CTR 7 7 BRIDGEVIEW $14.24 $40.03 $106.70 $160.97 7/1/20166001341 MIDWEST REHAB AND RESPIRATORY 11 11 BELLEVILLE $11.34 $44.45 $78.09 $133.88 7/1/2016 7/1/20146014294 MILLER HEALTHCARE CENTER 9 9 KANKAKEE $18.18 $49.74 $92.76 $160.68 7/1/20166006258 MOMENCE MEADOWS NURSING AND 9 9 MOMENCE $13.57 $50.62 $117.83 $182.02 7/1/2016 7/1/20156006266 MONMOUTH NURSING HOME 2 2 MONMOUTH $12.84 $46.60 $66.47 $125.91 7/1/2016 7/1/20156006290 MONROE PAVILION HEALTH CENTER 6 6 CHICAGO $12.63 $41.79 $52.34 $106.76 7/1/2014 Eligible for Provisional License as SMHRF6006316 MONTEBELLO HEALTH CARE CENTE 3 3 HAMILTON $9.52 $38.57 $66.66 $114.75 7/1/2016 7/1/20146004444 MONTGOMERY NURSING AND REHAB 3 3 HILLSBORO $11.19 $42.47 $82.35 $136.01 7/1/20166013171 MONTGOMERY PLACE 6 6 CHICAGO $14.39 $55.98 $59.37 $129.74 7/1/20166005698 MOORINGS HEALTH CENTER 7 7 ARLINGTON HGTS $14.39 $54.40 $94.38 $163.17 10/1/20146006407 MORTON TERRACE H AND R CENTRE 2 2 MORTON $11.73 $40.00 $90.21 $141.94 7/1/20166006399 MORTON VILLA HLTH AND REH CTR 2 2 MORTON $11.23 $38.85 $84.33 $134.41 7/1/20166012322 MOWEAQUA NRSG AND RETIREMENT 4 4 MOWEAQUA $12.66 $38.65 $70.62 $121.93 7/1/20166012512 MT VERNON COUNTRYSIDE MANOR 5 5 MOUNT VERNON $14.89 $41.16 $70.48 $126.53 7/1/20166001531 MT VERNON HEALTH CARE CENTER 5 5 MOUNT VERNON $8.92 $36.80 $84.94 $130.66 7/1/20166010904 NATHAN HEALTH CARE CENTER 11 11 EAST ST LOUIS $14.20 $41.10 $73.02 $128.32 7/1/20166006498 NATURE TRAIL HEALTH CARE CTR 5 5 MOUNT VERNON $10.03 $43.93 $78.15 $132.11 7/1/2016 7/1/20146006506 NAZARETHVILLE RETIREMENT HOME 7 7 DES PLAINES $11.10 $55.98 $87.68 $154.76 7/1/20166006522 NEW ATHENS HOME FOR THE AGED 11 11 NEW ATHENS $12.09 $44.26 $94.32 $150.67 7/1/2016 7/1/20156002091 NEWMAN REHAB HEALTH CARE CTR 4 4 NEWMAN $10.75 $49.18 $111.77 $171.70 7/1/2016 7/1/20146006548 NEWTON CARE CENTER 5 5 NEWTON $6.40 $41.39 $70.53 $118.32 7/1/20166003644 NILES NURSING AND REHAB CTR 7 7 NILES $17.51 $47.23 $115.48 $180.22 7/1/2016 7/1/20156006555 NOKOMIS REHAB HEALTH CARE CTR 3 3 NOKOMIS $11.41 $37.88 $73.76 $123.05 7/1/20166006571 NORRIDGE GARDENS 7 7 NORRIDGE $16.53 $47.35 $108.82 $172.70 7/1/20166006589 NORTH ADAMS HOME INC 3 3 MENDON $12.95 $40.30 $59.65 $112.90 7/1/20166006605 NORTH AURORA CARE CENTER 8 8 NORTH AURORA $11.24 $49.29 $69.44 $129.97 7/1/2016 7/1/20146000210 NORTH LOGAN HEALTHCARE CENTE 4 4 DANVILLE $9.40 $40.03 $89.96 $139.39 7/1/20166006670 NORTHWOODS CARE CENTRE 1 1 BELVIDERE $14.74 $46.05 $99.46 $160.25 7/1/2016 7/1/20146006696 NORWOOD CROSSING 6 6 CHICAGO $13.92 $55.98 $92.84 $162.74 7/1/2016 7/1/20146006274 OAK HILL 11 11 WATERLOO $16.85 $47.78 $72.95 $137.58 7/1/20166006779 OAK LAWN RESPIRATORY AND REHA 7 7 OAK LAWN $11.58 $47.75 $165.40 $224.73 7/1/20166006811 OAK TERRACE HEALTHCARE CENTE 3 3 SPRINGFIELD $7.49 $40.28 $33.57 $81.34 7/1/20166006720 OAKBROOK HEALTHCARE CENTER L 7 7 OAK BROOK $14.07 $51.25 $104.29 $169.61 7/1/20166006829 OAKRIDGE HEALTHCARE CENTER 7 1 HILLSIDE $11.01 $53.21 $104.06 $168.28 7/1/20166003487 OAKVIEW HTS CONT CARE REHAB 5 5 MOUNT CARMEL $15.97 $43.47 $61.36 $120.80 7/1/2016

