Rep. Jay Hoffman
Filed: 3/21/2014
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1 | AMENDMENT TO HOUSE BILL 1322
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2 | AMENDMENT NO. ______. Amend House Bill 1322 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 1. The Emergency Medical Services (EMS) Systems | ||||||
5 | Act is amended by changing Section 3.190 as follows:
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6 | (210 ILCS 50/3.190)
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7 | Sec. 3.190. Emergency Department Classifications. The | ||||||
8 | Department shall have the authority and
responsibility to:
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9 | (a) Establish criteria for classifying the
emergency | ||||||
10 | departments of all hospitals within the State as
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11 | Comprehensive, Basic, or Standby. In establishing such
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12 | criteria, the Department may consult with the Illinois
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13 | Hospital Licensing Board and incorporate by reference all
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14 | or part of existing standards adopted as rules pursuant to
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15 | the Hospital Licensing Act or Emergency Medical Treatment
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16 | Act;
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1 | (b) Classify the emergency departments of all
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2 | hospitals within the State in accordance with this Section;
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3 | (c) Annually publish, and distribute to all EMS
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4 | Systems, a list reflecting the classification of all
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5 | emergency departments.
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6 | For the purposes of paragraphs (a) and (b) of this Section, | ||||||
7 | long-term acute care hospitals and rehabilitation hospitals , | ||||||
8 | as defined under the Hospital Emergency Service Act, are not | ||||||
9 | required to provide hospital emergency services . Long-term | ||||||
10 | acute care hospitals and rehabilitation hospitals with no | ||||||
11 | emergency department and shall be classified as not available. | ||||||
12 | (Source: P.A. 97-667, eff. 1-13-12; 98-463, eff. 8-16-13.)
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13 | Section 3. The Hospital Emergency Service Act is amended by | ||||||
14 | changing Sections 1 and 1.3 as follows:
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15 | (210 ILCS 80/1) (from Ch. 111 1/2, par. 86)
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16 | Sec. 1.
Every hospital required to be licensed by the | ||||||
17 | Department of Public
Health pursuant to the Hospital Licensing | ||||||
18 | Act which provides general medical
and surgical
hospital | ||||||
19 | services, except long-term acute care hospitals and | ||||||
20 | rehabilitation hospitals identified in Section 1.3 of this Act, | ||||||
21 | shall provide a hospital emergency service in accordance
with | ||||||
22 | rules and regulations adopted by the Department of Public | ||||||
23 | Health and
shall furnish such hospital emergency services to | ||||||
24 | any applicant who applies
for the same in case of injury or |
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1 | acute medical condition where the same is
liable to cause death | ||||||
2 | or severe injury or serious illness.
For purposes of this Act, | ||||||
3 | "applicant" includes any person who is brought
to a hospital by | ||||||
4 | ambulance or specialized emergency medical services
vehicle as | ||||||
5 | defined in the Emergency Medical Services (EMS) Systems Act.
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6 | (Source: P.A. 97-667, eff. 1-13-12.)
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7 | (210 ILCS 80/1.3) | ||||||
8 | Sec. 1.3. Long-term acute care hospitals and | ||||||
9 | rehabilitation hospitals . For the purpose of this Act, general | ||||||
10 | acute care hospitals designated by Medicare as long-term acute | ||||||
11 | care hospitals and rehabilitation hospitals are not required to | ||||||
12 | provide hospital emergency services described in Section 1 of | ||||||
13 | this Act. Hospitals defined in this Section may provide | ||||||
14 | hospital emergency services at their option. | ||||||
15 | Any long-term acute care hospital defined in this Section | ||||||
16 | that opts to discontinue or otherwise not provide emergency | ||||||
17 | services described in Section 1 shall: | ||||||
18 | (1) comply with all provisions of the federal Emergency | ||||||
19 | Medical Treatment and & Labor Act (EMTALA); | ||||||
20 | (2) comply with all provisions required under the | ||||||
21 | Social Security Act; | ||||||
22 | (3) provide annual notice to communities in the | ||||||
23 | hospital's service area about available emergency medical | ||||||
24 | services; and | ||||||
25 | (4) make educational materials available to |
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1 | individuals who are present at the hospital concerning the | ||||||
2 | availability of medical services within the hospital's | ||||||
3 | service area. | ||||||
4 | Long-term acute care hospitals that operate standby | ||||||
5 | emergency services as of January 1, 2011 may discontinue | ||||||
6 | hospital emergency services by notifying the Department of | ||||||
7 | Public Health. Long-term acute care hospitals that operate | ||||||
8 | basic or comprehensive emergency services must notify the | ||||||
9 | Health Facilities and Services Review Board and follow the | ||||||
10 | appropriate procedures.
