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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 Nursing Home Care Act is amended by
5changing Section 3-120 as follows:
6    (210 ILCS 45/3-120)
7    Sec. 3-120. Certification of behavioral management units.
8    (a) No later than January 1, 2022 2011, the Department
9shall file with the Secretary of State's Office Joint
10Committee on Administrative Rules, pursuant to the Illinois
11Administrative Procedure Act, proposed rules or proposed
12amendments to existing rules to certify nursing homes or
13distinct self-contained units within existing nursing homes
14for the behavioral management of persons with a high risk of
15aggression. The purpose of the certification program is to
16ensure that the safety of residents, employees, and the public
17is preserved.
18    (b) The Department's rules shall, at a minimum, provide
19for the following:
20        (1) A security and safety assessment, completed before
21    admission to a certified unit if an Identified Offender
22    Report and Recommendation or other criminal risk analysis
23    has not been completed, to identify existing or potential



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1    residents at risk of committing violent acts and determine
2    appropriate preventive action to be taken. The assessment
3    shall include, but need not be limited to, (i) a measure of
4    the frequency of, (ii) an identification of the
5    precipitating factors for, and (iii) the consequences of,
6    violent acts. The security and safety assessment shall be
7    in addition to any risk-of-harm assessment performed by a
8    PAS screener, but may use the results of this or any other
9    assessment. The security and safety assessment shall be
10    completed by the same licensed forensic psychologist who
11    prepares Identified Offender Reports and Recommendations
12    for identified offenders.
13        (2) Development of an individualized treatment and
14    behavior management plan for each resident to reduce
15    overall and specific risks.
16        (3) Room selection and appropriateness of roommate
17    assignment.
18        (4) Protection of residents, employees, and members of
19    the public from aggression by residents.
20        (5) Supervision and monitoring.
21        (6) Staffing levels.
22        (7) Quality assurance and improvement.
23        (8) Staff training, conducted during orientation and
24    periodically thereafter, specific to each job description
25    covering the following topics as appropriate:
26            (A) The violence escalation cycle.



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1            (B) Violence predicting factors.
2            (C) Obtaining a history from a resident with a
3        history of violent behavior.
4            (D) Verbal and physical techniques to de-escalate
5        and minimize violent behavior.
6            (E) Strategies to avoid physical harm.
7            (F) Containment techniques, as permitted and
8        governed by law.
9            (G) Appropriate treatment to reduce violent
10        behavior.
11            (H) Documenting and reporting incidents of
12        violence.
13            (I) The process whereby employees affected by a
14        violent act may be debriefed or calmed down and the
15        tension of the situation may be reduced.
16            (J) Any resources available to employees for
17        coping with violence.
18            (K) Any other topic deemed appropriate based on
19        job description and the needs of this population.
20        (9) Elimination or reduction of environmental factors
21    that affect resident safety.
22        (10) Periodic independent reassessment of the
23    individual resident for appropriateness of continued
24    placement on the certified unit. For the purposes of this
25    paragraph (10), "independent" means that no professional
26    or financial relationship exists between any person making



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1    the assessment and any community provider or long term
2    care facility.
3        (11) A definition of a "person with high risk of
4    aggression". The definition shall not include any person
5    with a serious mental illness who is eligible to receive
6    services under the Specialized Mental Health
7    Rehabilitation Act of 2013.
8    The Department shall develop the administrative rules
9under this subsection (b) in collaboration with other relevant
10State agencies and in consultation with (i) advocates for
11residents, (ii) providers of nursing home services, and (iii)
12labor and employee-representation organizations.
13    (c) A long term care facility found to be out of compliance
14with the certification requirements under Section 3-120 may be
15subject to denial, revocation, or suspension of the behavioral
16management unit certification or the imposition of sanctions
17and penalties, including the immediate suspension of new
18admissions. Hearings shall be conducted pursuant to Part 7 of
19Article III of this Act.
20    (d) The Department shall establish a certification fee
21schedule by rule, in consultation with advocates, nursing
22homes, and representatives of associations representing long
23term care facilities.
24(Source: P.A. 96-1372, eff. 7-29-10.)
25    Section 99. Effective date. This Act takes effect upon
26becoming law.