17
ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES BUREAU OF RATE DEVELOPMENT AND ANALYSIS MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs) Building Facility Rate Capital Support Nursing Total Effective Capital Rate ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date 6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $75.53 $131.45 4/1/2018 6000020 ABBINGTON REHAB NURSING CENTER 7 7 ROSELLE $16.68 $49.47 $86.07 $152.22 4/1/2018 7/1/2017 6012595 ABINGTON OF GLENVIEW NURSING & 7 7 GLENVIEW $23.30 $55.98 $125.93 $205.21 4/1/2018 6003206 ACCOLADE HEALTHCARE OF PAXTON 4 4 PAXTON $15.55 $50.44 $77.28 $143.27 4/1/2018 6004642 ACCOLADE HEALTHCARE OF PONTIAC 4 4 PONTIAC $13.67 $48.27 $95.64 $157.58 4/1/2018 6004675 ACCOLADE PAXTON SENIOR LIVING 4 4 PAXTON $11.67 $50.44 $71.96 $134.07 4/1/2018 6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $98.93 $168.83 4/1/2018 6016869 ALDEN COURTS OF SHOREWOOD, INC 9 9 SHOREWOOD $19.21 $45.68 $89.32 $154.21 6/8/2017 6015507 ALDEN COURTS OF WATERFORD, LLC 8 8 AURORA $19.48 $45.20 $87.48 $152.16 4/1/2018 6000103 ALDEN DEBES REHABILITATION AND 1 1 ROCKFORD $14.99 $49.65 $97.91 $162.55 4/1/2018 6014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $125.79 $203.97 4/1/2018 6003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $156.43 $235.68 4/1/2018 6013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $21.67 $55.98 $129.83 $207.48 4/1/2018 6007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $115.74 $185.94 4/1/2018 6014500 ALDEN ESTATES OF NORTHMOOR 6 6 CHICAGO $22.43 $51.87 $114.40 $188.70 4/1/2018 6014922 ALDEN ESTATES OF ORLAND PARK 7 7 ORLAND PARK $18.80 $55.98 $113.77 $188.55 4/1/2018 6016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $116.07 $180.97 4/1/2018 6006886 ALDEN ESTATES OF SKOKIE 7 7 SKOKIE $22.33 $55.98 $142.78 $221.09 4/1/2018 6005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.99 $48.50 $141.46 $204.95 4/1/2018 6009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $100.59 $164.69 4/1/2018 6005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $104.29 $169.13 4/1/2018 6014765 ALDEN NORTH SHORE REHAB AND HC 7 7 SKOKIE $21.70 $55.98 $103.93 $181.61 4/1/2018 6014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $102.83 $178.29 4/1/2018 6007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $12.80 $49.65 $103.25 $165.70 4/1/2018 6001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $108.81 $179.10 4/1/2018 6008304 ALDEN TERRACE OF MCHENRY REHAB 8 8 MCHENRY $10.10 $43.65 $109.51 $163.26 4/1/2018 6013353 ALDEN TOWN MANOR REHAB AND HCC 7 7 CICERO $20.74 $49.73 $100.51 $170.98 4/1/2018 6000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $105.74 $169.79 4/1/2018 6003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $10.44 $38.14 $69.26 $117.84 4/1/2018 7/1/2016 6004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $65.66 $104.56 4/1/2018 6000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $15.04 $45.18 $78.14 $138.36 4/1/2018 7/1/2017 6000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $76.02 $139.00 4/1/2018 6000152 ALTON MEM HOSP HATCH SNF UNIT 11 11 ALTON $5.44 $46.71 $62.24 $114.39 1/1/2017 6000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $14.37 $50.93 $122.40 $187.70 4/1/2018 6001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $14.19 $40.82 $109.67 $164.68 4/1/2018 6001010 APERION CARE BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $87.78 $147.55 4/1/2018 6001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $95.93 $149.25 4/1/2018 6007207 APERION CARE BURBANK 7 7 BURBANK $19.73 $55.98 $125.68 $201.39 4/1/2018 7/1/2016 6010342 APERION CARE CAIRO 5 5 CAIRO $12.77 $42.46 $88.88 $144.11 4/1/2018 7/1/2016 6002489 APERION CARE CAPITOL 3 3 SPRINGFIELD $12.52 $40.88 $76.80 $130.20 4/1/2018 7/1/2017 6008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO HEIGHTS $14.05 $43.24 $94.81 $152.10 4/1/2018 Page 1

ALDEN ESTATES OF SKOKIE 7 7 SKOKIE $22.33 $55.98 $142.78 $221.09 4/1/2018 6005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.99 $48.50 $141.46 $204.95 4/1/2018 6009849 ALDEN LINCOLN

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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 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $75.53 $131.45 4/1/2018

6000020 ABBINGTON REHAB NURSING CENTER 7 7 ROSELLE $16.68 $49.47 $86.07 $152.22 4/1/2018 7/1/2017

6012595 ABINGTON OF GLENVIEW NURSING & 7 7 GLENVIEW $23.30 $55.98 $125.93 $205.21 4/1/2018

6003206 ACCOLADE HEALTHCARE OF PAXTON 4 4 PAXTON $15.55 $50.44 $77.28 $143.27 4/1/2018

6004642 ACCOLADE HEALTHCARE OF PONTIAC 4 4 PONTIAC $13.67 $48.27 $95.64 $157.58 4/1/2018

6004675 ACCOLADE PAXTON SENIOR LIVING 4 4 PAXTON $11.67 $50.44 $71.96 $134.07 4/1/2018

6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $98.93 $168.83 4/1/2018

6016869 ALDEN COURTS OF SHOREWOOD, INC 9 9 SHOREWOOD $19.21 $45.68 $89.32 $154.21 6/8/2017

6015507 ALDEN COURTS OF WATERFORD, LLC 8 8 AURORA $19.48 $45.20 $87.48 $152.16 4/1/2018

6000103 ALDEN DEBES REHABILITATION AND 1 1 ROCKFORD $14.99 $49.65 $97.91 $162.55 4/1/2018

6014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $125.79 $203.97 4/1/2018

6003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $156.43 $235.68 4/1/2018

6013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $21.67 $55.98 $129.83 $207.48 4/1/2018

6007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $115.74 $185.94 4/1/2018

6014500 ALDEN ESTATES OF NORTHMOOR 6 6 CHICAGO $22.43 $51.87 $114.40 $188.70 4/1/2018

6014922 ALDEN ESTATES OF ORLAND PARK 7 7 ORLAND PARK $18.80 $55.98 $113.77 $188.55 4/1/2018

6016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $116.07 $180.97 4/1/2018

6006886 ALDEN ESTATES OF SKOKIE 7 7 SKOKIE $22.33 $55.98 $142.78 $221.09 4/1/2018

6005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.99 $48.50 $141.46 $204.95 4/1/2018

6009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $100.59 $164.69 4/1/2018

6005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $104.29 $169.13 4/1/2018

6014765 ALDEN NORTH SHORE REHAB AND HC 7 7 SKOKIE $21.70 $55.98 $103.93 $181.61 4/1/2018

6014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $102.83 $178.29 4/1/2018

6007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $12.80 $49.65 $103.25 $165.70 4/1/2018

6001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $108.81 $179.10 4/1/2018

6008304 ALDEN TERRACE OF MCHENRY REHAB 8 8 MCHENRY $10.10 $43.65 $109.51 $163.26 4/1/2018

6013353 ALDEN TOWN MANOR REHAB AND HCC 7 7 CICERO $20.74 $49.73 $100.51 $170.98 4/1/2018

6000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $105.74 $169.79 4/1/2018

6003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $10.44 $38.14 $69.26 $117.84 4/1/2018 7/1/2016

6004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $65.66 $104.56 4/1/2018

6000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $15.04 $45.18 $78.14 $138.36 4/1/2018 7/1/2017

6000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $76.02 $139.00 4/1/2018

6000152 ALTON MEM HOSP HATCH SNF UNIT 11 11 ALTON $5.44 $46.71 $62.24 $114.39 1/1/2017

6000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $14.37 $50.93 $122.40 $187.70 4/1/2018

6001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $14.19 $40.82 $109.67 $164.68 4/1/2018

6001010 APERION CARE BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $87.78 $147.55 4/1/2018

6001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $95.93 $149.25 4/1/2018

6007207 APERION CARE BURBANK 7 7 BURBANK $19.73 $55.98 $125.68 $201.39 4/1/2018 7/1/2016

6010342 APERION CARE CAIRO 5 5 CAIRO $12.77 $42.46 $88.88 $144.11 4/1/2018 7/1/2016

6002489 APERION CARE CAPITOL 3 3 SPRINGFIELD $12.52 $40.88 $76.80 $130.20 4/1/2018 7/1/2017

6008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO HEIGHTS $14.05 $43.24 $94.81 $152.10 4/1/2018

Page 1

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6002547 APERION CARE DOLTON 7 7 DOLTON $18.79 $49.25 $119.55 $187.59 4/1/2018

