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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Nursing Home Care Act is amended by |
5 | | changing Sections 3-212 and 3-702 as follows:
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6 | | (210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
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7 | | Sec. 3-212. Inspection.
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8 | | (a) The Department, whenever it deems necessary in
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9 | | accordance with subsection (b), shall inspect, survey and |
10 | | evaluate every
facility to determine compliance with |
11 | | applicable licensure requirements and
standards. Submission of |
12 | | a facility's current Consumer Choice Information Report |
13 | | required by Section 2-214 shall be verified at time of |
14 | | inspection. An inspection should occur within 120 days prior
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15 | | to license renewal. The Department may periodically visit a |
16 | | facility for the
purpose of consultation. An inspection, |
17 | | survey, or evaluation, other than
an inspection of financial |
18 | | records, shall be conducted without prior notice
to the |
19 | | facility. A visit for the sole purpose of consultation may be
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20 | | announced.
The Department shall provide training to surveyors |
21 | | about the appropriate
assessment, care planning, and care of |
22 | | persons with mental illness (other than
Alzheimer's disease or |
23 | | related disorders) to enable its surveyors to
determine |
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1 | | whether a facility is complying with State and federal |
2 | | requirements
about the assessment, care planning, and care of |
3 | | those persons.
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4 | | (a-1) An employee of a State or unit of local government |
5 | | agency
charged with inspecting, surveying, and evaluating |
6 | | facilities who directly
or indirectly gives prior notice of an |
7 | | inspection, survey, or evaluation,
other than an inspection of |
8 | | financial records, to a facility or to an
employee of a |
9 | | facility is guilty of a Class A misdemeanor.
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10 | | An inspector or an employee of the Department who |
11 | | intentionally prenotifies
a facility,
orally or in writing, of |
12 | | a pending complaint investigation or inspection shall
be |
13 | | guilty of a Class A misdemeanor.
Superiors of persons who have |
14 | | prenotified a facility shall be subject to the
same penalties, |
15 | | if they have knowingly allowed the prenotification. A person
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16 | | found guilty of prenotifying a facility shall be subject to |
17 | | disciplinary action
by his or her employer.
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18 | | If the Department has a good faith belief, based upon |
19 | | information that comes
to its attention, that a violation of |
20 | | this subsection has occurred, it must
file a complaint with |
21 | | the Attorney General or the State's Attorney in the
county |
22 | | where the violation
took place within 30 days after discovery |
23 | | of the information.
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24 | | (a-2) An employee of a State or unit of local government |
25 | | agency charged with
inspecting, surveying, or evaluating |
26 | | facilities who willfully profits from
violating the |
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1 | | confidentiality of the inspection, survey, or evaluation
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2 | | process shall be guilty of a Class 4 felony and that conduct |
3 | | shall be deemed
unprofessional conduct that may subject a |
4 | | person to loss of his or her
professional license. An action to |
5 | | prosecute a person for violating this
subsection (a-2) may be |
6 | | brought by either the Attorney General or the State's
Attorney |
7 | | in the county where the violation took place.
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8 | | (a-3) The Department shall, by rule, establish guidelines |
9 | | for required continuing education of all employees who |
10 | | inspect, survey, or evaluate a facility. The Department shall |
11 | | offer continuing education opportunities at least quarterly. |
12 | | Employees of a State agency charged with inspecting, |
13 | | surveying, or evaluating a facility are required to complete |
14 | | at least 10 hours of continuing education annually on topics |
15 | | that support the survey process, including, but not limited |
16 | | to, trauma-informed care, infection control, abuse and |
17 | | neglect, and civil monetary penalties. Qualifying hours of |
18 | | continuing education intended to fulfill the requirements of |
19 | | this subsection shall only be offered by the Department. |
20 | | Content presented during the continuing education shall be |
21 | | consistent throughout the State, regardless of survey region. |
22 | | At least 5 of the 10 hours of continuing education required |
23 | | under this subsection shall be separate and distinct from any |
24 | | continuing education hours required for any license that the |
25 | | employee holds. Any continuing education hours provided by the |
26 | | Department in addition to the 10 hours of continuing education |
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1 | | required under this subsection may count towards continuing |
2 | | education hours required for any license that the employee |
3 | | holds. |
4 | | (b) In determining whether to make more than the required |
5 | | number of
unannounced inspections, surveys and evaluations of |
6 | | a facility the
Department shall consider one or more of the |
7 | | following: previous inspection
reports; the facility's history |
8 | | of compliance with standards, rules and
regulations |
9 | | promulgated under this Act and correction of violations,
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10 | | penalties or other enforcement actions; the number and |
11 | | severity of
complaints received about the facility; any |
12 | | allegations of resident abuse
or neglect; weather conditions; |
13 | | health emergencies; other reasonable belief
that deficiencies |
14 | | exist.
