PART 260 CHILDREN'S COMMUNITY-BASED HEALTH CARE CENTER CODE : Sections Listing

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER b: HOSPITALS AND AMBULATORY CARE FACILITIES
PART 260 CHILDREN'S COMMUNITY-BASED HEALTH CARE CENTER CODE


AUTHORITY: Implementing and authorized by the Alternative Health Care Delivery Act [210 ILCS 3].

SOURCE: Adopted at 22 Ill. Reg. 3899, effective February 20, 1998; amended at 24 Ill. Reg. 14016, effective August 31, 2000; amended at 26 Ill. Reg. 11974, effective July 31, 2002; emergency amendment at 27 Ill. Reg. 7937, effective April 30, 2003, for a maximum of 150 days; emergency expired September 26, 2003; amended at 27 Ill. Reg. 18070, effective November 12, 2003; amended at 30 Ill. Reg. 883, effective January 9, 2006; amended at 31 Ill. Reg. 3008, effective February 2, 2007; amended at 34 Ill. Reg. 2551, effective January 27, 2010; amended at 34 Ill. Reg. 10162, effective June 30, 2010; amended at 38 Ill. Reg. 9905, effective April 28, 2014; amended at 45 Ill. Reg. 13925, effective October 25, 2021.

 

Section 260.1000  Definitions

 

The following terms shall have the meanings ascribed to them here whenever the term is used in this Part.

 

Abuse – any physical or mental injury or sexual assault inflicted on a client other than by accidental means in a facility. Abuse includes:

 

Physical abuse refers to the infliction of injury on a client that occurs other than by accidental means and that requires (whether or not actually given) medical attention.

 

Mental injury arises from the following types of conduct:

 

Verbal abuse refers to the use by a licensee, employee or agent of oral, written or gestured language that includes disparaging and derogatory terms to clients or within their hearing or seeing distance, regardless of their age, ability to comprehend or disability.

 

Mental abuse includes, but is not limited to, humiliation, harassment, threats of punishment or deprivation, or offensive physical contact by a licensee, employee or agent.

 

Sexual harassment or sexual coercion perpetrated by a licensee, employee or agent.

 

Sexual assault.

 

Act – the Alternative Health Care Delivery Act.

 

Affiliate –

 

With respect to a partnership, each partner;

 

With respect to a corporation, each officer, director and stockholder;

 

With respect to a natural person:  any person related in the first degree of kinship to that person; each partnership and each partner of the partnership of which that person or any affiliate of that person is a partner; and each corporation in which that person or any affiliate of that person is an officer, director or stockholder.

 

Advanced Practice Registered Nurse or APRN – a person who is licensed as an advanced practice registered nurse under the Nurse Practice Act.

 

Board – the State Board of Health. (Section 10 of the Act)

 

Caregiver − Parent or other person who provides hands-on care for the child.

 

Charitable Care – the intentional provision of free or discounted services to persons who cannot afford to pay.

 

Children or Child with Special Health Care Needs − those children who have or are at increased risk, or a child who has or is at increased risk, for chronic physical ailments and who require health and related services of a type or amount beyond that which children generally require.

 

Child's Representative – a person authorized by law, including a child's legal guardian, to act on behalf of the child.

 

Children's Community-Based Health Care Center – a designated site that provides nursing care, clinical support services, and therapies for a period of one to 14 days for short-term respite care stays and one to 120 days to facilitate transitions to home or other appropriate settings for medically fragile children, technology dependent children, and children with special health care needs who are deemed clinically stable by a physician and are younger than 22 years of age.  This care is to be provided in a home-like environment that serves no more than 12 children at a time. (Section 35(3) of the Act)

 

Client – a child who has met the admission criteria in Section 260.1800 and who has been admitted to a facility.

 

Demonstration Program or Program – a program to license and study alternative health care models authorized under the Act.  (Section 10 of the Act)

 

Department – the Illinois Department of Public Health. (Section 10 of the Act)

 

Diagnostic Studies − any analytic tests, including, but not limited to, heart monitoring or sleep tests, used in identifying the nature or cause of an illness, disorder or problem that are typically done in the home and that are conducted in a Children's Community-Based Health Care Center for children with special health care needs.

 

Dietitian – a person who is a licensed dietitian as provided in the Dietitian Nutritionist Practice Act.

 

Director – the Director of the Illinois Department of Public Health or designee. (Section 10 of the Act)

 

Director of Nursing or DON − a registered professional nurse who holds at least a bachelor's degree in nursing and relevant continuing education, has experience in nursing administration, and employed full-time within the facility.

 

Facility – same as Children's Community-Based Health Care Center.

 

Health Care Provider – a physician licensed to practice medicine in all of its branches, an advanced practice registered nurse (APRN) licensed under the Nurse Practice Act, or a physician assistant licensed under the Physician Assistant Practice of 1987.

 

Hospital – a facility licensed pursuant to the Hospital Licensing Act.

 

Inspection – any survey, evaluation or investigation of the Children's Community-Based Health Care Center's compliance with the Act and this Part by the Department or designee.

 

Licensee – the person or entity licensed to operate the Children's Community-Based Health Care Center.

 

Medical Day Care − care provided by a Children's Community-Based Health Care Center for children with special health care needs for no more than 12 in 24 hours, in accordance with Section 260.1800(c).

 

Medically Fragile Children − children who are medically stable but require skilled nursing care, specialized therapy, and specialized medical equipment and supplies to enhance or sustain their lives.  "Medically fragile children" may include, but is not limited to, children who have neuro-muscular disease, heart disease, cancer, seizure disorder, spina bifida, chronic lung disease, or other medical conditions that threaten the child's ability to thrive and to survive without proper medical care.

 

Medical Plan of Care – a written plan that can include, but is not limited to, up-to-date medications, a feeding plan, treatment, and medical equipment settings.

 

Neglect – a failure in a facility to provide adequate medical or personal care or maintenance, resulting in physical or mental injury to a client or in the deterioration of a client's physical or mental condition. Neglect shall include any situation in which failure to provide adequate medical or personal care or maintenance:

 

causes injury or deterioration that is ongoing or repetitious; or

 

results in a client requiring medical treatment; or

 

causes a noticeable negative impact on a client's health, behavior or activities for more than 24 hours.

 

Physician – a person licensed to practice medicine in all of its branches under the Medical Practice Act of 1987.

 

Registered Nurse – a person who is licensed as a registered professional nurse under the Nurse Practice Act.

 

Respite Care – care for children who are under age 22, are medically complex, have a medical condition that requires care to be delivered by a nurse or a trained parent/caregiver, and who are admitted for no more than 14 days.