6005847 APERION CARE ELGIN 8 8 ELGIN $11.47 $54.20 $108.94 $174.61 4/1/2018

6006845 APERION CARE EVANSTON 7 7 EVANSTON $23.84 $48.47 $123.02 $195.33 4/1/2018 7/1/2016

6009815 APERION CARE FAIRFIELD 5 5 FAIRFIELD $10.73 $39.67 $82.53 $132.93 4/1/2018

6015333 APERION CARE FOREST PARK 7 7 FOREST PARK $21.70 $48.88 $123.80 $194.38 4/1/2018

6000434 APERION CARE GALESBURG 2 2 GALESBURG $13.09 $40.51 $103.77 $157.37 4/1/2018

6007280 APERION CARE HIGHWOOD 8 8 HIGHWOOD $19.52 $44.78 $121.53 $185.83 4/1/2018

6014617 APERION CARE INTERNATIONAL 6 6 CHICAGO $22.20 $48.75 $119.31 $190.26 4/1/2018

6008650 APERION CARE JACKSONVILLE 3 3 JACKSONVILLE $13.28 $39.56 $94.77 $147.61 4/1/2018

6000095 APERION CARE LITCHFIELD 3 3 LITCHFIELD $9.67 $40.08 $92.76 $142.51 4/1/2018

6008015 APERION CARE MARSEILLES 2 2 MARSEILLES $11.07 $46.72 $85.27 $143.06 4/1/2018

6003768 APERION CARE MASCOUTAH 11 11 MASCOUTAH $10.87 $45.62 $79.83 $136.32 4/1/2018 7/1/2016

6001077 APERION CARE MIDLOTHIAN 7 7 MIDLOTHIAN $14.70 $45.18 $113.54 $173.42 4/1/2018

6002646 APERION CARE MOLINE 10 10 EAST MOLINE $12.88 $44.26 $103.26 $160.40 4/1/2018

6006407 APERION CARE MORTON TERRACE 2 2 MORTON $11.73 $40.00 $81.77 $133.50 4/1/2018

6006399 APERION CARE MORTON VILLA 2 2 MORTON $11.23 $38.85 $81.49 $131.57 4/1/2018

6002059 APERION CARE OAK LAWN 7 7 OAK LAWN $18.87 $50.10 $128.89 $197.86 4/1/2018 7/1/2016

6004147 APERION CARE PEORIA HEIGHTS 2 2 PEORIA HEIGHTS $12.45 $48.20 $77.79 $138.44 4/1/2018

6007520 APERION CARE PLUM GROVE 7 7 PALATINE $20.49 $46.83 $114.09 $181.41 4/1/2018

6001945 APERION CARE PRINCETON 2 2 PRINCETON $11.17 $46.28 $82.37 $139.82 4/1/2018

6008783 APERION CARE SPRING VALLEY 2 2 SPRING VALLEY $7.72 $48.96 $100.43 $157.11 4/1/2018

6002661 APERION CARE SPRINGFIELD 3 3 SPRINGFIELD $8.12 $42.00 $95.10 $145.22 4/1/2018

6004204 APERION CARE ST ELMO 5 5 SAINT ELMO $13.10 $42.14 $103.78 $159.02 4/1/2018

6006308 APERION CARE TOLUCA 2 2 TOLUCA $8.57 $48.85 $92.96 $150.38 4/1/2018

6001713 APERION CARE WEST CHICAGO 7 7 WEST CHICAGO $16.31 $45.46 $68.27 $130.04 4/1/2018

6008312 APERION CARE WILMINGTON 9 9 WILMINGTON $14.50 $44.03 $98.22 $156.75 4/1/2018

6000384 APOSTOLIC CHRISTIAN HOME 2 2 ROANOKE $14.69 $50.44 $82.93 $148.06 4/1/2018

6002885 APOSTOLIC CHRISTIAN HOME 2 2 EUREKA $16.41 $49.92 $74.91 $141.24 4/1/2018

6000400 APOSTOLIC CHRISTIAN RESTMOR 2 2 MORTON $16.85 $50.44 $72.32 $139.61 4/1/2018

6000426 APOSTOLIC CHRISTIAN SKYLINES 2 2 PEORIA $13.82 $49.59 $96.14 $159.55 4/1/2018

6008155 ARBOUR HEALTH CARE CENTER 6 6 CHICAGO $14.65 $44.39 $79.95 $138.99 4/1/2018 7/1/2017

6009823 ARCOLA HEALTH CARE CENTER 4 4 ARCOLA $9.63 $36.01 $74.08 $119.72 4/1/2018

6000517 ARTHUR HOME 4 4 ARTHUR $9.51 $47.66 $66.93 $124.10 4/1/2018

6016729 ASBURY GARDENS NSG AND REHAB 8 8 NORTH AURORA $19.48 $55.98 $108.59 $184.05 4/1/2018

6008205 ASPEN REHAB AND HEALTH CARE 10 10 SILVIS $12.20 $50.96 $72.44 $135.60 4/1/2018

6016273 ASSISI HCC AT CLARE OAKS 7 7 BARTLETT $18.18 $55.98 $93.49 $167.65 4/1/2018

6006662 ASTORIA PLACE LIVING & REHAB 6 6 CHICAGO $17.76 $56.24 $118.31 $192.31 4/1/2018

6003834 ATRIUM HEALTH CARE CENTER 6 6 CHICAGO $13.80 $45.27 $98.58 $157.65 4/1/2018

6007181 AUBURN REHAB AND HCC 3 3 AUBURN $8.78 $35.60 $81.04 $125.42 4/1/2018

6001317 AUTUMN MEADOWS OF CAHOKIA 11 11 EAST SAINT LOUI $14.62 $42.39 $83.73 $140.74 4/1/2018 7/1/2017

6014344 AVANTARA LONG GROVE 8 8 LONG GROVE $19.87 $47.61 $117.55 $185.03 4/1/2018 7/1/2016

Page 2

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6009096 AVANTARA PARK RIDGE 7 7 PARK RIDGE $18.89 $55.98 $120.48 $195.35 4/1/2018

6003214 AVANTI WELLNESS AND REHAB 7 7 NILES $16.75 $49.29 $111.25 $177.29 4/1/2018

6011340 AVISTON COUNTRYSIDE MANOR 11 11 AVISTON $13.24 $42.38 $71.80 $127.42 4/1/2018

6016810 AVONDALE ESTATE OF ELGIN 8 8 ELGIN $19.48 $45.20 $90.20 $154.88 1/5/2017

6000640 BALLARD RESPIRATORY AND REHAB 7 7 DES PLAINES $17.48 $55.82 $157.19 $230.49 4/1/2018

6000657 BALMORAL NURSING HOME 6 6 CHICAGO $11.01 $32.49 $89.01 $132.51 4/1/2018

6000731 BARRY COMMUNITY CARE 3 3 BARRY $9.06 $40.29 $71.86 $121.21 4/1/2018

6008171 BATAVIA REHAB HEALTH CARE CTR 8 8 BATAVIA $12.76 $55.98 $97.70 $166.44 4/1/2018 7/1/2016

6001176 BEACON CARE CENTER 6 6 CHICAGO $14.61 $52.58 $98.05 $165.24 4/1/2018

6000806 BEECHER MANOR NURSG AND RHB CT 9 9 BEECHER $19.71 $53.08 $106.22 $179.01 4/1/2018

6000822 BELHAVEN NURSING REHAB CTR 6 6 CHICAGO $18.25 $55.98 $131.09 $205.32 4/1/2018

6000889 BELLA TERRA MORTON GROVE 7 7 MORTON GROVE $19.84 $49.44 $122.60 $191.88 4/1/2018

6000855 BEMENT HEALTH CARE CENTER 4 4 BEMENT $11.34 $41.46 $81.02 $133.82 4/1/2018

6005391 BENTON REHAB HEALTH CARE CTR 5 5 BENTON $9.26 $43.31 $74.21 $126.78 4/1/2018

6010110 BERKELEY NURSING REHAB CENTER 7 7 OAK PARK $18.15 $55.98 $122.87 $197.00 4/1/2018

6000863 BETHALTO CARE CENTER 11 11 BETHALTO $9.57 $44.50 $80.61 $134.68 4/1/2018

6014872 BETHANY REHAB AND HCC 1 1 DEKALB $18.85 $51.52 $79.27 $149.64 4/1/2018

6006688 BETHESDA REHAB AND SENIOR CARE 6 6 CHICAGO $14.88 $55.98 $85.05 $155.91 4/1/2018 7/1/2016

6000962 BIG MEADOWS 1 1 SAVANNA $13.91 $48.57 $92.60 $155.08 4/1/2018

6000988 BIRCHWOOD PLAZA 6 6 CHICAGO $13.51 $39.49 $107.30 $160.30 4/1/2018 7/1/2016

6000996 BLOOMINGTON REHAB AND HCC 4 4 BLOOMINGTON $9.66 $50.44 $85.47 $145.57 4/1/2018

6001101 BREESE NURSING HOME 11 11 BREESE $10.21 $41.54 $80.39 $132.14 4/1/2018

6001119 BRENTWOOD NORTH HC REHAB CTR 8 8 RIVERWOODS $15.79 $55.98 $123.46 $195.23 4/1/2018 7/1/2016

6005474 BRIA OF BELLEVILLE 11 11 BELLEVILLE $14.56 $41.92 $102.76 $159.24 4/1/2018

6007983 BRIA OF CAHOKIA 11 11 EAST SAINT LOUI $10.50 $38.76 $86.27 $135.53 4/1/2018

6007991 BRIA OF CHICAGO HEIGHTS 7 7 SOUTH CHICAGO H $17.19 $40.26 $114.51 $171.96 4/1/2018

6000954 BRIA OF FOREST EDGE 6 6 CHICAGO $11.79 $36.89 $115.33 $164.01 4/1/2018

6003503 BRIA OF GENEVA 8 8 GENEVA $11.25 $55.98 $117.05 $184.28 4/1/2018

6010086 BRIA OF PALOS HILLS 7 7 PALOS HILLS $22.82 $45.78 $118.68 $187.28 4/1/2018 7/1/2016

6001283 BRIA OF RIVER OAKS 7 7 BURNHAM $16.05 $36.83 $106.88 $159.76 4/1/2018

6009930 BRIA OF WESTMONT 7 7 WESTMONT $19.17 $44.26 $116.82 $180.25 4/1/2018 7/1/2016

6001143 BRIAR PLACE 7 7 INDIAN HEAD PAR $14.95 $44.40 $58.08 $117.43 4/1/2018 7/1/2016

6001168 BRIDGEVIEW HEALTH CARE CENTER 7 7 BRIDGEVIEW $15.05 $45.78 $116.11 $176.94 4/1/2018

6000353 BRIDGEWAY SENIOR LIVING 7 7 BENSENVILLE $16.52 $55.98 $103.33 $175.83 4/1/2018

6001242 BUCKINGHAM PAVILION INC 6 6 CHICAGO $14.49 $41.32 $74.96 $130.77 4/1/2018

6001259 BURGESS SQUARE HEALTHCARE CTR 7 7 WESTMONT $11.90 $51.15 $93.21 $156.26 4/1/2018

6001275 BURGIN MANOR 5 5 OLNEY $11.71 $38.61 $98.98 $149.30 4/1/2018

6001291 BURNSIDE COMMUNITY HEALTH CTR 4 4 MARSHALL $11.67 $46.84 $81.39 $139.90 4/1/2018

6014674 CALHOUN NURSING AND REHAB CTR 3 3 HARDIN $14.76 $39.41 $74.50 $128.67 4/1/2018 7/1/2016

6001333 CALIFORNIA GARDENS NURSING & R 6 6 CHICAGO $15.24 $44.14 $84.21 $143.59 4/1/2018

6008635 CAMBRIDGE NURSING REHAB CENTER 7 7 SKOKIE $17.64 $50.53 $112.84 $181.01 4/1/2018 7/1/2016

Page 3

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6001424 CARE CENTER OF ABINGDON 2 2 ABINGDON $12.34 $43.92 $74.70 $130.96 4/1/2018

6009336 CARLINVILLE REHAB AND HLTC 3 3 CARLINVILLE $11.97 $43.24 $78.56 $133.77 4/1/2018

6001473 CARLYLE HEALTHCARE CENTER INC 11 11 CARLYLE $14.18 $44.61 $76.48 $135.27 4/1/2018

6016539 CARMI MANOR 5 5 CARMI $11.55 $43.35 $65.50 $120.40 4/1/2018 7/1/2016

6001507 CARRIER MILLS NURSING & REHABI 5 5 CARRIER MILLS $12.50 $40.09 $83.74 $136.33 4/1/2018

6000970 CASEY HEALTH CARE CENTER 4 4 CASEY $11.55 $48.94 $69.85 $130.34 4/1/2018 7/1/2016

6010227 CASEYVILLE NRSG AND REHAB CTR 11 11 CASEYVILLE $13.23 $40.07 $80.56 $133.86 4/1/2018

6002869 CEDAR RIDGE HEALTH REHAB CTR 11 11 LEBANON $12.66 $46.71 $88.85 $148.22 4/1/2018

6001523 CENTER HOME HISPANIC ELDERLY 6 6 CHICAGO $15.97 $54.41 $106.02 $176.40 4/1/2018 7/1/2016

6001564 CENTRAL BAPTIST VILLAGE 7 7 NORRIDGE $17.23 $55.98 $83.97 $157.18 4/1/2018 7/1/2016

6001580 CENTRAL NURSING HOME 6 6 CHICAGO $9.44 $27.73 $103.09 $140.26 4/1/2018

6012355 CENTRALIA MANOR 5 5 CENTRALIA $16.97 $41.30 $90.24 $148.51 4/1/2018

6008601 CHALET LIVING & REHAB 6 6 CHICAGO $15.94 $55.98 $111.36 $183.28 4/1/2018

6001457 CHAMPAIGN URBANA NURSING REHAB 4 4 SAVOY $14.96 $50.44 $98.53 $163.93 4/1/2018

6001358 CHARLESTON REHAB HEALTH CARE 4 4 CHARLESTON $10.19 $42.27 $74.41 $126.87 4/1/2018

6010367 CHATEAU NURSING AND REHAB 7 7 WILLOWBROOK $16.27 $51.15 $114.13 $181.55 4/1/2018

6001697 CHICAGO RIDGE NURSING CENTER 7 7 CHICAGO RIDGE $13.89 $36.49 $92.72 $143.10 4/1/2018

6001739 CHRISTIAN NURSING HOME 3 3 LINCOLN $16.84 $44.38 $82.42 $143.64 4/1/2018

6001770 CISNE REHAB AND HEALTH CENTER 5 5 CISNE $8.38 $43.93 $88.39 $140.70 4/1/2018 7/1/2017

6000277 CITADEL CARE CENTER-ELGIN 8 8 ELGIN $16.04 $55.98 $116.90 $188.92 4/1/2018

6000269 CITADEL CARE CENTER-KANKAKEE 9 9 KANKAKEE $14.72 $48.06 $112.02 $174.80 4/1/2018

6006563 CITADEL CARE CENTER-WILMETTE 7 7 WILMETTE $18.26 $55.98 $113.93 $188.17 4/1/2018

6009948 CITY VIEW MULTICARE CENTER LLC 7 7 CICERO $14.84 $39.14 $100.53 $154.51 4/1/2018

6005144 CLARIDGE HEALTHCARE CENTER 8 8 LAKE BLUFF $10.83 $40.10 $127.76 $178.69 4/1/2018

6001796 CLARK MANOR CONVALESCENT CENTE 6 6 CHICAGO $16.68 $40.10 $109.65 $166.43 4/1/2018

6001887 CLINTON MANOR LIVING CENTER 11 11 NEW BADEN $11.34 $45.93 $67.06 $124.33 4/1/2018

6007496 COLLINSVILLE REHAB HEALTH CARE 11 11 COLLINSVILLE $11.15 $38.29 $80.11 $129.55 4/1/2018

6001952 COLONIAL MANOR 4 4 DANVILLE $16.24 $50.44 $89.06 $155.74 4/1/2018

6002026 COMMUNITY CARE CENTER 6 6 CHICAGO $12.60 $39.06 $86.76 $138.42 4/1/2018 7/1/2016

6006175 COMMUNITY NRSG AND REHAB CTR 7 7 NAPERVILLE $15.71 $50.90 $130.11 $196.72 4/1/2018

6016711 CONCORDIA VILLAGE CARE CENTER 3 3 SPRINGFIELD $16.85 $40.28 $79.09 $136.22 4/1/2018

6002075 CONTINENTAL NURSING REHAB CTR 6 6 CHICAGO $14.90 $50.31 $110.43 $175.64 4/1/2018

6003420 CORNERSTONE REHAB AND HC 2 2 PEORIA HEIGHTS $11.84 $50.44 $81.27 $143.55 4/1/2018

6015200 COULTERVILLE REHAB AND HCC 5 5 COULTERVILLE $18.18 $43.93 $78.89 $141.00 4/1/2018

6002141 COUNTRY HEALTH 4 4 GIFFORD $22.50 $50.44 $78.29 $151.23 4/1/2018

6002190 COUNTRYSIDE NURSING AND REHAB 7 7 DOLTON $16.11 $41.83 $102.43 $160.37 4/1/2018

6005631 COUNTRYVIEW CARE CTR OF MACOMB 2 2 MACOMB $9.68 $47.66 $59.10 $116.44 4/1/2018

6003008 COURTYARD HEALTHCARE CENTER 7 7 BERWYN $17.93 $50.15 $113.50 $181.58 4/1/2018

6001093 COVENANT HEALTH CARE CENTER 7 7 NORTHBROOK $14.88 $55.98 $90.39 $161.25 4/1/2018

6002208 COVENANT HEALTH CARE CENTER 8 8 BATAVIA $17.23 $55.98 $84.43 $157.64 4/1/2018

6016778 CRAWFORD MEMORIAL HOSPITAL LTC 5 5 ROBINSON $16.84 $43.93 $73.47 $134.24 2/1/2017

Page 4

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6002273 CRESTWOOD TERRACE NURSING CTR 7 7 CRESTWOOD $13.11 $35.07 $70.44 $118.62 4/1/2018

