[ Back ] [ Bottom ]
91_HB0182sam001
SRS91HB0182DLsaam01
1 AMENDMENT TO HOUSE BILL 182
2 AMENDMENT NO. . Amend House Bill 182 by replacing
3 everything after the enacting clause with the following:
4 "Section 5. The Illinois Act on the Aging is amended by
5 changing Section 4.04 as follows:
6 (20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
7 (Text of Section before amendment by P.A. 91-656)
8 Sec. 4.04. Long Term Care Ombudsman Program.
9 (a) Long Term Care Ombudsman Program. The Department
10 shall establish a Long Term Care Ombudsman Program, through
11 the Office of State Long Term Care Ombudsman ("the Office"),
12 in accordance with the provisions of the Older Americans Act
13 of 1965, as now or hereafter amended.
14 (b) Definitions. As used in this Section, unless the
15 context requires otherwise:
16 (1) "Access" has the same meaning as in Section
17 1-104 of the Nursing Home Care Act, as now or hereafter
18 amended; that is, it means the right to:
19 (i) Enter any long term care facility;
20 (ii) Communicate privately and without
21 restriction with any resident who consents to the
22 communication;
-2- SRS91HB0182DLsaam01
1 (iii) Seek consent to communicate privately
2 and without restriction with any resident;
3 (iv) Inspect the clinical and other records of
4 a resident with the express written consent of the
5 resident;
6 (v) Observe all areas of the long term care
7 facility except the living area of any resident who
8 protests the observation.
9 (2) "Long Term Care Facility" means (i) any
10 facility as defined by Section 1-113 of the Nursing Home
11 Care Act, as now or hereafter amended; and (ii) any
12 skilled nursing facility or a nursing facility which
13 meets the requirements of Section 1819(a), (b), (c), and
14 (d) or Section 1919(a), (b), (c), and (d) of the Social
15 Security Act, as now or hereafter amended (42 U.S.C.
16 1395i-3(a), (b), (c), and (d) and 42 U.S.C. 1396r(a),
17 (b), (c), and (d)).
18 (3) "Ombudsman" means any person employed by the
19 Department to fulfill the requirements of the Office, or
20 any representative of a sub-State long term care
21 ombudsman program; provided that the representative,
22 whether he is paid for or volunteers his ombudsman
23 services, shall be qualified and authorized by the
24 Department to perform the duties of an ombudsman as
25 specified by the Department in rules.
26 (c) Ombudsman; rules. The Office of State Long Term Care
27 Ombudsman shall be composed of at least one full-time
28 ombudsman within the Department and shall include a system of
29 designated sub-State long term care ombudsman programs. Each
30 sub-State program shall be designated by the Department as a
31 subdivision of the Office and any representative of a
32 sub-State program shall be treated as a representative of the
33 Office.
34 The Department shall promulgate administrative rules to
-3- SRS91HB0182DLsaam01
1 establish the responsibilities of the Department and the
2 Office of State Long Term Care Ombudsman. The administrative
3 rules shall include the responsibility of the Office to
4 investigate and resolve complaints made by or on behalf of
5 residents of long term care facilities relating to actions,
6 inaction, or decisions of providers, or their
7 representatives, of long term care facilities, of public
8 agencies, or of social services agencies, which may adversely
9 affect the health, safety, welfare, or rights of such
10 residents. When necessary and appropriate, representatives of
11 the Office shall refer complaints to the appropriate
12 regulatory State agency.
13 (d) Access and visitation rights.
14 (1) In accordance with subparagraphs (A) and (E) of
15 paragraph (3) of subsection (c) of Section 1819 and
16 subparagraphs (A) and (E) of paragraph (3) of subsection
17 (c) of Section 1919 of the Social Security Act, as now or
18 hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E)
19 and 42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712
20 of the Older Americans Act of 1965, as now or hereafter
21 amended (42 U.S.C. 3058f), a long term care facility
22 must:
23 (i) permit immediate access to any resident by
24 an ombudsman; and
25 (ii) permit representatives of the Office,
26 with the permission of the resident's legal
27 representative or legal guardian, to examine a
28 resident's clinical and other records, and if a
29 resident is unable to consent to such review, and
30 has no legal guardian, permit representatives of the
31 Office appropriate access, as defined by the
32 Department in administrative rules, to the
33 resident's records.