 

Restraint – any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of the child to move his or her arms, legs, body or head freely; or a drug or medication when it is used as a restriction to manage the child's behavior or restrict the child's freedom of movement and is not a standard treatment or dosage for the child's condition.  A restraint does not include orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or methods that involve physically holding the child to conduct routine physical examinations or tests, or to protect the child from falling out of the bed, or to permit the child to participate in activities without the risk of physical harm.

 

Site Interdisciplinary Team – a team that includes a site physician, a site APRN, a site case manager, a site social worker, a site child-life specialist, and a site clinical team.

 

Site Physician – a physician designated by a facility.

 

Serious Injury – any significant impairment of the physical condition of the child as determined by qualified medical personnel.  This includes, but is not limited to, burns, lacerations, bone fractures, substantial hematoma and injuries to internal organs, whether self-inflicted or inflicted by another person.

 

Specialist – a physician who is board certified in a specific area of medicine (e.g., a neurologist).

 

Serious safety event – a variation from expected practice followed by significant temporary harm, moderate permanent harm, severe permanent harm, or death.

 

Substantial Compliance – meeting requirements except for variance from the strict and literal performance, which results in unimportant omissions or defects given the particular circumstances involved.  This definition is limited to the phrase as used in Section 260.1200.

 

Technology Dependent Children − medically fragile children who require the constant or regular intermittent use of technology to meet their medical needs.  This technology may include, but is not limited to, devices that assist or support breathing, monitor bodily functions, or provide nutrition.

 

Weekend Camps − a planned program for medically fragile children, technology dependent children, or children with special health care needs that typically occurs from Friday afternoon through Sunday evening.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.1050  Incorporated and Referenced Materials

 

a)         The following State of Illinois statutes are referenced in this Part:

 

1)         Hospital Licensing Act [210 ILCS 85]

 

2)         Medical Practice Act of 1987 [225 ILCS 60]

 

3)         Nurse Practice Act [225 ILCS 65]

 

4)         Dietitian Nutritionist Practice Act [225 ILCS 30]

 

5)         Abused and Neglected Child Reporting Act [325 ILCS 5]

 

6)         Health Care Worker Background Check Act [225 ILCS 46]

 

7)         Physician Assistant Practice Act of 1987 [225 ILCS 95]

 

b)         The following Administrative Rules are incorporated in this Part:

 

1)         Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100)

 

2)         Control of Communicable Diseases Code (77 Ill. Adm. Code 690)

 

3)         Food Code (77 Ill. Adm. Code 750)

 

4)         Drinking Water Systems Code (77 Ill. Adm. Code 900)

 

5)         Public Area Sanitary Practice Code (77 Ill. Adm. Code 895)

 

6)         Private Sewage Disposal Code (77 Ill. Adm. Code 905)

 

7)         Control of Tuberculosis Code (77 Ill. Adm. Code 696)

 

8)         Long-Term Care Assistants and Aides Training Programs Code (77 Ill. Adm. Code 395)

 

9)         Health Care Worker Background Check Code (77 Ill. Adm. Code 955)

 

10)         Health Care Employee Vaccination Code (77 Ill. Adm. Code 956)

 

c)         The following private and professional association standards are incorporated in this Part:

 

1)         For new facilities as defined in Section 260.2400, National Fire Protection Association (NFPA) 101:  Life Safety Code, 2012 edition, Chapter 32, "New Residential Board and Care Occupancies", and appropriate references under Chapter 2, Reference Publications, which may be obtained from the National Fire Protection Association, 1 Batterymarch Park, Quincy, Massachusetts 02169-7471.

 

2)         For existing facilities as defined in Section 260.2400, NFPA 101: Life Safety Code 2012 edition, Chapter 33, Existing Residential Board and Care Occupancies, and appropriate references under Chapter 2 Referenced Publications.

 

d)         All incorporations by reference of the standards of nationally recognized organizations refer to the standards on the date specified and do not include any amendments or editions subsequent to the date specified.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.1100  Demonstration Program Elements

 

a)         The Children's Community-Based Health Care Center Demonstration Program shall be reviewed annually by the Board to determine if it should continue operation for a period of up to five years, commencing with February 20, 1998.

 

b)         A Children's Community-Based Health Care Center Model shall be licensed pursuant to this Part to be considered a participant in the Program.

 

c)         Applications for participation in the Program shall be considered only when a vacancy  exists in one of the allocated Program slots for the relevant geographic area.

 

d)         At the midpoint and end of the Program, the Board shall evaluate and make recommendations to the Governor and the General Assembly, through the Department, regarding the Program, in accordance with Section 20(b) of the Act.

 

e)         The Department shall deposit all application fees, renewal fees and fines collected under the Act and this Part into the Regulatory Evaluation and Basic Enforcement Fund in the State Treasury. (Section 25(d) of the Act)

 

(Source:  Amended at 31 Ill. Reg. 3008, effective February 2, 2007)

 

Section 260.1200  Application for and Issuance of a License to Operate a Children's Community-Based Health Care Center Model

 

a)         Applications for a license to operate a Children's Community-Based Health Care Center Model shall be in writing on forms provided by the Department.  The application shall be made under oath and shall contain the following:

 

1)         The name of the proposed Model;

 

2)         The address of the proposed Model;

 

3)         A precise description of the site of the proposed Model;

 

4)         The maximum occupancy of the Model;

 

5)         The name and address of the registered agent or other individual authorized to receive Service of Process for the Model licensee;

 

6)         The name of the person or persons under whose management or supervision the center will be operated;

 

7)         Documentation of compliance with Section 260.2300 of this Part; and

 

8)         The Model's admission policies and procedures in accordance with Section 260.1800 of this Part.

 

b)         An application for initial licensure shall be accompanied by an application fee of $500 plus $100 for each bed.

 

c)         Upon receipt and review of a complete application for licensure, the Department shall conduct an inspection to determine compliance with the Act and this Part.

 

d)         If the proposed Model is found to be in substantial compliance with the Act and this Part, the Department shall issue a license for a period of one year.  The license shall not be transferable; it is issued to the licensee and for the specific location and number of beds identified in the application.

 

e)         An application for license renewal shall be filed with the Department 90 to 120 days prior to the expiration of the license, on forms provided by the Department.

 

1)         The renewal application shall comply with the requirements of subsections (a) and (b) of this Section; and

 

2)         Upon receipt and review of a complete application for license renewal, the Department may conduct a survey.  The Department shall renew the license in accordance with subsection (d) of this Section.