6010136 CROSSROADS CARE CTR WOODSTOCK 8 8 WOODSTOCK $11.80 $48.90 $110.73 $171.43 4/1/2018

6002299 CRYSTAL PINES REHAB AND HCC 8 8 CRYSTAL LAKE $15.09 $53.62 $103.42 $172.13 4/1/2018

6002307 CUMBERLAND REHAB HEALTH CARE 4 4 GREENUP $9.41 $44.13 $73.96 $127.50 4/1/2018

6002364 DANVILLE CARE CENTER LTD 4 4 DANVILLE $10.98 $46.64 $89.15 $146.77 4/1/2018

6003081 DECATUR REHAB HEALTH CARE CTR 4 4 DECATUR $10.04 $50.44 $74.14 $134.62 4/1/2018

6005276 DIXON REHAB AND HCC 1 1 DIXON $11.18 $45.42 $83.59 $140.19 4/1/2018 7/1/2016

6002521 DOBSON PLAZA NURSING & REHAB 7 7 EVANSTON $16.41 $48.15 $108.37 $172.93 4/1/2018 7/1/2016

6002539 DOCTORS NURSING AND REHAB CTR 5 5 SALEM $13.36 $38.22 $101.59 $153.17 4/1/2018

6002570 DOUGLAS NURSING AND REHAB CTR 4 4 MATTOON $15.09 $44.20 $84.29 $143.58 4/1/2018

6002943 DUQUOIN NURSING & REHABILITATI 5 5 DU QUOIN $13.69 $37.19 $78.10 $128.98 4/1/2018 7/1/2016

6003222 EAST BANK CENTER 1 1 LOVES PARK $5.37 $48.05 $117.81 $171.23 4/1/2018

6007025 EASTSIDE HEALTH CARE CENTER 3 3 PITTSFIELD $10.49 $43.90 $83.37 $137.76 4/1/2018

6009237 EASTVIEW TERRACE 4 4 SULLIVAN $10.96 $44.46 $82.20 $137.62 4/1/2018

6002679 EDEN VILLAGE 11 11 GLEN CARBON $12.09 $44.73 $72.20 $129.02 4/1/2018

6002729 EDWARDSVILLE NRSNG REHAB CTR 11 11 EDWARDSVILLE $12.27 $42.28 $96.40 $150.95 4/1/2018

6009559 EFFINGHAM REHAB HEALTH CARE CT 5 5 EFFINGHAM $10.27 $41.70 $64.25 $116.22 4/1/2018

6002745 EL PASO HEALTH CARE CENTER 2 2 EL PASO $12.05 $45.14 $80.45 $137.64 4/1/2018

6003248 ELDORADO REHAB & HEALTHCARE LL 5 5 ELDORADO $11.85 $30.18 $80.90 $122.93 4/1/2018

6002810 ELIZABETH NURSING HOME 1 1 ELIZABETH $7.07 $44.08 $71.07 $122.22 4/1/2018

6002828 ELMHURST EXTENDED CARE CENTER 7 7 ELMHURST $11.94 $54.24 $79.54 $145.72 4/1/2018

6005961 ELMWOOD NURSING AND REHAB CTR 11 11 MARYVILLE $13.40 $41.32 $76.68 $131.40 4/1/2018

6002844 ELMWOOD TERRACE HEALTHCARE CTR 8 8 AURORA $11.11 $51.77 $104.70 $167.58 4/1/2018

6002851 ELSTON NURSING AND REHAB CENTR 6 6 CHICAGO $14.24 $50.36 $107.52 $172.12 4/1/2018

6005425 ENFIELD REHAB HEALTH CARE 5 5 PEORIA $8.70 $43.93 $75.88 $128.51 4/1/2018

6004667 ESTATES OF HYDE PARK 6 6 CHICAGO $14.72 $43.56 $88.44 $146.72 4/1/2018 7/1/2016

6002877 EUNICE C SMITH HOME 11 11 ALTON $5.44 $46.71 $84.79 $136.94 4/1/2018

6002901 EVENGLOW LODGE 4 4 PONTIAC $13.82 $48.31 $81.81 $143.94 4/1/2018

6002133 EVERGREEN NURSING AND REHAB CT 5 5 EFFINGHAM $10.62 $38.12 $83.13 $131.87 4/1/2018

6002950 FAIR HAVENS CHRISTIAN HOME 4 4 DECATUR $12.09 $50.22 $86.92 $149.23 4/1/2018

6002976 FAIR OAKS HEALTH CARE CENTER 8 8 CRYSTAL LAKE $15.55 $55.98 $108.68 $180.21 4/1/2018

6002984 FAIR OAKS REHAB AND HCC 1 1 SOUTH BELOIT $13.77 $50.75 $79.50 $144.02 4/1/2018

6003024 FAIRHAVEN CHRISTIAN RET HOME 1 1 ROCKFORD $16.41 $51.52 $82.26 $150.19 4/1/2018

6001051 FAIRMONT CARE CENTRE 6 6 CHICAGO $21.39 $49.59 $115.16 $186.14 4/1/2018

6003040 FAIRVIEW HAVEN NURSING HOME 4 4 FAIRBURY $13.93 $50.44 $63.55 $127.92 4/1/2018

6003099 FAIRVIEW NURSING CENTER 5 5 DU QUOIN $10.58 $36.15 $50.45 $97.18 4/1/2018

6003107 FAITH CARE CENTER 11 11 HIGHLAND $16.84 $46.44 $76.11 $139.39 4/1/2018

6004824 FARMER CITY REHAB AND HC 4 4 FARMER CITY $12.11 $47.43 $99.93 $159.47 4/1/2018 7/1/2016

6003115 FARMINGTON COUNTRY MANOR 2 2 FARMINGTON $12.37 $49.24 $75.09 $136.70 4/1/2018

6003123 FAYETTE COUNTY HOSPITAL NH 5 5 VANDALIA $6.15 $43.93 $65.13 $115.21 4/1/2018

6001614 FIRESIDE HOUSE OF CENTRALIA 5 5 CENTRALIA $10.38 $40.52 $70.41 $121.31 4/1/2018

Page 5

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6000939 FLANAGAN REHAB HEALTH CARE 4 4 FLANAGAN $10.95 $50.44 $89.55 $150.94 4/1/2018

6003172 FLORA GARDENS CARE CENTER 5 5 FLORA $10.68 $41.19 $75.02 $126.89 4/1/2018

6003156 FLORA REHAB HEALTH CARE CTR 5 5 FLORA $11.82 $43.93 $76.95 $132.70 4/1/2018

6003180 FLORENCE NURSING HOME 8 8 MARENGO $12.61 $49.25 $108.98 $170.84 4/1/2018

6003198 FONDULAC REHAB HEALTH CARE CTR 2 2 EAST PEORIA $12.22 $50.44 $79.06 $141.72 4/1/2018

6001135 FOREST CITY REHAB AND NRSG CTR 1 1 ROCKFORD $12.58 $35.60 $75.80 $123.98 4/1/2018

6000483 FOREST VIEW REHAB NURSING CTR 7 7 ITASCA $14.27 $47.27 $121.09 $182.63 4/1/2018

6000137 FOSTER HEALTH AND REHAB CENTER 6 6 CHICAGO $14.85 $47.14 $95.23 $157.22 4/1/2018

6012413 FRANCISCAN VILLAGE 7 7 LEMONT $13.46 $55.98 $89.73 $159.17 4/1/2018

6003289 FRANKFORT HEALTHCARE REHAB CTR 5 5 WEST FRANKFORT $8.80 $40.24 $67.56 $116.60 4/1/2018

6003297 FRANKFORT TERRACE NURSING CTR 9 9 FRANKFORT $10.80 $38.53 $71.41 $120.74 4/1/2018

6003305 FRANKLIN GROVE LIVING REHAB 1 1 FRANKLIN GROVE $14.12 $46.91 $88.86 $149.89 4/1/2018 7/1/2016

6003321 FREEBURG CARE CENTER 11 11 FREEBURG $11.93 $36.01 $75.10 $123.04 4/1/2018

6003388 FRIENDSHIP MANOR 10 10 ROCK ISLAND $15.13 $50.35 $62.83 $128.31 4/1/2018 7/1/2017

6015895 FRIENDSHIP MANOR HEALTH CARE 5 5 NASHVILLE $10.06 $38.41 $70.97 $119.44 4/1/2018

6005979 FRIENDSHIP SKILLED NSG REHAB 3 3 CARLINVILLE $10.32 $44.49 $82.67 $137.48 4/1/2018

6003404 FRIENDSHIP VILLAGE OF SCHAUMBU 7 7 SCHAUMBURG $16.97 $55.98 $104.56 $177.51 4/1/2018

6003438 GALENA STAUSS NURSING HOME 1 1 GALENA $7.78 $51.11 $76.78 $135.67 4/1/2018

6007975 GALLATIN MANOR 5 5 RIDGWAY $9.27 $34.50 $76.37 $120.14 4/1/2018

6009567 GARDENVIEW MANOR 4 4 DANVILLE $11.95 $37.42 $115.73 $165.10 4/1/2018

6000467 GENERATIONS AT APPLEWOOD 7 7 MATTESON $18.21 $49.08 $119.26 $186.55 4/1/2018 7/1/2016

6002067 GENERATIONS AT COLUMBUS PARK 6 6 CHICAGO $17.30 $40.15 $78.97 $136.42 4/1/2018

6008270 GENERATIONS AT ELMWOOD PARK 7 7 ELMWOOD PARK $18.63 $41.81 $132.92 $193.36 4/1/2018

6006514 GENERATIONS AT NEIGHBORS 1 1 BYRON $18.07 $48.47 $81.08 $147.62 4/1/2018 5/1/2017

6006837 GENERATIONS AT OAKTON PAVILLIO 7 7 DES PLAINES $18.01 $39.50 $110.49 $168.00 4/1/2018 7/1/2016

6007793 GENERATIONS AT REGENCY 7 7 NILES $21.04 $48.46 $112.40 $181.90 4/1/2018

6008130 GENERATIONS AT ROCK ISLAND 10 10 ROCK ISLAND $13.59 $40.61 $92.41 $146.61 4/1/2018

6006076 GENESIS SENIOR LIVING ALEDO 10 10 ALEDO $12.09 $47.02 $60.74 $119.85 4/1/2018

6003552 GIBSON COMMUNITY HOSPITAL ANNE 4 4 GIBSON CITY $15.97 $50.44 $77.96 $144.37 4/1/2018

6003578 GILMAN HEALTHCARE CENTER 4 4 GILMAN $13.97 $44.51 $95.98 $154.46 4/1/2018

6006191 GLEN BRIDGE NURSING AND REHAB 7 7 NILES $17.36 $45.95 $121.07 $184.38 4/1/2018

6003586 GLEN OAKS NURSING REHAB CENTER 7 7 NORTHBROOK $14.22 $44.61 $101.83 $160.66 4/1/2018

6008833 GLEN SAINT ANDREW LIVING COMM 7 7 NILES $12.75 $55.98 $111.20 $179.93 4/1/2018

6003610 GLEN VIEW TERRACE NURSING CTR 7 7 GLENVIEW $18.90 $53.28 $112.34 $184.52 4/1/2018

6003594 GLENCREST HLTHCR AND REHAB CTR 6 6 CHICAGO $16.29 $49.38 $133.24 $198.91 4/1/2018

6006647 GLENLAKE TERRACE NURSING REHAB 8 8 WAUKEGAN $11.79 $42.52 $113.29 $167.60 4/1/2018

6007918 GLENSHIRE NURSING REHAB CENTRE 7 7 RICHTON PARK $18.34 $51.25 $126.55 $196.14 4/1/2018

6003628 GLENWOOD HEALTHCARE AND REHAB 7 7 GLENWOOD $18.71 $48.77 $117.68 $185.16 4/1/2018 7/1/2016

6003636 GOLDEN GOOD SHEPHERD HOME 3 3 GOLDEN $10.43 $43.06 $53.49 $106.98 4/1/2018

6007637 GOOD SAM PROPHETS RIVERVIEW 1 1 PROPHETSTOWN $12.52 $51.52 $77.33 $141.37 4/1/2018

6003495 GOOD SAM SOC GENESEO VILLAGE 10 10 GENESEO $14.24 $48.44 $76.44 $139.12 4/1/2018

Page 6

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6001515 GOOD SAM SOCIETY MT CARROLL 1 1 MOUNT CARROLL $14.24 $48.25 $74.75 $137.24 4/1/2018