  • Page 13

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6006860 ODD FELLOWS REBEKAH HOME 4 4 MATTOON $12.52 $48.70 $63.65 $124.87 7/1/20166006878 ODIN HEALTH CARE CENTER 5 5 ODIN $11.42 $42.84 $88.11 $142.37 7/1/2016 7/1/20146009989 OREGON LIVING AND REHAB CENTE 1 1 OREGON $12.83 $47.39 $76.87 $137.09 7/1/2016 7/1/20156006985 OTTAWA PAVILION LTD 2 2 OTTAWA $18.14 $46.58 $93.16 $157.88 7/1/20166006993 OUR LADY OF ANGELS RETIREMENT 9 9 JOLIET $14.88 $50.50 $81.92 $147.30 7/1/20166002109 PALM TERRACE OF MATTOON 4 4 MATTOON $11.09 $38.77 $116.43 $166.29 7/1/20166006795 PARAMOUNT OAK PARK R AND N CT 7 7 OAK PARK $14.57 $44.45 $87.17 $146.19 7/1/20166004766 PARC AT JOLIET 9 9 JOLIET $12.87 $45.02 $93.22 $151.11 7/1/20166007090 PARIS HEALTH CARE CENTER 4 4 PARIS $11.07 $46.60 $76.33 $134.00 7/1/20166007140 PARK HOUSE NURSING REHAB CTR 6 6 CHICAGO $11.51 $47.06 $67.04 $125.61 7/1/20166003073 PARK PLACE OF BELVIDERE 1 1 BELVIDERE $9.50 $45.80 $112.13 $167.43 7/1/20166003875 PARK POINTE HEALTHCARE REHAB 9 9 MORRIS $19.22 $53.08 $85.50 $157.80 7/1/20166007157 PARK RIDGE CARE CENTER 7 7 PARK RIDGE $16.48 $55.44 $90.27 $162.19 7/1/2016 7/1/20146002315 PARK VIEW REHAB CENTER 6 6 CHICAGO $14.72 $41.72 $89.31 $145.75 7/1/2016 7/1/20146007934 PARK VILLA NURSING REHAB CTR 7 7 PALOS HEIGHTS $20.01 $53.58 $99.65 $173.24 7/1/20166001374 PARKER NURSING AND REHAB CTR 2 2 STREATOR $11.16 $43.62 $93.40 $148.18 7/1/20166005003 PARKSHORE ESTATES NRSG REHAB 6 6 CHICAGO $13.59 $48.85 $97.96 $160.40 7/1/20166014385 PARKWAY MANOR 5 5 MARION $19.68 $42.39 $84.22 $146.29 7/1/2016 7/1/20146009799 PAVILION OF WAUKEGAN 8 8 WAUKEGAN $12.63 $55.98 $116.28 $184.89 7/1/20166003206 PAXTON HEALTHCARE AND REHAB 4 4 PAXTON $15.55 $50.44 $76.34 $142.33 7/1/20166003339 PEARL PAVILION 1 1 FREEPORT $13.40 $45.38 $86.00 $144.78 7/1/20166011712 PEKIN MANOR 2 2 PEKIN $18.02 $44.32 $79.63 $141.97 7/1/20166007355 PERSHING GARDENS HC CENTER 7 7 STICKNEY $16.38 $50.42 $92.12 $158.92 7/1/2016 7/1/20156007371 PETERSON PARK HEALTH CARE CTR 6 6 CHICAGO $18.58 $48.71 $116.81 $184.10 7/1/20166007389 PIATT COUNTY NURSING HOME 4 4 MONTICELLO $11.23 $52.43 $81.23 $144.89 7/1/20166005441 PINCKNEYVILLE NURSING REHAB 5 5 PINCKNEYVILLE $13.92 $37.09 $80.86 $131.87 7/1/2016 7/1/20156007413 PINE ACRES REHAB LIVING CENTER 1 1 DEKALB $17.96 $51.52 $93.55 $163.03 7/1/2016 7/1/20146004741 PINE CREST HEALTH CARE 7 7 HAZEL CREST $17.78 $46.12 $83.45 $147.35 7/1/20166007447 PINECREST MANOR 1 1 MT MORRIS $13.82 $50.58 $70.56 $134.96 7/1/20166003792 PIPER CITY REHAB LIVING CTR 4 4 PIPER CITY $9.67 $50.44 $90.14 $150.25 7/1/20166012470 PITTSFIELD MANOR 3 3 PITTSFIELD $14.89 $40.30 $77.72 $132.91 7/1/20166007470 PLEASANT HILL HEALTHCARE 3 3 GIRARD $12.63 $38.68 $67.43 $118.74 7/1/20166007488 PLEASANT MEADOWS SENIOR LIVING 4 4 CHRISMAN $13.82 $48.02 $81.69 $143.53 7/1/20166007512 PLEASANT VIEW LUTHER HOME 2 2 OTTAWA $16.41 $50.44 $72.36 $139.21 7/1/2016 7/1/20146007504 PLEASANT VIEW REHAB AND HCC 1 1 MORRISON $9.30 $45.95 $86.98 $142.23 7/1/20166007546 POLO REHABILITATION AND HCC 1 1 POLO $9.94 $49.51 $84.77 $144.22 7/1/20166004642 PONTIAC HEALTHCARE AND REHAB 4 4 PONTIAC $13.67 $48.27 $84.01 $145.95 7/1/20166007561 PRAIRIE CITY REHAB AND HC 2 2 PRAIRIE CITY $9.17 $43.60 $79.18 $131.95 7/1/20166008502 PRAIRIE CROSSING LVG AND REHAB 1 1 SHABBONA $10.85 $47.64 $87.72 $146.21 7/1/20166011746 PRAIRIE MANOR NURSING REHAB 7 7 CHICAGO HEIGHTS $23.91 $49.26 $118.19 $191.36 7/1/2016 7/1/2014