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15 | | (b-1) The Department shall not be required to determine |
16 | | whether a
facility certified to participate in the Medicare |
17 | | program under Title XVIII of
the Social Security Act, or the |
18 | | Medicaid program under Title XIX of the Social
Security Act, |
19 | | and which the Department determines by inspection under this
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20 | | Section or under Section 3-702 of this Act to be in compliance |
21 | | with the
certification requirements of Title XVIII or XIX, is |
22 | | in compliance with any
requirement of this Act that is less |
23 | | stringent than or duplicates a federal
certification |
24 | | requirement. In accordance with subsection (a) of this Section
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25 | | or subsection (d) of Section 3-702, the Department shall |
26 | | determine whether a
certified facility is in
compliance with |
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1 | | requirements of this Act that exceed federal certification
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2 | | requirements. If a certified facility is found to be out of |
3 | | compliance with
federal certification requirements, the |
4 | | results of an inspection conducted
pursuant to Title XVIII or |
5 | | XIX of the Social Security Act may be used as the
basis for |
6 | | enforcement remedies authorized and commenced, with the |
7 | | Department's discretion to evaluate whether penalties are |
8 | | warranted, under this Act.
Enforcement of this Act against a |
9 | | certified facility shall be commenced
pursuant to the |
10 | | requirements of this Act, unless enforcement remedies sought
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11 | | pursuant to Title XVIII or XIX of the Social Security Act |
12 | | exceed those
authorized by this Act. As used in this |
13 | | subsection, "enforcement remedy"
means a sanction for |
14 | | violating a federal certification requirement or this
Act.
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15 | | (c) Upon completion of each inspection, survey and |
16 | | evaluation, the
appropriate Department personnel who conducted |
17 | | the inspection, survey or
evaluation shall submit a physical |
18 | | or electronic copy of their report to the licensee upon |
19 | | exiting
the facility, and shall submit the actual report to |
20 | | the appropriate
regional office of the Department. Such report |
21 | | and any recommendations for
action by the Department under |
22 | | this Act shall be transmitted to the
appropriate offices of |
23 | | the associate director of the Department, together
with |
24 | | related comments or documentation provided by the licensee |
25 | | which may
refute findings in the report, which explain |
26 | | extenuating circumstances that
the facility could not |
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1 | | reasonably have prevented, or which indicate methods
and |
2 | | timetables for correction of deficiencies described in the |
3 | | report.
Without affecting the application of subsection (a) of |
4 | | Section 3-303, any
documentation or comments of the licensee |
5 | | shall be provided within 10
days of receipt of the copy of the |
6 | | report. Such report shall recommend to
the Director |
7 | | appropriate action under this Act with respect to findings
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8 | | against a facility. The Director shall then determine whether |
9 | | the report's
findings constitute a violation or violations of |
10 | | which the facility must be
given notice. Such determination |
11 | | shall be based upon the severity of the
finding, the danger |
12 | | posed to resident health and safety, the comments and
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13 | | documentation provided by the facility, the diligence and |
14 | | efforts to
correct deficiencies, correction of the reported |
15 | | deficiencies, the
frequency and duration of similar findings |
16 | | in previous reports and the
facility's general inspection |
17 | | history. Violations shall be determined
under this subsection |
18 | | no later than 75 days after completion of each
inspection, |
19 | | survey and evaluation.
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20 | | (d) The Department shall maintain all inspection, survey |
21 | | and evaluation
reports for at least 5 years in a manner |
22 | | accessible to and understandable
by the public.
