97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5668

 

Introduced 2/16/2012, by Rep. Kelly M. Cassidy - Greg Harris

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Illinois Act on the Aging, the Illinois Health Facilities Planning Act, the Nursing Home Care Act, the ID/DD Community Care Act, and the Specialized Mental Health Rehabilitation Act. Makes changes concerning various matters relating to long-term care facilities, including the following: the Long Term Care Ombudsman Program; denial of permits by the Health Facilities and Services Review Board; notification of a resident's death or an unusual incident, abuse, or neglect involving a resident; notification to residents of violations; required liability insurance coverage; staffing; psychiatric services; staff training; dementia-specific orientation; submission of home office cost statements; public computer access to information; and Department of State Police training for facility staff. Amends the State Mandates Act to require implementation without reimbursement by the State.


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FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

HB5668LRB097 19458 DRJ 66076 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.04 as follows:
 
6    (20 ILCS 105/4.04)  (from Ch. 23, par. 6104.04)
7    Sec. 4.04. Long Term Care Ombudsman Program.
8    (a) Long Term Care Ombudsman Program. The Department shall
9establish a Long Term Care Ombudsman Program, through the
10Office of State Long Term Care Ombudsman ("the Office"), in
11accordance with the provisions of the Older Americans Act of
121965, as now or hereafter amended.
13    (b) Definitions. As used in this Section, unless the
14context requires otherwise:
15        (1) "Access" has the same meaning as in Section 1-104
16    of the Nursing Home Care Act, as now or hereafter amended;
17    that is, it means the right to:
18            (i) Enter any long term care facility or assisted
19        living or shared housing establishment or supportive
20        living facility;
21            (ii) Communicate privately and without restriction
22        with any resident, regardless of age, who consents to
23        the communication;

 

 

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1            (iii) Seek consent to communicate privately and
2        without restriction with any resident, regardless of
3        age;
4            (iv) Inspect the clinical and other records of a
5        resident, regardless of age, with the express written
6        consent of the resident;
7            (v) Observe all areas of the long term care
8        facility or supportive living facilities, assisted
9        living or shared housing establishment except the
10        living area of any resident who protests the
11        observation.
12        (2) "Long Term Care Facility" means (i) any facility as
13    defined by Section 1-113 of the Nursing Home Care Act, as
14    now or hereafter amended; and (ii) any skilled nursing
15    facility or a nursing facility which meets the requirements
16    of Section 1819(a), (b), (c), and (d) or Section 1919(a),
17    (b), (c), and (d) of the Social Security Act, as now or
18    hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
19    and 42 U.S.C. 1396r(a), (b), (c), and (d)); and any
20    facility as defined by Section 1-113 of the MR/DD Community
21    Care Act, as now or hereafter amended.
22        (2.5) "Assisted living establishment" and "shared
23    housing establishment" have the meanings given those terms
24    in Section 10 of the Assisted Living and Shared Housing
25    Act.
26        (2.7) "Supportive living facility" means a facility

 

 

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1    established under Section 5-5.01a of the Illinois Public
2    Aid Code.
3        (3) "State Long Term Care Ombudsman" means any person
4    employed by the Department to fulfill the requirements of
5    the Office of State Long Term Care Ombudsman as required
6    under the Older Americans Act of 1965, as now or hereafter
7    amended, and Departmental policy.
8        (3.1) "Ombudsman" means any designated representative
9    of a regional long term care ombudsman program; provided
10    that the representative, whether he is paid for or
11    volunteers his ombudsman services, shall be qualified and
12    designated by the Office to perform the duties of an
13    ombudsman as specified by the Department in rules and in
14    accordance with the provisions of the Older Americans Act
15    of 1965, as now or hereafter amended.
16    (c) Ombudsman; rules. The Office of State Long Term Care
17Ombudsman shall be composed of at least one full-time ombudsman
18and shall include a system of designated regional long term
19care ombudsman programs. Each regional program shall be
20designated by the State Long Term Care Ombudsman as a
21subdivision of the Office and any representative of a regional
22program shall be treated as a representative of the Office.
23    The Department, in consultation with the Office, shall
24promulgate administrative rules in accordance with the
25provisions of the Older Americans Act of 1965, as now or
26hereafter amended, to establish the responsibilities of the

 

 

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1Department and the Office of State Long Term Care Ombudsman and
2the designated regional Ombudsman programs. The administrative
3rules shall include the responsibility of the Office and
4designated regional programs to investigate and resolve
5complaints made by or on behalf of residents of long term care
6facilities, supportive living facilities, and assisted living
7and shared housing establishments, including the option to
8serve residents under the age of 60, relating to actions,
9inaction, or decisions of providers, or their representatives,
10of long term care facilities, of supported living facilities,
11of assisted living and shared housing establishments, of public
12agencies, or of social services agencies, which may adversely
13affect the health, safety, welfare, or rights of such
14residents. The Office and designated regional programs may
15represent all residents, but are not required by this Act to
16represent persons under 60 years of age, except to the extent
17required by federal law. By June 1, 2014, the Office and
18designated regional programs shall represent all residents,
19regardless of age. When necessary and appropriate,
20representatives of the Office shall refer complaints to the
21appropriate regulatory State agency. The Department, in
22consultation with the Office, shall cooperate with the
23Department of Human Services and other State agencies in
24providing information and training to designated regional long
25term care ombudsman programs about the appropriate assessment
26and treatment (including information about appropriate

 

 

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1supportive services, treatment options, and assessment of
2rehabilitation potential) of the residents they serve,
3including children, persons with mental illness (other than
4Alzheimer's disease and related disorders), and persons with
5developmental disabilities.
6    By June 1, 2013, there shall be one ombudsman for every
73,500 licensed or approved beds housing residents served by the
8ombudsman program. By June 1, 2014, there shall be one
9ombudsman for every 2,000 licensed or approved beds housing
10residents served by the ombudsman program.
11    The State Long Term Care Ombudsman and all other ombudsmen,
12as defined in paragraph (3.1) of subsection (b) must submit to
13background checks under the Health Care Worker Background Check
14Act and receive training, as prescribed by the Illinois
15Department on Aging, before visiting facilities. The training
16must include information specific to assisted living
17establishments, supportive living facilities, and shared
18housing establishments and to the rights of residents
19guaranteed under the corresponding Acts and administrative
20rules.
21    (c-5) Consumer Choice Information Reports. The Office
22shall:
23        (1) In collaboration with the Attorney General, create
24    a Consumer Choice Information Report form to be completed
25    by all licensed long term care facilities to aid
26    Illinoisans and their families in making informed choices

 

 

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1    about long term care. The Office shall create a Consumer
2    Choice Information Report for each type of licensed long
3    term care facility. The Office shall collaborate with the
4    Attorney General and the Department of Human Services to
5    create a Consumer Choice Information Report form for
6    facilities licensed under the ID/DD MR/DD Community Care
7    Act. To the extent possible, all Reports shall be in the
8    form of a spreadsheet or database.
9        (2) Develop a database of Consumer Choice Information
10    Reports completed by licensed long term care facilities
11    that includes information in the following consumer
12    categories:
13            (A) Medical Care, Services, and Treatment.
14            (B) Special Services and Amenities.
15            (C) Staffing.
16            (D) Facility Statistics and Resident Demographics.
17            (E) Ownership and Administration.
18            (F) Safety and Security.
19            (G) Meals and Nutrition.
20            (H) Rooms, Furnishings, and Equipment.
21            (I) Family, Volunteer, and Visitation Provisions.
22        (3) Make this information accessible to the public,
23    including on the Internet by means of a hyperlink labeled
24    "Resident's Right to Know" on the Office's World Wide Web
25    home page. Information about facilities licensed under the
26    MR/DD Community Care Act shall be made accessible to the

 

 

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1    public by the Department of Human Services, including on
2    the Internet by means of a hyperlink labeled "Resident's
3    and Families' Right to Know" on the Department of Human
4    Services' "For Customers" website.
5        (4) Have the authority, with the Attorney General, to
6    verify that information provided by a facility is accurate.
7        (5) Request a new report from any licensed facility
8    whenever it deems necessary.
9        (6) Include in the Office's Consumer Choice
10    Information Report for each type of licensed long term care
11    facility additional information on each licensed long term
12    care facility in the State of Illinois, including
13    information regarding each facility's compliance with the
14    relevant State and federal statutes, rules, and standards;
15    customer satisfaction surveys; and information generated
16    from quality measures developed by the Centers for Medicare
17    and Medicaid Services.
18    (d) Access and visitation rights.
19        (1) In accordance with subparagraphs (A) and (E) of
20    paragraph (3) of subsection (c) of Section 1819 and
21    subparagraphs (A) and (E) of paragraph (3) of subsection
22    (c) of Section 1919 of the Social Security Act, as now or
23    hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
24    42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
25    Older Americans Act of 1965, as now or hereafter amended
26    (42 U.S.C. 3058f), a long term care facility, supportive

 

 

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1    living facility, assisted living establishment, and shared
2    housing establishment must:
3            (i) permit immediate access to any resident,
4        regardless of age, by a designated ombudsman; and
5            (ii) permit representatives of the Office, with
6        the permission of the resident's legal representative
7        or legal guardian, to examine a resident's clinical and
8        other records, regardless of the age of the resident,
9        and if a resident is unable to consent to such review,
10        and has no legal guardian, permit representatives of
11        the Office appropriate access, as defined by the
12        Department, in consultation with the Office, in
13        administrative rules, to the resident's records.
14        (2) Each long term care facility, supportive living
15    facility, assisted living establishment, and shared
16    housing establishment shall display, in multiple,
17    conspicuous public places within the facility accessible
18    to both visitors and residents and in an easily readable
19    format, the address and phone number of the Office of the
20    Long Term Care Ombudsman, in a manner prescribed by the
21    Office.
22    (e) Immunity. An ombudsman or any representative of the
23Office participating in the good faith performance of his or
24her official duties shall have immunity from any liability
25(civil, criminal or otherwise) in any proceedings (civil,
26criminal or otherwise) brought as a consequence of the

 

 

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1performance of his official duties.
2    (f) Business offenses.
3        (1) No person shall:
4            (i) Intentionally prevent, interfere with, or
5        attempt to impede in any way any representative of the
6        Office in the performance of his official duties under
7        this Act and the Older Americans Act of 1965; or
8            (ii) Intentionally retaliate, discriminate
9        against, or effect reprisals against any long term care
10        facility resident or employee for contacting or
11        providing information to any representative of the
12        Office.
13        (2) A violation of this Section is a business offense,
14    punishable by a fine not to exceed $501.
15        (3) The Director of Aging, in consultation with the
16    Office, shall notify the State's Attorney of the county in
17    which the long term care facility, supportive living
18    facility, or assisted living or shared housing
19    establishment is located, or the Attorney General, of any
20    violations of this Section.
21    (g) Confidentiality of records and identities. The
22Department shall establish procedures for the disclosure by the
23State Ombudsman or the regional ombudsmen entities of files
24maintained by the program. The procedures shall provide that
25the files and records may be disclosed only at the discretion
26of the State Long Term Care Ombudsman or the person designated

 

 

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1by the State Ombudsman to disclose the files and records, and
2the procedures shall prohibit the disclosure of the identity of
3any complainant, resident, witness, or employee of a long term
4care provider unless:
5        (1) the complainant, resident, witness, or employee of
6    a long term care provider or his or her legal
7    representative consents to the disclosure and the consent
8    is in writing;
9        (2) the complainant, resident, witness, or employee of
10    a long term care provider gives consent orally; and the
11    consent is documented contemporaneously in writing in
12    accordance with such requirements as the Department shall
13    establish; or
14        (3) the disclosure is required by court order.
15    (h) Legal representation. The Attorney General shall
16provide legal representation to any representative of the
17Office against whom suit or other legal action is brought in
18connection with the performance of the representative's
19official duties, in accordance with the State Employee
20Indemnification Act.
21    (i) Treatment by prayer and spiritual means. Nothing in
22this Act shall be construed to authorize or require the medical
23supervision, regulation or control of remedial care or
24treatment of any resident in a long term care facility operated
25exclusively by and for members or adherents of any church or
26religious denomination the tenets and practices of which

 

 

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1include reliance solely upon spiritual means through prayer for
2healing.
3    (j) The Long Term Care Ombudsman Fund is created as a
4special fund in the State treasury to receive moneys for the
5express purposes of this Section. All interest earned on moneys
6in the fund shall be credited to the fund. Moneys contained in
7the fund shall be used to support the purposes of this Section.
8(Source: P.A. 96-328, eff. 8-11-09; 96-758, eff. 8-25-09;
996-1372, eff. 7-29-10; 97-38, eff. 6-28-11.)
 
10    Section 10. The Illinois Health Facilities Planning Act is
11amended by changing Sections 3 and 14.1 as follows:
 
12    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
13    (Section scheduled to be repealed on December 31, 2019)
14    Sec. 3. Definitions. As used in this Act:
15    "Health care facilities" means and includes the following
16facilities and organizations:
17        1. An ambulatory surgical treatment center required to
18    be licensed pursuant to the Ambulatory Surgical Treatment
19    Center Act;
20        2. An institution, place, building, or agency required
21    to be licensed pursuant to the Hospital Licensing Act;
22        3. Skilled and intermediate long term care facilities
23    licensed under the Nursing Home Care Act;
24        3.5. Skilled and intermediate care facilities licensed

 

 

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1    under the ID/DD Community Care Act;
2        3.7. Facilities licensed under the Specialized Mental
3    Health Rehabilitation Act;
4        4. Hospitals, nursing homes, ambulatory surgical
5    treatment centers, or kidney disease treatment centers
6    maintained by the State or any department or agency
7    thereof;
8        5. Kidney disease treatment centers, including a
9    free-standing hemodialysis unit required to be licensed
10    under the End Stage Renal Disease Facility Act;
11        6. An institution, place, building, or room used for
12    the performance of outpatient surgical procedures that is
13    leased, owned, or operated by or on behalf of an
14    out-of-state facility;
15        7. An institution, place, building, or room used for
16    provision of a health care category of service as defined
17    by the Board, including, but not limited to, cardiac
18    catheterization and open heart surgery; and
19        8. An institution, place, building, or room used for
20    provision of major medical equipment used in the direct
21    clinical diagnosis or treatment of patients, and whose
22    project cost is in excess of the capital expenditure
23    minimum.
24    This Act shall not apply to the construction of any new
25facility or the renovation of any existing facility located on
26any campus facility as defined in Section 5-5.8b of the

 

 

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1Illinois Public Aid Code, provided that the campus facility
2encompasses 30 or more contiguous acres and that the new or
3renovated facility is intended for use by a licensed
4residential facility.
5    No federally owned facility shall be subject to the
6provisions of this Act, nor facilities used solely for healing
7by prayer or spiritual means.
8    No facility licensed under the Supportive Residences
9Licensing Act or the Assisted Living and Shared Housing Act
10shall be subject to the provisions of this Act.
11    No facility established and operating under the
12Alternative Health Care Delivery Act as a children's respite
13care center alternative health care model demonstration
14program or as an Alzheimer's Disease Management Center
15alternative health care model demonstration program shall be
16subject to the provisions of this Act.
17    A facility designated as a supportive living facility that
18is in good standing with the program established under Section
195-5.01a of the Illinois Public Aid Code shall not be subject to
20the provisions of this Act.
21    This Act does not apply to facilities granted waivers under
22Section 3-102.2 of the Nursing Home Care Act. However, if a
23demonstration project under that Act applies for a certificate
24of need to convert to a nursing facility, it shall meet the
25licensure and certificate of need requirements in effect as of
26the date of application.

