Section 146.215  SLF Participation Requirements

 

a)         Facilities or distinct parts of facilities that are certified as SLFs and are in good standing with provisions contained in this Subpart B are exempt from the provisions of the Nursing Home Care Act [210 ILCS 45], the Illinois Health Facilities Planning Act [20 ILCS 3960] and the Assisted Living and Shared Housing Act [210 ILCS 9].  Nursing facilities rehabilitating a portion of the facility to conform with this Subpart B shall be allowed to retain their Certificate of Need for the nursing facility beds that were converted until the conclusion of the project or until the facility wishes to withdraw from the project and convert the SLF beds back to NF beds.

 

b)         An SLF does not include:

 

1)         A home, institution, or other place operated by the federal government or agency thereof, or by the State of Illinois;

 

2)         A "long term care facility" licensed by the Nursing Home Care Act or Hospital Licensing Act.  However, a nursing facility licensed under the aforementioned Acts can convert a distinct part to an SLF;

 

3)         Any "facility for child care" as defined in the Child Care Act of 1969 [225 ILCS 10];

 

4)         Any "Community Living Facility" as defined in the Community Living Facilities Licensing Act [210 ILCS 35];

 

5)         Any "community residential alternative" as defined in the Community Residential Alternatives Licensing Act [405 ILCS 30];

 

6)         Any nursing home or sanitarium operated solely by and for persons who rely exclusively upon treatment by spiritual means through prayer, in accordance with the creed of any well recognized church or religious denomination;

 

7)         Any facility licensed by the Department of Human Services as a community-integrated living arrangement as defined in the Community Integrated Living Arrangements Licensure and Certification Act [210 ILCS 135];

 

8)         Any "Supportive Residence" licensed under the Supportive Residences Licensing Act [210 ILCS 65];

 

9)         Any freestanding hospice facility [210 ILCS 60];

 

10)         Any "life care facility" as defined in the Life Care Facilities Act [210 ILCS 40]; or

 

11)         Any "assisted living and shared housing establishment" licensed under the Assisted Living and Shared Housing Act [210 ILCS 9].

 

c)         In order to participate in the Supportive Living Program, an SLF must be certified by the Department.  To become certified, an SLF shall:

 

1)         Submit an application to proceed toward certification.

 

A)        Except in the case of a rehabilitated nursing facility, the Department shall only accept applications for sites where all apartments are devoted to SLF residents. 

 

B)        The Department shall evaluate each application according to factors including, but not limited to, geographic distribution, waiver limits, market feasibility, the needs of the population being served, the compliance histories of other facilities owned or operated in the State of Illinois by the applicant or a related party, community support from local government, environmental issues, operational experience with assisted living and financial stability.  Applications that are found to be incomplete or inaccurate shall be returned to the applicant for completion and/or correction and must be resubmitted before the Department will evaluate them. The Department shall notify the applicant in writing that the application has been approved.

           

C)        The Department may withdraw approval of any application if the SLF fails to become operational (i.e., ready to admit residents) within 24 months after the Department's approval of the application.  Prior to the operational deadline, the applicant may make a written request, including documentation justifying the need for an extension, that the Department grant an extension to the operational deadline. A request for an extension shall not exceed 12 months from the original operational deadline.  The Department may grant an extension to the operational deadline. The Department shall not grant more than one extension to an approved SLF applicant where construction has not begun.

 

D)        At any time prior to or subsequent to certification, the applicant shall report to the Department in writing any change to the application, as soon as such change becomes known to the applicant.

 

2)         Submit a certificate of compliance signed by an architect that certifies that the project complies with applicable codes. 

 

3)         Submit for approval prior to use a model of every type of resident contract to be used by the SLF.

 

4)         Pass an on-site review, conducted by the Department, which includes review of:

 

A)        Documentation that demonstrates physical plant, health and sanitation, and food preparation compliance with local and county ordinances and regulations; compliance with current Fire and Life Safety standards for health care occupancy or the 2000 National Fire Protection Association Life Safety Code (NFPA) 101, Chapter 32, Residential Board and Care Occupancies, National Fire Protection Association, 1 Batterymarch Park, Quincy MA 02269 (March 11, 2003) (this incorporation by reference does not include any later amendments or editions); compliance with State building codes for the respective building type; and compliance with Section 146.210.

 

B)        Grievance procedures.

 

C)        Quality assurance policy and procedures established in accordance with Section 146.270.

 

D)        Emergency Contingency Plan as defined in Section 146.295.