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11 | Any rehabilitation hospital that opts to discontinue or | ||||||
12 | otherwise not provide emergency services described in Section 1 | ||||||
13 | shall: | ||||||
14 | (1) comply with all provisions of the federal Emergency | ||||||
15 | Medical Treatment and Active Labor Act (EMTALA); | ||||||
16 | (2) comply with all provisions required under the | ||||||
17 | Social Security Act; | ||||||
18 | (3) provide annual notice to communities in the | ||||||
19 | hospital's service area about available emergency medical | ||||||
20 | services; | ||||||
21 | (4) make educational materials available to | ||||||
22 | individuals who are present at the hospital concerning the | ||||||
23 | availability of medical services within the hospital's | ||||||
24 | service area; | ||||||
25 | (5) not use the term "hospital" in its name or on any | ||||||
26 | signage; and |
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1 | (6) notify in writing the Department and the Health | ||||||
2 | Facilities and Services Review Board of the | ||||||
3 | discontinuation. | ||||||
4 | (Source: P.A. 97-667, eff. 1-13-12; revised 9-11-13.) | ||||||
5 | Section 5. The Hospital Licensing Act is amended by | ||||||
6 | changing Sections 5 and 6 and by adding Section 14.5 as | ||||||
7 | follows:
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8 | (210 ILCS 85/5) (from Ch. 111 1/2, par. 146)
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9 | Sec. 5.
(a) An application for a permit to establish a | ||||||
10 | hospital shall be
made to the Department upon forms provided by | ||||||
11 | it. This application shall
contain such information as the | ||||||
12 | Department reasonably requires, which shall
include | ||||||
13 | affirmative evidence on which the Director may make the | ||||||
14 | findings
required under Section 6a of this Act.
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15 | (b) An application for a license to open, conduct, operate, | ||||||
16 | and maintain
a hospital shall be made to the Department upon | ||||||
17 | forms provided by it , accompanied by a license fee of $55 per | ||||||
18 | bed, or such lesser amount as the Department may establish by | ||||||
19 | administrative rule in consultation with the Department of | ||||||
20 | Healthcare and Family Services to comply with the limitations | ||||||
21 | on health care-related taxes imposed by 42 U.S.C. 1396b(w) | ||||||
22 | that, if violated, would result in reductions to the amount of | ||||||
23 | federal financial participation received by the State for | ||||||
24 | Medicaid expenditures, and
shall contain such information as |
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1 | the Department reasonably requires, which
may include | ||||||
2 | affirmative evidence of ability to comply with the provisions
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3 | of this Act and the standards, rules, and regulations, | ||||||
4 | promulgated by
virtue thereof.
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5 | (c) All applications required under this Section shall be | ||||||
6 | signed by the
applicant and shall be verified. Applications on | ||||||
7 | behalf of a corporation or
association or a governmental unit | ||||||
8 | or agency shall be made and verified by
any two officers | ||||||
9 | thereof.
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10 | (Source: Laws 1965, p. 2350.)
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11 | (210 ILCS 85/6) (from Ch. 111 1/2, par. 147)
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12 | Sec. 6.
(a) Upon receipt of an application for a permit to | ||||||
13 | establish
a hospital the Director shall issue a permit if he | ||||||
14 | finds (1) that the
applicant is fit, willing, and able to | ||||||
15 | provide a proper standard of
hospital service for the community | ||||||
16 | with particular regard to the
qualification, background, and | ||||||
17 | character of the applicant, (2) that the
financial resources | ||||||
18 | available to the applicant demonstrate an ability to
construct, | ||||||
19 | maintain, and operate a hospital in accordance with the
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20 | standards, rules, and regulations adopted pursuant to this Act, | ||||||
21 | and (3)
that safeguards are provided which assure hospital | ||||||
22 | operation and
maintenance consistent with the public interest | ||||||
23 | having particular regard
to safe, adequate, and efficient | ||||||
24 | hospital facilities and services.