 

 

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1    This Act does not apply to a dialysis facility that
2provides only dialysis training, support, and related services
3to individuals with end stage renal disease who have elected to
4receive home dialysis. This Act does not apply to a dialysis
5unit located in a licensed nursing home that offers or provides
6dialysis-related services to residents with end stage renal
7disease who have elected to receive home dialysis within the
8nursing home. The Board, however, may require these dialysis
9facilities and licensed nursing homes to report statistical
10information on a quarterly basis to the Board to be used by the
11Board to conduct analyses on the need for proposed kidney
12disease treatment centers.
13    This Act shall not apply to the closure of an entity or a
14portion of an entity licensed under the Nursing Home Care Act,
15the Specialized Mental Health Rehabilitation Act, or the ID/DD
16MR/DD Community Care Act, with the exceptions of facilities
17operated by a county or Illinois Veterans Homes, that elects to
18convert, in whole or in part, to an assisted living or shared
19housing establishment licensed under the Assisted Living and
20Shared Housing Act.
21    This Act does not apply to any change of ownership of a
22healthcare facility that is licensed under the Nursing Home
23Care Act, the Specialized Mental Health Rehabilitation Act, or
24the ID/DD Community Care Act, with the exceptions of facilities
25operated by a county or Illinois Veterans Homes. Changes of
26ownership of facilities licensed under the Nursing Home Care

 

 

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1Act must meet the requirements set forth in Sections 3-101
2through 3-119 of the Nursing Home Care Act.
3    With the exception of those health care facilities
4specifically included in this Section, nothing in this Act
5shall be intended to include facilities operated as a part of
6the practice of a physician or other licensed health care
7professional, whether practicing in his individual capacity or
8within the legal structure of any partnership, medical or
9professional corporation, or unincorporated medical or
10professional group. Further, this Act shall not apply to
11physicians or other licensed health care professional's
12practices where such practices are carried out in a portion of
13a health care facility under contract with such health care
14facility by a physician or by other licensed health care
15professionals, whether practicing in his individual capacity
16or within the legal structure of any partnership, medical or
17professional corporation, or unincorporated medical or
18professional groups. This Act shall apply to construction or
19modification and to establishment by such health care facility
20of such contracted portion which is subject to facility
21licensing requirements, irrespective of the party responsible
22for such action or attendant financial obligation.
23    "Person" means any one or more natural persons, legal
24entities, governmental bodies other than federal, or any
25combination thereof.
26    "Consumer" means any person other than a person (a) whose

 

 

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1major occupation currently involves or whose official capacity
2within the last 12 months has involved the providing,
3administering or financing of any type of health care facility,
4(b) who is engaged in health research or the teaching of
5health, (c) who has a material financial interest in any
6activity which involves the providing, administering or
7financing of any type of health care facility, or (d) who is or
8ever has been a member of the immediate family of the person
9defined by (a), (b), or (c).
10    "State Board" or "Board" means the Health Facilities and
11Services Review Board.
12    "Construction or modification" means the establishment,
13erection, building, alteration, reconstruction, modernization,
14improvement, extension, discontinuation, change of ownership,
15of or by a health care facility, or the purchase or acquisition
16by or through a health care facility of equipment or service
17for diagnostic or therapeutic purposes or for facility
18administration or operation, or any capital expenditure made by
19or on behalf of a health care facility which exceeds the
20capital expenditure minimum; however, any capital expenditure
21made by or on behalf of a health care facility for (i) the
22construction or modification of a facility licensed under the
23Assisted Living and Shared Housing Act or (ii) a conversion
24project undertaken in accordance with Section 30 of the Older
25Adult Services Act shall be excluded from any obligations under
26this Act.

 

 

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1    "Establish" means the construction of a health care
2facility or the replacement of an existing facility on another
3site or the initiation of a category of service as defined by
4the Board.
5    "Major medical equipment" means medical equipment which is
6used for the provision of medical and other health services and
7which costs in excess of the capital expenditure minimum,
8except that such term does not include medical equipment
9acquired by or on behalf of a clinical laboratory to provide
10clinical laboratory services if the clinical laboratory is
11independent of a physician's office and a hospital and it has
12been determined under Title XVIII of the Social Security Act to
13meet the requirements of paragraphs (10) and (11) of Section
141861(s) of such Act. In determining whether medical equipment
15has a value in excess of the capital expenditure minimum, the
16value of studies, surveys, designs, plans, working drawings,
17specifications, and other activities essential to the
18acquisition of such equipment shall be included.
19    "Capital Expenditure" means an expenditure: (A) made by or
20on behalf of a health care facility (as such a facility is
21defined in this Act); and (B) which under generally accepted
22accounting principles is not properly chargeable as an expense
23of operation and maintenance, or is made to obtain by lease or
24comparable arrangement any facility or part thereof or any
25equipment for a facility or part; and which exceeds the capital
26expenditure minimum.

 

 

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1    For the purpose of this paragraph, the cost of any studies,
2surveys, designs, plans, working drawings, specifications, and
3other activities essential to the acquisition, improvement,
4expansion, or replacement of any plant or equipment with
5respect to which an expenditure is made shall be included in
6determining if such expenditure exceeds the capital
7expenditures minimum. Unless otherwise interdependent, or
8submitted as one project by the applicant, components of
9construction or modification undertaken by means of a single
10construction contract or financed through the issuance of a
11single debt instrument shall not be grouped together as one
12project. Donations of equipment or facilities to a health care
13facility which if acquired directly by such facility would be
14subject to review under this Act shall be considered capital
15expenditures, and a transfer of equipment or facilities for
16less than fair market value shall be considered a capital
17expenditure for purposes of this Act if a transfer of the
18equipment or facilities at fair market value would be subject
19to review.
20    "Capital expenditure minimum" means $11,500,000 for
21projects by hospital applicants, $6,500,000 for applicants for
22projects related to skilled and intermediate care long-term
23care facilities licensed under the Nursing Home Care Act, and
24$3,000,000 for projects by all other applicants, which shall be
25annually adjusted to reflect the increase in construction costs
26due to inflation, for major medical equipment and for all other

 

 

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1capital expenditures.
2    "Non-clinical service area" means an area (i) for the
3benefit of the patients, visitors, staff, or employees of a
4health care facility and (ii) not directly related to the
5diagnosis, treatment, or rehabilitation of persons receiving
6services from the health care facility. "Non-clinical service
7areas" include, but are not limited to, chapels; gift shops;
8news stands; computer systems; tunnels, walkways, and
9elevators; telephone systems; projects to comply with life
10safety codes; educational facilities; student housing;
11patient, employee, staff, and visitor dining areas;
12administration and volunteer offices; modernization of
13structural components (such as roof replacement and masonry
14work); boiler repair or replacement; vehicle maintenance and
15storage facilities; parking facilities; mechanical systems for
16heating, ventilation, and air conditioning; loading docks; and
17repair or replacement of carpeting, tile, wall coverings,
18window coverings or treatments, or furniture. Solely for the
19purpose of this definition, "non-clinical service area" does
20not include health and fitness centers.
21    "Areawide" means a major area of the State delineated on a
22geographic, demographic, and functional basis for health
23planning and for health service and having within it one or
24more local areas for health planning and health service. The
25term "region", as contrasted with the term "subregion", and the
26word "area" may be used synonymously with the term "areawide".

 

 

HB5668- 20 -LRB097 19458 DRJ 66076 b

1    "Local" means a subarea of a delineated major area that on
2a geographic, demographic, and functional basis may be
3considered to be part of such major area. The term "subregion"
4may be used synonymously with the term "local".
5    "Physician" means a person licensed to practice in
6accordance with the Medical Practice Act of 1987, as amended.
7    "Licensed health care professional" means a person
8licensed to practice a health profession under pertinent
9licensing statutes of the State of Illinois.
10    "Director" means the Director of the Illinois Department of
11Public Health.
12    "Agency" means the Illinois Department of Public Health.
13    "Alternative health care model" means a facility or program
14authorized under the Alternative Health Care Delivery Act.
15    "Out-of-state facility" means a person that is both (i)
16licensed as a hospital or as an ambulatory surgery center under
17the laws of another state or that qualifies as a hospital or an
18ambulatory surgery center under regulations adopted pursuant
19to the Social Security Act and (ii) not licensed under the
20Ambulatory Surgical Treatment Center Act, the Hospital
21Licensing Act, or the Nursing Home Care Act. Affiliates of
22out-of-state facilities shall be considered out-of-state
23facilities. Affiliates of Illinois licensed health care
24facilities 100% owned by an Illinois licensed health care
25facility, its parent, or Illinois physicians licensed to
26practice medicine in all its branches shall not be considered

 

 

HB5668- 21 -LRB097 19458 DRJ 66076 b

1out-of-state facilities. Nothing in this definition shall be
2construed to include an office or any part of an office of a
3physician licensed to practice medicine in all its branches in
4Illinois that is not required to be licensed under the
5Ambulatory Surgical Treatment Center Act.
6    "Change of ownership of a health care facility" means a
7change in the person who has ownership or control of a health
8care facility's physical plant and capital assets. A change in
9ownership is indicated by the following transactions: sale,
10transfer, acquisition, lease, change of sponsorship, or other
11means of transferring control.
12    "Related person" means any person that: (i) is at least 50%
13owned, directly or indirectly, by either the health care
14facility or a person owning, directly or indirectly, at least
1550% of the health care facility; or (ii) owns, directly or
16indirectly, at least 50% of the health care facility.
17    "Charity care" means care provided by a health care
18facility for which the provider does not expect to receive
19payment from the patient or a third-party payer.
20    "Freestanding emergency center" means a facility subject
21to licensure under Section 32.5 of the Emergency Medical
22Services (EMS) Systems Act.
23(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
2496-1000, eff. 7-2-10; 97-38, eff. 6-28-11; 97-277, eff. 1-1-12;
25revised 9-7-11.)
 

 

 

HB5668- 22 -LRB097 19458 DRJ 66076 b

1    (20 ILCS 3960/14.1)
2    Sec. 14.1. Denial of permit; other sanctions.
3    (a) The State Board may deny an application for a permit or
4may revoke or take other action as permitted by this Act with
5regard to a permit as the State Board deems appropriate,
6including the imposition of fines as set forth in this Section,
7for any one or a combination of the following:
8        (1) The acquisition of major medical equipment without
9    a permit or in violation of the terms of a permit.
10        (2) The establishment, construction, or modification
11    of a health care facility without a permit or in violation
12    of the terms of a permit.
13        (3) The violation of any provision of this Act or any
14    rule adopted under this Act.
15        (4) The failure, by any person subject to this Act, to
16    provide information requested by the State Board or Agency
17    within 30 days after a formal written request for the
18    information.
19        (5) The failure to pay any fine imposed under this
20    Section within 30 days of its imposition.
21    (a-5) For facilities licensed under the ID/DD Community
22Care Act, no permit shall be denied on the basis of prior
23operator history, other than for actions specified under item
24(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
25Act. For facilities licensed under the Specialized Mental
26Health Rehabilitation Act, no permit shall be denied on the

 

 

HB5668- 23 -LRB097 19458 DRJ 66076 b

1basis of prior operator history, other than for: (i) actions
2specified under item (2), (3), (4), or (5), or (6) of Section
33-117 of the Specialized Mental Health Rehabilitation Act or
4item (2), (3), (4), (5), or (6) of Section 3-117 of the Nursing
5Home Care Act; (ii) actions specified under item (a)(6) of
6Section 3-119 of the Specialized Mental Health Rehabilitation
7Act or item (a)(6) of Section 3-119 of the Nursing Home Care
8Act; or (iii) actions within the preceding 5 years constituting
9a substantial and repeated failure to comply with the
10Specialized Mental Health Rehabilitation Act or the Nursing
11Home Care Act or the rules and regulations adopted by the
12Department under those Acts. For facilities licensed under the
13Nursing Home Care Act, no permit shall be denied on the basis
14of prior operator history, other than for: (i) actions
15specified under item (2), (3), (4), (5), or (6) of Section
163-117 of the Specialized Mental Health Rehabilitation Act or
17item (2), (3), (4), (5), or (6) of Section 3-117 of the Nursing
18Home Care Act; (ii) actions specified under item (a)(6) of
19Section 3-119 of the Specialized Mental Health Rehabilitation
20Act or item (2), (3), (4), (5), or (6) of Section 3-117 of the
21Nursing Home Care Act; or (iii) actions within the preceding 5
22years constituting a substantial and repeated failure to comply
23with the Specialized Mental Health Rehabilitation Act or the
24Nursing Home Care Act or the rules and regulations adopted by
25the Department under those Acts that Act. The State Board shall
26not deny a permit on account of any action described in this

 

 

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1subsection (a-5) without also considering all such actions in
2the light of all relevant information available to the State
3Board, including whether the permit is sought to substantially
4comply with a mandatory or voluntary plan of correction
5associated with any action described in this subsection (a-5).
6A permit for a change of ownership granted pursuant to this
7Section for a facility that has committed 2 Type "A" violations
8or at least one Type "AA" violation in the past 2 years must
9require the new owner to comply with a credible plan detailing
10how the facility will remain in compliance with its applicable
11licensing Act and rules and regulations adopted by the
12Department under that Act. Failure to comply with the plan
13shall be considered a modification of a health care facility
14for purposes of subsection (b) of this Section.
15    (b) Persons shall be subject to fines as follows:
16        (1) A permit holder who fails to comply with the
17    requirements of maintaining a valid permit shall be fined
18    an amount not to exceed 1% of the approved permit amount
19    plus an additional 1% of the approved permit amount for
20    each 30-day period, or fraction thereof, that the violation
21    continues.
22        (2) A permit holder who alters the scope of an approved
23    project or whose project costs exceed the allowable permit
24    amount without first obtaining approval from the State
25    Board shall be fined an amount not to exceed the sum of (i)
26    the lesser of $25,000 or 2% of the approved permit amount

 

 