 

5)         Enroll to participate in the Medical Assistance Program in accordance with 89 Ill. Adm. Code 140.11 and execute a Medicaid provider agreement with the Department.

           

d)         The SLF shall accept the SSI rate (less the  personal allowance) for room and board for Medicaid residents.  If the private and Medicaid rates are different, the SLF shall reserve not less than 25 percent of its apartments for Medicaid residents.  Those facilities that set a commensurate rate for both private pay and Medicaid residents are not required to reserve apartments for Medicaid residents but must accept Medicaid residents on a first come, first served basis.

 

e)         SLF certification is not transferable or applicable to any location, provider, management agent or ownership other than that indicated on the Medicaid provider agreement.

 

1)         An SLF shall notify the Department no fewer than 60 days prior to a change of ownership or management.  Change of ownership means a change of five percent or more.

 

2)         The Department has the right to terminate the provider agreement with an SLF if a change of ownership involves a barred Medicaid provider.

 

3)         The new owner shall comply with the applicable certification requirements found in subsection (c) of this Section.

 

4)         The Department shall conduct an on-site certification review no later than at the date of the next annual certification review or within three months after the effective date of the change of ownership, whichever is earlier.

 

5)         SLF certification shall be deemed to extend to a new owner until the Department separately certifies the SLF under the approved new owner.

 

f)          The certificate issued by the Department shall include:

 

1)         Name and address of the SLF;

 

2)         Maximum number of residents to be served at any time; and

 

3)         Number of apartments certified in the SLF.

 

g)         Providers certified as an SLF shall not operate or maintain SLF housing and services in combination with a home health, home care, nursing home, hospital, residential care setting, congregate care setting or other type of residence or service agency unless those settings and services are licensed, maintained and operated as separate and distinct entities.

 

h)         At least annually, the Department shall conduct an on-site review to ensure that the SLF is in compliance with the requirements of certification, which includes review of:

 

1)         Items listed in subsection (c)(4) of this Section.

 

2)         Comprehensive Resident Assessments, service plans  and the provision of services required under Section 146.230.

 

3)         Staff sufficient in number to meet the needs of residents.  Staff shall demonstrate capacity, within their job responsibilities, to provide covered services and perform tasks.

 

4)         Compliance with resident contracts and the Department's provider agreement.

 

5)         Protection of individual resident rights and involvement in directing their own care.

 

6)         Resident satisfaction surveys as defined in Section 146.270.     

 

i)          The SLF shall comply with all applicable enrollment and participation requirements set forth in Department rules, including, but not limited to,  89 Ill. Adm. Code 140.11 and 140.12.

 

j)          The SLF shall comply with the Americans with Disabilities Act of 1990.

 

k)         The SLF shall submit to the Department all marketing materials prior to their use.  If the Department does not notify the SLF of approval or disapproval of submitted materials within 30 days after submission, the SLF may begin to use those materials.  The Department reserves the right to disapprove any materials or require changes at any time, provided that any such changes are consistent with, or required by, applicable law.

 

l)          The SLF shall ensure that limited English speaking residents have meaningful and equal access to benefits and services.  Steps to ensure access may include, but are not limited to:

 

1)         hiring bi-lingual staff;

 

2)         hiring staff interpreters;

 

3)         contracting for interpreter services;

 

4)         engaging community volunteers;

 

5)         contracting with a telephone interpreter service; and

 

6)         hiring staff proficient in American Sign Language.

 

m)        The SLF shall encourage families of residents with impairments that limit the resident's decision-making ability to arrange to have a responsible party or guardian represent the resident's interests.  The SLF shall provide all residents with information about advance directives, including the Durable Power of Attorney for Health Care, Statement of Illinois Law on Advance Directives, Living Will, Declaration for Mental Health Treatment and Do Not Resuscitate Order.  The SLF shall maintain in a resident's file any of these documents authorized by the resident.

 

n)         Upon admission of a resident whose name appears on the Illinois State Police Sex Offender Registration website or the Illinois Department of Corrections registered sex offender database pursuant to Section 146.220(a)(4), the SLF shall:

 

1)         inform the Department and appropriate county and local law enforcement offices of the identity of the identified offenders being admitted to the SLF;

 

2)         notify every SLF resident and resident's guardian or family in writing that such offenders are residents of the facility;

 

3)         develop a service plan in accordance with Section 146.245; and

 

4)         ensure that the SLF has qualified staff to meet the needs of the individual and required level of supervision at all times.

 

(Source:  Amended at 30 Ill. Reg. 8845, effective May 1, 2006)