6003685 GOOD SAMARITAN HOME OF QUINCY 3 3 QUINCY $16.84 $44.49 $68.20 $129.53 4/1/2018

6005573 GOOD SAMARITAN PONTIAC 4 4 PONTIAC $10.80 $49.55 $75.49 $135.84 4/1/2018

6003727 GOTTLIEB MEMORIAL HOSPITAL 7 7 MELROSE PARK $7.85 $55.98 $99.40 $163.23 4/1/2018

6060524 GRAHAM HOSP EXT CARE FACILITY 2 2 CANTON $8.22 $50.44 $75.89 $134.55 4/1/2018

6001986 GRANITE NURSING AND REHAB CTR 11 11 GRANITE CITY $17.95 $38.49 $88.42 $144.86 4/1/2018

6015499 GREEK AMERICAN REHAB CARE CTR 7 7 WHEELING $17.26 $53.43 $111.30 $181.99 4/1/2018

6016570 GREENFIELDS OF GENEVA 8 8 GENEVA $18.18 $55.98 $122.62 $196.78 10/1/2016

6003511 GROSSE POINTE MANOR 7 7 NILES $19.37 $51.62 $127.08 $198.07 4/1/2018

6000574 GROVE OF FOX VALLEY 8 8 AURORA $19.36 $44.74 $113.04 $177.14 4/1/2018 7/1/2016

6003933 HALLMARK HOUSE NURSING CENTER 2 2 PEKIN $13.16 $49.37 $76.13 $138.66 4/1/2018

6003974 HAMILTON MEM REHAB AND HCC 5 5 MC LEANSBORO $13.26 $43.93 $73.80 $130.99 4/1/2018

6004006 HAMMOND HENRY DISTRICT HOSPITA 10 10 GENESEO $16.84 $53.08 $81.94 $151.86 4/1/2018

6004048 HARBOR CREST HOME 1 1 FULTON $5.80 $47.43 $63.99 $117.22 4/1/2018

6013684 HARMONY NURSING AND REHAB CTR 6 6 CHICAGO $21.44 $51.74 $125.00 $198.18 4/1/2018 7/1/2017

6004089 HAVANA HEALTH CARE CENTER 3 3 HAVANA $13.24 $41.19 $71.97 $126.40 4/1/2018

6015317 HAWTHORNE INN OF DANVILLE 4 4 DANVILLE $15.75 $41.96 $68.14 $125.85 4/1/2018

6009310 HEARTHSTONE MANOR 8 8 WOODSTOCK $14.54 $55.98 $103.09 $173.61 4/1/2018

6013437 HEARTLAND CHRISTIAN VILLAGE 4 4 NEOGA $14.24 $46.85 $79.22 $140.31 4/1/2018

6004121 HEARTLAND MANOR 4 4 CASEY $12.09 $49.76 $54.79 $116.64 4/1/2018 7/1/2016

6011597 HEARTLAND OF CANTON 2 2 CANTON $14.56 $49.02 $78.56 $142.14 4/1/2018

6000301 HEARTLAND OF CHAMPAIGN 4 4 CHAMPAIGN $11.11 $50.44 $79.15 $140.70 4/1/2018

6000285 HEARTLAND OF DECATUR 4 4 DECATUR $15.59 $47.67 $86.24 $149.50 4/1/2018

6003446 HEARTLAND OF GALESBURG 2 2 GALESBURG $17.02 $50.44 $72.27 $139.73 4/1/2018

6011613 HEARTLAND OF HENRY 2 2 HENRY $14.85 $48.47 $69.98 $133.30 4/1/2018

6005649 HEARTLAND OF MACOMB 2 2 MACOMB $15.73 $50.44 $80.61 $146.78 4/1/2018

6006233 HEARTLAND OF MOLINE 10 10 MOLINE $14.50 $48.19 $86.43 $149.12 4/1/2018

6000244 HEARTLAND OF NORMAL 4 4 NORMAL $14.04 $50.44 $75.14 $139.62 4/1/2018

6011571 HEARTLAND OF PAXTON 4 4 PAXTON $16.13 $49.50 $82.41 $148.04 4/1/2018

6000293 HEARTLAND OF PEORIA 2 2 PEORIA $14.35 $49.03 $80.53 $143.91 4/1/2018

6008056 HEARTLAND OF RIVERVIEW 2 2 EAST PEORIA $16.76 $50.44 $95.18 $162.38 4/1/2018

6004139 HEATHER HEALTH CARE CENTER 7 7 HARVEY $18.28 $49.69 $82.52 $150.49 4/1/2018

6006704 HELIA HEALTHCARE OF BELLEVILLE 11 11 BELLEVILLE $9.81 $46.71 $127.29 $183.81 4/1/2018

6016091 HELIA HEALTHCARE OF BENTON 5 5 BENTON $3.66 $43.93 $76.40 $123.99 4/1/2018

6003800 HELIA HEALTHCARE OF CHAMPAIGN 4 4 CHAMPAIGN $9.27 $44.00 $61.71 $114.98 4/1/2018

6005870 HELIA HEALTHCARE OF ENERGY 5 5 ENERGY $7.78 $36.52 $78.89 $123.19 4/1/2018

6004493 HELIA HEALTHCARE OF GREENVILLE 5 11 GREENVILLE $5.08 $44.33 $73.93 $123.34 4/1/2018

6006910 HELIA HEALTHCARE OF OLNEY 5 5 OLNEY $9.36 $26.23 $72.75 $108.34 4/1/2018

6003255 HELIA SOUTHBELT HEALTHCARE 11 11 BELLEVILLE $11.59 $43.65 $89.82 $145.06 4/1/2018

6012066 HENDERSON CO RETIREMENT CENTER 2 2 STRONGHURST $12.85 $45.59 $70.70 $129.14 4/1/2018

6003917 HENRY AND JANE VONDERLIETH CTR 3 3 MOUNT PULASKI $11.67 $44.49 $76.02 $132.18 4/1/2018

Page 7

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6000756 HERITAGE HEALTH 3 3 JACKSONVILLE $13.79 $44.49 $88.93 $147.21 4/1/2018

6000780 HERITAGE HEALTH BEARDSTOWN 3 3 BEARDSTOWN $11.88 $44.49 $64.82 $121.19 4/1/2018

6004261 HERITAGE HEALTH BLOOMINGTON 4 4 BLOOMINGTON $18.46 $50.44 $89.67 $158.57 4/1/2018

6000723 HERITAGE HEALTH CARLINVILLE 3 3 CARLINVILLE $12.89 $43.01 $89.88 $145.78 4/1/2018

6007199 HERITAGE HEALTH CHILLICOTHE 2 2 CHILLICOTHE $17.36 $50.41 $94.07 $161.84 4/1/2018 7/1/2016

6002083 HERITAGE HEALTH DWIGHT 4 4 DWIGHT $15.32 $50.32 $83.25 $148.89 4/1/2018

6005920 HERITAGE HEALTH EL PASO 2 2 EL PASO $16.72 $50.44 $89.61 $156.77 4/1/2018

6006902 HERITAGE HEALTH ELGIN 8 8 ELGIN $14.27 $55.33 $117.66 $187.26 4/1/2018

6003560 HERITAGE HEALTH GIBSON CITY 4 4 GIBSON CITY $13.82 $50.40 $81.71 $145.93 4/1/2018

6000681 HERITAGE HEALTH GILLESPIE 3 3 GILLESPIE $12.41 $43.33 $87.92 $143.66 4/1/2018

6004592 HERITAGE HEALTH HOOPESTON 4 4 HOOPESTON $17.99 $47.75 $76.76 $142.50 4/1/2018

6000699 HERITAGE HEALTH LITCHFIELD 3 3 LITCHFIELD $13.64 $44.41 $87.59 $145.64 4/1/2018

6004253 HERITAGE HEALTH MENDOTA 2 2 MENDOTA $11.94 $50.01 $85.37 $147.32 4/1/2018

6005367 HERITAGE HEALTH MINONK 2 2 MINONK $15.84 $50.44 $94.47 $160.75 4/1/2018

6010128 HERITAGE HEALTH MOUNT ZION 4 4 MOUNT ZION $16.56 $49.83 $76.38 $142.77 4/1/2018

6004287 HERITAGE HEALTH MT STERLING 3 3 MOUNT STERLING $13.68 $44.49 $73.00 $131.17 4/1/2018

6008510 HERITAGE HEALTH NORMAL 4 4 NORMAL $16.29 $49.94 $93.84 $160.07 4/1/2018

6000707 HERITAGE HEALTH PANA 3 3 PANA $13.23 $41.85 $89.77 $144.85 4/1/2018

6004303 HERITAGE HEALTH PERU 2 2 PERU $15.13 $48.38 $98.84 $162.35 4/1/2018

6002125 HERITAGE HEALTH ROBINSON 5 5 ROBINSON $13.41 $43.93 $70.72 $128.06 4/1/2018

6004279 HERITAGE HEALTH SPRINGFIELD 3 3 SPRINGFIELD $15.52 $44.49 $90.70 $150.71 4/1/2018

6000715 HERITAGE HEALTH STAUNTON 3 3 STAUNTON $12.01 $44.49 $81.54 $138.04 4/1/2018

6004311 HERITAGE HEALTH STREATOR 2 2 STREATOR $16.57 $49.16 $90.22 $155.95 4/1/2018

6009690 HERITAGE HEALTH WALNUT 2 2 WALNUT $11.90 $49.56 $88.41 $149.87 4/1/2018

6004337 HERITAGE SQUARE 1 1 DIXON $9.07 $50.53 $58.03 $117.63 4/1/2018

6004352 HICKORY NURSING PAVILION 7 7 HICKORY HILLS $15.52 $49.25 $80.74 $145.51 4/1/2018

6016687 HICKORY POINT CHRISTIAN VILL 4 4 FORSYTH $16.85 $46.11 $95.50 $158.46 1/1/2018

6001663 HIGHLAND HEALTH CARE CENTER 11 11 HIGHLAND $9.69 $46.52 $78.43 $134.64 4/1/2018

6000392 HIGHLAND OAKS 8 8 ELGIN $14.39 $55.98 $77.82 $148.19 4/1/2018

6004410 HILLCREST RETIREMENT VILLAGE 8 8 ROUND LAKE BEAC $13.34 $46.74 $108.14 $168.22 4/1/2018 7/1/2016

6004428 HILLSBORO REHAB AND HLTC 3 3 HILLSBORO $11.14 $42.63 $77.62 $131.39 4/1/2018

6004451 HILLSIDE REHAB AND CARE CENTER 9 9 YORKVILLE $6.68 $47.72 $106.01 $160.41 4/1/2018

6004477 HILLTOP SKILLED NURSING REHAB 4 4 CHARLESTON $11.49 $35.29 $77.14 $123.92 4/1/2018

6004485 HILLVIEW HEALTH CARE CENTER 5 5 VIENNA $8.72 $37.65 $56.75 $103.12 4/1/2018

6004501 HITZ MEMORIAL HOME 11 11 ALHAMBRA $11.23 $46.71 $57.72 $115.66 4/1/2018

6004550 HOLY FAMILY VILLA 7 7 PALOS PARK $18.18 $55.98 $91.68 $165.84 4/1/2018

6004212 ILLINI HERITAGE REHAB AND HC 4 4 CHAMPAIGN $9.69 $41.99 $77.82 $129.50 4/1/2018

6013023 ILLINI RESTORATIVE CARE 10 10 SILVIS $15.55 $51.52 $69.38 $136.45 4/1/2018

6012579 IMBODEN CREEK LIVING CENTER 4 4 DECATUR $15.94 $50.44 $65.39 $131.77 4/1/2018 7/1/2016

6002778 INTEGRITY HC OF ALTON 11 11 ALTON $11.52 $43.69 $97.60 $152.81 4/1/2018

6001788 INTEGRITY HC OF ANNA 5 5 ANNA $10.12 $40.67 $90.96 $141.75 4/1/2018

Page 8

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6009203 INTEGRITY HC OF CARBONDALE 5 5 CARBONDALE $10.34 $42.88 $84.22 $137.44 4/1/2018 7/1/2016

