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Public Act 102-0947
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| HB4674 Enrolled | LRB102 23801 CPF 32992 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Nursing Home Care Act is amended by |
changing Sections 3-212 and 3-702 as follows:
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(210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
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Sec. 3-212. Inspection.
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(a) The Department, whenever it deems necessary in
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accordance with subsection (b), shall inspect, survey and |
evaluate every
facility to determine compliance with |
applicable licensure requirements and
standards. Submission of |
a facility's current Consumer Choice Information Report |
required by Section 2-214 shall be verified at time of |
inspection. An inspection should occur within 120 days prior
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to license renewal. The Department may periodically visit a |
facility for the
purpose of consultation. An inspection, |
survey, or evaluation, other than
an inspection of financial |
records, shall be conducted without prior notice
to the |
facility. A visit for the sole purpose of consultation may be
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announced.
The Department shall provide training to surveyors |
about the appropriate
assessment, care planning, and care of |
persons with mental illness (other than
Alzheimer's disease or |
related disorders) to enable its surveyors to
determine |
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whether a facility is complying with State and federal |
requirements
about the assessment, care planning, and care of |
those persons.
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(a-1) An employee of a State or unit of local government |
agency
charged with inspecting, surveying, and evaluating |
facilities who directly
or indirectly gives prior notice of an |
inspection, survey, or evaluation,
other than an inspection of |
financial records, to a facility or to an
employee of a |
facility is guilty of a Class A misdemeanor.
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An inspector or an employee of the Department who |
intentionally prenotifies
a facility,
orally or in writing, of |
a pending complaint investigation or inspection shall
be |
guilty of a Class A misdemeanor.
Superiors of persons who have |
prenotified a facility shall be subject to the
same penalties, |
if they have knowingly allowed the prenotification. A person
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found guilty of prenotifying a facility shall be subject to |
disciplinary action
by his or her employer.
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If the Department has a good faith belief, based upon |
information that comes
to its attention, that a violation of |
this subsection has occurred, it must
file a complaint with |
the Attorney General or the State's Attorney in the
county |
where the violation
took place within 30 days after discovery |
of the information.
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(a-2) An employee of a State or unit of local government |
agency charged with
inspecting, surveying, or evaluating |
facilities who willfully profits from
violating the |
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confidentiality of the inspection, survey, or evaluation
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process shall be guilty of a Class 4 felony and that conduct |
shall be deemed
unprofessional conduct that may subject a |
person to loss of his or her
professional license. An action to |
prosecute a person for violating this
subsection (a-2) may be |
brought by either the Attorney General or the State's
Attorney |
in the county where the violation took place.
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(a-3) The Department shall, by rule, establish guidelines |
for required continuing education of all employees who |
inspect, survey, or evaluate a facility. The Department shall |
offer continuing education opportunities at least quarterly. |
Employees of a State agency charged with inspecting, |
surveying, or evaluating a facility are required to complete |
at least 10 hours of continuing education annually on topics |
that support the survey process, including, but not limited |
to, trauma-informed care, infection control, abuse and |
neglect, and civil monetary penalties. Qualifying hours of |
continuing education intended to fulfill the requirements of |
this subsection shall only be offered by the Department. |
Content presented during the continuing education shall be |
consistent throughout the State, regardless of survey region. |
At least 5 of the 10 hours of continuing education required |
under this subsection shall be separate and distinct from any |
continuing education hours required for any license that the |
employee holds. Any continuing education hours provided by the |
Department in addition to the 10 hours of continuing education |
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required under this subsection may count towards continuing |
education hours required for any license that the employee |
holds. |
(b) In determining whether to make more than the required |
number of
unannounced inspections, surveys and evaluations of |
a facility the
Department shall consider one or more of the |
following: previous inspection
reports; the facility's history |
of compliance with standards, rules and
regulations |
promulgated under this Act and correction of violations,
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penalties or other enforcement actions; the number and |
severity of
complaints received about the facility; any |
allegations of resident abuse
or neglect; weather conditions; |
health emergencies; other reasonable belief
that deficiencies |
exist.
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(b-1) The Department shall not be required to determine |
whether a
facility certified to participate in the Medicare |
program under Title XVIII of
the Social Security Act, or the |
Medicaid program under Title XIX of the Social
Security Act, |
and which the Department determines by inspection under this
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Section or under Section 3-702 of this Act to be in compliance |
with the
certification requirements of Title XVIII or XIX, is |
in compliance with any
requirement of this Act that is less |
stringent than or duplicates a federal
certification |
requirement. In accordance with subsection (a) of this Section
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or subsection (d) of Section 3-702, the Department shall |
determine whether a
certified facility is in
compliance with |
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requirements of this Act that exceed federal certification
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requirements. If a certified facility is found to be out of |
compliance with
federal certification requirements, the |
results of an inspection conducted
pursuant to Title XVIII or |
XIX of the Social Security Act may be used as the
basis for |
enforcement remedies authorized and commenced, with the |
Department's discretion to evaluate whether penalties are |
warranted, under this Act.