 

f)         The Department may issue a provisional license to any Children's Community-Based Health Care Center Model that does not substantially comply with the provisions of the Act and this Part:

 

1)         A provisional license may be issued only if the Department finds that:

 

A)        The Model has undertaken changes and corrections which upon completion will render the Model in substantial compliance with the Act; and

 

B)        The health and safety of the patients in the Model will be protected during the period for which the provisional license is issued. (Section 30(c) of the Act)

 

2)         The Department shall advise the applicant or licensee of the conditions under which the provisional license is issued, including:

 

A)        The manner in which the Model fails to comply with the provisions of the Act;

 

B)        The changes and corrections that shall be completed;

 

C)        The time within which the necessary changes and corrections shall be completed (Section 30(c) of the Act); and

 

D)        The interim actions that are necessary to protect the health and safety of the patients.

 

g)         The Children's Community-Based Health Care Center Model license or provisional license shall be prominently displayed in an area accessible to the public.

 

(Source:  Amended at 34 Ill. Reg. 10162, effective June 30, 2010)

 

Section 260.1300  Obligations and Privileges of Children's Community-Based Health Care Center Models

 

a)         Children's Community-Based Health Care Center Models shall, within 30 days after licensure, seek certification under Titles XVIII and XIX of the federal Social Security Act. (Section 30(d) of the Act)  Coverage for services provided by the Illinois Department of Healthcare and Family Services is contingent upon federal waiver approval and is provided only to Medicaid eligible clients participating in the Home and Community Based Services waiver designated in section1915(c) of the Social Security Act for medically frail and technologically dependent children. (Section 35(3) of the Act)

 

b)         Children's Community-Based Health Care Center Models shall provide charitable care consistent with that provided by comparable health care providers in the geographic area. (Section 30(d) of the Act)

 

c)         Children's Community-Based Health Care Center services must be available through the model to all families, including those whose care is paid for through the Department of Healthcare and Family Services, the Department of Children and Family Services, the Department of Human Services, and insurance companies who cover home health care services or private duty nursing care in the home.  (Section 35(3) of the Act)

 

d)         A licensed Children's Community-Based Health Care Center Model that continues to be in substantial compliance after the conclusion of the demonstration program shall be eligible for annual license renewals unless and until a different licensure program for that type of health care model is established by legislation. (Section 30(c) of the Act)

 

e)         Each Children's Community-Based Health Care Center Model location shall be physically separate and apart from any other facility licensed by the Department of Public Health. (Section 35(3) of the Act)

 

f)         Children's Community-Based Health Care Center Models shall provide the following services: respite care; registered nursing or licensed practical nursing care; transitional care to facilitate home placement or other appropriate settings and reunite families; medical day care; weekend camps; and diagnostic studies typically done in the home setting. (Section 35(3) of the Act)

 

(Source:  Amended at 31 Ill. Reg. 3008, effective February 2, 2007)

 

Section 260.1400  Inspections and Investigations

 

a)         The Department shall perform licensure inspections of Children's Community-Based Health Care Center Models, as deemed necessary, to ensure compliance with the Act and this Part. (Section 25(c) of the Act)

 

b)         All centers to which this Part applies shall be subject to and shall be deemed to have given consent to all inspections by properly identified personnel of the Department, or by other such properly identified persons as the Department might designate.  In addition, representatives of the Department shall have access to and may reproduce or photocopy any books, records and other documents maintained by the center or the licensee to the extent necessary to carry out the Act and this Part.

 

c)         The Department shall investigate an applicant or licensee whenever it receives a verified complaint in writing of any person setting forth facts which, if proven, would constitute grounds for the denial of an application for a license, refusal to renew a license, or suspension or revocation of a license. (Section 50 of the Act)

 

d)               The Department may also investigate an applicant or licensee on its own motion or based upon complaints received by mail, telephone or in person. (Section 50 of the Act)

 

(Source:  Amended at 31 Ill. Reg. 3008, effective February 2, 2007)

 

Section 260.1500  Notice of Violation and Plan of Correction

 

a)         Upon determination that the licensee or applicant is in violation of the Act or this Part, the Department shall issue a written Notice of Violation and request a plan of correction.  The notice shall specify the violations, and shall instruct the licensee or applicant to submit a plan of correction to the Department within 10 days after receipt of the Notice.

 

b)         Within the ten-day period, a licensee or applicant may request additional time for submission of the plan of correction.  The Department may extend the period for submission of the plan of correction for an additional 30 days, when the Department finds that corrective action by a facility to abate or eliminate the violation will require substantial capital improvement.  The Department will consider the extent and complexity of necessary physical plant repairs and improvements and any impact on the health, safety, or welfare of the patients of the facility in determining whether to grant a requested extension.

 

c)         Each plan of correction shall be based on an assessment by the facility of the conditions or occurrences that are the basis of the violation and an evaluation of the practices, policies, and procedures which have caused or contributed to the conditions or occurrences.  Evidence of such assessment and evaluation shall be maintained by the facility.  Each plan of correction shall include:

 

1)         A description of the specific corrective action the facility is taking, or plans to take, to abate, eliminate, or correct the violation cited in the Notice.

 

2)         A description of the steps that will be taken to avoid future occurrences of the same and similar violations.

 

3)         A specific date by which the corrective action will be completed.

 

d)         Submission of a plan of correction shall not be considered an admission by the facility that the violation has occurred.

 

e)         The Department shall review each plan of correction to ensure that it provides for the abatement, elimination, or correction of the violation.  The Department shall reject a submitted plan only if it finds any of the following deficiencies:

 

1)         The plan does not appear to address the conditions or occurrences that are the basis of the violation and an evaluation of the practices, policies, and procedures that have caused or contributed to the conditions or occurrences.

 

2)         The plan is not specific enough to indicate the actual actions the facility will be taking to abate, eliminate, or correct the violation.

 

3)         The plan does not provide for measures that will abate, eliminate, or correct the violation.

 

4)         The plan does not provide steps that will avoid future occurrences of the same and similar violations.

 

5)         The plan does not provide for timely completion of the corrective action, considering the seriousness of the violation, any possible harm to the patients, and the extent and complexity of the corrective action.

 

f)         The Department shall notify the licensee or applicant in writing of the acceptance or rejection of the plan of correction, including specific reasons for the rejection of the plan.  The facility shall have 10 days after receipt of notice of rejection in which to submit a modified plan that addresses the requirements of subsection (c) of this Section.

 

g)         If a licensee or applicant fails to make a timely submission of a modified plan of correction, or such modified plan is not acceptable to the Department, a plan of correction shall be specified and imposed by the Department.

 

h)         The Department shall verify the completion of the corrective action required by the plan of correction within the specified time period during subsequent investigations, surveys and evaluations of the facility.