6004469 INTEGRITY HC OF COBDEN 5 5 COBDEN $9.87 $39.73 $69.91 $119.51 4/1/2018

6013106 INTEGRITY HC OF COLUMBIA 11 11 COLUMBIA $16.05 $46.24 $91.11 $153.40 4/1/2018

6001028 INTEGRITY HC OF GODFREY 11 11 GODFREY $12.12 $46.71 $111.35 $170.18 4/1/2018

6003362 INTEGRITY HC OF HERRIN 5 5 HERRIN $9.00 $37.53 $81.88 $128.41 4/1/2018

6003230 INTEGRITY HC OF MARION 5 5 MARION $15.03 $41.60 $92.04 $148.67 4/1/2018

6007116 INTEGRITY HC OF SMITHTON 11 11 SMITHTON $10.57 $46.71 $55.73 $113.01 4/1/2018

6009534 INTEGRITY HC OF WOOD RIVER 11 11 WOOD RIVER $14.15 $46.71 $93.47 $154.33 4/1/2018

6004790 IROQUOIS RESIDENT HOME 4 4 WATSEKA $11.67 $50.44 $67.80 $129.91 4/1/2018

6004840 JACKSONVILLE SKILLED NRSG REH 3 3 JACKSONVILLE $11.62 $38.22 $95.21 $145.05 4/1/2018

6004899 JENNINGS TERRACE 8 8 AURORA $9.69 $45.20 $101.90 $156.79 4/1/2018

6013312 JERSEYVILLE MANOR 3 3 JERSEYVILLE $18.32 $40.75 $83.90 $142.97 4/1/2018 7/1/2016

6004907 JERSEYVILLE NSG AND REHAB CTR 3 3 JERSEYVILLE $16.22 $43.79 $81.22 $141.23 4/1/2018

6004964 JOLIET TERRACE NURSING CTR 9 9 JOLIET $10.57 $37.90 $62.04 $110.51 4/1/2018

6005433 JONESBORO REHAB HEALTH CARE 5 5 JONESBORO $9.58 $43.92 $76.69 $130.19 4/1/2018

6006126 KENSINGTON PLACE NRSG REHAB 6 6 CHICAGO $14.06 $45.30 $108.54 $167.90 4/1/2018

6005011 KEWANEE CARE HOME 10 10 KEWANEE $13.38 $44.88 $82.16 $140.42 4/1/2018 7/1/2016

6005128 LAHARPE DAVIER HEALTH CARE 3 3 LA HARPE $9.69 $44.23 $75.34 $129.26 4/1/2018

6005169 LAKEFRONT NURSING & REHAB CENT 6 6 CHICAGO $13.50 $47.53 $98.88 $159.91 4/1/2018

6005185 LAKELAND REHAB AND HCC 5 5 EFFINGHAM $11.81 $42.62 $78.01 $132.44 4/1/2018

6005227 LAKEVIEW REHAB NURSING CENTER 6 6 CHICAGO $13.51 $54.89 $128.25 $196.65 4/1/2018

6005235 LAKEWOOD NURSING AND REHAB CTR 9 9 PLAINFIELD $18.85 $49.99 $112.21 $181.05 4/1/2018

6001044 LEBANON CARE CENTER 11 11 LEBANON $11.01 $37.58 $81.63 $130.22 4/1/2018

6005284 LEE MANOR NURSING HM 7 7 DES PLAINES $16.88 $44.33 $110.10 $171.31 4/1/2018

6014492 LEMONT NURSING AND REHAB CTR 7 7 LEMONT $21.17 $50.59 $112.04 $183.80 4/1/2018

6005292 LENA LIVING CENTER 1 1 LENA $16.77 $47.56 $69.46 $133.79 4/1/2018 7/1/2016

6012157 LEROY MANOR 4 4 LE ROY $15.43 $45.75 $75.84 $137.02 4/1/2018

6005300 LEWIS MEMORIAL 3 3 SPRINGFIELD $16.84 $44.49 $84.97 $146.30 4/1/2018

6011993 LEXINGTON HEALTH CARE CENTER O 7 7 BLOOMINGDALE $18.25 $51.26 $106.67 $176.18 4/1/2018

6005318 LEXINGTON HEALTH CARE CTR INC 7 7 LOMBARD $15.73 $49.10 $106.60 $171.43 4/1/2018

6012967 LEXINGTON HEALTH CARE OF CHICA 7 7 CHICAGO RIDGE $21.14 $48.71 $103.21 $173.06 4/1/2018

6013098 LEXINGTON OF ELMHURST 7 7 ELMHURST $17.03 $51.93 $110.19 $179.15 4/1/2018

6013361 LEXINGTON OF LAGRANGE 7 7 LA GRANGE $23.21 $53.46 $112.81 $189.48 4/1/2018

6014138 LEXINGTON OF LAKE ZURICH 8 8 LAKE ZURICH $17.94 $50.32 $102.81 $171.07 4/1/2018

6014682 LEXINGTON OF ORLAND PARK 7 7 ORLAND PARK $21.06 $47.43 $111.37 $179.86 4/1/2018

6012553 LEXINGTON OF SCHAUMBURG 7 7 SCHAUMBURG $21.18 $49.62 $104.12 $174.92 4/1/2018

6012975 LEXINGTON OF STREAMWOOD 7 7 STREAMWOOD $21.20 $50.66 $108.10 $179.96 4/1/2018

6014369 LEXINGTON OF WHEELING 7 7 OTHER $20.99 $50.62 $111.83 $183.44 4/1/2018

6005359 LIBERTYVILLE MANOR EXT CARE 8 8 LIBERTYVILLE $12.08 $55.55 $52.80 $120.43 4/1/2018

6005375 LIEBERMAN CENTER FOR HEALTH 7 7 SKOKIE $16.29 $56.24 $99.77 $172.30 4/1/2018 7/1/2016

6005563 LITTLE SISTERS OF THE POOR 6 6 CHICAGO $10.11 $55.98 $73.66 $139.75 4/1/2018

Page 9

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6007140 LITTLE VILLAGE NURSING AND REH 6 6 CHICAGO $11.51 $47.06 $84.86 $143.43 4/1/2018

6005599 LUTHERAN CARE CTR 5 5 ALTAMONT $12.16 $43.93 $73.13 $129.22 4/1/2018

6005607 LUTHERAN HOME FOR THE AGED 7 7 ARLINGTON HGTS $18.18 $55.98 $82.46 $156.62 4/1/2018

6005615 LUTHERAN HOME INC 2 2 PEORIA $12.52 $50.44 $56.17 $119.13 4/1/2018

6009013 MADO HEALTHCARE - UPTOWN 6 6 CHICAGO $14.20 $50.55 $60.38 $125.13 4/1/2018 7/1/2016

6016885 MANOR COURT OF CARBONDALE 5 5 CARBONDALE $23.74 $43.93 $83.32 $150.99 4/1/2018

6015879 MANOR COURT OF CLINTON 4 4 CLINTON $17.98 $46.11 $84.96 $149.05 4/1/2018

6016133 MANOR COURT OF FREEPORT 1 1 FREEPORT $17.96 $51.52 $76.73 $146.21 4/1/2018

6013189 MANOR COURT OF MARYVILLE 11 11 MARYVILLE $13.47 $44.96 $73.53 $131.96 4/1/2018

6016190 MANOR COURT OF PEORIA 2 2 PEORIA $20.79 $46.11 $70.56 $137.46 4/1/2018

6015887 MANOR COURT OF PERU 2 2 PERU $17.87 $46.11 $78.32 $142.30 4/1/2018

6015861 MANOR COURT OF PRINCETON 2 2 PRINCETON $17.87 $46.11 $72.19 $136.17 4/1/2018

6000228 MANORCARE OF ARLINGTON HEIGHTS 7 7 ARLINGTON HEIGH $18.32 $55.98 $97.23 $171.53 4/1/2018

6012686 MANORCARE OF ELK GROVE VILLAGE 7 7 ELK GROVE VLG $21.58 $53.57 $101.66 $176.81 4/1/2018

6006332 MANORCARE OF HINSDALE 7 7 HINSDALE $11.08 $55.98 $90.90 $157.96 4/1/2018

6012611 MANORCARE OF HOMEWOOD 7 7 HOMEWOOD $21.11 $53.81 $103.42 $178.34 4/1/2018

6010482 MANORCARE OF LIBERTYVILLE 8 8 LIBERTYVILLE $16.43 $55.40 $101.04 $172.87 4/1/2018

6000251 MANORCARE OF NAPERVILLE 7 7 NAPERVILLE $14.95 $55.98 $88.82 $159.75 4/1/2018

6015168 MANORCARE OF NORTHBROOK 7 7 NORTHBROOK $21.70 $53.30 $94.65 $169.65 4/1/2018

6000236 MANORCARE OF OAK LAWN EAST 7 7 OAK LAWN $19.76 $54.32 $92.57 $166.65 4/1/2018

6000343 MANORCARE OF OAK LAWN WEST 7 7 OAK LAWN $17.75 $55.08 $107.05 $179.88 4/1/2018

6010912 MANORCARE OF PALOS HTS EAST 7 7 PALOS HEIGHTS $21.54 $53.48 $97.41 $172.43 4/1/2018

6014534 MANORCARE OF PALOS HTS WEST 7 7 PALOS HEIGHTS $23.37 $55.98 $98.93 $178.28 4/1/2018

6000327 MANORCARE OF ROLLING MEADOWS 7 7 ROLLING MEADOWS $19.67 $52.27 $100.98 $172.92 4/1/2018

6011589 MANORCARE OF SOUTH HOLLAND 7 7 SOUTH HOLLAND $21.20 $54.26 $107.48 $182.94 4/1/2018

6000335 MANORCARE OF WESTMONT 7 7 WESTMONT $17.31 $55.98 $99.76 $173.05 4/1/2018

6005706 MAPLE CREST CARE CENTRE 1 1 BELVIDERE $13.70 $46.96 $106.03 $166.69 4/1/2018

6005730 MAPLE CROSSING AT AMBOY LLC 1 1 AMBOY $11.60 $40.92 $92.85 $145.37 4/1/2018

6005748 MAR KA NURSING HOME 11 11 MASCOUTAH $10.11 $43.42 $80.83 $134.36 4/1/2018

6005797 MARIGOLD REHABILITATION HCC 2 2 GALESBURG $11.91 $46.74 $66.17 $124.82 4/1/2018

6011688 MASON CITY AREA NURSING HOME 3 3 MASON CITY $15.91 $44.49 $63.02 $123.42 4/1/2018 7/1/2016

6004691 MASON POINT 4 4 SULLIVAN $9.37 $50.44 $77.06 $136.87 4/1/2018

6005888 MATTOON REHAB AND HCC 4 4 MATTOON $10.99 $48.76 $79.59 $139.34 4/1/2018

6005896 MAYFIELD CARE CENTER 6 6 CHICAGO $12.93 $49.50 $101.42 $163.85 4/1/2018

6005938 MCKINLEY COURT 4 4 DECATUR $14.32 $47.72 $84.72 $146.76 4/1/2018

6005417 MCLEANSBORO REHAB HEALTH CARE 5 5 MC LEANSBORO $9.24 $43.93 $85.18 $138.35 4/1/2018

6005953 MEADOW MANOR SKILLED NRSG REH 3 3 TAYLORVILLE $10.26 $39.30 $72.70 $122.26 4/1/2018

6013120 MEADOWBROOK MANOR 9 9 BOLINGBROOK $17.07 $46.15 $121.89 $185.11 4/1/2018

6014518 MEADOWBROOK MANOR NAPERVILLE 7 7 NAPERVILLE $18.61 $48.91 $112.43 $179.95 4/1/2018

6016281 MEADOWBROOK MANOR OF LAGRANGE 7 7 LA GRANGE $16.22 $44.69 $123.05 $183.96 4/1/2018

6005987 MEADOWOOD 5 5 GRAYVILLE $9.03 $28.31 $53.42 $90.76 4/1/2018

Page 10

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6006001 MEADOWS MENNONITE 4 4 CHENOA $14.69 $49.26 $73.45 $137.40 4/1/2018