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23 | | (e) Revisit surveys. The Department shall conduct a |
24 | | revisit to its licensure and certification surveys, consistent |
25 | | with federal regulations and guidelines. |
26 | | (f) Notwithstanding any other provision of this Act, the |
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1 | | Department shall, no later than 180 days after the effective |
2 | | date of this amendatory Act of the 98th General Assembly, |
3 | | implement a single survey process that encompasses federal |
4 | | certification and State licensure requirements, health and |
5 | | life safety requirements, and an enhanced complaint |
6 | | investigation initiative. |
7 | | (1) To meet the requirement of a single survey |
8 | | process, the portions of the health and life safety survey |
9 | | associated with federal certification and State licensure |
10 | | surveys must be started within 7 working days of each |
11 | | other. Nothing in this paragraph (1) of subsection (f) of |
12 | | this Section applies to a complaint investigation. |
13 | | (2) The enhanced complaint and incident report |
14 | | investigation initiative shall permit the facility to |
15 | | challenge the amount of the fine due to the excessive |
16 | | length of the investigation which results in one or more |
17 | | of the following conditions: |
18 | | (A) prohibits the timely development and |
19 | | implementation of a plan of correction; |
20 | | (B) creates undue financial hardship impacting the |
21 | | quality of care delivered to the resident; |
22 | | (C) delays initiation of corrective training; and |
23 | | (D) negatively impacts quality assurance and |
24 | | patient improvement standards. |
25 | | This paragraph (2) does not apply to complaint |
26 | | investigations exited within 14 working days or a |
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1 | | situation that triggers an extended survey. |
2 | | (Source: P.A. 98-104, eff. 7-22-13.)
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3 | | (210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
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4 | | Sec. 3-702.
(a) A person who believes that this Act or a |
5 | | rule promulgated
under this Act may have been violated may |
6 | | request an investigation. The
request may be submitted to the |
7 | | Department in writing, by telephone, by electronic means, or |
8 | | by
personal visit. An oral complaint shall be reduced to |
9 | | writing by the
Department. The Department shall make |
10 | | available, through its website and upon request, information |
11 | | regarding the oral and phone intake processes and the list of |
12 | | questions that will be asked of the complainant. The |
13 | | Department shall request information identifying the
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14 | | complainant, including the name, address and telephone number, |
15 | | to help
enable appropriate follow-up. The Department shall act |
16 | | on such complaints
via on-site visits or other methods deemed |
17 | | appropriate to handle the
complaints with or without such |
18 | | identifying information, as otherwise
provided under this |
19 | | Section. The complainant shall be informed that
compliance |
20 | | with such request is not required to satisfy the procedures |
21 | | for
filing a complaint under this Act. The Department must |
22 | | notify complainants that complaints with less information |
23 | | provided are far more difficult to respond to and investigate.
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24 | | (b) The substance of the complaint shall be provided in |
25 | | writing to the
licensee, owner, or administrator no earlier |
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1 | | than at the commencement of an
on-site inspection of the |
2 | | facility which takes place pursuant to the complaint.
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3 | | (c) The Department shall not disclose the name of the |
4 | | complainant unless
the complainant consents in writing to the |
5 | | disclosure or the investigation
results in a judicial |
6 | | proceeding, or unless disclosure is essential to the
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7 | | investigation. The complainant shall be given the opportunity |
8 | | to withdraw
the complaint before disclosure. Upon the request |
9 | | of the complainant, the
Department may permit the complainant |
10 | | or a representative of the complainant
to accompany the person |
11 | | making the on-site inspection of the facility.
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12 | | (d) Upon receipt of a complaint, the Department shall |
13 | | determine whether this
Act or a rule promulgated under this |
14 | | Act has been or is being violated. The
Department shall |
15 | | investigate all complaints alleging abuse or neglect within
7 |
16 | | days after the receipt of the complaint except that complaints |
17 | | of abuse
or neglect which indicate that a resident's life or |
18 | | safety is in imminent
danger shall be investigated within 24 |
19 | | hours after receipt of the
complaint. All other complaints |
20 | | shall be investigated within 30 days after
the receipt of the |
21 | | complaint. The Department employees investigating a
complaint |
22 | | shall conduct a brief, informal exit conference with the |
23 | | facility
to alert its administration of any suspected serious |
24 | | deficiency that poses
a direct threat to the health, safety or |
25 | | welfare of a resident to enable an
immediate correction for |
26 | | the alleviation or elimination of such threat.