  • Page 14

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6007082 PRAIRIE ROSE HEALTH CARE CTR 3 3 PANA $9.13 $41.42 $84.79 $135.34 7/1/20166001812 PRAIRIE VIEW CARE OF LEWISTOWN 2 2 LEWISTOWN $9.87 $42.03 $92.73 $144.63 7/1/2016 7/1/20156006027 PRAIRIE VLG HEALTHCARE CTR INC 3 3 JACKSONVILLE $12.12 $38.31 $82.73 $133.16 7/1/2016 7/1/20156007595 PRAIRIEVIEW LUTHERAN HOME 4 4 DANFORTH $12.95 $50.44 $78.95 $142.34 7/1/20166005771 PRESENCE COR MARIAE CENTER 1 1 ROCKFORD $12.52 $51.52 $58.72 $122.76 7/1/20166005854 PRESENCE MARYHAVEN NSG REHAB 7 7 GLENVIEW $14.39 $55.98 $99.74 $170.11 7/1/20166005912 PRESENCE MCAULEY MANOR 8 8 AURORA $12.98 $55.98 $82.43 $151.39 7/1/20166007009 PRESENCE OUR LADY OF VICTORY 9 9 BOURBONNAIS $14.39 $53.08 $90.33 $157.80 7/1/20166007439 PRESENCE PINE VIEW CARE CENTER 8 8 SAINT CHARLES $10.96 $55.98 $85.79 $152.73 7/1/20166014575 PRESENCE RESURRECTION LIFE CT 6 6 CHICAGO $17.23 $54.57 $83.12 $154.92 7/1/20166007892 PRESENCE RESURRECTION NRC 7 7 PARK RIDGE $10.64 $54.29 $90.59 $155.52 7/1/20166008874 PRESENCE SAINT BENEDICT NRC 7 7 NILES $13.92 $55.98 $113.38 $183.28 7/1/20166008817 PRESENCE ST ANNE CENTER 1 1 ROCKFORD $12.09 $51.52 $92.87 $156.48 7/1/20166008973 PRESENCE ST JOSEPH CENTER 1 1 FREEPORT $14.24 $51.52 $82.33 $148.09 7/1/20166012678 PRESENCE VILLA FRANCISCAN 9 9 JOLIET $14.39 $53.08 $92.01 $159.48 7/1/20166009591 PRESENCE VILLA SCALABRINI NC 7 7 NORTHLAKE $12.05 $55.95 $101.77 $169.77 7/1/20166007876 PROVIDENCE DOWNERS GROVE 7 7 DOWNERS GROVE $14.88 $55.98 $85.53 $156.39 7/1/20166007843 PROVIDENCE PALOS HEIGHTS 7 7 PALOS HEIGHTS $14.39 $55.98 $98.48 $168.85 7/1/20166016356 RADFORD GREEN 8 8 LINCOLNSHIRE $18.90 $55.98 $86.42 $161.30 7/1/20166008734 RAINBOW BEACH CARE CENTER 6 6 CHICAGO $17.66 $55.19 $57.64 $130.49 7/1/2014 Eligible for Provisional License as SMHRF6007702 RANDOLPH COUNTY CARE CENTER 5 5 SPARTA $8.65 $44.40 $90.63 $143.68 7/1/2016 7/1/20146007751 RED BUD REGIONAL CARE 5 5 RED BUD $14.47 $43.93 $74.21 $132.61 7/1/2016 7/1/20146008239 REGENCY CARE 3 3 SPRINGFIELD $15.16 $44.49 $94.91 $154.56 7/1/20166011381 REGENCY CARE OF MORRIS 9 9 MORRIS $15.77 $53.01 $91.67 $160.45 7/1/20166006712 RENAISSANCE CARE CENTER 2 2 CANTON $10.70 $37.41 $82.38 $130.49 7/1/20166007850 REST HAVEN MANOR INC 5 5 ALBION $3.97 $37.18 $56.43 $97.58 7/1/20166007884 RESTHAVE HOME OF WHITESIDE CO 1 1 MORRISON $16.84 $47.87 $68.27 $132.98 7/1/2016 7/1/20156007942 RIDGEVIEW CARE CENTER 5 5 OBLONG $10.90 $35.23 $72.81 $118.94 7/1/2016 7/1/20146003453 RIDGEVIEW REHAB NURSING CENTE 6 6 CHICAGO $15.67 $48.06 $91.58 $155.31 7/1/20166007975 RIDGWAY REHAB AND NRSG CENTER 5 5 RIDGWAY $9.27 $34.50 $78.08 $121.85 7/1/2016 7/1/20146008007 RIVER BLUFF NURSING HOME 1 1 ROCKFORD $14.24 $53.75 $71.97 $139.96 7/1/2016 7/1/20146001085 RIVER NORTH BRADLEY H AND R 9 9 BRADLEY $13.41 $42.10 $94.99 $150.50 7/1/2016 7/1/20156004758 RIVER VIEW REHAB CENTER 8 8 ELGIN $12.62 $42.33 $84.38 $139.33 7/1/20166008015 RIVERSHORES HLTH AND REHAB CT 2 2 MARSEILLES $11.07 $46.72 $93.58 $151.37 7/1/20166008072 ROBINGS MANOR REHAB HLTH CR 3 3 BRIGHTON $12.11 $36.39 $84.55 $133.05 7/1/20166008098 ROCHELLE GARDENS CARE CENTER 1 1 ROCHELLE $8.80 $44.99 $61.98 $115.77 7/1/20166008106 ROCHELLE REHAB HEALTH CARE 1 1 ROCHELLE $10.07 $51.52 $84.27 $145.86 7/1/20166008114 ROCK FALLS REHAB HLTH CARE CTR 1 1 ROCK FALLS $9.89 $51.42 $98.30 $159.61 7/1/20166002695 ROCK RIVER GARDENS 1 1 STERLING $8.55 $39.13 $52.17 $99.85 7/1/20166008049 ROCK RIVER HEALTH CARE 1 1 ROCKFORD $10.89 $43.47 $98.13 $152.49 7/1/2016

