MedicaidAdministrativeLow impact
Long Term Care Provider Handbook Update - Revised Form HFS 1156, LTC Facility Notification
Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
May 14, 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. Long term care providers must use the updated form and replace the old version in their handbook appendix.
Action Required
Immediately: Long term care facility staff must download the revised Form HFS 1156 from www.hfs.illinois.gov/medicalforms/ and replace Appendix C-10 in their handbook. Update all facility notification processes to include the new 'Place of Birth' field when completing the form.