Enforcement of this Act against a |
certified facility shall be commenced
pursuant to the |
requirements of this Act, unless enforcement remedies sought
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pursuant to Title XVIII or XIX of the Social Security Act |
exceed those
authorized by this Act. As used in this |
subsection, "enforcement remedy"
means a sanction for |
violating a federal certification requirement or this
Act.
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(c) Upon completion of each inspection, survey and |
evaluation, the
appropriate Department personnel who conducted |
the inspection, survey or
evaluation shall submit a physical |
or electronic copy of their report to the licensee upon |
exiting
the facility, and shall submit the actual report to |
the appropriate
regional office of the Department. Such report |
and any recommendations for
action by the Department under |
this Act shall be transmitted to the
appropriate offices of |
the associate director of the Department, together
with |
related comments or documentation provided by the licensee |
which may
refute findings in the report, which explain |
extenuating circumstances that
the facility could not |
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reasonably have prevented, or which indicate methods
and |
timetables for correction of deficiencies described in the |
report.
Without affecting the application of subsection (a) of |
Section 3-303, any
documentation or comments of the licensee |
shall be provided within 10
days of receipt of the copy of the |
report. Such report shall recommend to
the Director |
appropriate action under this Act with respect to findings
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against a facility. The Director shall then determine whether |
the report's
findings constitute a violation or violations of |
which the facility must be
given notice. Such determination |
shall be based upon the severity of the
finding, the danger |
posed to resident health and safety, the comments and
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documentation provided by the facility, the diligence and |
efforts to
correct deficiencies, correction of the reported |
deficiencies, the
frequency and duration of similar findings |
in previous reports and the
facility's general inspection |
history. Violations shall be determined
under this subsection |
no later than 75 days after completion of each
inspection, |
survey and evaluation.
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(d) The Department shall maintain all inspection, survey |
and evaluation
reports for at least 5 years in a manner |
accessible to and understandable
by the public.
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(e) Revisit surveys. The Department shall conduct a |
revisit to its licensure and certification surveys, consistent |
with federal regulations and guidelines. |
(f) Notwithstanding any other provision of this Act, the |
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Department shall, no later than 180 days after the effective |
date of this amendatory Act of the 98th General Assembly, |
implement a single survey process that encompasses federal |
certification and State licensure requirements, health and |
life safety requirements, and an enhanced complaint |
investigation initiative. |
(1) To meet the requirement of a single survey |
process, the portions of the health and life safety survey |
associated with federal certification and State licensure |
surveys must be started within 7 working days of each |
other. Nothing in this paragraph (1) of subsection (f) of |
this Section applies to a complaint investigation. |
(2) The enhanced complaint and incident report |
investigation initiative shall permit the facility to |
challenge the amount of the fine due to the excessive |
length of the investigation which results in one or more |
of the following conditions: |
(A) prohibits the timely development and |
implementation of a plan of correction; |
(B) creates undue financial hardship impacting the |
quality of care delivered to the resident; |
(C) delays initiation of corrective training; and |
(D) negatively impacts quality assurance and |
patient improvement standards. |
This paragraph (2) does not apply to complaint |
investigations exited within 14 working days or a |
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situation that triggers an extended survey. |
(Source: P.A. 98-104, eff. 7-22-13.)
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(210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
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Sec. 3-702.
(a) A person who believes that this Act or a |
rule promulgated
under this Act may have been violated may |
request an investigation. The
request may be submitted to the |
Department in writing, by telephone, by electronic means, or |
by
personal visit. An oral complaint shall be reduced to |
writing by the
Department. The Department shall make |
available, through its website and upon request, information |
regarding the oral and phone intake processes and the list of |
questions that will be asked of the complainant. The |
Department shall request information identifying the
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complainant, including the name, address and telephone number, |
to help
enable appropriate follow-up. The Department shall act |
on such complaints
via on-site visits or other methods deemed |
appropriate to handle the
complaints with or without such |
identifying information, as otherwise
provided under this |
Section. The complainant shall be informed that
compliance |
with such request is not required to satisfy the procedures |
for
filing a complaint under this Act. The Department must |
notify complainants that complaints with less information |
provided are far more difficult to respond to and investigate.
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(b) The substance of the complaint shall be provided in |
writing to the
licensee, owner, or administrator no earlier |
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than at the commencement of an
on-site inspection of the |
facility which takes place pursuant to the complaint.