  • Page 15

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6008163 ROLLING HILLS MANOR 8 8 ZION $14.88 $55.98 $85.89 $156.75 7/1/20166005136 ROSEVILLE REHAB HEALTH CARE 2 2 ROSEVILLE $9.62 $46.49 $67.42 $123.53 7/1/20166012074 ROSEWOOD CARE CENTER ALTON 11 11 ALTON $14.95 $42.51 $77.84 $135.30 7/1/20166014237 ROSEWOOD CARE CENTER ELGIN 8 8 ELGIN $16.42 $51.18 $85.31 $152.91 7/1/20166010466 ROSEWOOD CARE CENTER GALESB 2 2 GALESBURG $14.23 $41.85 $71.39 $127.47 7/1/20166014633 ROSEWOOD CARE CENTER INVERNE 7 7 INVERNESS $22.20 $52.72 $94.26 $169.18 7/1/20166012835 ROSEWOOD CARE CENTER JOLIET 9 9 JOLIET $15.52 $50.13 $83.22 $148.87 7/1/20166012587 ROSEWOOD CARE CENTER MOLINE 10 10 MOLINE $14.73 $48.06 $67.41 $130.20 7/1/20166012165 ROSEWOOD CARE CENTER PEORIA 2 2 PEORIA $13.50 $49.68 $73.75 $136.93 7/1/20166014658 ROSEWOOD CARE CENTER ROCKFO 1 1 ROCKFORD $17.46 $49.15 $77.20 $143.81 7/1/20166010391 ROSEWOOD CARE CENTER SWANSE 11 11 SWANSEA $13.37 $46.71 $84.72 $144.80 7/1/20166012017 ROSEWOOD CARE CTR EAST PEORIA 2 2 EAST PEORIA $13.84 $48.51 $71.66 $134.01 7/1/20166014401 ROSEWOOD CARE CTR EDWARDSVI 11 11 EDWARDSVILLE $16.83 $46.71 $80.09 $143.63 7/1/20166019723 ROSEWOOD CARE CTR NORTHBROO 7 7 NORTHBROOK $21.11 $53.85 $110.68 $185.64 7/1/20166014666 ROSEWOOD CARE CTR ST CHARLES 8 8 ST CHARLES $19.01 $55.06 $86.53 $160.60 7/1/20166003065 ROSICLARE REHAB HEALTH CR 5 5 ROSICLARE $8.47 $43.93 $87.48 $139.88 7/1/20166005029 ROYAL OAKS CARE CENTER 10 10 KEWANEE $10.12 $37.71 $83.85 $131.68 7/1/20166008684 RUSHVILLE NURSING & REHABILITA 3 3 RUSHVILLE $9.48 $43.30 $67.85 $120.63 7/1/20166008320 SACRED HEART HOME 6 6 CHICAGO $12.07 $48.91 $55.59 $116.57 7/1/2014 Eligible for Provisional License as SMHRF6008338 SALEM VILLAGE NURSING AND REHA 9 9 JOLIET $13.08 $49.38 $111.44 $173.90 7/1/20166008346 SALINE CARE CENTER 5 5 HARRISBURG $9.86 $34.43 $72.99 $117.28 7/1/20166008213 SANDWICH REHAB HEALTH CARE 1 1 SANDWICH $11.37 $51.52 $81.06 $143.95 7/1/2016 7/1/20146001929 SAUK VALLEY SENIOR LIVING 1 1 ROCK FALLS $10.42 $47.83 $91.50 $149.75 7/1/20166008395 SCOTT COUNTY NURSING CENTER 3 3 WINCHESTER $13.24 $45.42 $65.45 $124.11 7/1/2016 7/1/20156008460 SELFHELP HOME OF CHICAGO 6 6 CHICAGO $18.18 $55.98 $74.76 $148.92 7/1/2016 7/14/20156010250 SEMINARY MANOR 2 2 GALESBURG $13.22 $46.44 $79.23 $138.89 7/1/20166007272 SHARON HEALTH CARE WILLOWS 2 2 PEORIA $9.22 $41.48 $91.51 $142.21 7/1/20166007926 SHARON HEALTH CARE WOODS INC 2 2 PEORIA $9.97 $41.01 $51.08 $102.06 7/1/2014 Eligible for Provisional License as SMHRF6007306 SHARON HEALTHCARE ELMS INC 2 2 PEORIA $10.53 $44.72 $102.31 $157.56 7/1/20166007298 SHARON HEALTHCARE PINES INC 2 2 PEORIA $10.56 $42.36 $69.16 $122.08 7/1/2016 7/1/20156008528 SHAWNEE CHRISTIAN NURSING CTR 5 5 HERRIN $11.23 $40.09 $77.74 $129.06 7/1/20166004055 SHAWNEE ROSE CARE CENTER 5 5 HARRISBURG $9.06 $32.62 $72.06 $113.74 7/1/20166008544 SHELBYVILLE MANOR 4 4 SHELBYVILLE $16.06 $41.91 $84.22 $142.19 7/1/20166008536 SHELBYVILLE REHAB HEALTH CARE 4 4 SHELBYVILLE $8.58 $49.62 $89.59 $147.79 7/1/20166008569 SHELDON HEALTH CARE CENTER 4 4 SHELDON $9.89 $50.44 $75.13 $135.46 7/1/20166002687 SHERIDAN SHORES REHAB CENTER 6 6 CHICAGO $18.03 $42.94 $83.79 $144.76 7/1/2016 7/1/20146012827 SHERMAN WEST COURT 8 8 ELGIN $14.88 $55.98 $93.41 $164.27 7/1/20166008643 SKOKIE MEADOWS NURSING CTR II 7 7 SKOKIE $16.07 $37.38 $57.09 $110.54 7/1/2014 Eligible for Provisional License as SMHRF6016059 SMITH CROSSING 9 9 ORLAND PARK $18.18 $45.68 $85.91 $149.77 7/1/20166009732 SMITH VILLAGE 6 6 CHICAGO $11.56 $55.98 $81.24 $148.78 7/1/2016