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1    and (ii) in those cases where the approved permit amount is
2    exceeded by more than $1,000,000, an additional $20,000 for
3    each $1,000,000, or fraction thereof, in excess of the
4    approved permit amount.
5        (3) A person who acquires major medical equipment or
6    who establishes a category of service without first
7    obtaining a permit or exemption, as the case may be, shall
8    be fined an amount not to exceed $10,000 for each such
9    acquisition or category of service established plus an
10    additional $10,000 for each 30-day period, or fraction
11    thereof, that the violation continues.
12        (4) A person who constructs, modifies, or establishes a
13    health care facility without first obtaining a permit shall
14    be fined an amount not to exceed $25,000 plus an additional
15    $25,000 for each 30-day period, or fraction thereof, that
16    the violation continues.
17        (5) A person who discontinues a health care facility or
18    a category of service without first obtaining a permit
19    shall be fined an amount not to exceed $10,000 plus an
20    additional $10,000 for each 30-day period, or fraction
21    thereof, that the violation continues. For purposes of this
22    subparagraph (5), facilities licensed under the Nursing
23    Home Care Act or the ID/DD Community Care Act, with the
24    exceptions of facilities operated by a county or Illinois
25    Veterans Homes, are exempt from this permit requirement.
26    However, facilities licensed under the Nursing Home Care

 

 

HB5668- 26 -LRB097 19458 DRJ 66076 b

1    Act or the ID/DD Community Care Act must comply with
2    Section 3-423 of the Nursing Home Care Act or Section 3-423
3    of the ID/DD Community Care Act and must provide the Board
4    with 30-days' written notice of its intent to close.
5        (6) A person subject to this Act who fails to provide
6    information requested by the State Board or Agency within
7    30 days of a formal written request shall be fined an
8    amount not to exceed $1,000 plus an additional $1,000 for
9    each 30-day period, or fraction thereof, that the
10    information is not received by the State Board or Agency.
11    (c) Before imposing any fine authorized under this Section,
12the State Board shall afford the person or permit holder, as
13the case may be, an appearance before the State Board and an
14opportunity for a hearing before a hearing officer appointed by
15the State Board. The hearing shall be conducted in accordance
16with Section 10.
17    (d) All fines collected under this Act shall be transmitted
18to the State Treasurer, who shall deposit them into the
19Illinois Health Facilities Planning Fund.
20(Source: P.A. 96-339, eff. 7-1-10; 96-1372, eff. 7-29-10;
2197-38, eff. 6-28-11; 97-227, eff. 1-1-12; revised 9-7-11.)
 
22    Section 15. The Nursing Home Care Act is amended by
23changing Sections 2-208, 3-109, 3-117, 3-119, 3-202, 3-202.05,
243-202.2b, 3-206, 3-207, 3-304.1, and 3-808.5 and by adding
25Sections 1-114.2, 2-218, 3-202.6, and 3-206.06 as follows:
 

 

 

HB5668- 27 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 45/1-114.2 new)
2    Sec. 1-114.2. Liability insurance. "Liability insurance"
3means insurance on risks based upon neglect of a resident for
4which a licensee is or may be responsible.
 
5    (210 ILCS 45/2-208)  (from Ch. 111 1/2, par. 4152-208)
6    Sec. 2-208. Notice of death, unusual incident, abuse, or
7neglect.
8    (a) A facility shall immediately notify the resident's next
9of kin, representative and physician of the resident's death or
10when the resident's death appears to be imminent. A facility
11shall notify the Department by telephone of a resident's death
12within 24 hours after the resident's death. The facility shall
13notify the Department of the death of a facility resident that
14does not occur in the facility immediately upon learning of the
15death. A facility shall promptly notify the coroner or medical
16examiner of a resident's death in a manner and form to be
17determined by the Department after consultation with the
18coroner or medical examiner of the county in which the facility
19is located. In addition to notice to the Department by
20telephone, the Department shall require the facility to submit
21written notification of the death of a resident within 72 hours
22after the death, including a report of any medication errors or
23other incidents that occurred, within 30 days after the
24resident's death. A facility's failure to comply with this

 

 

HB5668- 28 -LRB097 19458 DRJ 66076 b

1subsection shall constitute a Type "B" violation.
2    (b) A facility shall immediately notify a resident's next
3of kin, guardian, or representative of any unusual incident,
4abuse, or neglect involving the resident. A facility shall
5immediately notify the Department by telephone of any unusual
6incident, abuse, or neglect required to be reported pursuant to
7State law or administrative rule. In addition to notice to the
8Department by telephone, the Department shall require the
9facility to submit written notification of any unusual
10incident, abuse, or neglect within one day after the unusual
11incident, abuse, or neglect occurs. A facility's failure to
12comply with this subsection shall constitute a Type "B"
13violation. For purposes of this subsection, "unusual incident"
14means any of the following: a serious injury; an unscheduled
15hospital visit for treatment of serious injury; a 9-1-1 call
16for emergency services directly relating to a resident threat;
17or stalking of staff, a resident, or any other person.
18(Source: P.A. 81-223.)
 
19    (210 ILCS 45/2-218 new)
20    Sec. 2-218. Notification of violations or deficiencies.
21When the Department issues any notice pursuant to Section
223-119, 3-301, 3-303, 3-307, or 3-702 of this Act, or when the
23Centers for Medicare and Medicaid Services (CMS) issues a
24notice of federal Medicaid certification deficiencies, the
25facility receiving the notice shall provide notification of the

 

 

HB5668- 29 -LRB097 19458 DRJ 66076 b

1violations or deficiencies, within 10 days after receiving the
2notice, to (i) every resident identified or referred to
3anywhere within the Department's notice of violations or the
4CMS Form 2567 (Statement of Deficiencies and Plan of
5Correction) as having received care or services that violated
6State or federal standards and (ii) the guardian or resident's
7representative of every such resident. The notification
8provided by the facility shall include a Department-prescribed
9notification letter as determined by rule and a copy of the
10Department's notice of violations and CMS Form 2567, if any. A
11facility's failure to provide notification pursuant to this
12Section to a resident and the resident's representative or
13guardian, if any, shall constitute a Type "B" violation.
 
14    (210 ILCS 45/3-109)  (from Ch. 111 1/2, par. 4153-109)
15    Sec. 3-109. Upon receipt and review of an application for a
16license made under this Article and inspection of the applicant
17facility under this Article, the Director shall issue a license
18if he finds:
19        (1) that the individual applicant, or the corporation,
20    partnership or other entity if the applicant is not an
21    individual, is a person responsible and suitable to operate
22    or to direct or participate in the operation of a facility
23    by virtue of financial capacity, appropriate business or
24    professional experience, a record of compliance with
25    lawful orders of the Department and lack of revocation of a

 

 

HB5668- 30 -LRB097 19458 DRJ 66076 b

1    license during the previous 5 years;
2        (2) that the facility is under the supervision of an
3    administrator who is licensed, if required, under the
4    Nursing Home Administrators Licensing and Disciplinary
5    Act, as now or hereafter amended; and
6        (3) that the facility is covered by liability insurance
7    as required by this Act; and
8        (4) (3) that the facility is in substantial compliance
9    with this Act, and such other requirements for a license as
10    the Department by rule may establish under this Act.
11(Source: P.A. 95-331, eff. 8-21-07.)
 
12    (210 ILCS 45/3-117)  (from Ch. 111 1/2, par. 4153-117)
13    Sec. 3-117. An application for a license may be denied for
14any of the following reasons:
15        (1) Failure to meet any of the minimum standards set
16    forth by this Act or by rules and regulations promulgated
17    by the Department under this Act.
18        (2) Conviction of the applicant, or if the applicant is
19    a firm, partnership or association, of any of its members,
20    or if a corporation, the conviction of the corporation or
21    any of its officers or stockholders, or of the person
22    designated to manage or supervise the facility, of a
23    felony, or of 2 or more misdemeanors involving moral
24    turpitude, during the previous 5 years as shown by a
25    certified copy of the record of the court of conviction.

 

 

HB5668- 31 -LRB097 19458 DRJ 66076 b

1        (3) Personnel insufficient in number or unqualified by
2    training or experience to properly care for the proposed
3    number and type of residents.
4        (4) Insufficient financial or other resources to
5    operate and conduct the facility in accordance with
6    standards promulgated by the Department under this Act,
7    including failure to have or maintain liability insurance
8    as required by this Act, and in accordance with contractual
9    obligations assumed by a recipient of a grant under the
10    Equity in Long-term Care Quality Act and the plan (if
11    applicable) submitted by a grantee for continuing and
12    increasing adherence to best practices in providing
13    high-quality nursing home care.
14        (5) Revocation of a facility license during the
15    previous 5 years, if such prior license was issued to the
16    individual applicant, a controlling owner or controlling
17    combination of owners of the applicant; or any affiliate of
18    the individual applicant or controlling owner of the
19    applicant and such individual applicant, controlling owner
20    of the applicant or affiliate of the applicant was a
21    controlling owner of the prior license; provided, however,
22    that the denial of an application for a license pursuant to
23    this subsection must be supported by evidence that such
24    prior revocation renders the applicant unqualified or
25    incapable of meeting or maintaining a facility in
26    accordance with the standards and rules promulgated by the

 

 

HB5668- 32 -LRB097 19458 DRJ 66076 b

1    Department under this Act.
2        (6) That the facility is not under the direct
3    supervision of a full-time administrator, as defined by
4    regulation, who is licensed, if required, under the Nursing
5    Home Administrators Licensing and Disciplinary Act.
6        (7) That the facility is in receivership and the
7    proposed licensee has not submitted a specific detailed
8    plan to bring the facility into compliance with the
9    requirements of this Act and with federal certification
10    requirements, if the facility is certified, and to keep the
11    facility in such compliance.
12(Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)
 
13    (210 ILCS 45/3-119)  (from Ch. 111 1/2, par. 4153-119)
14    Sec. 3-119. (a) The Department, after notice to the
15applicant or licensee, may suspend, revoke or refuse to renew a
16license in any case in which the Department finds any of the
17following:
18        (1) There has been a substantial failure to comply with
19    this Act or the rules and regulations promulgated by the
20    Department under this Act. A substantial failure by a
21    facility shall include, but not be limited to, any of the
22    following:
23            (A) termination of Medicare or Medicaid
24        certification by the Centers for Medicare and Medicaid
25        Services; or

 

 

HB5668- 33 -LRB097 19458 DRJ 66076 b

1            (B) a failure by the facility to pay any fine
2        assessed under this Act after the Department has sent
3        to the facility at least 2 notices of assessment that
4        include a schedule of payments as determined by the
5        Department, taking into account extenuating
6        circumstances and financial hardships of the facility.
7        (2) Conviction of the licensee, or of the person
8    designated to manage or supervise the facility, of a
9    felony, or of 2 or more misdemeanors involving moral
10    turpitude, during the previous 5 years as shown by a
11    certified copy of the record of the court of conviction.
12        (3) Personnel is insufficient in number or unqualified
13    by training or experience to properly care for the number
14    and type of residents served by the facility.
15        (4) Financial or other resources are insufficient to
16    conduct and operate the facility in accordance with
17    standards promulgated by the Department under this Act,
18    including that the facility failed to maintain liability
19    insurance coverage as required by this Act at some time
20    during the term of its license.
21        (5) The facility is not under the direct supervision of
22    a full-time administrator, as defined by regulation, who is
23    licensed, if required, under the Nursing Home
24    Administrators Licensing and Disciplinary Act.
25        (6) The facility has committed 2 Type "AA" violations
26    within a 2-year period.

 

 

HB5668- 34 -LRB097 19458 DRJ 66076 b

1    (b) Notice under this Section shall include a clear and
2concise statement of the violations on which the nonrenewal or
3revocation is based, the statute or rule violated and notice of
4the opportunity for a hearing under Section 3-703.
5    (c) If a facility desires to contest the nonrenewal or
6revocation of a license, the facility shall, within 10 days
7after receipt of notice under subsection (b) of this Section,
8notify the Department in writing of its request for a hearing
9under Section 3-703. Upon receipt of the request the Department
10shall send notice to the facility and hold a hearing as
11provided under Section 3-703.
12    (d) The effective date of nonrenewal or revocation of a
13license by the Department shall be any of the following:
14        (1) Until otherwise ordered by the circuit court,
15    revocation is effective on the date set by the Department
16    in the notice of revocation, or upon final action after
17    hearing under Section 3-703, whichever is later.
18        (2) Until otherwise ordered by the circuit court,
19    nonrenewal is effective on the date of expiration of any
20    existing license, or upon final action after hearing under
21    Section 3-703, whichever is later; however, a license shall
22    not be deemed to have expired if the Department fails to
23    timely respond to a timely request for renewal under this
24    Act or for a hearing to contest nonrenewal under paragraph
25    (c).
26        (3) The Department may extend the effective date of

 

 

HB5668- 35 -LRB097 19458 DRJ 66076 b

1    license revocation or expiration in any case in order to
2    permit orderly removal and relocation of residents.
3    The Department may refuse to issue or may suspend the
4license of any person who fails to file a return, or to pay the
5tax, penalty or interest shown in a filed return, or to pay any
6final assessment of tax, penalty or interest, as required by
7any tax Act administered by the Illinois Department of Revenue,
8until such time as the requirements of any such tax Act are
9satisfied.
10(Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)
 
11    (210 ILCS 45/3-202)  (from Ch. 111 1/2, par. 4153-202)
12    Sec. 3-202. The Department shall prescribe minimum
13standards for facilities. These standards shall regulate:
14        (1) Location and construction of the facility,
15    including plumbing, heating, lighting, ventilation, and
16    other physical conditions which shall ensure the health,
17    safety, and comfort of residents and their protection from
18    fire hazard;
19        (2) Number and qualifications of all personnel,
20    including management and nursing personnel, having
21    responsibility for any part of the care given to residents;
22    specifically, the Department shall establish staffing
23    ratios for facilities which shall specify the number of
24    staff hours per resident of care that are needed for
25    professional nursing care for various types of facilities

 

 

HB5668- 36 -LRB097 19458 DRJ 66076 b

1    or areas within facilities and shall require consistent
2    assignment of the same nursing and other direct care staff
3    to the same residents, to the extent circumstances within
4    the control of the facility permit such assignment and
5    respecting requests by staff for reassignment;
6        (3) All sanitary conditions within the facility and its
7    surroundings, including water supply, sewage disposal,
8    food handling, and general hygiene, which shall ensure the
9    health and comfort of residents;
10        (4) Diet related to the needs of each resident based on
11    good nutritional practice and on recommendations which may
12    be made by the physicians attending the resident;
13        (5) Equipment essential to the health and welfare of
14    the residents;
15        (6) A program of habilitation and rehabilitation for
16    those residents who would benefit from such programs;
17        (7) A program for adequate maintenance of physical
18    plant and equipment;
19        (8) Adequate accommodations, staff and services for
20    the number and types of residents for whom the facility is
21    licensed to care, including standards for temperature and
22    relative humidity within comfort zones determined by the
23    Department based upon a combination of air temperature,
24    relative humidity and air movement. Such standards shall
25    also require facility plans that provide for health and
26    comfort of residents at medical risk as determined by the

 

 

HB5668- 37 -LRB097 19458 DRJ 66076 b

1    attending physician whenever the temperature and relative
2    humidity are outside such comfort zones established by the
3    Department. The standards must include a requirement that
4    areas of a nursing home used by residents of the nursing
5    home be air conditioned and heated by means of operable
6    air-conditioning and heating equipment. The areas subject
7    to this air-conditioning and heating requirement include,
8    without limitation, bedrooms or common areas such as
9    sitting rooms, activity rooms, living rooms, community
10    rooms, and dining rooms. No later than July 1, 2008, the
11    Department shall submit a report to the General Assembly
12    concerning the impact of the changes made by this
13    amendatory Act of the 95th General Assembly;
14        (9) Development of evacuation and other appropriate
15    safety plans for use during weather, health, fire, physical
16    plant, environmental and national defense emergencies; and
17        (10) Maintenance of minimum financial or other
18    resources necessary to meet the standards established
19    under this Section, and to operate and conduct the facility
20    in accordance with this Act.
21(Source: P.A. 95-31, eff. 8-9-07.)
 