Such |
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1 | | information and findings discussed in the brief exit |
2 | | conference shall
become a part of the investigating record but |
3 | | shall not in any way
constitute an official or final notice of |
4 | | violation as provided under
Section 3-301. All complaints |
5 | | shall be classified as
"an invalid report", "a valid report", |
6 | | or "an undetermined
report". For any complaint classified as |
7 | | "a valid report", the
Department must determine within 30 |
8 | | working days after any Department employee enters a facility |
9 | | to begin an on-site inspection
if any rule or provision of this |
10 | | Act has been or is being violated.
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11 | | (d-1) The Department shall, whenever possible, combine an |
12 | | on-site
investigation of a complaint in a facility with other |
13 | | inspections in order
to avoid duplication of inspections.
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14 | | (e) In all cases, the Department shall inform the |
15 | | complainant of its
findings within 10 days of its |
16 | | determination unless otherwise indicated
by the complainant, |
17 | | and the complainant may direct the Department to
send a copy of |
18 | | such findings to another person. The Department's findings
may |
19 | | include comments or documentation provided by either the |
20 | | complainant
or the licensee pertaining to the complaint. The |
21 | | Department shall also
notify the facility of such findings |
22 | | within 10 days of the determination,
but the name of the |
23 | | complainant or residents shall not be disclosed in this
notice |
24 | | to the facility. The notice of such
findings shall include a |
25 | | copy of the written determination; the
correction order, if |
26 | | any; the warning notice, if any; the inspection
report; or the |
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1 | | State licensure form on which the violation is listed.
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2 | | (f) A written determination, correction order, or warning |
3 | | notice
concerning a complaint, together with the facility's |
4 | | response, shall be
available for public inspection, but the |
5 | | name of the complainant or
resident shall not be disclosed |
6 | | without his consent.
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7 | | (g) A complainant who is dissatisfied with the |
8 | | determination or
investigation by the Department may request a |
9 | | hearing under Section
3-703. The facility shall be given |
10 | | notice of any such
hearing and may participate in the hearing |
11 | | as a party. If a facility
requests a hearing under Section |
12 | | 3-703 which
concerns a matter covered by a complaint, the |
13 | | complainant shall be given
notice and may participate in the |
14 | | hearing as a party. A request
for a hearing by either a |
15 | | complainant or a facility shall be
submitted in writing to the |
16 | | Department within 30 days after the mailing
of the |
17 | | Department's findings as described in subsection (e) of this
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18 | | Section. Upon receipt of the request the Department shall |
19 | | conduct a hearing
as provided under Section 3-703.
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20 | | (g-5) The Department shall conduct an annual review of all |
21 | | survey activity from the preceding fiscal year and make a |
22 | | report concerning the complaint and survey process . The report |
23 | | shall include, but not be limited to: that includes the total |
24 | | number of complaints received ; the breakdown of 24-hour, |
25 | | 7-day, and 30-day complaints; , the breakdown of anonymous and |
26 | | non-anonymous complaints ; and whether the number of complaints |
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1 | | that were substantiated versus unsubstantiated; or not, the |
2 | | total number of substantiated complaints that were completed |
3 | | in the time frame determined under subsection (d) ; the total |
4 | | number of informal dispute resolutions requested; the total |
5 | | number of informal dispute resolution requests approved; the |
6 | | total number of informal dispute resolutions that were |
7 | | overturned or reduced in severity; the total number of nurse |
8 | | surveyors
hired during the calendar year; the total number of |
9 | | nurse
surveyors who left Department employment; the average |
10 | | length of tenure for nurse surveyors employed by the |
11 | | Department at the time the report is created; the total number |
12 | | of times the Department imposed discretionary denial of |
13 | | payment within 15 days of notice and within 2 days of notice as |
14 | | well as the number of times the discretionary denial of |
15 | | payment took effect; , and any other complaint information |
16 | | requested by the Long-Term Care Facility Advisory Board |
17 | | created under Section 2-204 of this Act or the Illinois |
18 | | Long-Term Care Council created under Section 4.04a of the |
19 | | Illinois Act on the Aging. This report shall be provided to the |
20 | | Long-Term Care Facility Advisory Board, the Illinois Long-Term |
21 | | Care Council, and the General Assembly. The Long-Term Care |
22 | | Facility Advisory Board and the Illinois Long-Term Care |
23 | | Council shall review the report and suggest any changes deemed |
24 | | necessary to the Department for review and action, including |
25 | | how to investigate and substantiate anonymous complaints. |
26 | | (h) Any person who knowingly transmits a false report to |