  • Page 16

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6011464 SNYDER VILLAGE 2 2 METAMORA $15.11 $48.71 $67.58 $131.40 7/1/20166008718 SOUTH ELGIN REHAB HEALTH CARE 8 8 SOUTH ELGIN $10.80 $52.66 $103.84 $167.30 7/1/2016 7/1/20146016497 SOUTH SUBURBAN REHAB CENTER 7 7 HOMEWOOD $17.30 $49.95 $99.77 $167.02 7/1/2016 7/1/20156008759 SOUTHGATE H C 5 5 METROPOLIS $14.28 $41.44 $67.52 $123.24 7/1/20166014781 SOUTHPOINT NURSING REHAB CTR 6 6 CHICAGO $21.00 $48.97 $127.64 $197.61 7/1/20166001895 SOUTHVIEW MANOR NURSING CENT 6 6 CHICAGO $14.26 $38.92 $71.66 $124.84 7/1/20166016786 SPRING CREEK NRSG REHAB CTR 9 9 JOLIET $10.71 $46.84 $91.20 $148.75 7/1/20166011803 SPRINGS AT CRYSTAL LAKE 8 8 CRYSTAL LAKE $15.71 $45.20 $71.23 $132.14 7/1/20166014567 ST ANTHONYS HOSPITAL SNU 11 11 ALTON $6.15 $46.71 $25.90 $78.76 7/1/20146008866 ST ANTHONYS NURSING AND REHAB 10 10 ROCK ISLAND $17.37 $51.52 $74.03 $142.92 7/1/20166008890 ST CLARAS MANOR 3 3 LINCOLN $9.51 $44.24 $82.66 $136.41 7/1/20166010664 ST JAMES WELLNESS REHAB VILLAS 9 9 CRETE $15.16 $53.08 $102.81 $171.05 7/1/20166008940 ST JOHNS HOSPITAL LTC UNIT 3 3 SPRINGFIELD $7.26 $44.49 $87.11 $138.86 7/1/20166011407 ST JOSEPH MED CTR NURSING UNIT 4 4 BLOOMINGTON $3.66 $50.44 $29.21 $83.31 7/1/20146008957 ST JOSEPH VILLAGE OF CHICAGO 6 6 CHICAGO $11.56 $55.98 $107.36 $174.90 7/1/20166009005 ST JOSEPHS HOME FOR THE ELDER 7 7 PALATINE $9.22 $55.98 $68.95 $134.15 7/1/20166008999 ST JOSEPHS N H 2 2 LACON $4.19 $50.44 $71.40 $126.03 7/1/20166009013 ST MARTHA MANOR 6 6 CHICAGO $13.38 $50.55 $62.85 $126.78 7/1/20166011910 ST PATRICKS RES 7 7 NAPERVILLE $14.88 $53.80 $93.54 $162.22 7/1/20166009120 ST PAULS HOME 11 11 BELLEVILLE $9.51 $46.02 $64.73 $120.26 7/1/20166009112 ST PAULS HOUSE AND HEALTH CARE 6 6 CHICAGO $15.34 $55.98 $101.68 $173.00 7/1/2016 7/1/20146005466 ST VINCENTS HOME INC 3 3 QUINCY $14.48 $40.51 $64.97 $119.96 7/1/2016 7/1/20156010441 STEARNS NURSING AND REHAB CTR 11 11 GRANITE CITY $13.68 $41.65 $69.68 $125.01 7/1/20166009161 STEPHENSON NURSING CENTER 1 1 FREEPORT $9.88 $49.89 $68.94 $128.71 7/1/20166009179 STERLING PAVILION LTD 1 1 STERLING $11.67 $41.99 $94.80 $148.46 7/1/20166008494 STONEBRIDGE SENIOR LIVING 5 5 BENTON $9.13 $37.02 $86.28 $132.43 7/1/2016 7/1/20146009211 SULLIVAN REHAB HEALTH CARE CTR 4 4 SULLIVAN $9.76 $41.01 $79.87 $130.64 7/1/20166009245 SUNNY ACRES NURSING HOME 3 3 PETERSBURG $13.40 $43.81 $70.90 $128.11 7/1/2016 7/1/20156009252 SUNNY HILL NSG HOME OF WILL CO 9 9 JOLIET $18.18 $62.40 $100.80 $181.38 7/1/20166009294 SUNRISE SKILLED NURSING REHAB 3 3 VIRDEN $10.10 $38.30 $80.26 $128.66 7/1/20166009302 SUNSET HOME 3 3 QUINCY $13.40 $44.49 $75.87 $133.76 7/1/20166009328 SUNSET REHAB HEALTH CARE 2 2 CANTON $13.20 $36.90 $73.32 $123.42 7/1/20166009831 SWANSEA REHAB HEALTH CARE CEN 11 11 SWANSEA $9.17 $39.29 $96.98 $145.44 7/1/2016 7/1/20146007678 SYCAMORE HEALTHCARE CENTER 3 3 QUINCY $9.02 $32.65 $75.25 $116.92 7/1/2016 7/1/20146009401 SYMPHONY AT THE TILLERS 9 9 OSWEGO $16.29 $53.08 $93.10 $162.47 7/1/20166007967 SYMPHONY EVANSTON HEALTHCAR 7 7 EVANSTON $18.87 $45.20 $125.32 $189.39 7/1/20166014831 SYMPHONY OF BEVERLY 6 6 CHICAGO $22.15 $51.34 $106.64 $180.13 7/1/20166001689 SYMPHONY OF BRONZEVILLE PARK 6 6 CHICAGO $16.09 $45.18 $94.65 $155.92 7/1/2016 7/1/20146014195 SYMPHONY OF BUFFALO GROVE 8 8 BUFFALO GROVE $18.10 $50.88 $111.99 $180.97 7/1/20166002265 SYMPHONY OF CRESTWOOD 7 7 CRESTWOOD $17.53 $49.50 $109.22 $176.25 7/1/2016 7/1/2014