22    (210 ILCS 45/3-202.05)
23    Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
24thereafter.
25    (a) For the purpose of computing staff to resident ratios,

 

 

HB5668- 38 -LRB097 19458 DRJ 66076 b

1direct care staff shall include:
2        (1) registered nurses;
3        (2) licensed practical nurses;
4        (3) certified nurse assistants;
5        (4) psychiatric services rehabilitation aides;
6        (5) rehabilitation and therapy aides;
7        (6) psychiatric services rehabilitation coordinators;
8        (7) assistant directors of nursing;
9        (8) 50% of the Director of Nurses' time; and
10        (9) 30% of the Social Services Directors' time.
11    The Department shall, by rule, allow certain facilities
12subject to 77 Ill. Admin. Code 300.4000 and following (Subpart
13S) and 300.6000 and following (Subpart T) to utilize
14specialized clinical staff, as defined in rules, to count
15towards the staffing ratios.
16    An employee listed in any of items (1) through (7) shall be
17counted as direct care staff to the extent the individual
18actually provides direct care to residents, including any
19ancillary time the individual spends recording the direct care
20he or she has provided to residents. An individual's time spent
21on scheduled breaks, in training (other than one-on-one
22demonstration and practice of direct care techniques with a
23resident), making appointments, or serving other functions not
24in the presence of a resident, shall not be considered "direct
25care".
26    (b) Beginning January 1, 2011, and thereafter, light

 

 

HB5668- 39 -LRB097 19458 DRJ 66076 b

1intermediate care shall be staffed at the same staffing ratio
2as intermediate care.
3    (c) Facilities shall notify the Department within 60 days
4after the effective date of this amendatory Act of the 96th
5General Assembly, in a form and manner prescribed by the
6Department, of the staffing ratios in effect on the effective
7date of this amendatory Act of the 96th General Assembly for
8both intermediate and skilled care and the number of residents
9receiving each level of care.
10    (d)(1) Effective July 1, 2010, for each resident needing
11skilled care, a minimum staffing ratio of 2.5 hours of nursing
12and personal care each day must be provided; for each resident
13needing intermediate care, 1.7 hours of nursing and personal
14care each day must be provided.
15    (2) Effective January 1, 2011, the minimum staffing ratios
16shall be increased to 2.7 hours of nursing and personal care
17each day for a resident needing skilled care and 1.9 hours of
18nursing and personal care each day for a resident needing
19intermediate care.
20    (3) Effective January 1, 2012, the minimum staffing ratios
21shall be increased to 3.0 hours of nursing and personal care
22each day for a resident needing skilled care and 2.1 hours of
23nursing and personal care each day for a resident needing
24intermediate care.
25    (4) Effective January 1, 2013, the minimum staffing ratios
26shall be increased to 3.4 hours of nursing and personal care

 

 

HB5668- 40 -LRB097 19458 DRJ 66076 b

1each day for a resident needing skilled care and 2.3 hours of
2nursing and personal care each day for a resident needing
3intermediate care.
4    (5) Effective January 1, 2014, the minimum staffing ratios
5shall be increased to 3.8 hours of nursing and personal care
6each day for a resident needing skilled care and 2.5 hours of
7nursing and personal care each day for a resident needing
8intermediate care.
9(Source: P.A. 96-1372, eff. 7-29-10; 96-1504, eff. 1-27-11.)
 
10    (210 ILCS 45/3-202.2b)
11    Sec. 3-202.2b. Certification of psychiatric rehabilitation
12program.
13    (a) No later than January 1, 2011, the Department shall
14file with the Joint Committee on Administrative Rules, pursuant
15to the Illinois Administrative Procedure Act, proposed rules or
16proposed amendments to existing rules to establish a special
17certification program for compliance with 77 Ill. Admin. Code
18300.4000 and following (Subpart S), which provides for
19psychiatric rehabilitation services that are required to be
20offered by a long term care facility licensed under this Act
21that serves residents with serious mental illness. Compliance
22with standards promulgated pursuant to this Section must be
23demonstrated before a long term care facility licensed under
24this Act is eligible to become certified under this Section and
25annually thereafter.

 

 

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1    (b) No long term care facility shall establish, operate,
2maintain, or offer psychiatric rehabilitation services, or
3admit, retain, or seek referrals of a resident with a serious
4mental illness diagnosis, unless and until a valid
5certification, which remains unsuspended, unrevoked, and
6unexpired, has been issued.
7    (c) A facility that currently serves a resident with
8serious mental illness may continue to admit such residents
9until the Department performs a certification review and
10determines that the facility does not meet the requirements for
11certification. The Department, at its discretion, may provide
12an additional 90-day period for the facility to meet the
13requirements for certification if it finds that the facility
14has made a good faith effort to comply with all certification
15requirements and will achieve total compliance with the
16requirements before the end of the 90-day period. The facility
17shall be prohibited from admitting residents with serious
18mental illness until the Department certifies the facility to
19be in compliance with the requirements of this Section.
20    (d) A facility currently serving residents with serious
21mental illness that elects to terminate provision of services
22to this population must immediately notify the Department of
23its intent, cease to admit new residents with serious mental
24illness, and give notice to all existing residents with serious
25mental illness of their impending discharge. These residents
26shall be accorded all rights and assistance provided to a

 

 

HB5668- 42 -LRB097 19458 DRJ 66076 b

1resident being involuntarily discharged and those provided
2under Section 2-201.5. The facility shall continue to adhere to
3all requirements of 77 Ill. Admin. Code 300.4000 until all
4residents with serious mental illness have been discharged.
5    (e) A long term care facility found to be out of compliance
6with the certification requirements under this Section may be
7subject to denial, revocation, or suspension of the psychiatric
8rehabilitation services certification or the imposition of
9sanctions and penalties, including the immediate suspension of
10new admissions. Hearings shall be conducted pursuant to Article
11III, Part 7 of this Act.
12    (f) The Department shall indicate, on its list of licensed
13long term care facilities, which facilities are certified under
14this Section and shall distribute this list to the appropriate
15State agencies charged with administering and implementing the
16State's program of pre-admission screening and resident
17review, hospital discharge planners, Area Agencies on Aging,
18Case Coordination Units, and others upon request.
19    (g) No public official, agent, or employee of the State, or
20any subcontractor of the State, may refer or arrange for the
21placement of a person with serious mental illness in a long
22term care facility that is not certified under this Section. No
23public official, agent, or employee of the State, or any
24subcontractor of the State, may place the name of a long term
25care facility on a list of facilities serving the seriously
26mentally ill for distribution to the general public or to

 

 

HB5668- 43 -LRB097 19458 DRJ 66076 b

1professionals arranging for placements or making referrals
2unless the facility is certified under this Section.
3    (h) Certification requirements. The Department shall
4establish requirements for certification that augment current
5quality of care standards for long term care facilities serving
6residents with serious mental illness, which shall include
7admission, discharge planning, psychiatric rehabilitation
8services, development of age-group appropriate treatment plan
9goals and services, behavior management services, coordination
10with community mental health services, staff qualifications
11and training, clinical consultation, resident access to the
12outside community, and appropriate environment and space for
13resident programs, recreation, privacy, and any other issue
14deemed appropriate by the Department. The augmented standards
15shall at a minimum include, but need not be limited to, the
16following:
17        (1) Staff sufficient in number and qualifications
18    necessary to meet the scheduled and unscheduled needs of
19    the residents on a 24-hour basis. The Department shall
20    establish by rule the minimum number of psychiatric
21    services rehabilitation coordinators in relation to the
22    number of residents with serious mental illness residing in
23    the facility. When no psychiatric services rehabilitation
24    coordinator is in the facility, there shall be at least one
25    such person on call and available to respond to emergencies
26    in the facility.

 

 

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1        (2) The number and qualifications of consultants
2    required to be contracted with to provide continuing
3    education and training, and to assist with program
4    development.
5        (3) Training for all new employees specific to the care
6    needs of residents with a serious mental illness diagnosis
7    during their orientation period and annually thereafter.
8    Training shall be independent of the Department and
9    overseen by an agency designated by the Governor to
10    determine the content of all facility employee training and
11    to provide training for all trainers of facility employees.
12    Training of employees shall at minimum include, but need
13    not be limited to, (i) the impact of a serious mental
14    illness diagnosis, (ii) the recovery paradigm and the role
15    of psychiatric rehabilitation, (iii) preventive strategies
16    for managing aggression and crisis prevention, (iv) basic
17    psychiatric rehabilitation techniques and service
18    delivery, (v) resident rights, (vi) abuse prevention,
19    (vii) appropriate interaction between staff and residents,
20    and (viii) any other topic deemed by the Department to be
21    important to ensuring quality of care.
22        (4) Quality assessment and improvement requirements,
23    in addition to those contained in this Act on the effective
24    date of this amendatory Act of the 96th General Assembly,
25    specific to a facility's residential psychiatric
26    rehabilitation services, which shall be made available to

 

 

HB5668- 45 -LRB097 19458 DRJ 66076 b

1    the Department upon request. A facility shall be required
2    at a minimum to develop and maintain policies and
3    procedures that include, but need not be limited to,
4    evaluation of the appropriateness of resident admissions
5    based on the facility's capacity to meet specific needs,
6    resident assessments, development and implementation of
7    care plans, and discharge planning.
8        (5) Room selection and appropriateness of roommate
9    assignment, including the assignment of female residents
10    to female-only units or floors and, to the extent possible
11    (taking into account the availability of staff and staff
12    preference), the assignment of only female staff to work on
13    those floors or units.
14        (6) Comprehensive quarterly review of all treatment
15    plans for residents with serious mental illness by the
16    resident's interdisciplinary team, which takes into
17    account, at a minimum, the resident's progress, prior
18    assessments, and treatment plan.
19        (7) Substance abuse screening and management and
20    documented referral relationships with certified substance
21    abuse treatment providers.
22        (8) Administration of psychotropic medications to a
23    non-objecting resident with serious mental illness who is
24    incapable of giving informed consent, in compliance with
25    the applicable provisions of the Mental Health and
26    Developmental Disabilities Code. Administration of

 

 

HB5668- 46 -LRB097 19458 DRJ 66076 b

1    psychotropic medications to an objecting resident, only
2    with a court order authorizing such administration.
3    (i) The Department shall establish a certification fee
4schedule by rule, in consultation with advocates, nursing
5homes, and representatives of associations representing long
6term care facilities.
7    (j) The Director or her or his designee shall seek input
8from the Long Term Care Facility Advisory Board before filing
9rules to implement this Section.
10    Rules proposed no later than January 1, 2011 under this
11Section shall take effect 180 days after being approved by the
12Joint Committee on Administrative Rules.
13(Source: P.A. 96-1372, eff. 7-29-10.)
 
14    (210 ILCS 45/3-202.6 new)
15    Sec. 3-202.6. Liability insurance coverage required. No
16person may establish, operate, maintain, offer, or advertise a
17facility within this State without providing to the Department
18of Public Health proof of liability insurance coverage in an
19amount not less than $1,000,000 per occurrence. This
20requirement may not be waived. Failure to maintain such
21liability insurance coverage during the term of a facility's
22license shall be a separate Type "B" violation for each
23resident of the facility for each month, or part of a month, in
24which the facility did not have the minimum required liability
25insurance.
 

 

 

HB5668- 47 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 45/3-206)  (from Ch. 111 1/2, par. 4153-206)
2    Sec. 3-206. The Department shall prescribe a curriculum for
3training nursing assistants, habilitation aides, and child
4care aides.
5    (a) No person, except a volunteer who receives no
6compensation from a facility and is not included for the
7purpose of meeting any staffing requirements set forth by the
8Department, shall act as a nursing assistant, habilitation
9aide, or child care aide in a facility, nor shall any person,
10under any other title, not licensed, certified, or registered
11to render medical care by the Department of Professional
12Regulation, assist with the personal, medical, or nursing care
13of residents in a facility, unless such person meets the
14following requirements:
15        (1) Be at least 16 years of age, of temperate habits
16    and good moral character, honest, reliable and
17    trustworthy.
18        (2) Be able to speak and understand the English
19    language or a language understood by a substantial
20    percentage of the facility's residents.
21        (3) Provide evidence of employment or occupation, if
22    any, and residence for 2 years prior to his present
23    employment.
24        (4) Have completed at least 10 8 years of grade school
25    or provide proof of equivalent knowledge.