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25 | The Director may request the cooperation of county and
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1 | multiple-county health departments, municipal boards of | ||||||
2 | health, and
other governmental and non-governmental agencies | ||||||
3 | in obtaining
information and in conducting investigations | ||||||
4 | relating to such
applications.
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5 | A permit to establish a hospital shall be valid only for | ||||||
6 | the premises
and person named in the application for such | ||||||
7 | permit and shall not be
transferable or assignable.
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8 | In the event the Director issues a permit to establish a | ||||||
9 | hospital the
applicant shall thereafter submit plans and | ||||||
10 | specifications to the
Department in accordance with Section 8 | ||||||
11 | of this Act.
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12 | (b) Upon receipt of an application for license to open, | ||||||
13 | conduct,
operate, and maintain a hospital, the Director shall | ||||||
14 | issue a license if
he finds the applicant and the hospital | ||||||
15 | facilities comply with
standards, rules, and regulations | ||||||
16 | promulgated under this Act. A license,
unless sooner suspended | ||||||
17 | or revoked, shall be renewable annually upon
approval by the | ||||||
18 | Department and payment of a license fee as established pursuant | ||||||
19 | to Section 5 of this Act . Each license shall be issued only for | ||||||
20 | the
premises and persons named in the application and shall not | ||||||
21 | be
transferable or assignable. Licenses shall be posted in a | ||||||
22 | conspicuous
place on the licensed premises. The Department may, | ||||||
23 | either before or
after the issuance of a license, request the | ||||||
24 | cooperation of the State Fire
Marshal, county
and multiple | ||||||
25 | county health departments, or municipal boards of health to
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26 | make investigations to determine if the applicant or licensee |
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1 | is
complying with the minimum standards prescribed by the | ||||||
2 | Department. The
report and recommendations of any such agency | ||||||
3 | shall be in writing and
shall state with particularity its | ||||||
4 | findings with respect to compliance
or noncompliance with such | ||||||
5 | minimum standards, rules, and regulations.
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6 | The Director may issue a provisional license to any | ||||||
7 | hospital which
does not substantially comply with the | ||||||
8 | provisions of this Act and the
standards, rules, and | ||||||
9 | regulations promulgated by virtue thereof provided
that he | ||||||
10 | finds that such hospital has undertaken changes and corrections
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11 | which upon completion will render the hospital in substantial | ||||||
12 | compliance
with the provisions of this Act, and the standards, | ||||||
13 | rules, and
regulations adopted hereunder, and provided that the | ||||||
14 | health and safety
of the patients of the hospital will be | ||||||
15 | protected during the period for
which such provisional license | ||||||
16 | is issued. The Director shall advise the
licensee of the | ||||||
17 | conditions under which such provisional license is
issued, | ||||||
18 | including the manner in which the hospital facilities fail to
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19 | comply with the provisions of the Act, standards, rules, and
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20 | regulations, and the time within which the changes and | ||||||
21 | corrections
necessary for such hospital facilities to | ||||||
22 | substantially comply with this
Act, and the standards, rules, | ||||||
23 | and regulations of the Department
relating thereto shall be | ||||||
24 | completed.
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25 | (Source: P.A. 80-56.)
