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Completion and Submittal of Form HFS 2234, Bed Reserve/Temporary Absence Form

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Dec 11, 2006
We identified it
Jun 21, 2026
Days to comply

Summary

This policy provides detailed guidelines for ICF/DD facilities on completing and submitting Form HFS 2234 for bed reserve/temporary absence reporting to Illinois Medicaid. The notice clarifies submission timelines, proper channels, and specific requirements for different types of bed reserves.

Action Required

Action needed
ICF/DD facilities must submit Form HFS 2234 on the 1st day of the month following hospital stays or therapeutic home visits. Submit electronically through REV vendor or mail to HFS Springfield office. Do not submit until recipient has Medicaid RIN and long-term care admission is completed. Only fax corrections or deletions to 217-557-5061.