 

Section 260.1600  Adverse Licensure Action

 

a)         Before denying a license application, refusing to renew a license, suspending a license, revoking a license or assessing an administrative fine, the Department shall notify the applicant or the licensee in writing.  The notice shall specify the charges or reasons for the Department's contemplated action, and shall provide an opportunity to file a request for a hearing within 10 days after receiving the notice. (Section 50 of the Act)

 

1)         A failure to request a hearing within 10 days shall constitute a waiver of the applicant's or licensee's right to a hearing. (Section 50 of the Act)

 

2)         The hearing shall be conducted by the Director or an individual designated in writing by the Director as an Administrative Law Judge, and shall be conducted in conformance with the Department's Rules of Practice and Procedure in Administrative Hearings and the Act.  (Section 55 of the Act)

 

b)         A license may be denied, suspended, or revoked, or the renewal of a license may be denied or an administrative fine assessed, for any of the following reasons:

 

1)         Violation of any provision of the Act or this Part;

 

2)         Conviction of the owner or operator of the Children's Respite Care Center Model of a felony or of any other crime under the laws of any state or of the United States arising out of, or in connection with, the operation of a health care facility.  The record of conviction or a certified copy of it shall be conclusive evidence of conviction;

 

3)         An encumbrance on a health care license issued in Illinois or any other state to the owner or operator of the Children's Respite Care Center Model;

 

4)         Revocation of any facility license issued by the Department during the previous five years or surrender or expiration of the license during the pendency of action by the Department to revoke or suspend the license during the previous five years if:

 

A)        The prior license was issued to the individual applicant or a controlling owner or controlling combination of owners of the applicant; or

 

B)        Any affiliate or the individual applicant or controlling owner of the applicant or affiliate of the applicant was a controlling owner of the prior license. (Section 45 of the Act)

 

c)         An action to assess an administrative fine may be initiated in conjunction with or in lieu of other adverse licensure action.

 

d)         The amount of an administrative fine shall be determined based on consideration of the following:

 

1)         The nature and severity of the violation(s);

 

2)         The facility's diligence in correcting the violation(s);

 

3)         Whether the facility had been previously cited for similar violation(s);

 

4)         The number of violation(s);

 

5)         The duration of uncorrected violation(s); and

 

6)         The impact or potential impact of the violation(s) on the children's health and safety.

 

e)         The administrative fine shall be calculated in relation to the number of days the violation existed, or continues to exist if it has not been corrected. The total amount of the fine assessed shall fall within the following parameters:

 

1)         For a violation that occurred as a single event or incident – between $100 and $5,000 per violation;

 

2)         For a violation that was or is continuing beyond a single event or incident – between $100 and $500 per day per violation.

 

Section 260.1700  Policies and Procedures

 

a)         The facility shall have policies and procedures that implement and are consistent with the provisions of this Part.

 

b)         The facility shall have infection control policies and procedures, which shall include at least the following:

 

1)         Compliance with the Department's rules titled Control of Communicable Diseases Code;

 

2)         The use of standard precautions and isolation techniques;

 

3)         A continuing program of instruction for all personnel on the mode of spread of infections; and

 

4)         Posted hand-washing techniques.

 

c)         The facility shall provide for the registration and disposition of complaints to the facility and to the Department without threat of discharge or other reprisal against any employee, volunteer, child or child's representative. The facility shall provide forms for the employee, volunteer, child or child's representative to record the day, time and nature of the complaint. For complaints made to the Department, the facility shall provide to an employee, volunteer, child and child's representative a phone and the Department's toll-free complaint hotline telephone number.

 

d)         The facility shall have policies covering disaster preparedness, including a written plan for staff and children to follow in case of fire, explosion, severe weather or other hazardous circumstance or emergency.

 

1)         All personnel shall be trained annually in the proper use of a fire extinguisher, and documentation of the training shall be placed in their employee file.

 

2)         All personnel shall be trained in the evacuation plan, and documentation of the training shall be placed in their employee file.

 

e)         The facility shall develop, with the approval of the facility's medical director, policies and procedures to be followed during medical emergencies.  The types of medical emergencies addressed should be based on the needs of the children being served and may include, but are not limited to, choking, poisoning, allergic reactions, seizures, diabetic emergencies, and acute respiratory distress such as plugged tracheostomy, reactive airway, or asthmatic emergencies.

 

(Source:  Amended at 38 Ill. Reg. 9905, effective April 28, 2014)

 

Section 260.1750  Health Care Worker Background Check

 

A facility shall comply with the Health Care Worker Background Check Act and the Health Care Worker Background Check Code.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.1800  Admission and Participation Practices

 

a)         The facility shall establish admission criteria for respite care that provide for:

 

1)         The admission of children for no more than 14 days, unless an extended authorization is approved by the Division of Specialized Care for Children for a family emergency such as, but not limited to, a funeral, the primary caregiver recovering from a medical event, or if more time is needed for respite services;

 

2)         The admission of children whose medical plan of care can be met by the facility; and

 

3)         Nondiscrimination toward children or their families based on disability, race, religion, sex, source of payment, and any other basis recognized by applicable State and federal laws.

 

b)         Eligibility for Respite Care Admissions

 

1)         The child (under age 22) shall be medically complex, may be technology dependent, or shall have a medical condition that requires care to be delivered by a nurse or trained parent/caregiver.

 

2)         The facility's site physician or site APRN shall review the child's clinical documentation prior to admission. Documentation shall consist of a physician's signed medical plan of care from private duty nursing where applicable, or documentation provided by a caregiver such as a primary care physician, an APRN, or specialist.  The site APRN will confirm the information on the day of the child's admission and enter it in an electronic medical record, and obtain and review any other documentation necessary to provide safety and comfort in the facility environment.

 

3)         The medical plan of care provided by the health care provider and reviewed by the facility's medical director shall include, but not be limited to, the following:

 

A)        Diagnosis;

 

B)        Food or drug allergies;

 

C)        Prescription medications;

 

D)        Other medications, including holistic or over-the-counter;

 

E)        Scheduled treatments or therapies;

 

F)         Feeding and nutritional guidelines;

 

G)        Vital sign and transfer parameters;

 

H)        Equipment and monitoring parameters;

 

I)         Current vaccines;

 

J)         Any additional information that will help the child's stay, such as individual child's preferences or habits to assist in the child's care; and

 

K)        Any activity restrictions.

 

4)         The facility shall employ Registered Nurses who are trained in cardio-pulmonary resuscitation (CPR), are certified in Pediatric Advanced Life Support, and who have additional training on equipment specific to the child, such as ventilator equipment.