34 (2) Each long term care facility shall display, in
-4- SRS91HB0182DLsaam01
1 multiple, conspicuous public places within the facility
2 accessible to both visitors and patients and in an easily
3 readable format, the address and phone number of the
4 Office, in a manner prescribed by the Office.
5 (e) Immunity. An ombudsman or any other representative
6 of the Office participating in the good faith performance of
7 his or her official duties shall have immunity from any
8 liability (civil, criminal or otherwise) in any proceedings
9 (civil, criminal or otherwise) brought as a consequence of
10 the performance of his official duties.
11 (f) Business offenses.
12 (1) No person shall:
13 (i) Intentionally prevent, interfere with, or
14 attempt to impede in any way any representative of
15 the Office in the performance of his official duties
16 under this Act and the Older Americans Act of 1965;
17 or
18 (ii) Intentionally retaliate, discriminate
19 against, or effect reprisals against any long term
20 care facility resident or employee for contacting or
21 providing information to any representative of the
22 Office.
23 (2) A violation of this Section is a business
24 offense, punishable by a fine not to exceed $501.
25 (3) The Director of Aging shall notify the State's
26 Attorney of the county in which the long term care
27 facility is located, or the Attorney General, of any
28 violations of this Section.
29 (g) Confidentiality of records and identities. No files
30 or records maintained by the Office of State Long Term Care
31 Ombudsman shall be disclosed unless the State Ombudsman or
32 the ombudsman having the authority over the disposition of
33 such files authorizes the disclosure in writing. The
34 ombudsman shall not disclose the identity of any complainant,
-5- SRS91HB0182DLsaam01
1 resident, witness or employee of a long term care provider
2 involved in a complaint or report unless such person or such
3 person's guardian or legal representative consents in writing
4 to the disclosure, or the disclosure is required by court
5 order.
6 (h) Legal representation. The Attorney General shall
7 provide legal representation to any representative of the
8 Office against whom suit or other legal action is brought in
9 connection with the performance of the representative's
10 official duties, in accordance with "An Act to provide for
11 representation and indemnification in certain civil law
12 suits", approved December 3, 1977, as now or hereafter
13 amended.
14 (i) Treatment by prayer and spiritual means. Nothing in
15 this Act shall be construed to authorize or require the
16 medical supervision, regulation or control of remedial care
17 or treatment of any resident in a long term care facility
18 operated exclusively by and for members or adherents of any
19 church or religious denomination the tenets and practices of
20 which include reliance solely upon spiritual means through
21 prayer for healing.
22 (Source: P.A. 90-639, eff. 1-1-99; 91-174, eff. 7-16-99.)
23 (Text of Section after amendment by P.A. 91-656)
24 Sec. 4.04. Long Term Care Ombudsman Program.
25 (a) Long Term Care Ombudsman Program. The Department
26 shall establish a Long Term Care Ombudsman Program, through
27 the Office of State Long Term Care Ombudsman ("the Office"),
28 in accordance with the provisions of the Older Americans Act
29 of 1965, as now or hereafter amended.
30 (b) Definitions. As used in this Section, unless the
31 context requires otherwise:
32 (1) "Access" has the same meaning as in Section
33 1-104 of the Nursing Home Care Act, as now or hereafter
34 amended; that is, it means the right to:
-6- SRS91HB0182DLsaam01
1 (i) Enter any long term care facility or
2 assisted living or shared housing establishment;
3 (ii) Communicate privately and without
4 restriction with any resident who consents to the
5 communication;
6 (iii) Seek consent to communicate privately
7 and without restriction with any resident;
8 (iv) Inspect the clinical and other records of
9 a resident with the express written consent of the
10 resident;
11 (v) Observe all areas of the long term care
12 facility or assisted living or shared housing
13 establishment except the living area of any resident
14 who protests the observation.
15 (2) "Long Term Care Facility" means (i) any
16 facility as defined by Section 1-113 of the Nursing Home
17 Care Act, as now or hereafter amended; and (ii) any
18 skilled nursing facility or a nursing facility which
19 meets the requirements of Section 1819(a), (b), (c), and
20 (d) or Section 1919(a), (b), (c), and (d) of the Social
21 Security Act, as now or hereafter amended (42 U.S.C.
22 1395i-3(a), (b), (c), and (d) and 42 U.S.C. 1396r(a),
23 (b), (c), and (d)).