  • Page 17

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6006282 SYMPHONY OF DECATUR 4 4 DECATUR $13.70 $44.44 $99.12 $157.26 7/1/2016 7/1/20146002463 SYMPHONY OF JOLIET 9 9 JOLIET $16.31 $47.40 $110.18 $173.89 7/1/2016 7/1/20146005490 SYMPHONY OF LINCOLN 3 3 LINCOLN $15.05 $42.60 $108.65 $166.30 7/1/2016 7/1/20146014641 SYMPHONY OF MIDWAY 6 6 CHICAGO $20.12 $49.75 $114.84 $184.71 7/1/20166003958 SYMPHONY OF PARK SOUTH 6 6 CHICAGO $14.80 $48.00 $98.79 $161.59 7/1/20166014823 SYMPHONY OF SOUTH SHORE 6 6 CHICAGO $21.75 $52.59 $105.23 $179.57 7/1/2016 7/1/20156014252 TABOR HILLS HEALTHCARE FAC 7 7 NAPERVILLE $17.23 $55.98 $94.78 $167.99 7/1/2016 7/1/20146009369 TAYLORVILLE CARE CENTER 3 3 TAYLORVILLE $10.83 $39.24 $84.39 $134.46 7/1/20166009377 TERRACE NURSING HOME 8 8 WAUKEGAN $12.15 $44.89 $102.97 $160.01 7/1/20166003768 TERRACE ON THE PARK 11 11 MASCOUTAH $10.11 $45.62 $80.66 $136.39 7/1/20166001465 THE CARLTON AT THE LAKE 6 6 CHICAGO $19.28 $50.66 $94.58 $164.52 7/1/20166005516 THE GROVE AT LINCOLN PARK 6 6 CHICAGO $16.12 $44.99 $114.32 $175.43 7/1/2016 7/1/20156008593 THE GROVE AT THE LAKE 8 8 ZION $17.26 $49.89 $101.38 $168.53 7/1/2016 7/1/20146008916 THE GROVE OF EVANSTON LIVING & 7 7 EVANSTON $17.94 $55.98 $126.37 $200.29 7/1/20166003057 THE GROVE OF LAGRANGE PARK LIV 7 7 LA GRANGE PARK $18.50 $52.81 $109.76 $181.07 7/1/2016 7/1/20146003412 THE GROVE OF NORTHBROOK 7 7 NORTHBROOK $16.72 $50.77 $104.53 $172.02 7/1/20166009625 THE GROVE OF SKOKIE 7 7 SKOKIE $17.04 $47.36 $112.71 $177.11 7/1/2016 7/1/20146004733 THE IMPERIAL OF LINCOLN PARK 6 6 CHICAGO $17.73 $53.60 $112.70 $184.03 7/1/20166009385 THORNTON HEIGHTS TERRACE LTD 7 7 CHICAGO HEIGHTS $14.68 $40.07 $62.27 $117.02 7/1/2014 Eligible for Provisional License as SMHRF6009393 THREE SPRINGS LODGE NRSG HOME 5 5 CHESTER $11.23 $40.10 $62.70 $114.03 7/1/2016 7/1/20156007330 TIMBERCREEK REHAB AND HEALTH 2 2 PEKIN $11.32 $45.39 $91.21 $147.92 7/1/20166003750 TIMBERPOINT HEALTHCARE CENTER 3 3 CAMP POINT $9.76 $44.15 $77.06 $130.97 7/1/20166009427 TOULON REHAB HEALTH CARE CTR 2 2 TOULON $12.29 $45.01 $88.48 $145.78 7/1/20166003263 TOWER HILL HEALTHCARE CENTER 8 8 SOUTH ELGIN $13.01 $45.97 $101.74 $160.72 7/1/20166009443 TRI STATE NURSING REHAB CENTER 7 7 LANSING $17.37 $50.93 $107.55 $175.85 7/1/20166002588 TUSCOLA HEALTH CARE CENTER 4 4 TUSCOLA $8.90 $38.53 $105.48 $152.91 7/1/20166004188 TWIN LAKES REHAB HEALTH CARE 4 4 PARIS $9.09 $41.32 $118.31 $168.72 7/1/20166009484 TWIN WILLOWS NURSING CENTER 5 5 SALEM $8.66 $35.35 $75.62 $119.63 7/1/2016 7/1/20156009492 UNION COUNTY HOSPITAL LTC 5 5 ANNA $4.73 $43.93 $84.91 $133.57 7/1/20166009500 UNITED METHODIST VILLAGE 5 5 LAWRENCEVILLE $8.65 $41.56 $67.21 $117.42 7/1/20166013072 UNITED METHODIST VILLAGE N CAM 5 5 LAWRENCEVILLE $14.27 $40.24 $63.20 $117.71 7/1/20166002711 UNIVERSITY NURSING AND RHB CTR 11 11 EDWARDSVILLE $10.82 $41.10 $102.16 $154.08 7/1/20166009542 VALLEY HI NURSING HOME 8 8 WOODSTOCK $18.18 $62.41 $82.88 $163.47 7/1/20166009260 VANDALIA REHAB HEALTH CARE 5 5 VANDALIA $8.33 $43.47 $87.22 $139.02 7/1/20166007322 VILLA AT EVERGREEN PARK 7 7 EVERGREEN PARK $16.99 $55.98 $99.79 $172.76 7/1/20166007041 VILLA AT PA PETERSON 1 1 ROCKFORD $15.73 $51.52 $72.12 $139.37 7/1/20166007868 VILLA AT SOUTH HOLLAND 7 7 SOUTH HOLLAND $26.32 $55.98 $111.50 $193.80 7/1/20166014856 VILLA AT WINDSOR PARK 6 7 CHICAGO $21.08 $47.06 $112.10 $180.24 7/1/20166012991 VILLA HEALTH CARE INC EAST 3 3 SHERMAN $14.69 $44.49 $80.62 $139.80 7/1/20166011332 VILLAGE AT VICTORY LAKES 8 8 LINDENHURST $12.51 $55.98 $103.66 $172.15 7/1/2016

