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Illinois license type

Supportive Living Program (SLP)

The Illinois Medicaid assisted-living alternative (no Texas equivalent)

The Supportive Living Program (SLP) is the Illinois Medicaid alternative to nursing-home care, run by Illinois HFS, that pays for assisted-living-style services for low-income seniors (65 or older) and adults 22 to 64 with physical disabilities at nursing-facility level of need. The service rate must be at least 54.75% of the regional nursing-facility per-diem; the Chicago regular daily rate is about $151.81 effective January 1, 2026. Residents pay room and board separately. SLP is a competitive, capacity-limited certification through HFS, not an open IDPH license, and it is the major Illinois feature that Texas does not have.

Reviewed by Erika Crossley, senior living AI specialist · Information last verified June 2026

License fee

No license fee; certification by HFS (apply through the program)

SLP is a Medicaid certification, separate from the IDPH establishment license. Many operators hold both.

Capacity

Apartment-style; residents are 65 or older (or 22 to 64 with a physical disability), Medicaid-eligible, at nursing-facility level of need

Model

A Medicaid home and community-based services program run by Illinois HFS, not an IDPH license. It pays for assisted-living-style services as a nursing-home alternative. The resident pays room and board separately.

License term

Certification by HFS; approved sites must be operational within 24 months.

Governing law

305 ILCS 5/5-5.01a; 89 Ill. Adm. Code 146

Best for

Operators who want a Medicaid-backed census to hedge vacancy, and can win a competitive HFS certification slot.

Building and physical plant

  • Apartment-style units, consistent with the assisted living physical plant, not a shared-bedroom house.
  • The building must be certified by HFS, including an architect-signed certificate that it meets all applicable codes.
  • Approved development sites must become operational within 24 months of approval.

Staffing and training

  • Staffing consistent with the assisted living model, including 24-hour on-site coverage.
  • Same Health Care Worker Background Check and training rules apply.

How residents pay

  • Medicaid pays the service rate: at least 54.75% of the regional nursing-facility per-diem. The Chicago regular daily rate is about $151.81 effective January 1, 2026.
  • The resident pays room and board separately (about $847 per month for single occupancy in 2025) and keeps a $120 monthly personal-needs allowance.
  • This turns filled beds into a Medicaid-backed annuity, at a lower but reliable rate than private pay.

Strengths

  • A guaranteed Medicaid census that hedges the number-one risk in a small home: vacancy.
  • Opens the much larger low-income senior market that private pay cannot reach.
  • A genuine Illinois moat; there is no clean Texas equivalent.

Watch-outs

  • Certification is competitive and capacity-limited; HFS approves sites by geographic distribution and slot availability, which functions like a development cap in saturated areas. Confirm current openings with HFS before underwriting Medicaid revenue.
  • Requires an apartment-style building, not a converted shared-bedroom house.
  • The rate is lower than private pay, and approved sites must open within 24 months.

The official Illinois sources

Straight to the regulator and the statute, verified June 2026.

Compare the other Illinois license types