24 (2.5) "Assisted living establishment" and "shared
25 housing establishment" have the meanings given those
26 terms in Section 10 of the Assisted Living and Shared
27 Housing Act.
28 (3) "Ombudsman" means any person employed by the
29 Department to fulfill the requirements of the Office, or
30 any representative of a sub-State long term care
31 ombudsman program; provided that the representative,
32 whether he is paid for or volunteers his ombudsman
33 services, shall be qualified and authorized by the
34 Department to perform the duties of an ombudsman as
-7- SRS91HB0182DLsaam01
1 specified by the Department in rules.
2 (c) Ombudsman; rules. The Office of State Long Term Care
3 Ombudsman shall be composed of at least one full-time
4 ombudsman within the Department and shall include a system of
5 designated sub-State long term care ombudsman programs. Each
6 sub-State program shall be designated by the Department as a
7 subdivision of the Office and any representative of a
8 sub-State program shall be treated as a representative of the
9 Office.
10 The Department shall promulgate administrative rules to
11 establish the responsibilities of the Department and the
12 Office of State Long Term Care Ombudsman. The administrative
13 rules shall include the responsibility of the Office to
14 investigate and resolve complaints made by or on behalf of
15 residents of long term care facilities and assisted living
16 and shared housing establishments relating to actions,
17 inaction, or decisions of providers, or their
18 representatives, of long term care facilities, of assisted
19 living and shared housing establishments, of public agencies,
20 or of social services agencies, which may adversely affect
21 the health, safety, welfare, or rights of such residents.
22 When necessary and appropriate, representatives of the Office
23 shall refer complaints to the appropriate regulatory State
24 agency. The Department shall cooperate with the Department of
25 Human Services in providing information and training to
26 designated sub-State long term care ombudsman programs about
27 the appropriate assessment and treatment (including
28 information about appropriate supportive services, treatment
29 options, and assessment of rehabilitation potential) of
30 persons with mental illness (other than Alzheimer's disease
31 and related disorders).
32 (d) Access and visitation rights.
33 (1) In accordance with subparagraphs (A) and (E) of
34 paragraph (3) of subsection (c) of Section 1819 and
-8- SRS91HB0182DLsaam01
1 subparagraphs (A) and (E) of paragraph (3) of subsection
2 (c) of Section 1919 of the Social Security Act, as now or
3 hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E)
4 and 42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712
5 of the Older Americans Act of 1965, as now or hereafter
6 amended (42 U.S.C. 3058f), a long term care facility,
7 assisted living establishment, and shared housing
8 establishment must:
9 (i) permit immediate access to any resident by
10 an ombudsman; and
11 (ii) permit representatives of the Office,
12 with the permission of the resident's legal
13 representative or legal guardian, to examine a
14 resident's clinical and other records, and if a
15 resident is unable to consent to such review, and
16 has no legal guardian, permit representatives of the
17 Office appropriate access, as defined by the
18 Department in administrative rules, to the
19 resident's records.
20 (2) Each long term care facility, assisted living
21 establishment, and shared housing establishment shall
22 display, in multiple, conspicuous public places within
23 the facility accessible to both visitors and patients and
24 in an easily readable format, the address and phone
25 number of the Office, in a manner prescribed by the
26 Office.
27 (e) Immunity. An ombudsman or any other representative
28 of the Office participating in the good faith performance of
29 his or her official duties shall have immunity from any
30 liability (civil, criminal or otherwise) in any proceedings
31 (civil, criminal or otherwise) brought as a consequence of
32 the performance of his official duties.
33 (f) Business offenses.
34 (1) No person shall:
-9- SRS91HB0182DLsaam01
1 (i) Intentionally prevent, interfere with, or
2 attempt to impede in any way any representative of
3 the Office in the performance of his official duties
4 under this Act and the Older Americans Act of 1965;
5 or
6 (ii) Intentionally retaliate, discriminate
7 against, or effect reprisals against any long term
8 care facility resident or employee for contacting or
9 providing information to any representative of the
10 Office.
11 (2) A violation of this Section is a business
12 offense, punishable by a fine not to exceed $501.
