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IMPORTANT REMINDERS

  • All correspondence must be received through HFSRB’s official email address (dph.hfsrb@illinois.gov).  Correspondence submitted through other emails will not be considered received and will not be processed or reviewed.
  • Applications for Certificate of Need permits, Certificate of Exemptions, and requests for Extension of Financial Commitment, Permit Renewal, and Permit Alteration can be submitted via dph.hfsrb@illinois.gov.  In lieu of this process, applications and requests can be submitted to HFSRB’s principal office:  525 West Jefferson Street, 2nd Floor, Springfield, Illinois 62761.  At this time, all fees associated with the above-referenced applications and requests must be mailed to HFSRB's principal office in Springfield.
  • HFSRB will take no action on any request that requires a fee until the fee payment is received at HFSRB’s principal office.
  • Effective July 1, 2025, revisions to HFSRB’s rules at 77 Ill. Adm. Code 1130 take effect.  These changes center on definitions, technical assistance, fees, extension of financial commitment, permit renewal, and permit alterations.  Applications for permit or exemption, and post-permit transactions received by HFSRB on or after July 1, 2025, will be subject to the new rules and fee requirements.
  • The new rules can be viewed here. When viewing the rules in the Illinois Register, go to Pages 92-153.  In addition, a summary of the rule changes can be viewed here: Changes to Part 1130

2024 Schedule for Annual Facility Questionnaires

If you have any questions or problems, please contact us at (217) 782-3516 or send an email to DPH.FacilitySurvey@illinois.gov

ANNUAL END-STAGE RENAL DIALYSIS (ESRD) FACILITY SURVEY

 Distribution Date: January 2025
 Due Date for Return of Completed Form: April 1, 2025

ANNUAL AMBULATORY SURGICAL CENTER QUESTIONNAIRE

 Distribution Date: January  2025
 Due Date for Return of Completed Form: April 1, 2025

ANNUAL HOSPITAL QUESTIONNAIRE

 Distribution Date: January  2025
 Due Date for Return of Completed Form:  April 15, 2025

To download Annual Hospital Questionnaire forms:

Annual Hospital Questionnaire Form - Hospitals with Over 100 Authorized Beds

Annual Hospital Questionnaire Form - Hospitals with Up to 100 Authorized Beds

ANNUAL LONG-TERM CARE FACILITY QUESTIONNAIRE

 Distribution Date: February 2025
 Updated Due Date for Completion: April 30, 2025

All Long-Term Care (LTC) facilities should receive an email notification of the questionnaire with the appropriate form for their facility type and directions for the completion and submission of the form

Long-Term Care (LTC) Facility Questionnaire Forms:
Form for Hospital-based Skilled Nursing Units

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