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1 | (210 ILCS 85/14.5 new) | ||||||
2 | Sec. 14.5. Hospital Licensure Fund. | ||||||
3 | (a) There is created in the State treasury the Hospital | ||||||
4 | Licensure Fund. The Fund is created for the purpose of | ||||||
5 | providing funding for the administration of the licensure | ||||||
6 | program and patient safety and quality initiatives for | ||||||
7 | hospitals, including, without limitation, the implementation | ||||||
8 | of the Illinois Adverse Health Care Events Reporting Law of | ||||||
9 | 2005. | ||||||
10 | (b) The Fund shall consist of the following: | ||||||
11 | (1) fees collected pursuant to this Section; | ||||||
12 | (2) federal matching funds received by the State as a | ||||||
13 | result of expenditures made by the Department that are | ||||||
14 | attributable to moneys deposited in the Fund; | ||||||
15 | (3) interest earned on moneys deposited in the Fund; | ||||||
16 | and | ||||||
17 | (4) other moneys received for the Fund from any other | ||||||
18 | source, including interest earned thereon. | ||||||
19 | (c) Disbursements from the Fund shall be made only for: | ||||||
20 | (1) initially, the implementation of the Illinois | ||||||
21 | Adverse Health Care Events Reporting Law of 2005; | ||||||
22 | (2) subsequently, programs, information, or | ||||||
23 | assistance, including measures to address public | ||||||
24 | complaints, designed to measurably improve quality and | ||||||
25 | patient safety; and | ||||||
26 | (3) the reimbursement of moneys collected by the |
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1 | Department through error or mistake. | ||||||
2 | (d) The uses described in paragraph (2) of subsection (c) | ||||||
3 | shall be developed in conjunction with a statewide organization | ||||||
4 | representing a majority of hospitals. | ||||||
5 | Section 8. The Illinois Adverse Health Care Events | ||||||
6 | Reporting Law of 2005 is amended by changing Sections 10-10 and | ||||||
7 | 10-15 as follows: | ||||||
8 | (410 ILCS 522/10-10)
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9 | Sec. 10-10. Definitions. As used in this Law, the following | ||||||
10 | terms have the following meanings: | ||||||
11 | "Adverse health care event" means any event identified as a | ||||||
12 | serious reportable event by the National Quality Forum and the | ||||||
13 | Centers for Medicare and Medicaid Services on the effective | ||||||
14 | date of this amendatory Act of the 98th General Assembly. The | ||||||
15 | Department shall adopt, by rule, the list of adverse health | ||||||
16 | care events. The rules in effect on May 1, 2013, that define | ||||||
17 | "adverse health care event" shall remain in effect until new | ||||||
18 | rules are adopted in accordance with this amendatory Act of the | ||||||
19 | 98th General Assembly. If the National Quality Forum or the | ||||||
20 | Centers for Medicare and Medicaid Services thereafter revises | ||||||
21 | its list of serious reportable events through addition, | ||||||
22 | deletion, or modification, then the term "adverse health care | ||||||
23 | event" for purposes of this Law shall be similarly revised, | ||||||
24 | effective no sooner than 6 months after the revision by the |
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1 | originating organization described in subsections (b) through | ||||||
2 | (g) of Section 10-15 . | ||||||
3 | "Department" means the Illinois Department of Public | ||||||
4 | Health. | ||||||
5 | "Health care facility" means a hospital maintained by the | ||||||
6 | State or any department or agency thereof where such department | ||||||
7 | or agency has authority under law to establish and enforce | ||||||
8 | standards for the hospital under its management and control, a | ||||||
9 | hospital maintained by any university or college established | ||||||
10 | under the laws of this State and supported principally by | ||||||
11 | public funds raised by taxation, a hospital licensed under the | ||||||
12 | Hospital Licensing Act, a hospital organized under the | ||||||
13 | University of Illinois Hospital Act, and an ambulatory surgical | ||||||
14 | treatment center licensed under the Ambulatory Surgical | ||||||
15 | Treatment Center Act.