6006019 MEDINA NURSING CENTER 1 1 DURAND $14.27 $48.91 $77.41 $140.59 4/1/2018

6006035 MEMORIAL CARE CENTER 11 11 BELLEVILLE $6.15 $46.71 $88.66 $141.52 4/1/2018

6006050 MENDOTA LUTHERAN HOME 2 2 MENDOTA $12.09 $49.20 $78.63 $139.92 4/1/2018

6016737 MERCY CIRCLE 6 6 CHICAGO $18.18 $55.98 $75.21 $149.37 4/1/2018

6015697 MERCY HARVARD HOSPITAL CR CTR 8 8 HARVARD $10.15 $55.98 $85.95 $152.08 4/1/2018

6010391 MERCY REHAB AND CARE CENTER, I 11 11 SWANSEA $13.37 $46.71 $78.12 $138.20 4/1/2018

6015812 MERIDIAN VILLAGE CARE CENTER 11 11 GLEN CARBON $16.85 $46.71 $68.68 $132.24 4/1/2018

6006118 METROPOLIS REHAB AND HCC 5 5 METROPOLIS $16.62 $43.74 $77.18 $137.54 4/1/2018

6003826 MIDWAY NEUROLOGICAL REHAB CTR 7 7 BRIDGEVIEW $14.24 $40.03 $110.81 $165.08 4/1/2018

6001341 MIDWEST REHAB AND RESPIRATORY 11 11 BELLEVILLE $11.34 $44.45 $77.78 $133.57 4/1/2018

6014294 MILLER HEALTHCARE CENTER 9 9 KANKAKEE $18.18 $49.74 $88.04 $155.96 4/1/2018

6006258 MOMENCE MEADOWS NURSING AND RE 9 9 MOMENCE $13.57 $50.62 $121.27 $185.46 4/1/2018

6006266 MONMOUTH NURSING HOME 2 2 MONMOUTH $12.84 $46.60 $66.53 $125.97 4/1/2018

6006316 MONTEBELLO HEALTH CARE CENTER 3 3 HAMILTON $9.52 $38.57 $80.06 $128.15 4/1/2018

6004444 MONTGOMERY NURSING AND REHAB 3 3 HILLSBORO $11.19 $42.47 $86.37 $140.03 4/1/2018

6013171 MONTGOMERY PLACE 6 6 CHICAGO $14.39 $55.98 $63.89 $134.26 4/1/2018

6005698 MOORINGS OF ARLINGTON HEIGHTS 7 7 ARLINGTON HTS $14.39 $54.40 $94.38 $163.17 10/1/2014

6005177 MOSAIC OF LAKESHORE 6 6 CHICAGO $14.60 $49.20 $118.51 $182.31 4/1/2018

6012322 MOWEAQUA REHAB AND HEALTH CR 4 4 MOWEAQUA $12.66 $38.65 $69.61 $120.92 4/1/2018

6012512 MT VERNON COUNTRYSIDE MANOR 5 5 MOUNT VERNON $14.89 $41.16 $67.11 $123.16 4/1/2018

6001531 MT VERNON HEALTH CARE CENTER 5 5 MOUNT VERNON $8.92 $36.80 $83.73 $129.45 4/1/2018

6006498 NATURE TRAIL HEALTH CARE CTR 5 5 MOUNT VERNON $10.03 $43.93 $85.01 $138.97 4/1/2018

6006506 NAZARETHVILLE 7 7 DES PLAINES $11.10 $55.98 $93.96 $161.04 4/1/2018

6006522 NEW ATHENS HOME FOR THE AGED 11 11 NEW ATHENS $12.09 $44.26 $89.23 $145.58 4/1/2018

6002091 NEWMAN REHAB HEALTH CARE CTR 4 4 NEWMAN $10.75 $49.18 $98.42 $158.35 4/1/2018

6006548 NEWTON CARE CENTER 5 5 NEWTON $6.40 $41.39 $79.14 $126.93 4/1/2018

6003644 NILES NURSING AND REHAB CTR 7 7 NILES $17.51 $47.23 $117.92 $182.66 4/1/2018

6006555 NOKOMIS REHAB HEALTH CARE CTR 3 3 NOKOMIS $11.41 $37.88 $79.93 $129.22 4/1/2018

6006571 NORRIDGE GARDENS 7 7 NORRIDGE $16.53 $47.35 $116.96 $180.84 4/1/2018

6006589 NORTH ADAMS HOME 3 3 MENDON $12.95 $40.30 $65.92 $119.17 4/1/2018

6006605 NORTH AURORA CARE CENTER 8 8 NORTH AURORA $11.24 $49.29 $67.71 $128.24 4/1/2018

6000210 NORTH LOGAN HEALTHCARE CENTER 4 4 DANVILLE $16.27 $40.03 $98.49 $154.79 4/1/2018 7/1/2016

6006670 NORTHWOODS CARE CENTRE 1 1 BELVIDERE $14.74 $46.05 $96.83 $157.62 4/1/2018

6006696 NORWOOD CROSSING 6 6 CHICAGO $15.83 $55.98 $91.37 $163.18 4/1/2018 7/1/2016

6006779 OAK LAWN RESPIRATORY AND REHAB 7 7 OAK LAWN $13.23 $47.75 $162.62 $223.60 4/1/2018 7/1/2016

6006720 OAKBROOK HEALTHCARE CENTER 7 7 OAK BROOK $14.07 $51.25 $109.85 $175.17 4/1/2018

6006829 OAKRIDGE HEALTHCARE CENTER 7 1 HILLSIDE $11.01 $53.21 $85.22 $149.44 4/1/2018

6003487 OAKVIEW HTS CONT CARE REHAB 5 5 MOUNT CARMEL $15.97 $43.47 $64.57 $124.01 4/1/2018

6006860 ODD FELLOWS REBEKAH HOME 4 4 MATTOON $12.52 $48.70 $67.98 $129.20 4/1/2018

6006878 ODIN HEALTH CARE CENTER 5 5 ODIN $11.42 $42.84 $84.46 $138.72 4/1/2018

Page 11

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6009989 OREGON LIVING AND REHAB CENTER 1 1 OREGON $12.83 $47.39 $99.29 $159.51 4/1/2018

6012728 OSF ST ANTHONYS HEALTHCARE SNU 11 11 ALTON $6.15 $46.71 $25.90 $78.76 7/1/2014

6006985 OTTAWA PAVILION 2 2 OTTAWA $18.14 $46.58 $86.66 $151.38 4/1/2018

6006993 OUR LADY OF ANGELS RETIREMENT 9 9 JOLIET $14.88 $50.50 $79.67 $145.05 4/1/2018

6007041 PA PETERSON AT THE CITADEL 1 1 ROCKFORD $15.73 $51.52 $98.76 $166.01 4/1/2018

6002109 PALM TERRACE OF MATTOON 4 4 MATTOON $11.63 $38.77 $78.78 $129.18 4/1/2018 7/1/2016

6006795 PARAMOUNT OAK PARK R AND N CTR 7 7 OAK PARK $15.92 $44.45 $89.40 $149.77 4/1/2018

6004766 PARC AT JOLIET 9 9 JOLIET $12.87 $45.02 $90.84 $148.73 4/1/2018

6007090 PARIS HEALTH CARE CENTER 4 4 PARIS $11.07 $46.60 $89.41 $147.08 4/1/2018

6003073 PARK PLACE OF BELVIDERE 1 1 BELVIDERE $9.50 $45.80 $104.35 $159.65 4/1/2018

6003875 PARK POINTE HEALTHCARE AND REH 9 9 MORRIS $19.22 $53.08 $83.75 $156.05 4/1/2018

6007157 PARK RIDGE CARE CENTER 7 7 PARK RIDGE $16.48 $55.44 $92.18 $164.10 4/1/2018

6002315 PARK VIEW REHAB CENTER 6 6 CHICAGO $14.72 $41.72 $91.43 $147.87 4/1/2018

6007934 PARK VILLA NURSING REHAB CTR 7 7 PALOS HEIGHTS $20.01 $53.58 $107.96 $181.55 4/1/2018

6001374 PARKER NURSING AND REHAB CTR 2 2 STREATOR $11.16 $43.62 $101.40 $156.18 4/1/2018

6005003 PARKSHORE ESTATES NRSG REHAB 6 6 CHICAGO $13.59 $48.85 $99.08 $161.52 4/1/2018

6014385 PARKWAY MANOR 5 5 MARION $19.68 $42.39 $83.03 $145.10 4/1/2018

6009799 PAVILION OF WAUKEGAN 8 8 WAUKEGAN $12.63 $55.98 $112.74 $181.35 4/1/2018

6003339 PEARL PAVILION 1 1 FREEPORT $16.15 $45.38 $98.16 $159.69 4/1/2018 7/1/2016

6011712 PEKIN MANOR 2 2 PEKIN $18.02 $44.32 $78.55 $140.89 4/1/2018

6007355 PERSHING GARDENS HC CENTER 7 7 STICKNEY $16.38 $50.42 $102.65 $169.45 4/1/2018

6007371 PETERSON PARK HEALTH CARE CTR 6 6 CHICAGO $18.58 $48.71 $120.82 $188.11 4/1/2018

6005441 PINCKNEYVILLE NURSING & REHABI 5 5 PINCKNEYVILLE $13.92 $37.09 $88.72 $139.73 4/1/2018

6007413 PINE ACRES REHAB LIVING CENTER 1 1 DEKALB $17.96 $51.52 $97.46 $166.94 4/1/2018

6004741 PINE CREST HEALTH CARE 7 7 HAZEL CREST $17.78 $46.12 $86.71 $150.61 4/1/2018

6007447 PINECREST MANOR 1 1 MOUNT MORRIS $13.82 $50.58 $59.73 $124.13 4/1/2018

6003792 PIPER CITY REHAB LIVING CTR 4 4 PIPER CITY $10.96 $50.44 $74.75 $136.15 4/1/2018 7/1/2016

6012470 PITTSFIELD MANOR 3 3 PITTSFIELD $14.89 $40.30 $78.81 $134.00 4/1/2018

6007470 PLEASANT HILL HEALTHCARE 3 3 GIRARD $12.63 $38.68 $76.94 $128.25 4/1/2018

6007488 PLEASANT MEADOWS SENIOR LIVING 4 4 CHRISMAN $13.82 $48.02 $91.04 $152.88 4/1/2018

6007512 PLEASANT VIEW LUTHER HOME 2 2 OTTAWA $16.41 $50.44 $80.15 $147.00 4/1/2018

6007504 PLEASANT VIEW REHAB AND HCC 1 1 MORRISON $9.30 $45.95 $98.76 $154.01 4/1/2018

6007546 POLO REHABILITATION AND HCC 1 1 POLO $9.94 $49.51 $88.43 $147.88 4/1/2018

6007561 PRAIRIE CITY REHAB AND HC 2 2 PRAIRIE CITY $9.17 $43.60 $60.75 $113.52 4/1/2018

6008502 PRAIRIE CROSSING LVG AND REHAB 1 1 SHABBONA $12.10 $47.64 $89.77 $149.51 4/1/2018 7/1/2016

6011746 PRAIRIE MANOR NURSING REHAB 7 7 CHICAGO HEIGHTS $23.91 $49.26 $128.95 $202.12 4/1/2018

6007082 PRAIRIE ROSE HEALTH CARE CTR 3 3 PANA $10.40 $41.42 $74.32 $126.14 4/1/2018 7/1/2016

6006027 PRAIRIE VLG HEALTHCARE CTR INC 3 3 JACKSONVILLE $12.12 $38.31 $94.36 $144.79 4/1/2018

6007595 PRAIRIEVIEW LUTHERAN HOME 4 4 DANFORTH $12.95 $50.44 $84.84 $148.23 4/1/2018

6005771 PRESENCE COR MARIAE CENTER 1 1 ROCKFORD $12.52 $51.52 $66.87 $130.91 4/1/2018

6005854 PRESENCE MARYHAVEN NSG REHAB 7 7 GLENVIEW $14.39 $55.98 $95.89 $166.26 4/1/2018

Page 12

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6005912 PRESENCE MCAULEY MANOR 8 8 AURORA $12.98 $55.98 $91.91 $160.87 4/1/2018

