How to start a hospice in Illinois

Illinois requires a Hospice program license — comprehensive or volunteer hospice program from Illinois Department of Public Health to operate a hospice. Fee: $500.

License required

Yes

License

Hospice program license — comprehensive or volunteer hospice program

Issuing agency

Illinois Department of Public Health

Fee

$500

Fee details

Comprehensive hospice application $500; volunteer hospice $250; certified local health departments exempt.

Renewal

Every year · $500 annual renewal; file 60 days before the license expires.

Survey and inspection

IDPH inspects before the initial license; renewal surveys are at IDPH discretion based on compliance history, key personnel changes, complaints and time since last survey.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

Hospice Program Licensing Act (210 ILCS 60); 77 Ill. Adm. Code Part 280

1. File a written application under oath on IDPH forms (initial or renewal)
2. Pay the fee ($500 comprehensive / $250 volunteer)
3. Respond within 90 days to any IDPH request for revisions or documents
4. Pass the IDPH initial licensure inspection
5. Receive a one-year license if in substantial compliance
6. Renew annually 60 days before expiration; notify IDPH 30 days before any change of ownership (new owner needs a new license)

Program

Illinois Medical Assistance Program (Department of Healthcare and Family Services)

Enrollment portal

IMPACT (Illinois Medicaid Program Advanced Cloud Technology) provider enrollment system

Fiscal agent

None named — HFS runs provider enrollment itself through IMPACT Provider Enrollment Services

Application fee

Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

IMPACT uses CMS's risk levels and sets its own for provider types CMS does not classify; high-risk providers must submit fingerprints and pass criminal background checks before enrollment. DMEPOS suppliers are high risk and must be licensed (or exempt) and accredited by a recognized body. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

IMPACT does onsite visits before and after enrollment for moderate- and high-risk providers, including at revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

HFS restarted revalidation in IMPACT in rolling stages from September 3, 2024; providers revalidate through the 'Provider Revalidation List' in IMPACT and may be asked for more documents. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Illinois Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need permit (Illinois Health Facilities Planning Act)

Agency

Illinois Health Facilities and Services Review Board (HFSRB), staffed by the Illinois Department of Public Health

Services covered

• hospitals
• ambulatory surgical treatment centers
• skilled and intermediate long-term care facilities (nursing homes)
• ID/DD and MC/DD skilled and intermediate care facilities
• Specialized Mental Health Rehabilitation Act facilities
• kidney disease treatment centers / freestanding hemodialysis
• state-operated hospitals, nursing homes, surgery and dialysis centers

Illinois certificate of need details →

State minimum wage

$15.00 an hour

Effective

2025-01-01

Scheduled increases

No scheduled change found in the official sources reviewed.

Direct-care wage floor

Department on Aging homemaker rates were raised to $30.80/hour from 2026-01-01 to sustain a minimum wage of $18.75/hour for direct service workers (after $17 in 2024 and $18 in 2025).

Rate pass-through

In-home service providers must certify they pay the mandated wage increase, and may not cut fringe benefits (paid time off, training pay, health insurance, travel) in response to the rate increases.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

365 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

149 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

2,932,625 (as of Jun 1, 2026)