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(c) The Department shall not disclose the name of the |
complainant unless
the complainant consents in writing to the |
disclosure or the investigation
results in a judicial |
proceeding, or unless disclosure is essential to the
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investigation. The complainant shall be given the opportunity |
to withdraw
the complaint before disclosure. Upon the request |
of the complainant, the
Department may permit the complainant |
or a representative of the complainant
to accompany the person |
making the on-site inspection of the facility.
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(d) Upon receipt of a complaint, the Department shall |
determine whether this
Act or a rule promulgated under this |
Act has been or is being violated. The
Department shall |
investigate all complaints alleging abuse or neglect within
7 |
days after the receipt of the complaint except that complaints |
of abuse
or neglect which indicate that a resident's life or |
safety is in imminent
danger shall be investigated within 24 |
hours after receipt of the
complaint. All other complaints |
shall be investigated within 30 days after
the receipt of the |
complaint. The Department employees investigating a
complaint |
shall conduct a brief, informal exit conference with the |
facility
to alert its administration of any suspected serious |
deficiency that poses
a direct threat to the health, safety or |
welfare of a resident to enable an
immediate correction for |
the alleviation or elimination of such threat.
Such |
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information and findings discussed in the brief exit |
conference shall
become a part of the investigating record but |
shall not in any way
constitute an official or final notice of |
violation as provided under
Section 3-301. All complaints |
shall be classified as
"an invalid report", "a valid report", |
or "an undetermined
report". For any complaint classified as |
"a valid report", the
Department must determine within 30 |
working days after any Department employee enters a facility |
to begin an on-site inspection
if any rule or provision of this |
Act has been or is being violated.
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(d-1) The Department shall, whenever possible, combine an |
on-site
investigation of a complaint in a facility with other |
inspections in order
to avoid duplication of inspections.
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(e) In all cases, the Department shall inform the |
complainant of its
findings within 10 days of its |
determination unless otherwise indicated
by the complainant, |
and the complainant may direct the Department to
send a copy of |
such findings to another person. The Department's findings
may |
include comments or documentation provided by either the |
complainant
or the licensee pertaining to the complaint. The |
Department shall also
notify the facility of such findings |
within 10 days of the determination,
but the name of the |
complainant or residents shall not be disclosed in this
notice |
to the facility. The notice of such
findings shall include a |
copy of the written determination; the
correction order, if |
any; the warning notice, if any; the inspection
report; or the |
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State licensure form on which the violation is listed.
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(f) A written determination, correction order, or warning |
notice
concerning a complaint, together with the facility's |
response, shall be
available for public inspection, but the |
name of the complainant or
resident shall not be disclosed |
without his consent.
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(g) A complainant who is dissatisfied with the |
determination or
investigation by the Department may request a |
hearing under Section
3-703. The facility shall be given |
notice of any such
hearing and may participate in the hearing |
as a party. If a facility
requests a hearing under Section |
3-703 which
concerns a matter covered by a complaint, the |
complainant shall be given
notice and may participate in the |
hearing as a party. A request
for a hearing by either a |
complainant or a facility shall be
submitted in writing to the |
Department within 30 days after the mailing
of the |
Department's findings as described in subsection (e) of this
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Section. Upon receipt of the request the Department shall |
conduct a hearing
as provided under Section 3-703.
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(g-5) The Department shall conduct an annual review of all |
survey activity from the preceding fiscal year and make a |
report concerning the complaint and survey process. The report |
shall include, but not be limited to: that includes the total |
number of complaints received; the breakdown of 24-hour, |
7-day, and 30-day complaints; , the breakdown of anonymous and |
non-anonymous complaints; and whether the number of complaints |
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that were substantiated versus unsubstantiated; or not, the |
total number of substantiated complaints that were completed |
in the time frame determined under subsection (d); the total |
number of informal dispute resolutions requested; the total |
number of informal dispute resolution requests approved; the |
total number of informal dispute resolutions that were |
overturned or reduced in severity; the total number of nurse |
surveyors
hired during the calendar year; the total number of |
nurse
surveyors who left Department employment; the average |
length of tenure for nurse surveyors employed by the |
Department at the time the report is created; the total number |
of times the Department imposed discretionary denial of |
payment within 15 days of notice and within 2 days of notice as |
well as the number of times the discretionary denial of |
payment took effect; , and any other complaint information |
requested by the Long-Term Care Facility Advisory Board |
created under Section 2-204 of this Act or the Illinois |
Long-Term Care Council created under Section 4.04a of the |
Illinois Act on the Aging. This report shall be provided to the |
Long-Term Care Facility Advisory Board, the Illinois Long-Term |
Care Council, and the General Assembly. The Long-Term Care |
Facility Advisory Board and the Illinois Long-Term Care |
Council shall review the report and suggest any changes deemed |
necessary to the Department for review and action, including |
how to investigate and substantiate anonymous complaints. |
(h) Any person who knowingly transmits a false report to |