 

5)         Prior to a child's admission for respite care, the facility shall conduct an assessment of the child, review the home care plan with the child's representative, and develop a medical plan of care to meet the needs of the child. The facility shall obtain the information that forms the basis for the medical plan of care from the child's representative. That information shall include, but not be limited to:

 

A)        A description of the child's usual routine;

 

B)        Instructions for the child's personal care;

 

C)        Food preferences and feeding schedule;

 

D)        Food, drug or other allergies;

 

E)        Scheduled treatments or therapies;

 

F)         Vaccines and immunizations;

 

G)        Educational or therapy programming;

 

H)        Emergency contact information; and

 

I)         Any additional information, such as the child's preferences or habits, that will assist in the child's care.

 

c)          The facility shall establish admission criteria for transitional care that provide for:

 

1)         The admission of children for no more than 120 days;

 

2)         The admission of children whose medical plan of care can be met by the facility; and

 

3)         Nondiscrimination toward children or their families based on disability, race, religion, sex, source of payment, and any other basis recognized by applicable State and federal laws.

 

d)         Eligibility Criteria for Transitional Care Admissions

 

1)         The child (under age 22) shall be medically complex, may be technology dependent, or shall have a medical condition that requires care to be delivered by a nurse or trained parent/caregiver.

 

2)         The facility shall employ Registered Nurses who are current in CPR and are certified in Pediatric Advanced Life Support, and who have additional training on equipment specific to the child, such as ventilator equipment.

 

3)         There shall be an identified child’s representative and a plan in place to secure a safe residence upon discharge from transitional care.

 

4)         If the child doesn't have an identified primary health care provider, the site physician will act as the primary health care provider until a primary health care provider is identified.

 

5)         The facility's medical director shall review the child's clinical documentation prior to admission. Documentation shall include, but not be limited to, a medical plan of care, hospital health care provider progress notes, medical history and a physical examination, and any other documentation that would assist the facility in caring for the child.

 

6)         A child being referred from an acute care or intermediate care hospital shall have a complete onsite preadmission assessment by the facility's case manager and may include the site APRN as needed before admission is approved.

 

7)         The child's diagnosis or history shall not include behaviors that would interfere with the safety of the child or others, or that would prevent the child from being safely cared for in the physical and medical environment provided.

 

8)         The child shall be clinically stable. 

 

9)         A child with a new tracheostomy shall be stable and shall have the first tracheostomy change done in the hospital setting prior to transfer.

 

10)         A child transferring from a newborn intensive care unit (NICU) shall be stable on a home ventilator for at least three weeks with no significant setting changes (e.g., breath rate, pressure changes, mode, oxygen requirements, a change in the amount of time on a ventilator).

 

11)         For a child's initial transfer from a pediatric intensive care unit (PICU), the child shall be stable on a home ventilator for one week with no significant changes (e.g., breath rate, pressure changes, mode, oxygen requirements, a change in the amount of time on a ventilator).

 

12)         If, at the time of admission, a child currently is being treated for a bacterial infection, the child shall have been on antibiotics and afebrile for 48 hours prior to admission.

 

13)         The child shall tolerate feedings or have an alternative means of nutrition.

 

14)         Vaccines and immunizations shall be current, or the facility shall ensure that the child has a catch-up immunization plan.

 

15)         Durable medical equipment company supplies shall be functional. Equipment and supplies shall be present 24 hours prior to admission, unless the child's equipment is transferring with the child from the hospital.

 

16)         Identified child's representative shall sign or have signed a training agreement within 24 hours after admission.

 

e)         The child shall be ineligible for admission if the child requires any of the following:

 

1)         Continuous 1:1 direct, visual nursing supervision or care;

 

2)         Scheduled nebulizer treatment more frequently than every two hours;

 

3)         Except for children in hospice care, scheduled supplemental oxygen greater than 40% FiO2;

 

4)         Hyperalimentation requiring daily adjustments;

 

5)         Endotracheal intubation; or

 

6)         Pressor medications requiring monitored adjustments.

 

f)          Within the first eight hours after admission, the child shall undergo a complete nursing assessment, and a nursing narrative shall be completed.

 

g)         The facility shall admit and serve only those children for whom it has the trained personnel, equipment and supplies to meet the medical plan of care and to ensure the safety of the child.

 

h)         A site physician shall be identified for each child admitted.  The medical plan of care shall document the method for contacting the site physician at any time.

 

i)          The facility shall ensure that all of a child's home medical equipment is managed by an identified durable medical equipment company who shall provide proof of service.

 

j)          The facility shall establish participation criteria for medical day care that provide for:

 

1)         The participation of children for no more than 12 hours in 24 hours;

 

2)         The participation of children whose plans of treatment can be met by the facility;

 

3)         Nondiscrimination toward children or their families based on disability, race, religion, sex, source of payment, and any other basis recognized by applicable State and federal laws; and

 

4)         A staff for the medical day care that is separate and distinct from the staff that provides services for children receiving respite care or transitional care.

 

k)         The facility shall establish participation criteria for weekend camps that provide for:

 

1)         The participation of children whose plans of treatment can be met by the facility;

 

2)         Nondiscrimination toward children or their families based on disability, race, religion, sex, source of payment, and any other basis recognized by applicable State and federal laws; and

 

3)         A staff for the weekend camps that is separate and distinct from the staff that provides services for children receiving respite care or transitional care.

 

l)         The facility shall establish criteria for diagnostic studies that provide for:

 

1)         Conducting only those diagnostic studies ordered by a physician and that are typically conducted in the home;

 

2)         Meeting all provisions for short-term stays, in accordance with subsection (a), if children are admitted overnight;

 

3)         The participation of children whose plans of treatment can be met by the facility; and

 

4)         Nondiscrimination toward children or their families based on disability, race, religion, sex, source of payment, and any other basis recognized by applicable State and federal laws.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.1850  Medical Oversight

 

a)         The facility shall ensure that comprehensive multidisciplinary rounds, led by a site provider, are conducted twice per week.  A site physician shall attend rounds a minimum of once per week. Subsequent rounds may be overseen by an APRN when available.

 

b)         The site provider or designee shall be on call 24 hours per day.

 

c)         Medical Advisory Committee

 

1)         The facility's medical advisory committee shall consist of multidisciplinary team members, including:

 

A)        A primary care physician;

 

B)        A pediatrician;

 

C)        A pulmonologist or an ear, nose and throat (ENT) physician;

 

D)        A registered nurse;

 

E)        A respiratory therapist;

 

F)         Representatives from a hospital's emergency department, NICU/PICU; and

 

G)        A site interdisciplinary team representative.

 

2)         The medical advisory committee shall develop annual goals and document them in writing, and shall meet quarterly to review quality indicators and other strategic data for the organization.  The quality indicators and other strategic data shall consist, at a minimum, of infection control, emergency transfers, evidence-based and best practice protocols, and family satisfaction surveys.

