093_HB1181

 
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 1        AN ACT concerning hospitals.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  1.  Short  title.  This  Act may be cited as the
 5    Hospital Report Card Act.

 6        Section 5.  Findings. The  General  Assembly  finds  that
 7    Illinois  consumers  have a right to access information about
 8    the quality of health care provided in Illinois hospitals  in
 9    order  to  make better decisions about their choice of health
10    care provider.

11        Section 10.  Definitions. For the purposes of this Act:
12        "Direct-care  nurse"  and  "direct-care  nursing   staff"
13    includes  any  registered nurse, licensed practical nurse, or
14    assistive nursing personnel  with  direct  responsibility  to
15    oversee or carry out medical regimens or nursing care for one
16    or more patients.
17        "Hospital"  means  a  health care facility licensed under
18    the Hospital Licensing Act.
19        "Nursing care" means the care that falls within the scope
20    of practice set forth in the Nursing  and  Advanced  Practice
21    Nursing  Act  or  is  otherwise encompassed within recognized
22    professional  standards  of   nursing   practice,   including
23    assessment,   nursing   diagnosis,   planning,  intervention,
24    evaluation, and patient advocacy.
25        "Retaliate" means the discipline, discharge,  suspension,
26    demotion,  harassment,  denial  of  employment  or promotion,
27    layoff, or any other adverse action taken against direct-care
28    nursing staff as a result of nursing staff taking any  action
29    described in this Act.
30        "Skill   mix"   means   the   differences  in  licensing,
 
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 1    specialty, and experience among direct-care nurses.
 2        "Staffing level" means the  numerical  nurse  to  patient
 3    ratio  by  licensed  nurse  classification  within  a nursing
 4    department or unit.
 5        "Unit" means a functional division or area of a  hospital
 6    in which nursing care is provided.

 7        Section 15.  Staffing levels.
 8        (a)  Staffing  levels  in  hospitals  must  be  based  on
 9    patient  acuity,  how much care a patient needs as determined
10    by a professional nursing  assessment  of  the  patient,  the
11    skill  mix  of the staff, and additional criteria established
12    by the hospital.
13        (b)  Staffing  levels  must  be   posted   daily   in   a
14    conspicuous place readily accessible by the general public.
15        (c)  Personnel  not  documented  as competent for a given
16    unit shall not be  assigned  to  work  there  without  direct
17    supervision until appropriately trained.

18        Section 20.  Hospital quarterly reports.
19        (a)  Individual   hospitals  shall  prepare  a  quarterly
20    report including all of the following:
21             (1)  Mortality and morbidity rates for each  nursing
22        unit or department.
23             (2)  Average  staffing  levels,  patient acuity, and
24        duty hours by nursing unit or department.
25             (3)  Infection  rates  for  each  nursing  unit   or
26        department   within   the   facility   by  the  following
27        categories:  urinary   tract,   surgical   wound,   lower
28        respiratory tract, and blood stream.
29             (4)  Training  hours  completed  in  the  quarter by
30        category of staff and type of training.
31             (5)  Staff  retention  rates  by  nursing  unit   or
32        department.
 
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 1        (b)  Quarterly reports shall be a condition of licensure,
 2    submitted  to  the  Department  of Public Health by March 31,
 3    June 30, September 30, and December  31  each  year  for  the
 4    previous  quarter,  and  made available to the public on-site
 5    and through the Department of Public Health.
 6        (c)  If the hospital  is  a  division  or  subsidiary  of
 7    another  entity  that  owns  or  operates  other hospitals or
 8    related organizations, the annual  public  disclosure  report
 9    shall  be for the specific division or subsidiary and not for
10    the other entity.

11        Section 25.  Department reports. The Department of Public
12    Health shall annually submit to the General Assembly a report
13    summarizing the quarterly reports by region and shall publish
14    that report on its website. The Department of  Public  Health
15    may   issue   quarterly   informational   bulletins   at  its
16    discretion,  summarizing  all  or  part  of  the  information
17    submitted in the quarterly reports.

18        Section 30.  Whistleblower protections.
19        (a)  A hospital covered by this Act shall  not  penalize,
20    discriminate,  or retaliate in any manner against an employee
21    with respect to compensation  or  the  terms,  conditions  or
22    privileges  of  employment who in good faith, individually or
23    in conjunction with another person or persons,  does  any  of
24    the following:
25             (1)  Discloses or intends to disclose to the nursing
26        staff  supervisor  or  manager,  a  private accreditation
27        organization, the nurse's collective bargaining agent, or
28        a regulatory agency any activity, policy, or practice  of
29        a hospital that violates this Act or any other law, rule,
30        or  professional  standard  of  practice  and  which  the
31        employee  reasonably believes poses a risk to the health,
32        safety, or welfare of a patient or the public.
 