13 (3) The Director of Aging shall notify the State's
14 Attorney of the county in which the long term care
15 facility is located, or the Attorney General, of any
16 violations of this Section.
17 (g) Confidentiality of records and identities. No files
18 or records maintained by the Office of State Long Term Care
19 Ombudsman shall be disclosed unless the State Ombudsman or
20 the ombudsman having the authority over the disposition of
21 such files authorizes the disclosure in writing. The
22 ombudsman shall not disclose the identity of any complainant,
23 resident, witness or employee of a long term care provider
24 involved in a complaint or report unless such person or such
25 person's guardian or legal representative consents in writing
26 to the disclosure, or the disclosure is required by court
27 order.
28 (h) Legal representation. The Attorney General shall
29 provide legal representation to any representative of the
30 Office against whom suit or other legal action is brought in
31 connection with the performance of the representative's
32 official duties, in accordance with the State Employee
33 Indemnification Act.
34 (i) Treatment by prayer and spiritual means. Nothing in
-10- SRS91HB0182DLsaam01
1 this Act shall be construed to authorize or require the
2 medical supervision, regulation or control of remedial care
3 or treatment of any resident in a long term care facility
4 operated exclusively by and for members or adherents of any
5 church or religious denomination the tenets and practices of
6 which include reliance solely upon spiritual means through
7 prayer for healing.
8 (Source: P.A. 90-639, eff. 1-1-99; 91-174, eff. 7-16-99;
9 91-656, eff. 1-1-01; revised 1-5-00.)
10 Section 10. The Nursing Home Care Act is amended by
11 changing Section 3-212 as follows:
12 (210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
13 Sec. 3-212. Inspection.
14 (a) The Department, whenever it deems necessary in
15 accordance with subsection (b), shall inspect, survey and
16 evaluate every facility to determine compliance with
17 applicable licensure requirements and standards. An
18 inspection should occur within 120 days prior to license
19 renewal. The Department may periodically visit a facility
20 for the purpose of consultation. An inspection, survey, or
21 evaluation, other than an inspection of financial records,
22 shall be conducted without prior notice to the facility. A
23 visit for the sole purpose of consultation may be announced.
24 The Department shall provide training to surveyors about the
25 appropriate assessment, care planning, and care of persons
26 with mental illness (other than Alzheimer's disease or
27 related disorders) to enable its surveyors to determine
28 whether a facility is complying with State and federal
29 requirements about the assessment, care planning, and care of
30 those persons.
31 (a-1) An employee of a State or unit of local government
32 agency charged with inspecting, surveying, and evaluating
-11- SRS91HB0182DLsaam01
1 facilities who directly or indirectly gives prior notice of
2 an inspection, survey, or evaluation, other than an
3 inspection of financial records, to a facility or to an
4 employee of a facility is guilty of a Class A misdemeanor.
5 (a-2) An employee of a State or unit of local government
6 agency charged with inspecting, surveying, or evaluating
7 facilities who willfully profits from violating the
8 confidentiality of the inspection, survey, or evaluation
9 process shall be guilty of a Class 4 felony and that conduct
10 shall be deemed unprofessional conduct that may subject a
11 person to loss of his or her professional license. An action
12 to prosecute a person for violating this subsection (a-2) may
13 be brought by either the Attorney General or the State's
14 Attorney in the county where the violation took place.
15 (b) In determining whether to make more than the
16 required number of unannounced inspections, surveys and
17 evaluations of a facility the Department shall consider one
18 or more of the following: previous inspection reports; the
19 facility's history of compliance with standards, rules and
20 regulations promulgated under this Act and correction of
21 violations, penalties or other enforcement actions; the
22 number and severity of complaints received about the
23 facility; any allegations of resident abuse or neglect;
24 weather conditions; health emergencies; other reasonable
25 belief that deficiencies exist.