 

3)         The medical advisory committee shall review all updates or amendments to clinical policies and procedures. Documentation of amended reviews shall be kept on file at the facility for no less than five years.

 

4)         Minutes from the medical advisory committee's meetings shall be kept on file at the facility for no less than five years.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.1900  Child's Rights

 

a)         A child shall not be deprived of any rights, benefits or privileges guaranteed by law based solely on his/her status as a client of the facility.

 

b)         A child shall be permitted to retain and use or wear his/her personal property in his/her immediate living quarters unless deemed medically inappropriate or socially disruptive by a physician and so documented in the patient's record.

 

c)         The facility shall make reasonable efforts to prevent loss and theft of children's property.  The facility shall develop procedures for investigating complaints concerning theft of children's property and shall promptly investigate each complaint.

 

d)         Children under 16 years of age who are not facility clients and who are related to employees or volunteers of a facility, and who are not themselves employees or volunteers of the facility, shall be restricted to areas reserved for family or employee use, except during times when these children are part of a group visiting the facility as part of a planned program or similar activity.

 

e)         A child shall be permitted the free exercise of religion.  Upon the child's request, and if necessary at the expense of the child's representative, the facility management shall make arrangements for a child's attendance at religious services of the child's choice.  However, no religious beliefs or practices, or attendance at religious services, may be imposed upon any child.

 

f)         The facility shall immediately notify the child's representative whenever the child suffers from symptoms that require treatment not listed on the child's medical care plan or any acute illness or injury.

 

g)         A child may not be transferred, discharged, evicted, harassed or retaliated against for filing a complaint or providing information concerning a complaint against the facility.

 

h)         A child's representative may not be evicted, harassed or retaliated against for filing a complaint or providing information concerning a complaint against the facility.

 

i)          A child's representative shall be permitted to retain the services of the child's own personal physician at the representative's own expense, under an individual or group plan of health insurance, or under any public or private assistance program providing such coverage.

 

j)          Every child's representative shall be permitted to refuse medical treatment for the child and to know that this action may result in further referrals for medical care.

 

k)         Every child's representative shall be permitted to inspect and copy all of the child's clinical and other records concerning the child's care and maintenance kept by the facility or by the child's physician at the expense of the representative.

 

l)          All children shall be permitted respect and privacy in their medical and personal care program.  Every child's case discussion, consultation, examination and treatment shall be confidential and shall be conducted discreetly.  Those persons not directly involved in the child's care shall have the permission of the child's representative to be present at consultations, discussions, examinations and treatments.

 

m)        Neither physical restraints nor confinements shall be employed for the purpose of punishment or for the convenience of any facility personnel or volunteer.  Orthopedic equipment, high chairs, playpens, cribs or youth beds are not restraints for children less than four years old.

 

n)         Restraints shall be used only for the safety and security of the child upon written order of the attending physician and with the informed consent of the child's representative.   The physician's written authorization shall specify the precise time periods and conditions in which any restraints shall be employed.  The reasons for ordering and using restraints shall be recorded in the child's treatment plan. Staff shall be trained and be able to demonstrate, at least annually, competency in the application of restraints and in the monitoring, assessment and provision of care for the client in restraints.  The training shall include techniques to identify client behaviors and events that may trigger circumstances that require the use of restraints and the safe application and use of all types of restraints, including:

 

1)         Training in how to recognize and respond to signs of physical and psychological distress; and

 

2)         The clinical identification of specific behavioral or medical changes that indicate that the restraint is no longer necessary.

 

o)         The facility management shall ensure that children may have private visits at any reasonable hour unless those visits are not medically advisable for the child or are contrary to the directions of the child's representative as documented in the child's plan of treatment.  The facility shall allow daily visiting.  Visiting hours shall be posted in plain view of visitors.  The facility management shall ensure that space for visits is available and that facility personnel knock, except in an emergency, before entering any child's room.

 

p)         No visitor shall enter the immediate living area of any child without first identifying himself/herself and then receiving permission from the child to enter.  The rights of other children present in the room shall be respected.  Facility staff may terminate visits or provide other accommodations for the visit if the child requests or the visitor is involved in behavior violating other children's rights.

 

q)         A child shall be voluntarily discharged from a facility after the child's representative gives facility management, a physician or a nurse of the facility written notice of the desire for the child to be discharged.  A child shall be discharged upon written consent of the child's representative unless there is a court order to the contrary, such as a Department of Children and Family Services (DCFS) safety plan. Upon the child's discharge, the facility is relieved of any responsibility for the child's care, safety or well-being.

 

r)          The facility shall establish involuntary discharge procedures in accordance with this Section, which shall include at least the following:

 

1)         Child's behavior that may result in involuntary discharge;

 

2)         Child's decline or improvement in medical condition that may result in involuntary discharge;

 

3)         Child and child's representative counseling that may be provided to avoid involuntary discharge;

 

4)         Notification of child's representative concerning involuntary discharge; and

 

5)         Time frames between counseling, notice and involuntary discharge.

 

s)         A facility may involuntarily transfer or discharge a child only for one or more of the following reasons:

 

1)         The child's medical condition;

 

2)         The child's physical safety; and

 

3)         The child's action that directly impinges on the physical safety of other children, the facility staff or facility visitors.

 

t)          A licensee, facility manager, employee, volunteer or agent of a facility shall not abuse or neglect a child.

 

(Source:  Amended at 38 Ill. Reg. 9905, effective April 28, 2014)

 

Section 260.1950  Reporting Requirements for Allegations of Abuse and Neglect

 

a)         All employees and volunteers shall be considered mandated reporters as defined in the Abused and Neglected Child Reporting Act.

 

1)         Reports of suspected child abuse or neglect shall be immediately reported to the DCFS Child Abuse Hotline and to local law enforcement.

 

2)         Reports of suspected child abuse or neglect shall be immediately reported to the Department of Public Health's Central Complaint Registry (1-800-252-4343).

 

b)         A facility employee, agent or volunteer who becomes aware of abuse or neglect of a child shall immediately report the matter to the DCFS hotline, and then to the DON or equivalent.  If the abuse or neglect is alleged to be a result of actions by an employee of the facility, the facility shall immediately remove the alleged perpetrator from direct contact with the children.

 

c)         Upon becoming aware of abuse or neglect, the DON or equivalent shall contact the local law enforcement authorities (e.g., telephoning 911 where available) and the Department, and shall confirm that DCFS was notified. The DON or equivalent shall, immediately after notifying law enforcement authorities and the Department, report the matter by telephone and in writing to the child's representative.