6007009 PRESENCE OUR LADY OF VICTORY 9 9 BOURBONNAIS $14.39 $53.08 $92.14 $159.61 4/1/2018

6007439 PRESENCE PINE VIEW CARE CENTER 8 8 SAINT CHARLES $10.96 $55.98 $81.97 $148.91 4/1/2018

6014575 PRESENCE RESURRECTION LIFE CTR 6 6 CHICAGO $17.23 $54.57 $77.95 $149.75 4/1/2018

6007892 PRESENCE RESURRECTION NRC 7 7 PARK RIDGE $10.64 $54.29 $113.30 $178.23 4/1/2018

6008874 PRESENCE SAINT BENEDICT NRC 7 7 NILES $13.92 $55.98 $101.00 $170.90 4/1/2018

6008817 PRESENCE ST ANNE CENTER 1 1 ROCKFORD $12.09 $51.52 $92.62 $156.23 4/1/2018

6008973 PRESENCE ST JOSEPH CENTER 1 1 FREEPORT $14.24 $51.52 $77.93 $143.69 4/1/2018

6012678 PRESENCE VILLA FRANCISCAN 9 9 JOLIET $14.39 $53.08 $87.74 $155.21 4/1/2018

6009591 PRESENCE VILLA SCALABRINI NC 7 7 NORTHLAKE $12.05 $55.95 $101.86 $169.86 4/1/2018

6012645 PRINCETON REHABILITATION AND H 6 6 CHICAGO $17.33 $51.00 $87.81 $156.14 4/1/2018

6007876 PROVIDENCE DOWNERS GROVE 7 7 DOWNERS GROVE $14.88 $55.98 $91.27 $162.13 4/1/2018

6007843 PROVIDENCE PALOS HEIGHTS 7 7 PALOS HEIGHTS $14.39 $55.98 $99.27 $169.64 4/1/2018

6016356 RADFORD GREEN 8 8 LINCOLNSHIRE $18.90 $55.98 $104.61 $179.49 4/1/2018

6007751 RED BUD REGIONAL CARE 5 5 RED BUD $14.47 $43.93 $76.44 $134.84 4/1/2018

6008239 REGENCY CARE 3 3 SPRINGFIELD $15.16 $44.49 $75.81 $135.46 4/1/2018

6011381 REGENCY CARE OF MORRIS 9 9 MORRIS $17.11 $53.01 $98.57 $168.69 4/1/2018 7/1/2016

6011373 REGENCY CARE OF STERLING 1 1 STERLING $15.00 $51.52 $91.42 $157.94 4/1/2018 7/1/2016

6006712 RENAISSANCE CARE CENTER 2 2 CANTON $10.70 $37.41 $88.18 $136.29 4/1/2018

6007850 REST HAVEN MANOR 5 5 ALBION $3.97 $37.18 $55.69 $96.84 4/1/2018

6007884 RESTHAVE HOME OF WHITESIDE CO 1 1 MORRISON $16.84 $47.87 $69.12 $133.83 4/1/2018

6007942 RIDGEVIEW CARE CENTER 5 5 OBLONG $10.90 $35.23 $69.46 $115.59 4/1/2018

6003453 RIDGEVIEW REHAB NURSING CENTER 6 6 CHICAGO $15.67 $48.06 $94.22 $157.95 4/1/2018

6001085 RIVER NORTH BRADLEY H AND R 9 9 BRADLEY $13.41 $42.10 $99.87 $155.38 4/1/2018

6004758 RIVER VIEW REHAB CENTER 8 8 ELGIN $12.62 $42.33 $85.71 $140.66 4/1/2018

6008072 ROBINGS MANOR REHAB HLTH CR 3 3 BRIGHTON $12.11 $36.39 $79.21 $127.71 4/1/2018

6008098 ROCHELLE GARDENS CARE CENTER 1 1 ROCHELLE $10.47 $44.99 $60.71 $116.17 4/1/2018 7/1/2016

6008106 ROCHELLE REHAB HEALTH CARE 1 1 ROCHELLE $11.79 $51.52 $75.01 $138.32 4/1/2018 7/1/2016

6008114 ROCK FALLS REHAB HLTH CARE CTR 1 1 ROCK FALLS $9.89 $51.42 $72.11 $133.42 4/1/2018

6002695 ROCK RIVER GARDENS 1 1 STERLING $8.55 $39.13 $49.94 $97.62 4/1/2018

6008049 ROCK RIVER HEALTH CARE 1 1 ROCKFORD $12.71 $43.47 $97.11 $153.29 4/1/2018 7/1/2016

6008163 ROLLING HILLS MANOR 8 8 ZION $14.88 $55.98 $90.77 $161.63 4/1/2018

6005136 ROSEVILLE REHAB HEALTH CARE 2 2 ROSEVILLE $9.62 $46.49 $63.71 $119.82 4/1/2018

6012074 ROSEWOOD CARE CENTER ALTON 11 11 ALTON $14.95 $42.51 $77.57 $135.03 4/1/2018

6014237 ROSEWOOD CARE CENTER ELGIN 8 8 ELGIN $16.42 $51.18 $87.85 $155.45 4/1/2018

6010466 ROSEWOOD CARE CENTER GALESBURG 2 2 GALESBURG $14.23 $41.85 $74.93 $131.01 4/1/2018

6014633 ROSEWOOD CARE CENTER INVERNESS 7 7 INVERNESS $22.20 $52.72 $93.02 $167.94 4/1/2018

6012835 ROSEWOOD CARE CENTER JOLIET 9 9 JOLIET $15.52 $50.13 $87.89 $153.54 4/1/2018

6012587 ROSEWOOD CARE CENTER OF MOLINE 10 10 MOLINE $14.73 $48.06 $69.84 $132.63 4/1/2018

6012165 ROSEWOOD CARE CENTER PEORIA 2 2 PEORIA $13.50 $49.68 $72.48 $135.66 4/1/2018

6014658 ROSEWOOD CARE CENTER ROCKFORD 1 1 ROCKFORD $17.46 $49.15 $63.03 $129.64 4/1/2018

Page 13

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6012017 ROSEWOOD CARE CTR EAST PEORIA 2 2 EAST PEORIA $13.84 $48.51 $77.88 $140.23 4/1/2018

6014401 ROSEWOOD CARE CTR EDWARDSVILLE 11 11 EDWARDSVILLE $16.83 $46.71 $74.61 $138.15 4/1/2018

6019723 ROSEWOOD CARE CTR NORTHBROOK 7 7 NORTHBROOK $21.11 $53.85 $110.69 $185.65 4/1/2018

6014666 ROSEWOOD CARE CTR ST CHARLES 8 8 ST CHARLES $19.01 $55.06 $77.64 $151.71 4/1/2018

6003065 ROSICLARE REHAB HEALTH CR 5 5 ROSICLARE $9.85 $43.93 $84.01 $137.79 4/1/2018

6005029 ROYAL OAKS CARE CENTER 10 10 KEWANEE $10.12 $37.71 $73.97 $121.80 4/1/2018

6008684 RUSHVILLE NURSING & REHABILITA 3 3 RUSHVILLE $9.48 $43.30 $86.44 $139.22 4/1/2018

6008338 SALEM VILLAGE NURSING AND REHA 9 9 JOLIET $13.08 $49.38 $120.55 $183.01 4/1/2018

6008346 SALINE CARE NURSING AND REHAB 5 5 HARRISBURG $10.65 $34.43 $77.01 $122.09 4/1/2018 7/1/2016

6008213 SANDWICH REHAB HEALTH CARE 1 1 SANDWICH $11.63 $51.52 $86.31 $149.46 4/1/2018

6001929 SAUK VALLEY SENIOR LIVING 1 1 ROCK FALLS $10.42 $47.83 $78.95 $137.20 4/1/2018

6005722 SELECT POST ACUTE CARE 2 2 EUREKA $12.09 $50.44 $65.46 $127.99 4/1/2018

6008460 SELFHELP HOME OF CHICAGO 6 6 CHICAGO $18.18 $55.98 $75.42 $149.58 4/1/2018

6010250 SEMINARY MANOR 2 2 GALESBURG $16.38 $46.44 $80.19 $143.01 4/1/2018

6007272 SHARON HEALTH CARE WILLOWS 2 2 PEORIA $10.74 $41.48 $92.33 $144.55 4/1/2018 7/1/2016

6007306 SHARON HEALTHCARE ELMS 2 2 PEORIA $10.53 $44.72 $106.25 $161.50 4/1/2018

6007298 SHARON HEALTHCARE PINES 2 2 PEORIA $10.56 $42.36 $73.93 $126.85 4/1/2018

6008528 SHAWNEE CHRISTIAN NURSING CTR 5 5 HERRIN $11.23 $40.09 $79.59 $130.91 4/1/2018

6004055 SHAWNEE ROSE CARE CENTER 5 5 HARRISBURG $9.06 $32.62 $84.62 $126.30 4/1/2018

6008544 SHELBYVILLE MANOR 4 4 SHELBYVILLE $16.06 $41.91 $88.15 $146.12 4/1/2018

6008536 SHELBYVILLE REHAB HEALTH CARE 4 4 SHELBYVILLE $8.58 $49.62 $86.06 $144.26 4/1/2018

6008569 SHELDON HEALTH CARE CENTER 4 4 SHELDON $9.89 $50.44 $74.71 $135.04 4/1/2018

6002687 SHERIDAN SHORES REHAB CENTER 6 6 CHICAGO $18.03 $42.94 $88.07 $149.04 4/1/2018

6012827 SHERMAN WEST COURT 8 8 ELGIN $14.88 $55.98 $76.96 $147.82 4/1/2018

6016059 SMITH CROSSING 9 9 ORLAND PARK $18.18 $45.68 $100.32 $164.18 4/1/2018

6009732 SMITH VILLAGE 6 6 CHICAGO $11.56 $55.98 $77.44 $144.98 4/1/2017

6011464 SNYDER VILLAGE 2 2 METAMORA $15.97 $48.71 $71.44 $136.12 4/1/2018 7/1/2016

6008718 SOUTH ELGIN REHAB HEALTH CARE 8 8 SOUTH ELGIN $11.33 $52.66 $89.64 $153.63 4/1/2018 7/1/2017

6016497 SOUTH SUBURBAN REHAB CENTER 7 7 HOMEWOOD $17.30 $49.95 $100.01 $167.26 4/1/2018

6008759 SOUTHGATE HEALTH CARE CENTER 5 5 METROPOLIS $14.28 $41.44 $72.06 $127.78 4/1/2018

6014781 SOUTHPOINT NURSING REHAB CTR 6 6 CHICAGO $21.00 $48.97 $130.25 $200.22 4/1/2018

6001895 SOUTHVIEW MANOR NURSING CENTER 6 6 CHICAGO $14.26 $38.92 $74.50 $127.68 4/1/2018

6016786 SPRING CREEK NRSG REHAB CTR 9 9 JOLIET $13.45 $46.84 $100.56 $160.85 4/1/2018 7/1/2016

6011803 SPRINGS AT CRYSTAL LAKE 8 8 CRYSTAL LAKE $20.77 $55.98 $120.36 $197.11 4/1/2018

6016877 SPRINGS AT MONARCH LANDING 7 7 NAPERVILLE $22.19 $45.20 $77.44 $144.83 4/1/2018

6008866 ST ANTHONYS NURSING AND REHAB 10 10 ROCK ISLAND $17.37 $51.52 $73.47 $142.36 4/1/2018

6008890 ST CLARAS MANOR 3 3 LINCOLN $9.51 $44.24 $79.28 $133.03 4/1/2018

6010664 ST JAMES WELLNESS REHAB VILLAS 9 9 CRETE $15.16 $53.08 $105.05 $173.29 4/1/2018

6011407 ST JOSEPH MED CTR NURSING UNIT 4 4 BLOOMINGTON $3.66 $50.44 $29.21 $83.31 7/1/2014

6008957 ST JOSEPH VILLAGE OF CHICAGO 6 6 CHICAGO $11.56 $55.98 $108.45 $175.99 4/1/2018

6009005 ST JOSEPHS HOME FOR THE ELDERL 7 7 PALATINE $9.22 $55.98 $67.37 $132.57 4/1/2018

Page 14

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6008999 ST JOSEPHS NURSING HOME 2 2 LACON $5.80 $50.44 $65.16 $121.40 4/1/2018 7/1/2017