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 1             (2)  Initiates,     cooperates,     or     otherwise
 2        participates in an investigation or proceeding bought  by
 3        a   regulatory   agency  or  private  accreditation  body
 4        concerning matters covered by this Act or any other  law,
 5        rule,  or  professional  standard  of  practice  that the
 6        employee reasonably believes poses a risk to the  health,
 7        safety, or welfare of a patient or the public.
 8             (3)  Objects  to  or  refuses  to participate in any
 9        activity, policy, or practice of a hospital that violates
10        this Act or any law, rule, or  professional  standard  of
11        practice and which the employee staff reasonably believes
12        poses  a  risk  to  the  health,  safety, or welfare of a
13        patient or the public.
14             (4)  Participates in  a  committee  or  peer  review
15        process  or  files  a  report or complaint that discusses
16        allegation of unsafe, dangerous, or potentially dangerous
17        care within the hospital.
18        (b)  For the purposes of this  Section,  an  employee  is
19    presumed  to  act  in  good  faith if the employee reasonably
20    believes that (i) the information reported  or  disclosed  is
21    true and (ii) a violation has occurred or may occur.

22        Section 35.  Private right of action.
23        (a)  Any   health   care   facility   that  violates  the
24    provisions of Section 30 may be held liable to  the  employee
25    affected  in  an  action  brought  in  a  court  of competent
26    jurisdiction for such legal or equitable  relief  as  may  be
27    appropriate to effectuate the purposes of this Act, including
28    but  not  limited to reinstatement, promotion, lost wages and
29    benefits,  and   compensatory   and   consequential   damages
30    resulting from the violation together with an equal amount in
31    liquidated  damages.  The  court  in  such  action  shall, in
32    addition to any judgment  awarded  to  the  plaintiff,  award
33    reasonable  attorney's fees and costs of action to be paid by
 
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 1    the defendant.
 2        (b)  The employee's right to institute a  private  action
 3    under this Section is not limited by any other rights granted
 4    under this Act.

 5        Section  40.  Regulatory  oversight.  The  Department  of
 6    Public  Health  shall  be responsible for ensuring compliance
 7    with this Act as a  condition  of  licensure  and  is  hereby
 8    empowered  to  issue  such  rules  as  may  be  necessary  or
 9    appropriate  to  carry  out this function. At a minimum, such
10    rules shall provide for all of the following:
11             (1)  Unannounced, random compliance site  visits  of
12        licensed health care facilities covered by this Act.
13             (2)  An  accessible  and confidential system for the
14        public and nursing staff to report  a  health  facility's
15        failure to comply with the requirements of this Act.
16             (3)  A   systematic   means  for  investigating  and
17        correcting violation of this Act.
18             (4)  Public access to information regarding  reports
19        of inspections, results, deficiencies and corrections.
20             (5)  A  process for imposing the statutory penalties
21        for violations of the staffing requirements of this Act.

22        Section 45.  Penalties.
23        (a)  A determination that a  hospital  has  violated  the
24    provisions  of  this  Act  may  result  in the termination of
25    licensure under the Hospital Licensing Act.
26        (b)  A hospital that fails  to  post  a  notice  required
27    under  this  Act  is subject to a civil penalty of $1,000 per
28    day for each day that the required notice is not posted.
29        (c)  A hospital that violates Section 30 is subject to  a
30    civil penalty of $15,000 per violation.
31        (d)  A  person  or  hospital  that  fails  to  report  or
32    falsifies  information or coerces, threatens, intimidates, or
 
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 1    otherwise influences another person to fail to report  or  to
 2    falsify information required to be reported under this Act is
 3    subject  to  a  civil  penalty of up to $15,000 for each such
 4    incident.