 

d)         The facility shall send, by registered mail, a written report within 24 hours after the completion of the investigation to the Supervisor of Central Office Operations, Division of Health Care Facilities and Programs, at the Illinois Department of Public Health, 525 W. Jefferson St., Springfield, Illinois 62761.  The facility shall keep a copy of the report on its premises for at least five years.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.2000  Medical Day Care

 

a)         No more than 12 children shall be served at a time.

 

b)         The facility shall provide services as necessary to implement and support the child's plan of treatment and overall needs, including provisions for:

 

1)         Case management;

 

2)         Fostering maximum independence of the child; and

 

3)         Protection of the child's rights, privacy and dignity.

 

c)         The facility shall have one or more transfer agreements with hospitals to provide emergency care to children.

 

d)         The facility shall provide recreational and leisure activities for children during their stay, two to four hours per day as tolerated by the child.

 

e)         A written summary of the child's stay shall be sent home with each child. The summary shall contain documentation of any extreme (positive or negative) occurrences and any changes to the plan of treatment.

 

f)         All information related to the child, the child's representative or the child's plan of treatment is confidential and shall be accessible only to those individuals who need the information to assure appropriate service delivery.

 

(Source:  Amended at 38 Ill. Reg. 9905, effective April 28, 2014)

 

Section 260.2100  Medication Administration

 

a)         Except for medications allowed in subsection (b), the only medications allowed in the facility are those for particular individual children.  The medication of each child shall be kept and stored in the original container received from the pharmacy.

 

1)         Each multi-dose medication container shall indicate the child's name, health care provider's name, prescription number, name, strength and quantity of drug, administration dose, date this container was last filled, the initials of the pharmacist filling the prescription, the identity of the pharmacy, the expiration date, the refill date and any special instructions.

 

2)         Each single unit or unit dose package shall contain the proprietary and nonproprietary name of the drug and the strength of the dose.  The name of the child and the health care provider do not have to be on the label of the package, but they shall be identified with the package to assure that the drug is administered to the correct child.

 

b)         A facility may stock a small supply of medications regularly available without prescription at a commercial pharmacy, such as non-controlled cough syrups, laxatives and analgesics.  These shall be given to a child only upon the order of a physician or health care provider.

 

c)         The facility may stock a small supply of prescription medications (approved by the facility's site physician) to be available for immediate use, such as first dose antibiotics, anti-seizure drugs, or rescue drugs such as albuterol and oral steroids.

 

d)         The facility shall have a first aid kit that contains items appropriate to treat minor cuts, burns, abrasions, etc.

 

e)         All medications shall be properly stored as directed in a secured location not accessible to unauthorized individuals.

 

f)         All medications shall be sent home with the child for whom the medication was prescribed.

 

g)         The facility shall have a written policy and procedure in place for the administration, storage, and disposal of controlled substances.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.2200  Personnel

 

a)         Each facility shall develop and maintain written personnel policies that are followed in the operation of the facility.

 

b)         The facility shall establish policies to screen all current and prospective employees and volunteers, which shall include at least the following:

 

1)         Conduct a check of the DCFS Central Registry (1-800-25A-BUSE), in a form and a manner prescribed by DCFS.

 

2)         Conduct a check of the Sex Offender Registry in a form and a manner prescribed by the Illinois State Police (ISP).

 

3)         Maintain records of these checks in the employee's personnel file or the volunteer's file.

 

c)         The facility shall define in written policy that individuals with findings on the DCFS Central Registry shall be ineligible for hire or to volunteer.

 

d)         The facility shall provide orientation to new staff regarding their responsibilities under the Abused and Neglected Child Reporting Act prior to the first day of employment.

 

e)         The facility shall provide orientation to new volunteers prior to the first day of volunteering.

 

f)         Orientation of staff and volunteers shall include, at least, definitions of what constitutes abuse and neglect, the individual's responsibility under the Abused and Neglected Child Reporting Act, and the facility's policy on reporting abuse and neglect. This information shall be reviewed annually with current staff and volunteers.

 

g)         Each employee shall have an initial health evaluation, which shall be used to ensure that employees are not placed in positions that would pose undue risk of infection to themselves, other employees, children or visitors.

 

1)         The initial health evaluation shall be completed no more than 30 days prior to or 30 days after the employee's first day of employment.

 

2)         The initial health evaluation shall include a health inventory from the employee, including an evaluation of the employee's immunization status.

 

3)         The initial health evaluation shall include tuberculin testing in accordance with the Control of Tuberculosis Code. Annual tuberculin testing in accordance with the Control of Tuberculosis Code shall be tracked.

 

4)         Employee's annual influenza shots shall be tracked in accordance with the Health Care Employee Vaccination Code.

 

h)         The facility shall provide enough trained and supervised staff to meet each child's medical plan of care.

 

i)          The facility shall have a designated facility manager.

 

j)          The facility shall have a designated director of nursing (DON) or equivalent. The DON or equivalent shall be a registered professional nurse who holds at least a bachelor's degree in nursing and relevant continuing education.  The DON also shall have experience in nursing administration and shall be employed full-time within the facility.

 

k)         At least two registered nurses shall be at the facility at all times that a child is present.  The minimum staffing ratio for respite and transitional care is one RN to four children; however, a second nurse shall be in a facility even when the number of children in a facility is below four. All certified nursing assistants shall meet training requirements by completing a training program approved under the Long-Term Care Assistants and Aides Training Programs Code.

 

l)          The facility's site physician shall be a physician with expertise in chronic diseases of children.  The facility's site physician shall review medical protocols, resolve issues with children's primary health care provider and provide medical advice when a child's primary health care provider is not available.

 

m)        The facility shall define, through job descriptions, minimum nursing education and clinical experience requirements for all staff, consultants and contract staff, approved DCFS providers, and all others providing nursing services to the facility.  All RNs and licensed practical nurses shall be CPR certified prior to employment. All RNs shall be certified in Pediatric Advanced Life Support within three months after employment.

 

n)         The facility shall provide an initial orientation and routine, pertinent training to all staff, including, for registered nurses, training on ventilator equipment within three months after employment.  This training may include return demonstration, one-on-one training, small group exercises or lecture.  All training shall be documented by a clinical skills checklist that includes:

 

1)         Date;

 

2)         Instructors;

 

3)         Short description of content; and

 

4)         Participants' written and printed signatures.

 

o)         Prior to employing any individual in a position that requires a State license, the facility shall contact the Illinois Department of Financial and Professional Regulation-Division of Professional Regulation to verify that the individual's license is active. A copy of the verification shall be placed in the individual's personnel file.

 

p)         The facility shall check the status of all applicants with the Health Care Worker Registry prior to hiring.

 

q)         All new clinical employees shall review the clinical policies and procedures manual within 15 days after employment. A letter documenting the review, signed by the facility manager, shall be kept in the employee's file.