  • Page 18

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6009674 WABASH CHRISTIAN RETIREMENT C 5 5 CARMI $13.10 $43.79 $80.45 $137.34 7/1/2016 7/1/20156009682 WALKER NURSING HOME 3 3 VIRGINIA $12.07 $43.65 $50.05 $105.77 7/1/20166009690 WALNUT MANOR 2 2 WALNUT $11.90 $49.56 $72.17 $133.63 7/1/20166014377 WARREN BARR LINCOLNSHIRE 8 8 LINCOLNSHIRE $17.97 $55.98 $110.62 $184.57 7/1/20166004725 WARREN BARR LIV AND REHAB CTR 6 6 CHICAGO $18.36 $55.98 $125.21 $199.55 7/1/20166014963 WARREN BARR NORTH SHORE 8 8 HIGHLAND PARK $19.27 $54.23 $114.40 $187.90 7/1/20166008825 WARREN BARR SOUTH LOOP 6 6 CHICAGO $15.29 $54.02 $149.03 $218.34 7/1/20166008262 WARREN PARK HEALTH LIVING CTR 6 6 CHICAGO $13.56 $50.85 $75.95 $140.36 7/1/2016 7/1/20146009740 WASHINGTON CHRISTIAN VILLAGE 2 2 WASHINGTON $11.83 $45.83 $75.17 $132.83 7/1/2016 7/1/20156002430 WATERFORD NURSING AND REHAB 6 6 CHICAGO $17.06 $38.10 $82.26 $137.42 7/1/2016 7/1/20156009757 WATERFRONT TERRACE INC 6 6 CHICAGO $16.34 $48.69 $87.60 $152.63 7/1/20166009765 WATSEKA REHAB HEALTH CARE CTR 4 4 WATSEKA $10.37 $46.59 $83.72 $140.68 7/1/20166009435 WAUCONDA HEALTHCARE AND REHA 8 8 WAUCONDA $15.67 $50.55 $105.44 $171.66 7/1/20166006365 WAVERLY PLACE OF STOCKTON 1 1 STOCKTON $12.04 $43.60 $103.76 $159.40 7/1/2016 7/1/20146009815 WAY FAIR NURSING AND REHAB CTR 5 5 FAIRFIELD $10.73 $39.67 $76.05 $126.45 7/1/20166006100 WESLEY PLACE 6 6 CHICAGO $16.29 $55.98 $99.29 $171.56 7/1/20166009864 WESLEY VILLAGE 2 2 MACOMB $14.79 $45.95 $69.96 $130.70 7/1/20166009872 WEST CHICAGO TERRACE NH 7 7 WEST CHICAGO $11.40 $39.35 $62.43 $113.18 7/1/20166013478 WEST SUBURBAN HOSP MED CTR SN 7 7 OAK PARK $13.46 $45.20 $49.78 $108.44 7/1/20146001002 WEST SUBURBAN NURSING REHAB 7 7 BLOOMINGDALE $13.59 $45.64 $125.35 $184.58 7/1/2016 7/1/20156012173 WESTCHESTER HEALTH AND REHAB 7 7 WESTCHESTER $20.38 $55.98 $93.91 $170.27 7/1/2016 7/1/20156007603 WESTMINSTER PLACE 7 7 EVANSTON $9.22 $55.98 $95.97 $161.17 7/1/20166000194 WESTSIDE REHAB CARE CENTER 