26 (b-1) The Department shall not be required to determine
27 whether a facility certified to participate in the Medicare
28 program under Title XVIII of the Social Security Act, or the
29 Medicaid program under Title XIX of the Social Security Act,
30 and which the Department determines by inspection under this
31 Section or under Section 3-702 of this Act to be in
32 compliance with the certification requirements of Title XVIII
33 or XIX, is in compliance with any requirement of this Act
34 that is less stringent than or duplicates a federal
-12- SRS91HB0182DLsaam01
1 certification requirement. In accordance with subsection (a)
2 of this Section or subsection (d) of Section 3-702, the
3 Department shall determine whether a certified facility is in
4 compliance with requirements of this Act that exceed federal
5 certification requirements. If a certified facility is found
6 to be out of compliance with federal certification
7 requirements, the results of an inspection conducted pursuant
8 to Title XVIII or XIX of the Social Security Act may be used
9 as the basis for enforcement remedies authorized and
10 commenced under this Act. Enforcement of this Act against a
11 certified facility shall be commenced pursuant to the
12 requirements of this Act, unless enforcement remedies sought
13 pursuant to Title XVIII or XIX of the Social Security Act
14 exceed those authorized by this Act. As used in this
15 subsection, "enforcement remedy" means a sanction for
16 violating a federal certification requirement or this Act.
17 (c) Upon completion of each inspection, survey and
18 evaluation, the appropriate Department personnel who
19 conducted the inspection, survey or evaluation shall submit a
20 copy of their report to the licensee upon exiting the
21 facility, and shall submit the actual report to the
22 appropriate regional office of the Department. Such report
23 and any recommendations for action by the Department under
24 this Act shall be transmitted to the appropriate offices of
25 the associate director of the Department, together with
26 related comments or documentation provided by the licensee
27 which may refute findings in the report, which explain
28 extenuating circumstances that the facility could not
29 reasonably have prevented, or which indicate methods and
30 timetables for correction of deficiencies described in the
31 report. Without affecting the application of subsection (a)
32 of Section 3-303, any documentation or comments of the
33 licensee shall be provided within 10 days of receipt of the
34 copy of the report. Such report shall recommend to the
-13- SRS91HB0182DLsaam01
1 Director appropriate action under this Act with respect to
2 findings against a facility. The Director shall then
3 determine whether the report's findings constitute a
4 violation or violations of which the facility must be given
5 notice. Such determination shall be based upon the severity
6 of the finding, the danger posed to resident health and
7 safety, the comments and documentation provided by the
8 facility, the diligence and efforts to correct deficiencies,
9 correction of the reported deficiencies, the frequency and
10 duration of similar findings in previous reports and the
11 facility's general inspection history. Violations shall be
12 determined under this subsection no later than 60 days after
13 completion of each inspection, survey and evaluation.
14 (d) The Department shall maintain all inspection, survey
15 and evaluation reports for at least 5 years in a manner
16 accessible to and understandable by the public.
17 (Source: P.A. 88-278; 89-21, eff. 1-1-96; 89-171, eff.
18 1-1-96; 89-197, eff. 7-21-95; 89-626, eff. 8-9-96.)
19 Section 15. The Illinois Public Aid Code is amended by
20 changing Section 5-5.5 as follows:
21 (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
22 Sec. 5-5.5. Elements of Payment Rate.
23 (a) The Department of Public Aid shall develop a
24 prospective method for determining payment rates for skilled
25 nursing and intermediate care services in nursing facilities
26 composed of the following cost elements:
27 (1) Standard Services, with the cost of this
28 component being determined by taking into account the
29 actual costs to the facilities of these services subject
30 to cost ceilings to be defined in the Department's rules.