 

 

HB5668- 48 -LRB097 19458 DRJ 66076 b

1        (5) Begin a current course of training for nursing
2    assistants, habilitation aides, or child care aides,
3    approved by the Department, within 45 days of initial
4    employment in the capacity of a nursing assistant,
5    habilitation aide, or child care aide at any facility. Such
6    courses of training shall be successfully completed within
7    120 days of initial employment in the capacity of nursing
8    assistant, habilitation aide, or child care aide at a
9    facility. Nursing assistants, habilitation aides, and
10    child care aides who are enrolled in approved courses in
11    community colleges or other educational institutions on a
12    term, semester or trimester basis, shall be exempt from the
13    120 day completion time limit. The Department shall adopt
14    rules for such courses of training. These rules shall
15    include procedures for facilities to carry on an approved
16    course of training within the facility.
17        The Department may accept comparable training in lieu
18    of the 120 hour course for student nurses, foreign nurses,
19    military personnel, or employes of the Department of Human
20    Services.
21        The facility shall develop and implement procedures
22    and at least 6 hours of quarterly in-service training,
23    which shall be approved by the Department, for an ongoing
24    review process, which shall take place within the facility,
25    for nursing assistants, habilitation aides, and child care
26    aides. The facility shall retain records of all staff

 

 

HB5668- 49 -LRB097 19458 DRJ 66076 b

1    in-service training and shall provide such records to the
2    Department upon request. At least half of each quarter of
3    in-service training shall be one-on-one direct resident
4    care demonstration and practice of patient care
5    techniques.
6        At the time of each regularly scheduled licensure
7    survey, or at the time of a complaint investigation, the
8    Department may require any nursing assistant, habilitation
9    aide, or child care aide to demonstrate, either through
10    written examination or action, or both, sufficient
11    knowledge in all areas of required training. If such
12    knowledge is inadequate the Department shall require the
13    nursing assistant, habilitation aide, or child care aide to
14    complete inservice training and review in the facility
15    until the nursing assistant, habilitation aide, or child
16    care aide demonstrates to the Department, either through
17    written examination or action, or both, sufficient
18    knowledge in all areas of required training.
19        (6) Be familiar with and have general skills related to
20    resident care.
21    (a-0.5) An educational entity, other than a secondary
22school, conducting a nursing assistant, habilitation aide, or
23child care aide training program shall initiate a criminal
24history record check in accordance with the Health Care Worker
25Background Check Act prior to entry of an individual into the
26training program. A secondary school may initiate a criminal

 

 

HB5668- 50 -LRB097 19458 DRJ 66076 b

1history record check in accordance with the Health Care Worker
2Background Check Act at any time during or after a training
3program.
4    (a-1) Nursing assistants, habilitation aides, or child
5care aides seeking to be included on the registry maintained
6under Section 3-206.01 on or after January 1, 1996 must
7authorize the Department of Public Health or its designee to
8request a criminal history record check in accordance with the
9Health Care Worker Background Check Act and submit all
10necessary information. An individual may not newly be included
11on the registry unless a criminal history record check has been
12conducted with respect to the individual.
13    (b) Persons subject to this Section shall perform their
14duties under the supervision of a licensed nurse.
15    (c) It is unlawful for any facility to employ any person in
16the capacity of nursing assistant, habilitation aide, or child
17care aide, or under any other title, not licensed by the State
18of Illinois to assist in the personal, medical, or nursing care
19of residents in such facility unless such person has complied
20with this Section.
21    (d) Proof of compliance by each employee with the
22requirements set out in this Section shall be maintained for
23each such employee by each facility in the individual personnel
24folder of the employee. Proof of training shall be obtained
25only from the health care worker registry.
26    (e) Each facility shall obtain access to the health care

 

 

HB5668- 51 -LRB097 19458 DRJ 66076 b

1worker registry's web application, maintain the employment and
2demographic information relating to each employee, and verify
3by the category and type of employment that each employee
4subject to this Section meets all the requirements of this
5Section.
6    (f) Any facility that is operated under Section 3-803 shall
7be exempt from the requirements of this Section.
8    (g) Each skilled nursing and intermediate care facility
9that admits persons who are diagnosed as having Alzheimer's
10disease or related dementias shall require all nursing
11assistants, habilitation aides, or child care aides, who did
12not receive 12 hours of training in the care and treatment of
13such residents during the training required under paragraph (5)
14of subsection (a), to obtain 12 hours of in-house training in
15the care and treatment of such residents. If the facility does
16not provide the training in-house, the training shall be
17obtained from other facilities, community colleges or other
18educational institutions that have a recognized course for such
19training. The Department shall, by rule, establish a recognized
20course for such training. The Department's rules shall provide
21that such training may be conducted in-house at each facility
22subject to the requirements of this subsection, in which case
23such training shall be monitored by the Department.
24    The Department's rules shall also provide for
25circumstances and procedures whereby any person who has
26received training that meets the requirements of this

 

 

HB5668- 52 -LRB097 19458 DRJ 66076 b

1subsection shall not be required to undergo additional training
2if he or she is transferred to or obtains employment at a
3different facility or a facility other than a long-term care
4facility but remains continuously employed for pay as a nursing
5assistant, habilitation aide, or child care aide. Individuals
6who have performed no nursing or nursing-related services for a
7period of 24 consecutive months shall be listed as "inactive"
8and as such do not meet the requirements of this Section.
9Licensed sheltered care facilities shall be exempt from the
10requirements of this Section.
11(Source: P.A. 96-1372, eff. 7-29-10.)
 
12    (210 ILCS 45/3-206.06 new)
13    Sec. 3-206.06. Dementia-specific orientation.
14    (a) A facility that admits or retains persons with
15Alzheimer's disease or other dementias shall give all staff who
16have any direct contact with these residents at least 4 hours
17of dementia-specific orientation within their first 7 days of
18employment. Nurses, nursing assistants, and social service and
19activities staff who work with these residents shall, within
20their first 45 days of employment, receive a minimum of 12
21additional hours of orientation specifically related to the
22care of persons with Alzheimer's disease and other dementias.
23All staff who have any direct contact with these residents
24shall have at least 12 hours of dementia-specific education and
25training annually thereafter.

 

 

HB5668- 53 -LRB097 19458 DRJ 66076 b

1    (b) The Department shall specify the content of the
2orientation and the annual education and training.
 
3    (210 ILCS 45/3-207)  (from Ch. 111 1/2, par. 4153-207)
4    Sec. 3-207. (a) As a condition of the issuance or renewal
5of the license of any facility, the applicant shall file a
6statement of ownership. The applicant shall update the
7information required in the statement of ownership within 10
8days of any change.
9    (b) The statement of ownership shall include the following:
10    (1) The name, address, telephone number, occupation or
11business activity, business address and business telephone
12number of the person who is the owner of the facility and every
13person who owns the building in which the facility is located,
14if other than the owner of the facility, which is the subject
15of the application or license; and if the owner is a
16partnership or corporation, the name of every partner and
17stockholder of the owner;
18    (2) The name and address of any facility, wherever located,
19any financial interest in which is owned by the applicant, if
20the facility were required to be licensed if it were located in
21this State;
22    (3) Other information necessary to determine the identity
23and qualifications of an applicant or licensee to operate a
24facility in accordance with this Act as required by the
25Department in regulations.

 

 

HB5668- 54 -LRB097 19458 DRJ 66076 b

1    (c) The information in the statement of ownership shall be
2public information and shall be available from the Department.
3    (d) A facility which is owned by a chain organization as
4defined by the Centers for Medicare and Medicaid Services shall
5submit annually to the Department an electronic copy of the
6Home Office Cost Statement required to be submitted by the home
7office of the chain to the United States Department of Health
8and Human Services. The facility shall send the cost statement
9in electronic form to the Department forthwith after it submits
10the statement to the Department of Health and Human Services.
11Each week that a facility fails to comply with the requirements
12of this subsection shall be cited as a separate administrative
13warning.
14(Source: P.A. 85-1183.)
 
15    (210 ILCS 45/3-304.1)
16    Sec. 3-304.1. Public computer access to information.
17    (a) The Department must make information regarding nursing
18homes in the State available to the public in electronic form
19on the World Wide Web, including all of the following
20information:
21        (1) who regulates nursing homes;
22        (2) information in the possession of the Department
23    that is listed in Sections 3-210 and 3-304;
24        (3) deficiencies and plans of correction;
25        (4) enforcement remedies;

 

 

HB5668- 55 -LRB097 19458 DRJ 66076 b

1        (5) penalty letters;
2        (6) designation of penalty monies;
3        (7) the U.S. Department of Health and Human Services'
4    Health Care Financing Administration special projects or
5    federally required inspections;
6        (8) advisory standards;
7        (9) deficiency-free surveys;
8        (10) enforcement actions and enforcement summaries;
9    and
10        (11) distressed facilities; .
11        (12) a link to the most recent facility cost report
12    filed with the Department of Healthcare and Family
13    Services;
14        (13) a link to the most recent Consumer Choice
15    Information Report filed with the Department on Aging;
16        (14) whether the facility is part of a chain; the
17    facility shall be deemed part of a chain if it meets
18    criteria established by the United States Department of
19    Health and Human Services that identify it as owned by a
20    chain organization; and
21        (15) a copy of the latest Home Office Cost Statement,
22    if any, filed by the home office of the owner of the
23    facility with the United States Department of Health and
24    Human Services.
25    (b) No fee or other charge may be imposed by the Department
26as a condition of accessing the information.

 

 

HB5668- 56 -LRB097 19458 DRJ 66076 b

1    (c) The electronic public access provided through the World
2Wide Web shall be in addition to any other electronic or print
3distribution of the information.
4    (d) The information shall be made available as provided in
5this Section in the shortest practicable time after it is
6publicly available in any other form.
7    (e) The Department shall cooperate with a tax-exempt,
8not-for-profit organization dedicated solely to advocacy for
9long-term care residents to make available in electronic form
10the results of all surveys, including any enforcement actions,
11and current information about individual nursing home
12staffing, in the shortest practicable time after they become
13publicly available. The data shall be provided without charge,
14so long as the organization charges no fee for sharing the
15information with the general public. If the organization makes
16the data available on a website, the Department shall create a
17link to the website on the Department's website.
18(Source: P.A. 96-1372, eff. 7-29-10.)
 
19    (210 ILCS 45/3-808.5)
20    Sec. 3-808.5. Nursing home fraud, abuse, and neglect
21prevention and reporting.
22    (a) Every licensed long term care facility that receives
23Medicaid funding shall prominently display in its lobby, in its
24dining areas, and on each floor of the facility information
25approved by the Illinois Medicaid Fraud Control Unit on how to

 

 

HB5668- 57 -LRB097 19458 DRJ 66076 b

1report fraud, abuse, and neglect. In addition, information
2regarding the reporting of fraud, abuse, and neglect shall be
3provided to each resident at the time of admission and to the
4resident's family members or emergency contacts, or to both the
5resident's family members and his or her emergency contacts.
6    (b) Any owner or licensee of a long term care facility
7licensed under this Act shall be responsible for the collection
8and maintenance of any and all records required to be
9maintained under this Section and any other applicable
10provisions of this Act, and as a provider under the Illinois
11Public Aid Code, and shall be responsible for compliance with
12all of the disclosure requirements under this Section. All
13books and records and other papers and documents that are
14required to be kept, and all records showing compliance with
15all of the disclosure requirements to be made pursuant to this
16Section, shall be kept at the facility and shall, at all times
17during business hours, be subject to inspection by any law
18enforcement or health oversight agency or its duly authorized
19agents or employees.
20    (c) Any report of abuse and neglect of residents made by
21any individual in whatever manner, including, but not limited
22to, reports made under Sections 2-107 and 3-610 of this Act, or
23as provided under the Abused and Neglected Long Term Care
24Facility Residents Reporting Act, that is made to an
25administrator, a director of nursing, or any other person with
26management responsibility at a long term care facility must be

 

 

HB5668- 58 -LRB097 19458 DRJ 66076 b

1disclosed to the owners and licensee of the facility within 24
2hours of the report. The owners and licensee of a long term
3care facility shall maintain all records necessary to show
4compliance with this disclosure requirement.
5    (d) Any person with an ownership interest in a long term
6care facility licensed by the Department must, within 30 days
7of the effective date of this amendatory Act of the 96th
8General Assembly, disclose the existence of any ownership
9interest in any vendor who does business with the facility. The
10disclosures required by this subsection shall be made in the
11form and manner prescribed by the Department. Licensed long
12term care facilities who receive Medicaid funding shall submit
13a copy of the disclosures required by this subsection to the
14Illinois Medicaid Fraud Control Unit. The owners and licensee
15of a long term care facility shall maintain all records
16necessary to show compliance with this disclosure requirement.
17    (e) Notwithstanding the provisions of Section 3-318 of this
18Act, and in addition thereto, any person, owner, or licensee
19who willfully fails to keep and maintain, or willfully fails to
20produce for inspection, books and records, or willfully fails
21to make the disclosures required by this Section, is guilty of
22a Class A misdemeanor. A second or subsequent violation of this
23Section shall be punishable as a Class 4 felony.
24    (f) Any owner or licensee who willfully files or willfully
25causes to be filed a document with false information with the
26Department, the Department of Healthcare and Family Services,

 

 

HB5668- 59 -LRB097 19458 DRJ 66076 b

1or the Illinois Medicaid Fraud Control Unit or any other law
2enforcement agency, is guilty of a Class A misdemeanor.
3    (g) At the request of the Department of State Police, a
4facility shall cooperate with that agency in arranging for the
5Department of State Police to train facility staff on
6preventing resident abuse and neglect.
7(Source: P.A. 96-1373, eff. 7-29-10.)
 
8    Section 20. The ID/DD Community Care Act is amended by
9changing Section 3-206 and by adding Sections 3-202.05 and
103-206.06 as follows:
 
11    (210 ILCS 47/3-202.05 new)
12    Sec. 3-202.05. Staffing ratios.
13    (a) For the purpose of computing staff to resident ratios,
14direct care staff shall include:
15        (1) registered nurses;
16        (2) licensed practical nurses;
17        (3) certified nurse assistants;
18        (4) psychiatric services rehabilitation aides;
19        (5) rehabilitation and therapy aides;
20        (6) psychiatric services rehabilitation coordinators;
21        (7) assistant directors of nursing;
22        (8) 50% of the Director of Nurses' time; and
23        (9) 30% of the Social Services Directors' time.
24    An employee listed in any of items (1) through (7) shall be

 

 

HB5668- 60 -LRB097 19458 DRJ 66076 b

1counted as direct care staff to the extent the individual
2actually provides direct care to residents, including any
3ancillary time the individual spends recording the direct care
4he or she has provided to residents. An individual's time spent
5on scheduled breaks, in training (other than one-on-one
6demonstration and practice of direct care techniques with a
7resident), making appointments, or serving other functions not
8in the presence of a resident, shall not be considered "direct
9care".
10    (b) Light intermediate care shall be staffed at the same
11staffing ratio as intermediate care.
12    (c) Facilities shall notify the Department within 60 days
13after the effective date of this amendatory Act of the 97th
14General Assembly, in a form and manner prescribed by the
15Department, of the staffing ratios in effect on the effective
16date of this amendatory Act of the 97th General Assembly for
17both intermediate and skilled care and the number of residents
18receiving each level of care.
19    (d) Minimum staffing ratios shall be increased as follows:
20        (1) Effective January 1, 2013, the minimum staffing
21    ratios shall be increased to 3.4 hours of nursing and
22    personal care each day for a resident needing skilled care
23    and 2.3 hours of nursing and personal care each day for a
24    resident needing intermediate care.
25        (2) Effective January 1, 2014, the minimum staffing
26    ratios shall be increased to 3.8 hours of nursing and

 

 

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1    personal care each day for a resident needing skilled care
2    and 2.5 hours of nursing and personal care each day for a
3    resident needing intermediate care.
 