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16 | (Source: P.A. 94-242, eff. 7-18-05.) | ||||||
17 | (410 ILCS 522/10-15)
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18 | Sec. 10-15. Health care facility requirements to report, | ||||||
19 | analyze, and correct. | ||||||
20 | (a) Reports of adverse health care events required. Each | ||||||
21 | health care facility shall report to the Department the | ||||||
22 | occurrence of any of the adverse health care events described | ||||||
23 | in subsections (b) through (g) no later than 30 days after | ||||||
24 | discovery of the event. The report shall be filed in a format | ||||||
25 | specified by the Department and shall identify the health care |
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1 | facility, but shall not include any information identifying or | ||||||
2 | that tends to identify any of the health care professionals, | ||||||
3 | employees, or patients involved. | ||||||
4 | (b) (Blank). Surgical events. Events reportable under this | ||||||
5 | subsection are: | ||||||
6 | (1) Surgery performed on a wrong body part that is not | ||||||
7 | consistent with the documented informed consent for that | ||||||
8 | patient. Reportable events under this clause do not include | ||||||
9 | situations requiring prompt action that occur in the course | ||||||
10 | of surgery or situations whose urgency precludes obtaining | ||||||
11 | informed consent. | ||||||
12 | (2) Surgery performed on the wrong patient. | ||||||
13 | (3) The wrong surgical procedure performed on a patient | ||||||
14 | that is not consistent with the documented informed consent | ||||||
15 | for that patient. Reportable events under this clause do | ||||||
16 | not include situations requiring prompt action that occur | ||||||
17 | in the course of surgery or situations whose urgency | ||||||
18 | precludes obtaining informed consent. | ||||||
19 | (4) Retention of a foreign object in a patient after | ||||||
20 | surgery or other procedure, excluding objects | ||||||
21 | intentionally implanted as part of a planned intervention | ||||||
22 | and objects present prior to surgery that are intentionally | ||||||
23 | retained. | ||||||
24 | (5) Death during or immediately after surgery of a | ||||||
25 | normal, healthy patient who has no organic, physiologic, | ||||||
26 | biochemical, or psychiatric disturbance and for whom the |
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1 | pathologic processes for which the operation is to be | ||||||
2 | performed are localized and do not entail a systemic | ||||||
3 | disturbance. | ||||||
4 | (c) (Blank). Product or device events. Events reportable | ||||||
5 | under this subsection are: | ||||||
6 | (1) Patient death or serious disability associated | ||||||
7 | with the use of contaminated drugs, devices, or biologics | ||||||
8 | provided by the health care facility when the contamination | ||||||
9 | is the result of generally detectable contaminants in | ||||||
10 | drugs, devices, or biologics regardless of the source of | ||||||
11 | the contamination or the product. | ||||||
12 | (2) Patient death or serious disability associated | ||||||
13 | with the use or function of a device in patient care in | ||||||
14 | which the device is used or functions other than as | ||||||
15 | intended. "Device" includes, but is not limited to, | ||||||
16 | catheters, drains, and other specialized tubes, infusion | ||||||
17 | pumps, and ventilators. | ||||||
18 | (3) Patient death or serious disability associated | ||||||
19 | with intravascular air embolism that occurs while being | ||||||
20 | cared for in a health care facility, excluding deaths | ||||||
21 | associated with neurosurgical procedures known to present | ||||||
22 | a high risk of intravascular air embolism. | ||||||
23 | (d) (Blank). Patient protection events. Events reportable | ||||||
24 | under this subsection are: | ||||||
25 | (1) An infant discharged to the wrong person. | ||||||
26 | (2) Patient death or serious disability associated |
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1 | with patient disappearance for more than 4 hours, excluding | ||||||
2 | events involving adults who have decision-making capacity. | ||||||
3 | (3) Patient suicide or attempted suicide resulting in | ||||||
4 | serious disability while being cared for in a health care | ||||||
5 | facility due to patient actions after admission to the | ||||||
6 | health care facility, excluding deaths resulting from | ||||||
7 | self-inflicted injuries that were the reason for admission | ||||||
8 | to the health care facility. | ||||||
9 | (e) (Blank). Care management events. Events reportable | ||||||
10 | under this subsection are: | ||||||
11 | (1) Patient death or serious disability associated | ||||||
12 | with a medication error, including, but not limited to, | ||||||
13 | errors involving the wrong drug, the wrong dose, the wrong | ||||||
14 | patient, the wrong time, the wrong rate, the wrong | ||||||
15 | preparation, or the wrong route of administration, | ||||||
16 | excluding reasonable differences in clinical judgment on | ||||||
17 | drug selection and dose. | ||||||
18 | (2) Patient death or serious disability associated | ||||||
19 | with a hemolytic reaction due to the administration of | ||||||
20 | ABO-incompatible blood or blood products. | ||||||
21 | (3) Maternal death or serious disability associated | ||||||
22 | with labor or delivery in a low-risk pregnancy while being | ||||||
23 | cared for in a health care facility, excluding deaths from | ||||||
24 | pulmonary or amniotic fluid embolism, acute fatty liver of | ||||||
25 | pregnancy, or cardiomyopathy. | ||||||
26 | (4) Patient death or serious disability directly |
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1 | related to hypoglycemia, the onset of which occurs while | ||||||
2 | the patient is being cared for in a health care facility | ||||||
3 | for a condition unrelated to hypoglycemia. | ||||||
4 | (f) (Blank). Environmental events. Events reportable under | ||||||
5 | this subsection are: | ||||||
6 | (1) Patient death or serious disability associated | ||||||
7 | with an electric shock while being cared for in a health | ||||||
8 | care facility, excluding events involving planned | ||||||
9 | treatments such as electric countershock.