31 (2) Resident Services, with the cost of this
32 component being determined by taking into account the
-14- SRS91HB0182DLsaam01
1 actual costs, needs and utilization of these services, as
2 derived from an assessment of the resident needs in the
3 nursing facilities. The Department shall adopt rules
4 governing reimbursement for resident services as listed
5 in Section 5-1.1. Surveys or assessments of resident
6 needs under this Section shall include a review by the
7 facility of the results of such assessments and a
8 discussion of issues in dispute with authorized survey
9 staff, unless the facility elects not to participate in
10 such a review process. Surveys or assessments of
11 resident needs under this Section may be conducted
12 semi-annually and payment rates relating to resident
13 services may be changed on a semi-annual basis. The
14 Illinois Department shall initiate a project, either on a
15 pilot basis or Statewide, to reimburse the cost of
16 resident services based on a methodology which utilizes
17 an assessment of resident needs to determine the level of
18 reimbursement. This methodology shall be different from
19 the payment criteria for resident services utilized by
20 the Illinois Department on July 1, 1981. On March 1,
21 1982, and each year thereafter, until such time when the
22 Illinois Department adopts the methodology used in such
23 project for use statewide or the Illinois Department
24 reports to the Citizens Assembly/Council on Public Aid
25 that the methodology did not meet the Department's goals
26 and objectives and therefore is ceasing such project, the
27 Illinois Department shall report to the General Assembly
28 on the implementation and progress of such project. The
29 report shall include:
30 (A) A statement of the Illinois Department's
31 goals and objectives for such project;
32 (B) A description of such project, including
33 the number and type of nursing facilities involved
34 in the project;
-15- SRS91HB0182DLsaam01
1 (C) A description of the methodology used in
2 such project;
3 (D) A description of the Illinois Department's
4 application of the methodology;
5 (E) A statement on the methodology's effect on
6 the quality of care given to residents in the sample
7 nursing facilities; and
8 (F) A statement on the cost of the methodology
9 used in such project and a comparison of this cost
10 with the cost of the current payment criteria.
11 (3) Ancillary Services, with the payment rate being
12 developed for each individual type of service. Payment
13 shall be made only when authorized under procedures
14 developed by the Department of Public Aid.
15 (4) Nurse's Aide Training, with the cost of this
16 component being determined by taking into account the
17 actual cost to the facilities of such training.
18 (5) Real Estate Taxes, with the cost of this
19 component being determined by taking into account the
20 figures contained in the most currently available cost
21 reports (with no imposition of maximums) updated to the
22 midpoint of the current rate year for long term care
23 services rendered between July 1, 1984 and June 30, 1985,
24 and with the cost of this component being determined by
25 taking into account the actual 1983 taxes for which the
26 nursing homes were assessed (with no imposition of
27 maximums) updated to the midpoint of the current rate
28 year for long term care services rendered between July 1,
29 1985 and June 30, 1986.
30 (b) In developing a prospective method for determining
31 payment rates for skilled nursing and intermediate care
32 services in nursing facilities, the Department of Public Aid
33 shall consider the following cost elements:
34 (1) Reasonable capital cost determined by utilizing
-16- SRS91HB0182DLsaam01
1 incurred interest rate and the current value of the
2 investment, including land, utilizing composite rates, or
3 by utilizing such other reasonable cost related methods
4 determined by the Department. However, beginning with the
5 rate reimbursement period effective July 1, 1987, the
6 Department shall be prohibited from establishing,
7 including, and implementing any depreciation factor in
8 calculating the capital cost element.
9 (2) Profit, with the actual amount being produced
10 and accruing to the providers in the form of a return on
11 their total investment, on the basis of their ability to
12 economically and efficiently deliver a type of service.
13 The method of payment may assure the opportunity for a
14 profit, but shall not guarantee or establish a specific
15 amount as a cost.
16 (c) The Illinois Department may implement the amendatory
17 changes to this Section made by this amendatory Act of 1991
18 through the use of emergency rules in accordance with the
19 provisions of Section 5.02 of the Illinois Administrative
20 Procedure Act. For purposes of the Illinois Administrative
21 Procedure Act, the adoption of rules to implement the
22 amendatory changes to this Section made by this amendatory
23 Act of 1991 shall be deemed an emergency and necessary for
24 the public interest, safety and welfare.
25 (d) No later than January 1, 2001, the Department of
26 Public Aid shall file with the Joint Committee on
27 Administrative Rules, pursuant to the Illinois Administrative
28 Procedure Act, a proposed rule, or a proposed amendment to an
29 existing rule, regarding payment for appropriate services,
30 including assessment, care planning, and treatment provided
31 by nursing facilities to residents who have a serious mental
32 illness.
33 (Source: P.A. 86-651; 86-705; 86-1028; 87-14; 87-435.)
-17- SRS91HB0182DLsaam01
1 Section 99. Effective date. This Act takes effect
2 January 1, 2001.".
[ Top ]