4    (210 ILCS 47/3-206)
5    Sec. 3-206. Curriculum for training nursing assistants and
6aides. The Department shall prescribe a curriculum for training
7nursing assistants, habilitation aides, and child care aides.
8    (a) No person, except a volunteer who receives no
9compensation from a facility and is not included for the
10purpose of meeting any staffing requirements set forth by the
11Department, shall act as a nursing assistant, habilitation
12aide, or child care aide in a facility, nor shall any person,
13under any other title, not licensed, certified, or registered
14to render medical care by the Department of Financial and
15Professional Regulation, assist with the personal, medical, or
16nursing care of residents in a facility, unless such person
17meets the following requirements:
18        (1) Be at least 18 16 years of age, of temperate habits
19    and good moral character, honest, reliable and
20    trustworthy.
21        (2) Be able to speak and understand the English
22    language or a language understood by a substantial
23    percentage of the facility's residents.
24        (3) Provide evidence of employment or occupation, if
25    any, and residence for 2 years prior to his or her present

 

 

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1    employment.
2        (4) Have completed at least 10 8 years of grade school
3    or provide proof of equivalent knowledge.
4        (5) Begin a current course of training for nursing
5    assistants, habilitation aides, or child care aides,
6    approved by the Department, within 45 days of initial
7    employment in the capacity of a nursing assistant,
8    habilitation aide, or child care aide at any facility. Such
9    courses of training shall be successfully completed within
10    120 days of initial employment in the capacity of nursing
11    assistant, habilitation aide, or child care aide at a
12    facility. Nursing assistants, habilitation aides, and
13    child care aides who are enrolled in approved courses in
14    community colleges or other educational institutions on a
15    term, semester or trimester basis, shall be exempt from the
16    120-day completion time limit. The Department shall adopt
17    rules for such courses of training. These rules shall
18    include procedures for facilities to carry on an approved
19    course of training within the facility.
20        The Department may accept comparable training in lieu
21    of the 120-hour course for student nurses, foreign nurses,
22    military personnel, or employees of the Department of Human
23    Services.
24        The facility shall develop and implement procedures
25    and at least 6 hours of quarterly in-service training,
26    which shall be approved by the Department, for an ongoing

 

 

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1    review process, which shall take place within the facility,
2    for nursing assistants, habilitation aides, and child care
3    aides. The facility shall retain records of all staff
4    in-service training and shall provide such records to the
5    Department upon request. At least half of each quarter of
6    in-service training shall be one-on-one direct resident
7    care demonstration and practice of patient care
8    techniques.
9        At the time of each regularly scheduled licensure
10    survey, or at the time of a complaint investigation, the
11    Department may require any nursing assistant, habilitation
12    aide, or child care aide to demonstrate, either through
13    written examination or action, or both, sufficient
14    knowledge in all areas of required training. If such
15    knowledge is inadequate the Department shall require the
16    nursing assistant, habilitation aide, or child care aide to
17    complete inservice training and review in the facility
18    until the nursing assistant, habilitation aide, or child
19    care aide demonstrates to the Department, either through
20    written examination or action, or both, sufficient
21    knowledge in all areas of required training; and
22        (6) Be familiar with and have general skills related to
23    resident care.
24    (a-0.5) An educational entity, other than a secondary
25school, conducting a nursing assistant, habilitation aide, or
26child care aide training program shall initiate a criminal

 

 

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1history record check in accordance with the Health Care Worker
2Background Check Act prior to entry of an individual into the
3training program. A secondary school may initiate a criminal
4history record check in accordance with the Health Care Worker
5Background Check Act at any time during or after a training
6program.
7    (a-1) Nursing assistants, habilitation aides, or child
8care aides seeking to be included on the registry maintained
9under Section 3-206.01 of this Act must authorize the
10Department of Public Health or its designee to request a
11criminal history record check in accordance with the Health
12Care Worker Background Check Act and submit all necessary
13information. An individual may not newly be included on the
14registry unless a criminal history record check has been
15conducted with respect to the individual.
16    (b) Persons subject to this Section shall perform their
17duties under the supervision of a licensed nurse or other
18appropriately trained, licensed, or certified personnel.
19    (c) It is unlawful for any facility to employ any person in
20the capacity of nursing assistant, habilitation aide, or child
21care aide, or under any other title, not licensed by the State
22of Illinois to assist in the personal, medical, or nursing care
23of residents in such facility unless such person has complied
24with this Section.
25    (d) Proof of compliance by each employee with the
26requirements set out in this Section shall be maintained for

 

 

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1each such employee by each facility in the individual personnel
2folder of the employee. Proof of training shall be obtained
3only from the health care worker registry.
4    (e) Each facility shall obtain access to the health care
5worker registry's web application, maintain the employment and
6demographic information relating to each employee, and verify
7by the category and type of employment that each employee
8subject to this Section meets all the requirements of this
9Section.
10    (f) Any facility that is operated under Section 3-803 shall
11be exempt from the requirements of this Section.
12    (g) Each skilled nursing and intermediate care facility
13that admits persons who are diagnosed as having Alzheimer's
14disease or related dementias shall require all nursing
15assistants, habilitation aides, or child care aides, who did
16not receive 12 hours of training in the care and treatment of
17such residents during the training required under paragraph (5)
18of subsection (a), to obtain 12 hours of in house training in
19the care and treatment of such residents. If the facility does
20not provide the training in house, the training shall be
21obtained from other facilities, community colleges or other
22educational institutions that have a recognized course for such
23training. The Department shall, by rule, establish a recognized
24course for such training.
25    The Department's rules shall provide that such training may
26be conducted in house at each facility subject to the

 

 

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1requirements of this subsection, in which case such training
2shall be monitored by the Department. The Department's rules
3shall also provide for circumstances and procedures whereby any
4person who has received training that meets the requirements of
5this subsection shall not be required to undergo additional
6training if he or she is transferred to or obtains employment
7at a different facility or a facility other than those licensed
8under this Act but remains continuously employed as a nursing
9assistant, habilitation aide, or child care aide. Individuals
10who have performed no nursing, nursing-related services, or
11habilitation services for a period of 24 consecutive months
12shall be listed as inactive and as such do not meet the
13requirements of this Section. Licensed sheltered care
14facilities shall be exempt from the requirements of this
15Section.
16(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11.)
 
17    (210 ILCS 47/3-206.06 new)
18    Sec. 3-206.06. Dementia-specific orientation.
19    (a) A facility that admits or retains persons with
20Alzheimer's disease or other dementias shall give all staff who
21have any direct contact with these residents at least 4 hours
22of dementia-specific orientation within their first 7 days of
23employment. Nurses, nursing assistants, and social service and
24activities staff who work with these residents shall, within
25their first 45 days of employment, receive a minimum of 12

 

 

HB5668- 67 -LRB097 19458 DRJ 66076 b

1additional hours of orientation specifically related to the
2care of persons with Alzheimer's disease and other dementias.
3All staff who have any direct contact with these residents
4shall have at least 12 hours of dementia-specific education and
5training annually thereafter.
6    (b) The Department shall specify the content of the
7orientation and the annual education and training.
 
8    Section 25. The Specialized Mental Health Rehabilitation
9Act is amended by changing Sections 2-208, 3-109, 3-117, 3-119,
103-202, 3-202.2b, 3-206, 3-207, 3-304.1, and 3-808.5 and by
11adding Sections 1-114.2, 2-218, 3-202.6, and 3-206.06, as
12follows:
 
13    (210 ILCS 48/1-114.2 new)
14    Sec. 1-114.2. Liability insurance. "Liability insurance"
15means insurance on risks based upon neglect of a resident for
16which a licensee is or may be responsible.
 
17    (210 ILCS 48/2-208)
18    Sec. 2-208. Notice of imminent death, unusual incident,
19abuse, or neglect.
20    (a) A facility shall immediately notify the resident's next
21of kin, representative and physician of the resident's death or
22when the resident's death appears to be imminent. A facility
23shall notify the Department by telephone of a resident's death

 

 

HB5668- 68 -LRB097 19458 DRJ 66076 b

1within 24 hours after the resident's death. The facility shall
2notify the Department of the death of a facility resident that
3does not occur in the facility immediately upon learning of the
4death. A facility shall promptly notify the coroner or medical
5examiner of a resident's death in a manner and form to be
6determined by the Department after consultation with the
7coroner or medical examiner of the county in which the facility
8is located. In addition to notice to the Department by
9telephone, the Department shall require the facility to submit
10written notification of the death of a resident within 72 hours
11after the death, including a report of any medication errors or
12other incidents that occurred, within 30 days after the
13resident's death. A facility's failure to comply with this
14subsection shall constitute a Type "B" violation.
15    (b) A facility shall immediately notify a resident's next
16of kin, guardian, or representative of any unusual incident,
17abuse, or neglect involving the resident. A facility shall
18immediately notify the Department by telephone of any unusual
19incident, abuse, or neglect required to be reported pursuant to
20State law or administrative rule. In addition to notice to the
21Department by telephone, the Department shall require the
22facility to submit written notification of any unusual
23incident, abuse, or neglect within one day after the unusual
24incident, abuse, or neglect occurs. A facility's failure to
25comply with this subsection shall constitute a Type "B"
26violation. For purposes of this subsection, "unusual incident"

 

 

HB5668- 69 -LRB097 19458 DRJ 66076 b

1means any of the following: a serious injury; an unscheduled
2hospital visit for treatment of serious injury; a 9-1-1 call
3for emergency services directly relating to a resident threat;
4or stalking of staff, a resident, or any other person.
5(Source: P.A. 97-38, eff. 6-28-11.)
 
6    (210 ILCS 48/2-218 new)
7    Sec. 2-218. Notification of violations or deficiencies.
8When the Department issues any notice pursuant to Section
93-119, 3-301, 3-303, 3-307, or 3-702 of this Act, or when the
10Centers for Medicare and Medicaid Services (CMS) issues a
11notice of federal Medicaid certification deficiencies, the
12facility receiving the notice shall provide notification of the
13violations or deficiencies, within 10 days after receiving the
14notice, to (i) every resident identified or referred to
15anywhere within the Department's notice of violations or the
16CMS Form 2567 (Statement of Deficiencies and Plan of
17Correction) as having received care or services that violated
18State or federal standards and (ii) the guardian or resident's
19representative of every such resident. The notification
20provided by the facility shall include a Department-prescribed
21notification letter as determined by rule and a copy of the
22Department's notice of violations and CMS Form 2567, if any. A
23facility's failure to provide notification pursuant to this
24Section to a resident and the resident's representative or
25guardian, if any, shall constitute a Type "B" violation.
 

 

 

HB5668- 70 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 48/3-109)
2    Sec. 3-109. Issuance of license based on Director's
3findings. Upon receipt and review of an application for a
4license made under this Article and inspection of the applicant
5facility under this Article, the Director shall issue a license
6if he or she finds:
7        (1) That the individual applicant, or the corporation,
8    partnership or other entity if the applicant is not an
9    individual, is a person responsible and suitable to operate
10    or to direct or participate in the operation of a facility
11    by virtue of financial capacity, appropriate business or
12    professional experience, a record of compliance with
13    lawful orders of the Department and lack of revocation of a
14    license during the previous 5 years;
15        (2) That the facility is under the supervision of an
16    administrator who is licensed, if required, under the
17    Nursing Home Administrators Licensing and Disciplinary
18    Act, as now or hereafter amended; and
19        (3) that the facility is covered by liability insurance
20    as required by this Act; and
21        (4) (3) That the facility is in substantial compliance
22    with this Act, and such other requirements for a license as
23    the Department by rule may establish under this Act.
24(Source: P.A. 97-38, eff. 6-28-11.)
 

 

 

HB5668- 71 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 48/3-117)
2    Sec. 3-117. Denial of license; grounds. An application for
3a license may be denied for any of the following reasons:
4        (1) Failure to meet any of the minimum standards set
5    forth by this Act or by rules and regulations promulgated
6    by the Department under this Act.
7        (2) Conviction of the applicant, or if the applicant is
8    a firm, partnership or association, of any of its members,
9    or if a corporation, the conviction of the corporation or
10    any of its officers or stockholders, or of the person
11    designated to manage or supervise the facility, of a
12    felony, or of 2 or more misdemeanors involving moral
13    turpitude, during the previous 5 years as shown by a
14    certified copy of the record of the court of conviction.
15        (3) Personnel insufficient in number or unqualified by
16    training or experience to properly care for the proposed
17    number and type of residents.
18        (4) Insufficient financial or other resources to
19    operate and conduct the facility in accordance with
20    standards promulgated by the Department under this Act,
21    including failure to have or maintain liability insurance
22    as required by this Act, and in accordance with contractual
23    obligations assumed by a recipient of a grant under the
24    Equity in Long-term Care Quality Act and the plan (if
25    applicable) submitted by a grantee for continuing and
26    increasing adherence to best practices in providing

 

 

HB5668- 72 -LRB097 19458 DRJ 66076 b

1    high-quality nursing home care.
2        (5) Revocation of a facility license during the
3    previous 5 years, if such prior license was issued to the
4    individual applicant, a controlling owner or controlling
5    combination of owners of the applicant; or any affiliate of
6    the individual applicant or controlling owner of the
7    applicant and such individual applicant, controlling owner
8    of the applicant or affiliate of the applicant was a
9    controlling owner of the prior license; provided, however,
10    that the denial of an application for a license pursuant to
11    this subsection must be supported by evidence that such
12    prior revocation renders the applicant unqualified or
13    incapable of meeting or maintaining a facility in
14    accordance with the standards and rules promulgated by the
15    Department under this Act.
16        (6) That the facility is not under the direct
17    supervision of a full-time administrator, as defined by
18    regulation, who is licensed, if required, under the Nursing
19    Home Administrators Licensing and Disciplinary Act.
20        (7) That the facility is in receivership and the
21    proposed licensee has not submitted a specific detailed
22    plan to bring the facility into compliance with the
23    requirements of this Act and with federal certification
24    requirements, if the facility is certified, and to keep the
25    facility in such compliance.
26(Source: P.A. 97-38, eff. 6-28-11.)
 

 

 

HB5668- 73 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 48/3-119)
2    Sec. 3-119. Suspension, revocation, or refusal to renew
3license.    
4    (a) The Department, after notice to the applicant or
5licensee, may suspend, revoke, or refuse to renew a license in
6any case in which the Department finds any of the following:
7        (1) There has been a substantial failure to comply with
8    this Act or the rules and regulations promulgated by the
9    Department under this Act. A substantial failure by a
10    facility shall include, but not be limited to, any of the
11    following:
12            (A) termination of Medicare or Medicaid
13        certification by the Centers for Medicare and Medicaid
14        Services; or
15            (B) a failure by the facility to pay any fine
16        assessed under this Act after the Department has sent
17        to the facility at least 2 notices of assessment that
18        include a schedule of payments as determined by the
19        Department, taking into account extenuating
20        circumstances and financial hardships of the facility.
21        (2) Conviction of the licensee, or of the person
22    designated to manage or supervise the facility, of a
23    felony, or of 2 or more misdemeanors involving moral
24    turpitude, during the previous 5 years as shown by a
25    certified copy of the record of the court of conviction.