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10 | (2) Any incident in which a line designated for oxygen | ||||||
11 | or other gas to be delivered to a patient contains the | ||||||
12 | wrong gas or is contaminated by toxic substances.
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13 | (3) Patient death or serious disability associated | ||||||
14 | with a burn incurred from any source while being cared for | ||||||
15 | in a health care facility that is not consistent with the | ||||||
16 | documented informed consent for that patient. Reportable | ||||||
17 | events under this clause do not include situations | ||||||
18 | requiring prompt action that occur in the course of surgery | ||||||
19 | or situations whose urgency precludes obtaining informed | ||||||
20 | consent.
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21 | (4) Patient death associated with a fall while being | ||||||
22 | cared for in a health care facility.
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23 | (5) Patient death or serious disability associated | ||||||
24 | with the use of restraints or bedrails while being cared | ||||||
25 | for in a health care facility. | ||||||
26 | (g) (Blank). Physical security events. Events reportable |
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1 | under this subsection are: | ||||||
2 | (1) Any instance of care ordered by or provided by | ||||||
3 | someone impersonating a physician, nurse, pharmacist, or | ||||||
4 | other licensed health care provider. | ||||||
5 | (2) Abduction of a patient of any age. | ||||||
6 | (3) Sexual assault on a patient within or on the | ||||||
7 | grounds of a health care facility. | ||||||
8 | (4) Death or significant injury of a patient or staff | ||||||
9 | member resulting from a physical assault that occurs within | ||||||
10 | or on the grounds of a health care facility. | ||||||
11 | (g-5) If the adverse health care events subject to this Law | ||||||
12 | are revised as described in Section 10-10, then the Department | ||||||
13 | shall provide notice to all affected health care facilities | ||||||
14 | promptly upon the revision and shall inform affected health | ||||||
15 | care facilities of the effective date of the revision for | ||||||
16 | purposes of reporting under this Law. | ||||||
17 | (h) Definitions. As pertains to an adverse health care | ||||||
18 | event used in this Section 10-15: | ||||||
19 |
"Death" means patient death related to an adverse event | ||||||
20 | and not related solely to the natural course of the patient's | ||||||
21 | illness or underlying condition. Events otherwise reportable | ||||||
22 | under this Section 10-15 shall be reported even if the death | ||||||
23 | might have otherwise occurred as the natural course of the | ||||||
24 | patient's illness or underlying condition. | ||||||
25 | "Serious disability" means a physical or mental | ||||||
26 | impairment, including loss of a body part, related to an |
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1 | adverse event and not related solely to the natural course of | ||||||
2 | the patient's illness or underlying condition, that | ||||||
3 | substantially limits one or more of the major life activities | ||||||
4 | of an individual or a loss of bodily function, if the | ||||||
5 | impairment or loss lasts more than 7 days prior to discharge or | ||||||
6 | is still present at the time of discharge from an inpatient | ||||||
7 | health care facility.
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8 | (Source: P.A. 94-242, eff. 7-18-05.) | ||||||
9 | Section 10. The State Finance Act is amended by adding | ||||||
10 | Section 5.855 as follows: | ||||||
11 | (30 ILCS 105/5.855 new) | ||||||
12 | Sec. 5.855. The Hospital Licensure Fund.
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13 | Section 99. Effective date. This Act takes effect upon | ||||||
14 | becoming law.".
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