5 5 WEST FRANKFORT $7.90 $35.39 $88.95 $132.24 7/1/20166009955 WESTWOOD MANOR 6 6 CHICAGO $14.15 $37.86 $69.10 $121.11 7/1/2016 7/1/20146009963 WHEATON CARE CENTER 7 7 WHEATON $13.40 $47.85 $91.05 $152.30 7/1/2016 7/1/20156006597 WHITE HALL NURSING AND REHAB C 3 3 WHITE HALL $17.79 $30.87 $84.73 $133.39 7/1/2016 7/1/20156004881 WHITE OAK REHABILITATION HCC 5 5 MOUNT VERNON $11.10 $43.93 $73.18 $128.21 7/1/2016 7/1/20146008379 WILLOW CREST NURS PAVILION LTD 1 1 SANDWICH $12.03 $43.09 $91.13 $146.25 7/1/20166003842 WILLOW ROSE REHAB HEALTH CARE 3 3 JERSEYVILLE $9.01 $40.48 $83.99 $133.48 7/1/20166010037 WILLOWS HEALTH CENTER 1 1 ROCKFORD $12.04 $51.52 $71.30 $134.86 7/1/20166010045 WILSON CARE INC 6 6 CHICAGO $13.63 $37.19 $56.87 $107.69 7/1/2014 Eligible for Provisional License as SMHRF6010052 WINCHESTER HOUSE 8 8 LIBERTYVILLE $7.27 $66.61 $101.91 $175.79 7/1/20166010078 WINDMILL NURSING PAVILION LTD 7 7 SOUTH HOLLAND $15.21 $44.27 $87.14 $146.62 7/1/20166005904 WINDSOR ESTATES NURSING AND R 7 7 COUNTRY CLUB HI $18.03 $54.05 $107.63 $179.71 7/1/20166011753 WINDSOR PARK MANOR 7 7 CAROL STREAM $16.76 $45.20 $96.66 $158.62 11/1/20156005334 WINFIELD WOODS HEALTHCARE CTR 7 7 WINFIELD $14.12 $44.76 $86.99 $145.87 7/1/20166010094 WINNING WHEELS INC 1 1 PROPHETSTOWN $15.97 $51.52 $82.20 $149.69 7/1/20166010102 WINSTON MANOR CONVALESCENT N 6 6 CHICAGO $10.01 $36.42 $67.85 $114.28 7/1/20166001713 WOOD GLEN NURSING AND REHAB C 7 7 WEST CHICAGO $16.31 $45.46 $55.62 $117.39 7/1/20166007074 WOODBRIDGE NURSING PAVILION 6 6 CHICAGO $15.17 $40.95 $106.64 $162.76 7/1/2016

  • Page 19

    ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

    BUREAU OF RATE DEVELOPMENT AND ANALYSIS

    MEDICAID RATE LIST FOR NURSING FACILITIES as of 07-01-2016

    Building Facility Rate Capital Support Nursing Total Effective Capital Rate

    ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6008361 WYNSCAPE HEALTH AND REHAB 7 7 WHEATON $14.82 $55.98 $69.61 $140.41 7/1/2016

    ALLRT17a