 

 

HB5668- 74 -LRB097 19458 DRJ 66076 b

1        (3) Personnel are insufficient in number or
2    unqualified by training or experience to properly care for
3    the number and type of residents served by the facility.
4        (4) Financial or other resources are insufficient to
5    conduct and operate the facility in accordance with
6    standards promulgated by the Department under this Act,
7    including that the facility failed to maintain liability
8    insurance coverage as required by this Act at some time
9    during the term of its license.
10        (5) The facility is not under the direct supervision of
11    a full-time administrator, as defined by regulation, who is
12    licensed, if required, under the Nursing Home
13    Administrators Licensing and Disciplinary Act.
14        (6) The facility has committed 2 Type "AA" violations
15    within a 2-year period.
16    (b) Notice under this Section shall include a clear and
17concise statement of the violations on which the nonrenewal or
18revocation is based, the statute or rule violated and notice of
19the opportunity for a hearing under Section 3-703.
20    (c) If a facility desires to contest the nonrenewal or
21revocation of a license, the facility shall, within 10 days
22after receipt of notice under subsection (b) of this Section,
23notify the Department in writing of its request for a hearing
24under Section 3-703. Upon receipt of the request, the
25Department shall send notice to the facility and hold a hearing
26as provided under Section 3-703.

 

 

HB5668- 75 -LRB097 19458 DRJ 66076 b

1    (d) The effective date of nonrenewal or revocation of a
2license by the Department shall be any of the following:
3        (1) Until otherwise ordered by the circuit court,
4    revocation is effective on the date set by the Department
5    in the notice of revocation, or upon final action after
6    hearing under Section 3-703, whichever is later.
7        (2) Until otherwise ordered by the circuit court,
8    nonrenewal is effective on the date of expiration of any
9    existing license, or upon final action after hearing under
10    Section 3-703, whichever is later; however, a license shall
11    not be deemed to have expired if the Department fails to
12    timely respond to a timely request for renewal under this
13    Act or for a hearing to contest nonrenewal under paragraph
14    (c).
15        (3) The Department may extend the effective date of
16    license revocation or expiration in any case in order to
17    permit orderly removal and relocation of residents.
18    The Department may refuse to issue or may suspend the
19license of any person who fails to file a return, or to pay the
20tax, penalty or interest shown in a filed return, or to pay any
21final assessment of tax, penalty or interest, as required by
22any tax Act administered by the Illinois Department of Revenue,
23until such time as the requirements of any such tax Act are
24satisfied.
25(Source: P.A. 97-38, eff. 6-28-11.)
 

 

 

HB5668- 76 -LRB097 19458 DRJ 66076 b

1    (210 ILCS 48/3-202)
2    Sec. 3-202. Standards for facilities. The Department shall
3prescribe minimum standards for facilities. These standards
4shall regulate:
5        (1) Location and construction of the facility,
6    including plumbing, heating, lighting, ventilation, and
7    other physical conditions which shall ensure the health,
8    safety, and comfort of residents and their protection from
9    fire hazard;
10        (2) Number and qualifications of all personnel,
11    including management and nursing personnel, having
12    responsibility for any part of the care given to residents;
13    specifically, the Department shall establish staffing
14    ratios for facilities which shall specify the number of
15    staff hours per resident of care that are needed for
16    professional nursing care for various types of facilities
17    or areas within facilities and shall require consistent
18    assignment of the same nursing and other direct care staff
19    to the same residents, to the extent circumstances within
20    the control of the facility permit such assignment and
21    respecting requests by staff for reassignment;
22        (3) All sanitary conditions within the facility and its
23    surroundings, including water supply, sewage disposal,
24    food handling, and general hygiene, which shall ensure the
25    health and comfort of residents;
26        (4) Diet related to the needs of each resident based on

 

 

HB5668- 77 -LRB097 19458 DRJ 66076 b

1    good nutritional practice and on recommendations which may
2    be made by the physicians attending the resident;
3        (5) Equipment essential to the health and welfare of
4    the residents;
5        (6) A program of habilitation and rehabilitation for
6    those residents who would benefit from such programs;
7        (7) A program for adequate maintenance of physical
8    plant and equipment;
9        (8) Adequate accommodations, staff and services for
10    the number and types of residents for whom the facility is
11    licensed to care, including standards for temperature and
12    relative humidity within comfort zones determined by the
13    Department based upon a combination of air temperature,
14    relative humidity and air movement. Such standards shall
15    also require facility plans that provide for health and
16    comfort of residents at medical risk as determined by the
17    attending physician whenever the temperature and relative
18    humidity are outside such comfort zones established by the
19    Department. The standards must include a requirement that
20    areas of a facility used by residents of the facility be
21    air-conditioned and heated by means of operable
22    air-conditioning and heating equipment. The areas subject
23    to this air-conditioning and heating requirement include,
24    without limitation, bedrooms or common areas such as
25    sitting rooms, activity rooms, living rooms, community
26    rooms, and dining rooms;

 

 

HB5668- 78 -LRB097 19458 DRJ 66076 b

1        (9) Development of evacuation and other appropriate
2    safety plans for use during weather, health, fire, physical
3    plant, environmental and national defense emergencies; and
4        (10) Maintenance of minimum financial or other
5    resources necessary to meet the standards established
6    under this Section, and to operate and conduct the facility
7    in accordance with this Act.
8(Source: P.A. 97-38, eff. 6-28-11.)
 
9    (210 ILCS 48/3-202.2b)
10    Sec. 3-202.2b. Certification of specialized mental health
11rehabilitation facilities.
12    (a) The Department shall file with the Joint Committee on
13Administrative Rules, pursuant to the Illinois Administrative
14Procedure Act, proposed rules or proposed amendments to
15existing rules to establish a special certification program
16that provides for psychiatric rehabilitation services that are
17required to be offered by a facility licensed under this Act
18that serves residents with serious mental illness. Compliance
19with standards promulgated pursuant to this Section must be
20demonstrated before a facility licensed under this Act is
21eligible to become certified under this Section and annually
22thereafter.
23    (b) No facility shall establish, operate, maintain, or
24offer psychiatric rehabilitation services, or admit, retain,
25or seek referrals of a resident with a serious mental illness

 

 

HB5668- 79 -LRB097 19458 DRJ 66076 b

1diagnosis, unless and until a valid certification, which
2remains unsuspended, unrevoked, and unexpired, has been
3issued.
4    (c) A facility that currently serves a resident with
5serious mental illness may continue to admit such residents
6until the Department performs a certification review and
7determines that the facility does not meet the requirements for
8certification. The Department, at its discretion, may provide
9an additional 90-day period for the facility to meet the
10requirements for certification if it finds that the facility
11has made a good faith effort to comply with all certification
12requirements and will achieve total compliance with the
13requirements before the end of the 90-day period. The facility
14shall be prohibited from admitting residents with serious
15mental illness until the Department certifies the facility to
16be in compliance with the requirements of this Section.
17    (d) A facility currently serving residents with serious
18mental illness that elects to terminate provision of services
19to this population must immediately notify the Department of
20its intent, cease to admit new residents with serious mental
21illness, and give notice to all existing residents with serious
22mental illness of their impending discharge. These residents
23shall be accorded all rights and assistance provided to a
24resident being involuntarily discharged and those provided
25under Section 2-201.5 of this Act. The facility shall continue
26to adhere to all requirements of this Act until all residents

 

 

HB5668- 80 -LRB097 19458 DRJ 66076 b

1with serious mental illness have been discharged.
2    (e) A facility found to be out of compliance with the
3certification requirements under this Section may be subject to
4denial, revocation, or suspension of the psychiatric
5rehabilitation services certification or the imposition of
6sanctions and penalties, including the immediate suspension of
7new admissions. Hearings shall be conducted pursuant to Part 7
8of Article III of this Act.
9    (f) The Department shall indicate on its list of licensed
10facilities which facilities are certified under this Section
11and shall distribute this list to the appropriate State
12agencies charged with administering and implementing the
13State's program of pre-admission screening and resident
14review, hospital discharge planners, and others upon request.
15    (g) No public official, agent, or employee of the State, or
16any subcontractor of the State, may refer or arrange for the
17placement of a person with serious mental illness in a facility
18that is not certified under this Section. No public official,
19agent, or employee of the State, or any subcontractor of the
20State, may place the name of a facility on a list of facilities
21serving the seriously mentally ill for distribution to the
22general public or to professionals arranging for placements or
23making referrals unless the facility is certified under this
24Section.
25    (h) The Department shall establish requirements for
26certification that augment current quality of care standards

 

 

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1for facilities serving residents with serious mental illness,
2which shall include admission, discharge planning, psychiatric
3rehabilitation services, development of age group appropriate
4treatment plan goals and services, behavior management
5services, coordination with community mental health services,
6staff qualifications and training, clinical consultation,
7resident access to the outside community, and appropriate
8environment and space for resident programs, recreation,
9privacy, and any other issue deemed appropriate by the
10Department. The augmented standards shall at a minimum include,
11but need not be limited to, the following:
12        (1) Staff sufficient in number and qualifications
13    necessary to meet the scheduled and unscheduled needs of
14    the residents on a 24-hour basis. The Department shall
15    establish by rule the minimum number of psychiatric
16    services rehabilitation coordinators in relation to the
17    number of residents with serious mental illness residing in
18    the facility. When no psychiatric services rehabilitation
19    coordinator is in the facility, there shall be at least one
20    such person on call and available to respond to emergencies
21    in the facility.
22        (2) The number and qualifications of consultants
23    required to be contracted with to provide continuing
24    education and training and to assist with program
25    development.
26        (3) Training for all new employees specific to the care

 

 

HB5668- 82 -LRB097 19458 DRJ 66076 b

1    needs of residents with a serious mental illness diagnosis
2    during their orientation period and annually thereafter.
3    Training shall be independent of the Department and
4    overseen by an agency designated by the Governor to
5    determine the content of all facility employee training and
6    to provide training for all trainers of facility employees.
7    Training of employees shall at minimum include, but need
8    not be limited to, (i) the impact of a serious mental
9    illness diagnosis, (ii) the recovery paradigm and the role
10    of psychiatric rehabilitation, (iii) preventive strategies
11    for managing aggression and crisis prevention, (iv) basic
12    psychiatric rehabilitation techniques and service
13    delivery, (v) resident rights, (vi) abuse prevention,
14    (vii) appropriate interaction between staff and residents,
15    and (viii) any other topic deemed by the Department to be
16    important to ensuring quality of care.
17        (4) Quality assessment and improvement requirements
18    specific to a facility's residential psychiatric
19    rehabilitation services, which shall be made available to
20    the Department upon request. A facility shall be required
21    at a minimum to develop and maintain policies and
22    procedures that include, but need not be limited to,
23    evaluation of the appropriateness of resident admissions
24    based on the facility's capacity to meet specific needs,
25    resident assessments, development and implementation of
26    care plans, and discharge planning.

 

 

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1        (5) Room selection and appropriateness of roommate
2    assignment, including the assignment of female residents
3    to female-only units or floors and, to the extent possible
4    (taking into account the availability of staff and staff
5    preference), the assignment of only female staff to work on
6    those floors or units.
7        (6) Comprehensive quarterly review of all treatment
8    plans for residents with serious mental illness by the
9    resident's interdisciplinary team, which takes into
10    account, at a minimum, the resident's progress, prior
11    assessments, and treatment plan.
12        (7) Substance abuse screening and management and
13    documented referral relationships with certified substance
14    abuse treatment providers.
15        (8) Administration of psychotropic medications to a
16    non-objecting resident with serious mental illness who is
17    incapable of giving informed consent, in compliance with
18    the applicable provisions of the Mental Health and
19    Developmental Disabilities Code. Administration of
20    psychotropic medications to an objecting resident, only
21    with a court order authorizing such administration.
22    (i) The Department shall establish a certification fee
23schedule by rule, in consultation with advocates, nursing
24homes, and representatives of associations representing long
25term care facilities. Rules proposed under this Section shall
26take effect 180 days after being approved by the Joint

 

 

HB5668- 84 -LRB097 19458 DRJ 66076 b

1Committee on Administrative Rules.
2(Source: P.A. 97-38, eff. 6-28-11.)
 
3    (210 ILCS 48/3-202.6 new)
4    Sec. 3-202.6. Liability insurance coverage required. No
5person may establish, operate, maintain, offer, or advertise a
6facility within this State without providing to the Department
7of Public Health proof of liability insurance coverage in an
8amount not less than $1,000,000 per occurrence. This
9requirement may not be waived. Failure to maintain such
10liability insurance coverage during the term of a facility's
11license shall be a separate Type "B" violation for each
12resident of the facility for each month, or part of a month, in
13which the facility did not have the minimum required liability
14insurance.
 
15    (210 ILCS 48/3-206)
16    Sec. 3-206. Nursing assistants, habilitation aids, and
17child care aides. The Department shall prescribe a curriculum
18for training nursing assistants, habilitation aides, and child
19care aides.
20    (a) No person, except a volunteer who receives no
21compensation from a facility and is not included for the
22purpose of meeting any staffing requirements set forth by the
23Department, shall act as a nursing assistant, habilitation
24aide, or child care aide in a facility, nor shall any person,

 

 

HB5668- 85 -LRB097 19458 DRJ 66076 b

1under any other title, not licensed, certified, or registered
2to render medical care by the Department of Professional
3Regulation, assist with the personal, medical, or nursing care
4of residents in a facility, unless such person meets the
5following requirements:
6        (1) Be at least 18 16 years of age, of temperate habits
7    and good moral character, honest, reliable, and
8    trustworthy.
9        (2) Be able to speak and understand the English
10    language or a language understood by a substantial
11    percentage of the facility's residents.
12        (3) Provide evidence of employment or occupation, if
13    any, and residence for 2 years prior to his or her present
14    employment.
15        (4) Have completed at least 10 8 years of grade school
16    or provide proof of equivalent knowledge.
17        (5) Begin a current course of training for nursing
18    assistants, habilitation aides, or child care aides,
19    approved by the Department, within 45 days of initial
20    employment in the capacity of a nursing assistant,
21    habilitation aide, or child care aide at any facility. Such
22    courses of training shall be successfully completed within
23    120 days of initial employment in the capacity of nursing
24    assistant, habilitation aide, or child care aide at a
25    facility. Nursing assistants, habilitation aides, and
26    child care aides who are enrolled in approved courses in

 

 

HB5668- 86 -LRB097 19458 DRJ 66076 b

1    community colleges or other educational institutions on a
2    term, semester, or trimester basis shall be exempt from the
3    120-day completion time limit. The Department shall adopt
4    rules for such courses of training. These rules shall
5    include procedures for facilities to carry on an approved
6    course of training within the facility.
7        The Department may accept comparable training in lieu
8    of the 120-hour course for student nurses, foreign nurses,
9    military personnel, or employes of the Department of Human
10    Services.
11        The facility shall develop and implement procedures
12    and at least 6 hours of quarterly in-service training,
13    which shall be approved by the Department, for an ongoing
14    review process, which shall take place within the facility,
15    for nursing assistants, habilitation aides, and child care
16    aides. The facility shall retain records of all staff
17    in-service training and shall provide such records to the
18    Department upon request. At least half of each quarter of
19    in-service training shall be one-on-one direct resident
20    care demonstration and practice of patient care
21    techniques.
22        At the time of each regularly scheduled licensure
23    survey, or at the time of a complaint investigation, the
24    Department may require any nursing assistant, habilitation
25    aide, or child care aide to demonstrate, either through
26    written examination or action, or both, sufficient