6011910 ST PATRICKS RES 7 7 NAPERVILLE $14.88 $53.80 $93.29 $161.97 4/1/2018

6009120 ST PAULS HOME 11 11 BELLEVILLE $16.84 $46.02 $68.91 $131.77 4/1/2018 7/1/2016

6009112 ST PAULS HOUSE AND HEALTH CARE 6 6 CHICAGO $15.34 $55.98 $78.88 $150.20 4/1/2018

6005466 ST VINCENTS HOME INC 3 3 QUINCY $14.48 $40.51 $72.65 $127.64 4/1/2018

6010441 STEARNS NURSING AND REHAB CTR 11 11 GRANITE CITY $13.68 $41.65 $78.60 $133.93 4/1/2018

6009179 STERLING PAVILION 1 1 STERLING $11.67 $41.99 $81.10 $134.76 4/1/2018

6008494 STONEBRIDGE NURSING AND REHAB 5 5 BENTON $10.15 $37.02 $80.89 $128.06 4/1/2018 7/1/2016

6009211 SULLIVAN REHAB HEALTH CARE CTR 4 4 SULLIVAN $10.43 $41.01 $73.85 $125.29 4/1/2018 7/1/2016

6009294 SUNRISE SKILLED NURSING REHAB 3 3 VIRDEN $10.10 $38.30 $69.17 $117.57 4/1/2018

6009302 SUNSET HOME 3 3 QUINCY $14.69 $44.49 $73.00 $132.18 4/1/2018 7/1/2016

6009328 SUNSET REHAB HEALTH CARE 2 2 CANTON $13.92 $36.90 $72.04 $122.86 4/1/2018 7/1/2016

6009831 SWANSEA REHAB HEALTH CARE CENT 11 11 SWANSEA $9.17 $39.29 $97.54 $146.00 4/1/2018

6014831 SYMPHONY AT 87TH STREET 6 6 CHICAGO $22.15 $51.34 $111.93 $185.42 4/1/2018

6014906 SYMPHONY AT ARIA 7 7 HILLSIDE $21.46 $49.62 $110.46 $181.54 4/1/2018

6014641 SYMPHONY AT MIDWAY 6 6 CHICAGO $20.12 $49.75 $105.95 $175.82 4/1/2018

6009401 SYMPHONY AT THE TILLERS 9 9 OSWEGO $18.04 $53.08 $94.06 $165.18 4/1/2018

6007967 SYMPHONY EVANSTON HEALTHCARE 7 7 EVANSTON $19.93 $55.98 $104.00 $179.91 4/1/2018

6001689 SYMPHONY OF BRONZEVILLE 6 6 CHICAGO $16.09 $45.18 $108.26 $169.53 4/1/2018

6014195 SYMPHONY OF BUFFALO GROVE 8 8 BUFFALO GROVE $18.10 $50.88 $116.03 $185.01 4/1/2018

6004832 SYMPHONY OF CHICAGO WEST 6 6 CHICAGO $16.82 $48.78 $106.48 $172.08 4/1/2018

6002265 SYMPHONY OF CRESTWOOD 7 7 CRESTWOOD $17.53 $49.50 $108.38 $175.41 4/1/2018

6006282 SYMPHONY OF DECATUR 4 4 DECATUR $13.70 $44.44 $98.36 $156.50 4/1/2018

6016554 SYMPHONY OF HANOVER PARK 7 7 HANOVER PARK $26.15 $55.98 $120.63 $202.76 4/1/2018

6002463 SYMPHONY OF JOLIET 9 9 JOLIET $16.31 $47.40 $112.51 $176.22 4/1/2018

6005490 SYMPHONY OF LINCOLN 3 3 LINCOLN $15.05 $42.60 $107.30 $164.95 4/1/2018

6004733 SYMPHONY OF LINCOLN PARK 6 6 CHICAGO $17.73 $53.60 $116.50 $187.83 4/1/2018

6003958 SYMPHONY OF MORGAN PARK 6 6 CHICAGO $14.80 $48.00 $107.40 $170.20 4/1/2018

6002174 SYMPHONY OF ORCHARD VALLEY 8 8 AURORA $15.60 $46.13 $114.55 $176.28 4/1/2018

6014823 SYMPHONY OF SOUTH SHORE 6 6 CHICAGO $21.75 $52.59 $108.97 $183.31 4/1/2018

6014252 TABOR HILLS HEALTHCARE FACILIT 7 7 NAPERVILLE $17.23 $55.98 $87.45 $160.66 4/1/2018

6009369 TAYLORVILLE CARE CENTER 3 3 TAYLORVILLE $10.83 $39.24 $79.85 $129.92 4/1/2018

6009377 TERRACE NURSING HOME 8 8 WAUKEGAN $12.15 $44.89 $98.18 $155.22 4/1/2018

6001465 THE CARLTON AT THE LAKE 6 6 CHICAGO $19.28 $50.66 $108.91 $178.85 4/1/2018

6008593 THE GROVE AT THE LAKE 8 8 ZION $17.26 $49.89 $123.51 $190.66 4/1/2018

6010144 THE GROVE OF ELMHURST 7 7 ELMHURST $12.90 $50.63 $121.01 $184.54 4/1/2018

6008916 THE GROVE OF EVANSTON LIVING & 7 7 EVANSTON $17.94 $55.98 $116.50 $190.42 4/1/2018

6003057 THE GROVE OF LAGRANGE PARK LIV 7 7 LA GRANGE PARK $18.50 $52.81 $116.59 $187.90 4/1/2018

6003412 THE GROVE OF NORTHBROOK 7 7 NORTHBROOK $16.72 $50.77 $112.85 $180.34 4/1/2018

6009625 THE GROVE OF SKOKIE 7 7 SKOKIE $17.04 $47.36 $108.07 $172.47 4/1/2018

6009393 THREE SPRINGS LODGE NRSG HOME 5 5 CHESTER $11.23 $40.10 $59.75 $111.08 4/1/2018

Page 15

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6007330 TIMBERCREEK REHAB AND HEALTH C 2 2 PEKIN $11.32 $45.39 $73.63 $130.34 4/1/2018

6003750 TIMBERPOINT HEALTHCARE CENTER 3 3 CAMP POINT $10.17 $44.15 $95.44 $149.76 4/1/2018 7/1/2016

6009427 TOULON REHAB HEALTH CARE CTR 2 2 TOULON $12.29 $45.01 $72.42 $129.72 4/1/2018

6003263 TOWER HILL HEALTHCARE CENTER 8 8 SOUTH ELGIN $13.01 $45.97 $98.38 $157.36 4/1/2018

6016901 TRANSITIONAL CARE OF ARLINGTON 7 7 ARLINGTON HEIGH $23.30 $55.98 $122.90 $202.18 4/1/2018

6009443 TRI STATE NURSING REHAB CENTER 7 7 LANSING $17.37 $50.93 $121.73 $190.03 4/1/2018

6002588 TUSCOLA HEALTH CARE CENTER 4 4 TUSCOLA $9.01 $38.53 $102.96 $150.50 4/1/2018

6004188 TWIN LAKES REHAB HEALTH CARE 4 4 PARIS $10.37 $41.32 $92.96 $144.65 4/1/2018

6009484 TWIN WILLOWS NURSING CENTER 5 5 SALEM $8.66 $35.35 $78.91 $122.92 4/1/2018

6009492 UNION COUNTY HOSPITAL LTC 5 5 ANNA $4.73 $43.93 $84.08 $132.74 4/1/2018

6009500 UNITED METHODIST VILLAGE 5 5 LAWRENCEVILLE $8.65 $41.56 $66.71 $116.92 4/1/2018

6013072 UNITED METHODIST VILLAGE NORTH 5 5 LAWRENCEVILLE $14.27 $40.24 $61.75 $116.26 4/1/2018

6002711 UNIVERSITY NURSING AND RHB CTR 11 11 EDWARDSVILLE $10.82 $41.10 $97.87 $149.79 4/1/2018

6006134 UPTOWN CARE CENTER 6 6 CHICAGO $16.10 $47.51 $96.67 $160.28 4/1/2018 7/1/2016

6009260 VANDALIA REHAB HEALTH CARE 5 5 VANDALIA $8.76 $43.47 $80.70 $132.93 4/1/2018

6001127 VERACARE BURBANK 7 7 BURBANK $19.23 $55.98 $128.35 $203.56 4/1/2018

6007322 VILLA AT EVERGREEN PARK 7 7 EVERGREEN PARK $16.99 $55.98 $96.51 $169.48 4/1/2018

6007868 VILLA AT SOUTH HOLLAND 7 7 SOUTH HOLLAND $25.52 $55.98 $100.04 $181.54 4/1/2018 7/1/2017

6014856 VILLA AT WINDSOR PARK 6 7 CHICAGO $21.08 $47.06 $101.24 $169.38 4/1/2018

6012991 VILLA HEALTH CARE INC EAST 3 3 SHERMAN $14.69 $44.49 $73.94 $133.12 4/1/2018

6011332 VILLAGE AT VICTORY LAKES 8 8 LINDENHURST $12.51 $55.98 $86.48 $154.97 4/1/2018

6009674 WABASH CHRISTIAN VILLAGE 5 5 CARMI $13.10 $43.79 $79.85 $136.74 4/1/2018

6009682 WALKER NURSING HOME 3 3 VIRGINIA $12.07 $43.65 $58.75 $114.47 4/1/2018

6005516 WARREN BARR LINCOLN PARK 6 6 CHICAGO $17.48 $44.99 $118.19 $180.66 4/1/2018 7/1/2016

6014377 WARREN BARR LINCOLNSHIRE 8 8 LINCOLNSHIRE $17.97 $55.98 $102.22 $176.17 4/1/2018

6004725 WARREN BARR LIVING & REHAB CTR 6 6 CHICAGO $18.36 $55.98 $111.50 $185.84 4/1/2018

6014963 WARREN BARR NORTH SHORE 8 8 HIGHLAND PARK $20.70 $54.23 $112.87 $187.80 4/1/2018 7/1/2016

6008825 WARREN BARR SOUTH LOOP 6 6 CHICAGO $15.29 $54.02 $172.86 $242.17 4/1/2018

6008262 WARREN PARK HEALTH LIVING CTR 6 6 CHICAGO $15.36 $50.85 $91.23 $157.44 4/1/2018 7/1/2017

6009740 WASHINGTON CHRISTIAN VILLAGE 2 2 WASHINGTON $11.83 $45.83 $81.57 $139.23 4/1/2018

6002430 WATERFORD CARE CENTER, THE 6 6 CHICAGO $17.06 $38.10 $106.24 $161.40 4/1/2018

6009757 WATERFRONT TERRACE 6 6 CHICAGO $16.40 $48.69 $103.18 $168.27 4/1/2018 7/1/2016

6009765 WATSEKA REHAB HEALTH CARE CTR 4 4 WATSEKA $10.37 $46.59 $78.68 $135.64 4/1/2018

6009435 WAUCONDA HEALTHCARE AND REHAB 8 8 WAUCONDA $15.67 $50.55 $113.09 $179.31 4/1/2018

6006365 WAVERLY PLACE OF STOCKTON 1 1 STOCKTON $12.04 $43.60 $98.86 $154.50 4/1/2018

6009856 WENTWORTH REHAB AND HCC 6 6 CHICAGO $17.55 $44.13 $94.71 $156.39 4/1/2018

6006100 WESLEY PLACE 6 6 CHICAGO $16.29 $55.98 $104.72 $176.99 4/1/2018

6009864 WESLEY VILLAGE 2 2 MACOMB $15.97 $45.95 $75.38 $137.30 4/1/2018 7/1/2016

6009872 WEST CHICAGO TERRACE NH 7 7 WEST CHICAGO $11.40 $39.35 $58.79 $109.54 4/1/2018

6013478 WEST SUBURBAN HOSP MED CTR SNF 7 7 OAK PARK $13.46 $45.20 $49.78 $108.44 7/1/2014

6001002 WEST SUBURBAN NURSING REHAB 7 7 BLOOMINGDALE $13.59 $45.64 $124.64 $183.87 4/1/2018

Page 16

ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

BUREAU OF RATE DEVELOPMENT AND ANALYSIS

MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2018 (no SMHRFs)

Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Change Eff Date

6012173 WESTCHESTER HEALTH AND REHAB C 7 7 WESTCHESTER $20.38 $55.98 $97.43 $173.79 4/1/2018

6007603 WESTMINSTER PLACE 7 7 EVANSTON $9.22 $55.98 $114.49 $179.69 1/1/2018

6000194 WESTSIDE REHAB CARE CENTER 5 5 WEST FRANKFORT $7.90 $35.39 $73.84 $117.13 4/1/2018

6009955 WESTWOOD MANOR 6 6 CHICAGO $14.15 $37.86 $78.02 $130.03 4/1/2018

6009963 WHEATON CARE CENTER 7 7 WHEATON $13.40 $47.85 $83.99 $145.24 4/1/2018

6006597 WHITE HALL NURSING AND REHAB 3 3 WHITE HALL $17.79 $30.87 $76.99 $125.65 4/1/2018

6004881 WHITE OAK REHABILITATION HCC 5 5 MOUNT VERNON $11.10 $43.93 $71.85 $126.88 4/1/2018

6008379 WILLOW CREST NURS PAVILION LTD 1 1 SANDWICH $13.88 $43.09 $96.83 $153.80 4/1/2018 7/1/2016

6003842 WILLOW ROSE REHAB HEALTH CARE 3 3 JERSEYVILLE $10.40 $40.48 $77.62 $128.50 4/1/2018 7/1/2016

6010037 WILLOWS HEALTH CENTER 1 1 ROCKFORD $12.04 $51.52 $82.95 $146.51 4/1/2018

6010052 WINCHESTER HOUSE 8 8 LIBERTYVILLE $7.27 $66.61 $97.23 $171.11 4/1/2018

6010078 WINDMILL NURSING PAVILION 7 7 SOUTH HOLLAND $17.87 $44.27 $91.81 $153.95 4/1/2018

6005904 WINDSOR ESTATES NURSING AND RE 7 7 COUNTRY CLUB HI $18.03 $54.05 $115.35 $187.43 4/1/2018

6011753 WINDSOR PARK MANOR 7 7 CAROL STREAM $16.76 $55.98 $90.75 $163.49 4/1/2018

6005334 WINFIELD WOODS HEALTHCARE CTR 7 7 WINFIELD $14.12 $44.76 $91.17 $150.05 4/1/2018

6010094 WINNING WHEELS 1 1 PROPHETSTOWN $16.84 $51.52 $106.13 $174.49 4/1/2018 7/1/2017

6010102 WINSTON MANOR CONVALESCENT N H 6 6 CHICAGO $10.75 $36.42 $64.72 $111.89 4/1/2018 7/1/2016

6007074 WOODBRIDGE NURSING PAVILION 6 6 CHICAGO $16.18 $40.95 $123.17 $180.30 4/1/2018 7/1/2016

6008361 WYNSCAPE HEALTH AND REHAB 7 7 WHEATON $14.82 $55.98 $80.15 $150.95 4/1/2018

Page 17