 5        Section 90.  The Hospital Licensing  Act  is  amended  by
 6    changing Section 7 as follows:

 7        (210 ILCS 85/7) (from Ch. 111 1/2, par. 148)
 8        Sec. 7. (a) The Director after notice and opportunity for
 9    hearing  to  the  applicant or licensee may deny, suspend, or
10    revoke a permit to establish a hospital or deny, suspend,  or
11    revoke  a  license  to open, conduct, operate, and maintain a
12    hospital in any case in which he finds that there has been  a
13    substantial failure to comply with the provisions of this Act
14    or  the Hospital Report Card Act or the standards, rules, and
15    regulations established by virtue of  either  of  those  Acts
16    thereof.
17        (b)  Such  notice shall be effected by registered mail or
18    by personal service setting forth the particular reasons  for
19    the  proposed action and fixing a date, not less than 15 days
20    from the date of such mailing or service, at which  time  the
21    applicant  or  licensee  shall  be given an opportunity for a
22    hearing. Such hearing shall be conducted by the  Director  or
23    by an employee of the Department designated in writing by the
24    Director  as  Hearing  Officer to conduct the hearing. On the
25    basis of any such hearing, or upon default of  the  applicant
26    or   licensee,   the  Director  shall  make  a  determination
27    specifying his findings and conclusions. In case of a  denial
28    to  an  applicant  of  a permit to establish a hospital, such
29    determination shall specify the subsection of Section 6 under
30    which the permit was denied and  shall  contain  findings  of
31    fact  forming  the  basis  of  such  denial.  A  copy of such
32    determination shall be sent  by  registered  mail  or  served
 
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 1    personally  upon  the  applicant  or  licensee.  The decision
 2    denying, suspending, or revoking a permit or a license  shall
 3    become  final 35 days after it is so mailed or served, unless
 4    the  applicant  or  licensee,  within  such  35  day  period,
 5    petitions for review pursuant to Section 13.
 6        (c)  The procedure governing hearings authorized by  this
 7    Section  shall be in accordance with rules promulgated by the
 8    Department and approved by the Hospital  Licensing  Board.  A
 9    full  and  complete  record shall be kept of all proceedings,
10    including the notice of hearing,  complaint,  and  all  other
11    documents  in  the nature of pleadings, written motions filed
12    in the proceedings, and the report and orders of the Director
13    and Hearing Officer. All testimony shall be reported but need
14    not be transcribed unless the decision is  appealed  pursuant
15    to  Section  13.  A  copy  or copies of the transcript may be
16    obtained by any interested party on payment of  the  cost  of
17    preparing such copy or copies.
18        (d)  The  Director  or Hearing Officer shall upon his own
19    motion, or on  the  written  request  of  any  party  to  the
20    proceeding,  issue subpoenas requiring the attendance and the
21    giving of testimony by witnesses, and subpoenas  duces  tecum
22    requiring  the  production  of  books,  papers,  records,  or
23    memoranda.  All  subpoenas  and  subpoenas duces tecum issued
24    under the terms of this Act may be served by  any  person  of
25    full  age.  The  fees  of witnesses for attendance and travel
26    shall be the same as the fees of witnesses before the Circuit
27    Court of this State, such fees to be paid when the witness is
28    excused  from  further  attendance.  When  the   witness   is
29    subpoenaed  at  the  instance  of  the  Director,  or Hearing
30    Officer, such fees shall be paid in the same manner as  other
31    expenses   of   the  Department,  and  when  the  witness  is
32    subpoenaed at the instance of any other  party  to  any  such
33    proceeding  the  Department  may  require  that  the  cost of
34    service of the subpoena or subpoena duces tecum and  the  fee
 
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 1    of  the  witness  be borne by the party at whose instance the
 2    witness is summoned. In such  case,  the  Department  in  its
 3    discretion,  may  require a deposit to cover the cost of such
 4    service and witness fees. A subpoena or subpoena duces  tecum
 5    issued  as  aforesaid shall be served in the same manner as a
 6    subpoena issued out of a court.
 7        (e)  Any Circuit Court of this State upon the application
 8    of the Director, or upon the application of any  other  party
 9    to  the  proceeding,  may,  in  its  discretion,  compel  the
10    attendance  of  witnesses,  the  production of books, papers,
11    records, or memoranda and the giving of testimony before  the
12    Director  or  Hearing  Officer conducting an investigation or
13    holding a hearing authorized by this Act,  by  an  attachment
14    for  contempt, or otherwise, in the same manner as production
15    of evidence may be compelled before the court.
16        (f)  The Director or Hearing Officer, or any party in  an
17    investigation or hearing before the Department, may cause the
18    depositions  of witnesses within the State to be taken in the
19    manner prescribed  by  law  for  like  depositions  in  civil
20    actions  in  courts of this State, and to that end compel the
21    attendance of witnesses and the production of books,  papers,
22    records, or memoranda.
23    (Source: Laws 1967, p. 3969.)