 

 

HB5668- 87 -LRB097 19458 DRJ 66076 b

1    knowledge in all areas of required training. If such
2    knowledge is inadequate, the Department shall require the
3    nursing assistant, habilitation aide, or child care aide to
4    complete inservice training and review in the facility
5    until the nursing assistant, habilitation aide, or child
6    care aide demonstrates to the Department, either through
7    written examination or action, or both, sufficient
8    knowledge in all areas of required training.
9        (6) Be familiar with and have general skills related to
10    resident care.
11    (a-0.5) An educational entity, other than a secondary
12school, conducting a nursing assistant, habilitation aide, or
13child care aide training program shall initiate a criminal
14history record check in accordance with the Health Care Worker
15Background Check Act prior to entry of an individual into the
16training program. A secondary school may initiate a criminal
17history record check in accordance with the Health Care Worker
18Background Check Act at any time during or after a training
19program.
20    (a-1) Nursing assistants, habilitation aides, or child
21care aides seeking to be included on the registry maintained
22under Section 3-206.01 must authorize the Department of Public
23Health or its designee to request a criminal history record
24check in accordance with the Health Care Worker Background
25Check Act and submit all necessary information. An individual
26may not newly be included on the registry unless a criminal

 

 

HB5668- 88 -LRB097 19458 DRJ 66076 b

1history record check has been conducted with respect to the
2individual.
3    (b) Persons subject to this Section shall perform their
4duties under the supervision of a licensed nurse.
5    (c) It is unlawful for any facility to employ any person in
6the capacity of nursing assistant, habilitation aide, or child
7care aide, or under any other title, not licensed by the State
8of Illinois to assist in the personal, medical, or nursing care
9of residents in such facility unless such person has complied
10with this Section.
11    (d) Proof of compliance by each employee with the
12requirements set out in this Section shall be maintained for
13each such employee by each facility in the individual personnel
14folder of the employee. Proof of training shall be obtained
15only from the health care worker registry.
16    (e) Each facility shall obtain access to the health care
17worker registry's web application, maintain the employment and
18demographic information relating to each employee, and verify
19by the category and type of employment that each employee
20subject to this Section meets all the requirements of this
21Section.
22    (f) Any facility that is operated under Section 3-803 shall
23be exempt from the requirements of this Section.
24    (g) Each facility that admits persons who are diagnosed as
25having Alzheimer's disease or related dementias shall require
26all nursing assistants, habilitation aides, or child care

 

 

HB5668- 89 -LRB097 19458 DRJ 66076 b

1aides, who did not receive 12 hours of training in the care and
2treatment of such residents during the training required under
3paragraph (5) of subsection (a), to obtain 12 hours of in-house
4training in the care and treatment of such residents. If the
5facility does not provide the training in-house, the training
6shall be obtained from other facilities, community colleges, or
7other educational institutions that have a recognized course
8for such training. The Department shall, by rule, establish a
9recognized course for such training. The Department's rules
10shall provide that such training may be conducted in-house at
11each facility subject to the requirements of this subsection,
12in which case such training shall be monitored by the
13Department.
14    The Department's rules shall also provide for
15circumstances and procedures whereby any person who has
16received training that meets the requirements of this
17subsection shall not be required to undergo additional training
18if he or she is transferred to or obtains employment at a
19different facility or a facility other than a long-term care
20facility but remains continuously employed for pay as a nursing
21assistant, habilitation aide, or child care aide. Individuals
22who have performed no nursing or nursing-related services for a
23period of 24 consecutive months shall be listed as "inactive"
24and, as such, do not meet the requirements of this Section.
25Licensed sheltered care facilities shall be exempt from the
26requirements of this Section.

 

 

HB5668- 90 -LRB097 19458 DRJ 66076 b

1(Source: P.A. 97-38, eff. 6-28-11.)
 
2    (210 ILCS 48/3-206.06 new)
3    Sec. 3-206.06. Dementia-specific orientation.
4    (a) A facility that admits or retains persons with
5Alzheimer's disease or other dementias shall give all staff who
6have any direct contact with these residents at least 4 hours
7of dementia-specific orientation within their first 7 days of
8employment. Nurses, nursing assistants, and social service and
9activities staff who work with these residents shall, within
10their first 45 days of employment, receive a minimum of 12
11additional hours of orientation specifically related to the
12care of persons with Alzheimer's disease and other dementias.
13All staff who have any direct contact with these residents
14shall have at least 12 hours of dementia-specific education and
15training annually thereafter.
16    (b) The Department shall specify the content of the
17orientation and the annual education and training.
 
18    (210 ILCS 48/3-207)
19    Sec. 3-207. Statement of ownership.    
20    (a) As a condition of the issuance or renewal of the
21license of any facility, the applicant shall file a statement
22of ownership. The applicant shall update the information
23required in the statement of ownership within 10 days of any
24change.

 

 

HB5668- 91 -LRB097 19458 DRJ 66076 b

1    (b) The statement of ownership shall include the following:
2        (1) The name, address, telephone number, occupation or
3    business activity, business address and business telephone
4    number of the person who is the owner of the facility and
5    every person who owns the building in which the facility is
6    located, if other than the owner of the facility, which is
7    the subject of the application or license; and if the owner
8    is a partnership or corporation, the name of every partner
9    and stockholder of the owner;
10        (2) The name and address of any facility, whereever
11    located, any financial interest in which is owned by the
12    applicant, if the facility were required to be licensed if
13    it were located in this State;
14        (3) Other information necessary to determine the
15    identity and qualifications of an applicant or licensee to
16    operate a facility in accordance with this Act as required
17    by the Department in regulations.
18    (c) The information in the statement of ownership shall be
19public information and shall be available from the Department.
20    (d) A facility which is owned by a chain organization as
21defined by the Centers for Medicare and Medicaid Services shall
22submit annually to the Department an electronic copy of the
23Home Office Cost Statement required to be submitted by the home
24office of the chain to the United States Department of Health
25and Human Services. The facility shall send the cost statement
26in electronic form to the Department forthwith after it submits

 

 

HB5668- 92 -LRB097 19458 DRJ 66076 b

1the statement to the Department of Health and Human Services.
2Each week that a facility fails to comply with the requirements
3of this subsection shall be cited as a separate administrative
4warning.
5(Source: P.A. 97-38, eff. 6-28-11.)
 
6    (210 ILCS 48/3-304.1)
7    Sec. 3-304.1. Public computer access to information.
8    (a) The Department must make information regarding nursing
9homes in the State available to the public in electronic form
10on the World Wide Web, including all of the following
11information:
12        (1) who regulates facilities licensed under this Act;
13        (2) information in the possession of the Department
14    that is listed in Sections 3-210 and 3-304;
15        (3) deficiencies and plans of correction;
16        (4) enforcement remedies;
17        (5) penalty letters;
18        (6) designation of penalty monies;
19        (7) the U.S. Department of Health and Human Services'
20    special projects or federally required inspections;
21        (8) advisory standards;
22        (9) deficiency free surveys;
23        (10) enforcement actions and enforcement summaries;
24    and
25        (11) distressed facilities; .

 

 

HB5668- 93 -LRB097 19458 DRJ 66076 b

1        (12) a link to the most recent facility cost report
2    filed with the Department of Healthcare and Family
3    Services;
4        (13) a link to the most recent Consumer Choice
5    Information Report filed with the Department on Aging;
6        (14) whether the facility is part of a chain; the
7    facility shall be deemed part of a chain if it meets
8    criteria established by the United States Department of
9    Health and Human Services that identify it as owned by a
10    chain organization; and
11        (15) a copy of the latest Home Office Cost Statement,
12    if any, filed by the home office of the owner of the
13    facility with the United States Department of Health and
14    Human Services.
15    (b) No fee or other charge may be imposed by the Department
16as a condition of accessing the information.
17    (c) The electronic public access provided through the World
18Wide Web shall be in addition to any other electronic or print
19distribution of the information.
20    (d) The information shall be made available as provided in
21this Section in the shortest practicable time after it is
22publicly available in any other form.
23    (e) The Department shall cooperate with a tax-exempt,
24not-for-profit organization dedicated solely to advocacy for
25long-term care residents to make available in electronic form
26the results of all surveys, including any enforcement actions,

 

 

HB5668- 94 -LRB097 19458 DRJ 66076 b

1and current information about individual nursing home
2staffing, in the shortest practicable time after they become
3publicly available. The data shall be provided without charge,
4so long as the organization charges no fee for sharing the
5information with the general public. If the organization makes
6the data available on a website, the Department shall create a
7link to the website on the Department's website.
8(Source: P.A. 97-38, eff. 6-28-11.)
 
9    (210 ILCS 48/3-808.5)
10    Sec. 3-808.5. Nursing home fraud, abuse, and neglect
11prevention and reporting.
12    (a) Every licensed long-term care facility that receives
13Medicaid funding shall prominently display in its lobby, in its
14dining areas, and on each floor of the facility information
15approved by the Illinois Medicaid Fraud Control Unit on how to
16report fraud, abuse, and neglect. In addition, information
17regarding the reporting of fraud, abuse, and neglect shall be
18provided to each resident at the time of admission and to the
19resident's family members or emergency contacts, or to both the
20resident's family members and his or her emergency contacts.
21    (b) Any owner or licensee of a long-term care facility
22licensed under this Act shall be responsible for the collection
23and maintenance of any and all records required to be
24maintained under this Section and any other applicable
25provisions of this Act, and as a provider under the Illinois

 

 

HB5668- 95 -LRB097 19458 DRJ 66076 b

1Public Aid Code, and shall be responsible for compliance with
2all of the disclosure requirements under this Section. All
3books and records and other papers and documents that are
4required to be kept, and all records showing compliance with
5all of the disclosure requirements to be made pursuant to this
6Section, shall be kept at the facility and shall, at all times
7during business hours, be subject to inspection by any law
8enforcement or health oversight agency or its duly authorized
9agents or employees.
10    (c) Any report of abuse and neglect of residents made by
11any individual in whatever manner, including, but not limited
12to, reports made under Sections 2-107 and 3-610 of this Act, or
13as provided under the Abused and Neglected Long Term Care
14Facility Residents Reporting Act, that is made to an
15administrator, a director of nursing, or any other person with
16management responsibility at a long-term care facility must be
17disclosed to the owners and licensee of the facility within 24
18hours of the report. The owners and licensee of a long-term
19care facility shall maintain all records necessary to show
20compliance with this disclosure requirement.
21    (d) Any person with an ownership interest in a long-term
22care facility licensed by the Department must, within 30 days
23of the effective date of this Act, disclose the existence of
24any ownership interest in any vendor who does business with the
25facility. The disclosures required by this subsection shall be
26made in the form and manner prescribed by the Department.

 

 

HB5668- 96 -LRB097 19458 DRJ 66076 b

1Licensed long-term care facilities who receive Medicaid
2funding shall submit a copy of the disclosures required by this
3subsection to the Illinois Medicaid Fraud Control Unit. The
4owners and licensee of a long-term care facility shall maintain
5all records necessary to show compliance with this disclosure
6requirement.
7    (e) Notwithstanding the provisions of Section 3-318 of this
8Act, and in addition thereto, any person, owner, or licensee
9who willfully fails to keep and maintain, or willfully fails to
10produce for inspection, books and records, or willfully fails
11to make the disclosures required by this Section, is guilty of
12a Class A misdemeanor. A second or subsequent violation of this
13Section shall be punishable as a Class 4 felony.
14    (f) Any owner or licensee who willfully files or willfully
15causes to be filed a document with false information with the
16Department, the Department of Healthcare and Family Services,
17or the Illinois Medicaid Fraud Control Unit or any other law
18enforcement agency, is guilty of a Class A misdemeanor.
19    (g) At the request of the Department of State Police, a
20facility shall cooperate with that agency in arranging for the
21Department of State Police to train facility staff on
22preventing resident abuse and neglect.
23(Source: P.A. 97-38, eff. 6-28-11.)
 
24    Section 90. The State Mandates Act is amended by adding
25Section 8.36 as follows:
 

 

 

HB5668- 97 -LRB097 19458 DRJ 66076 b

1    (30 ILCS 805/8.36 new)
2    Sec. 8.36. Exempt mandate. Notwithstanding Sections 6 and 8
3of this Act, no reimbursement by the State is required for the
4implementation of any mandate created by this amendatory Act of
5the 97th General Assembly.

 

 

HB5668- 98 -LRB097 19458 DRJ 66076 b

1 INDEX
2 Statutes amended in order of appearance
3    20 ILCS 105/4.04from Ch. 23, par. 6104.04
4    20 ILCS 3960/3from Ch. 111 1/2, par. 1153
5    20 ILCS 3960/14.1
6    210 ILCS 45/1-114.2 new
7    210 ILCS 45/2-208from Ch. 111 1/2, par. 4152-208
8    210 ILCS 45/2-218 new
9    210 ILCS 45/3-109from Ch. 111 1/2, par. 4153-109
10    210 ILCS 45/3-117from Ch. 111 1/2, par. 4153-117
11    210 ILCS 45/3-119from Ch. 111 1/2, par. 4153-119
12    210 ILCS 45/3-202from Ch. 111 1/2, par. 4153-202
13    210 ILCS 45/3-202.05
14    210 ILCS 45/3-202.2b
15    210 ILCS 45/3-202.6 new
16    210 ILCS 45/3-206from Ch. 111 1/2, par. 4153-206
17    210 ILCS 45/3-206.06 new
18    210 ILCS 45/3-207from Ch. 111 1/2, par. 4153-207
19    210 ILCS 45/3-304.1
20    210 ILCS 45/3-808.5
21    210 ILCS 47/3-202.05 new
22    210 ILCS 47/3-206
23    210 ILCS 47/3-206.06 new
24    210 ILCS 48/1-114.2 new
25    210 ILCS 48/2-208

 

 

HB5668- 99 -LRB097 19458 DRJ 66076 b

1    210 ILCS 48/2-218 new
2    210 ILCS 48/3-109
3    210 ILCS 48/3-117
4    210 ILCS 48/3-119
5    210 ILCS 48/3-202
6    210 ILCS 48/3-202.2b
7    210 ILCS 48/3-202.6 new
8    210 ILCS 48/3-206
9    210 ILCS 48/3-206.06 new
10    210 ILCS 48/3-207
11    210 ILCS 48/3-304.1
12    210 ILCS 48/3-808.5
13    30 ILCS 805/8.36 new