MedicaidAdministrativeLow impact
Revised Form HFS 1156, Long Term Care Facility Notification
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Jun 21, 2007
We identified it
Jun 21, 2026
Summary
Form HFS 1156, Long Term Care Facility Notification, has been revised to include a new 'Place of Birth' field at the top of the form. This administrative update affects facilities serving developmentally disabled patients who need to complete this Illinois state form.
Action Required
Immediately: ICF/DD facilities must download the revised Form HFS 1156 from www.hfs.illinois.gov/medicalforms/ and begin using the updated version that includes the 'Place of Birth' field. Administrative staff should update their form inventory and ensure the new field is completed for all future notifications.