 

r)          All new administrative employees shall review the facility's operation manual within 15 days after employment. A letter documenting the review, signed by the facility manager, shall be kept in the employee's file.

 

s)         All new employees shall receive fire safety and evacuation training upon hiring. The training shall be reviewed annually for all employees.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.2300  Food Service

 

a)         All children at the facility shall have a nutrition plan approved by the primary care physician or primary health care provider prior to admission.

 

b)         The facility's site physician shall review the nutrition plans weekly.

 

c)         Nutrition consultants shall be made available at the facility as needed.

 

d)         The facility's site physicianr shall include a nutrition summary in the discharge plan of all children at the facility.

 

e)         If a child refuses the food provided at a meal, a reasonable and nutritionally appropriate alternative shall be offered.

 

f)         Adequate supplies of food shall be available for each child according to their approved nutrition plan.

 

g)         All food served shall be prepared in accordance with theFoodCode.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.2400  Physical Plant

 

a)         New facilities shall meet the requirements established in the NFPA 101, Life Safety Code, Chapter 32, "New Residential Board and Care Occupancies", and appropriate references under Chapter 2, Referred Publications. Existing facilities shall meet the requirements established in the NFPA 101, Life Safety Code, Chapter 33, Existing Residential Board and Care Occupancies, and appropriate references under Chapter 2, Referred Publications.

 

b)         For the purposes of this Section, a "new facility" is any facility licensed by the Department on or after the effective date of this rulemaking, and an "existing facility" is any facility licensed by the Department prior to the effective date of this rulemaking.

 

c)         When possible, the facility shall be located at grade level. If not at grade level, the facility shall be equipped with ramps or elevators to allow easy access for residents to the street level.

 

d)         The facility may be located within a mixed-use-occupancy building, subject to the requirements of Section 35(3) of the Act and Section 260.1300(e) of this Part. All occupancies within the building shall fully meet the life safety requirements in NFPA 101 for the occupancy for which they are designated.

 

e)         Children more than six years of age occupying the same bedroom shall be of the same gender unless the children are siblings.

 

f)         A child's bedroom shall not serve as access to any other area of the building.

 

g)         The facility shall be kept in a clean, safe and orderly condition and in good repair.

 

1)         Electrical, mechanical, heating/air conditioning, fire protection and sewage disposal systems shall be maintained.

 

2)         Furnishings and furniture shall be maintained in a clean, safe condition.

 

3)         Attics, basements, stairways, and similar areas shall be kept free of refuse, newspapers, boxes and other items.

 

4)         Bathtubs, shower stalls and lavatories shall not be used for janitorial, laundry or storage purposes.

 

5)         All cleaning compounds, insecticides and other potentially hazardous compounds or agents shall be stored in locked cabinets or rooms.

 

h)         Every facility shall supply clean linen.

 

1)         Clean linen shall be protected from contamination during handling, transport and storage.

 

2)         Soiled linen shall be handled, transported and stored in a manner that protects individuals and the environment from contamination.  Soiled diapers shall be placed in identified diaper receptacles immediately after removal from the client.

 

i)          Each child shall be provided with a bed that meets the child's developmental needs and size.

 

j)          The water supply shall comply with all applicable Department rules and local ordinances.  Each facility shall be served by:

 

1)         Water from a community water supply; or

 

2)         A water supply that complies with theDrinking Water Systems Code; or

 

3)         A water supply that complies Public Area Sanitary Practice Code.

 

k)         If the facility provides respite care (Section 260.1800(a) and (b)), transitional care (Section 260.1800(c) and (d)), weekend camps (Section 260.1800(k)), or diagnostic studies (Section 260.1800(l)), then bathing facilities, such as an assisted bathing facility, shall be provided.  Bathing facilities are not required in facilities that provide only medical day care (Section 260.1800(j)). 

 

l)          Hot water temperatures in shower, bathing and hand-washing facilities shall not exceed 110 degrees Fahrenheit (43 degrees Celsius). 

 

m)        All sewage and liquid wastes shall be discharged into a public sewage disposal system or shall be collected, treated, and disposed of in a private sewage disposal system that is designed, constructed, maintained and operated in accordance with thePrivate Sewage Disposal Code.

 

n)         Emergency call stations shall be provided in any toilet room used by a client.

 

o)         A request for a waiver from the requirements of this Section shall be submitted, in writing, to the Department's Division of Life Safety and Construction. The waiver request shall document that strict enforcement of the life safety requirement in question will result in unreasonable hardship on the facility and a waiver will not adversely affect the health and safety of the clients. The Department will review waiver requests and will grant or deny a waiver based on whether the documentation submitted demonstrates that the hardship imposed on the facility is unreasonable and that a waiver would not adversely affect the health and safety of the clients.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)

 

Section 260.2500  Quality Assessment and Improvement

 

a)         The facility shall develop and implement a quality assessment and improvement program designed to meet at least the following goals:

 

1)         Ongoing monitoring and evaluation of the quality and accessibility of care and services provided at the facility or under contract, including but not limited to:

 

A)        Admission of children appropriate to the capabilities of the facility;

 

B)        Family satisfaction survey;

 

C)        Clinical costs per day;

 

D)        Infection control and safety; and

 

E)        Medication administration.

 

2)         Identification and analysis of safety event reporting; and

 

3)         Identification of serious safety events and implementation of corrective action plan within 30 days after the event.

 

b)         The quality assessment and improvement program shall operate pursuant to a written plan supported by detailed policies and procedures, which shall include, but not be limited to:

 

1)         A detailed statement of goals and objectives;

 

2)         The methodology and criteria that will be used to meet each stated goal;

 

3)         The action plans for addressing problems;

 

4)         Procedures for evaluating the effectiveness of action plans and revising action plans to prevent reoccurrence of problems;

 

5)         Procedures for documenting the activities of the program; and

 

6)         Identification of the persons responsible for administering the program.

 

c)         The facility shall report to the Department, no later than 5 p.m. the next business day, any serious incident or accident involving a child.  The report shall include the name of the child, a description of the incident or accident, and the date and time of the incident or accident.  Incidents or accidents include, but are not limited to:

 

1)         A serious injury to a child, including while in a restraint;

 

2)         A serious medication error resulting in medical intervention or hospitalization; or

 

3)         A child's death while the child is a resident in the facility.

 

d)         The facility shall afford the Department and the Board access to any materials or documents generated pursuant to the facility's quality assessment and improvement program or that otherwise relate to client demand, utilization and satisfaction; cost effectiveness; financial viability of the facility; and access to services.

 

(Source:  Amended at 45 Ill. Reg. 13925, effective October 25, 2021)