Illinois General Assembly - Full Text of HB4674
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Full Text of HB4674  102nd General Assembly




HB4674 EnrolledLRB102 23801 CPF 32992 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 Nursing Home Care Act is amended by
5changing Sections 3-212 and 3-702 as follows:
6    (210 ILCS 45/3-212)  (from Ch. 111 1/2, par. 4153-212)
7    Sec. 3-212. Inspection.
8    (a) The Department, whenever it deems necessary in
9accordance with subsection (b), shall inspect, survey and
10evaluate every facility to determine compliance with
11applicable licensure requirements and standards. Submission of
12a facility's current Consumer Choice Information Report
13required by Section 2-214 shall be verified at time of
14inspection. An inspection should occur within 120 days prior
15to license renewal. The Department may periodically visit a
16facility for the purpose of consultation. An inspection,
17survey, or evaluation, other than an inspection of financial
18records, shall be conducted without prior notice to the
19facility. A visit for the sole purpose of consultation may be
20announced. The Department shall provide training to surveyors
21about the appropriate assessment, care planning, and care of
22persons with mental illness (other than Alzheimer's disease or
23related disorders) to enable its surveyors to determine



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1whether a facility is complying with State and federal
2requirements about the assessment, care planning, and care of
3those persons.
4    (a-1) An employee of a State or unit of local government
5agency charged with inspecting, surveying, and evaluating
6facilities who directly or indirectly gives prior notice of an
7inspection, survey, or evaluation, other than an inspection of
8financial records, to a facility or to an employee of a
9facility is guilty of a Class A misdemeanor.
10    An inspector or an employee of the Department who
11intentionally prenotifies a facility, orally or in writing, of
12a pending complaint investigation or inspection shall be
13guilty of a Class A misdemeanor. Superiors of persons who have
14prenotified a facility shall be subject to the same penalties,
15if they have knowingly allowed the prenotification. A person
16found guilty of prenotifying a facility shall be subject to
17disciplinary action by his or her employer.
18    If the Department has a good faith belief, based upon
19information that comes to its attention, that a violation of
20this subsection has occurred, it must file a complaint with
21the Attorney General or the State's Attorney in the county
22where the violation took place within 30 days after discovery
23of the information.
24    (a-2) An employee of a State or unit of local government
25agency charged with inspecting, surveying, or evaluating
26facilities who willfully profits from violating the



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1confidentiality of the inspection, survey, or evaluation
2process shall be guilty of a Class 4 felony and that conduct
3shall be deemed unprofessional conduct that may subject a
4person to loss of his or her professional license. An action to
5prosecute a person for violating this subsection (a-2) may be
6brought by either the Attorney General or the State's Attorney
7in the county where the violation took place.
8    (a-3) The Department shall, by rule, establish guidelines
9for required continuing education of all employees who
10inspect, survey, or evaluate a facility. The Department shall
11offer continuing education opportunities at least quarterly.
12Employees of a State agency charged with inspecting,
13surveying, or evaluating a facility are required to complete
14at least 10 hours of continuing education annually on topics
15that support the survey process, including, but not limited
16to, trauma-informed care, infection control, abuse and
17neglect, and civil monetary penalties. Qualifying hours of
18continuing education intended to fulfill the requirements of
19this subsection shall only be offered by the Department.
20Content presented during the continuing education shall be
21consistent throughout the State, regardless of survey region.
22At least 5 of the 10 hours of continuing education required
23under this subsection shall be separate and distinct from any
24continuing education hours required for any license that the
25employee holds. Any continuing education hours provided by the
26Department in addition to the 10 hours of continuing education



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1required under this subsection may count towards continuing
2education hours required for any license that the employee
4    (b) In determining whether to make more than the required
5number of unannounced inspections, surveys and evaluations of
6a facility the Department shall consider one or more of the
7following: previous inspection reports; the facility's history
8of compliance with standards, rules and regulations
9promulgated under this Act and correction of violations,
10penalties or other enforcement actions; the number and
11severity of complaints received about the facility; any
12allegations of resident abuse or neglect; weather conditions;
13health emergencies; other reasonable belief that deficiencies
15    (b-1) The Department shall not be required to determine
16whether a facility certified to participate in the Medicare
17program under Title XVIII of the Social Security Act, or the
18Medicaid program under Title XIX of the Social Security Act,
19and which the Department determines by inspection under this
20Section or under Section 3-702 of this Act to be in compliance
21with the certification requirements of Title XVIII or XIX, is
22in compliance with any requirement of this Act that is less
23stringent than or duplicates a federal certification
24requirement. In accordance with subsection (a) of this Section
25or subsection (d) of Section 3-702, the Department shall
26determine whether a certified facility is in compliance with



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1requirements of this Act that exceed federal certification
2requirements. If a certified facility is found to be out of
3compliance with federal certification requirements, the
4results of an inspection conducted pursuant to Title XVIII or
5XIX of the Social Security Act may be used as the basis for
6enforcement remedies authorized and commenced, with the
7Department's discretion to evaluate whether penalties are
8warranted, under this Act. Enforcement of this Act against a
9certified facility shall be commenced pursuant to the
10requirements of this Act, unless enforcement remedies sought
11pursuant to Title XVIII or XIX of the Social Security Act
12exceed those authorized by this Act. As used in this
13subsection, "enforcement remedy" means a sanction for
14violating a federal certification requirement or this Act.
15    (c) Upon completion of each inspection, survey and
16evaluation, the appropriate Department personnel who conducted
17the inspection, survey or evaluation shall submit a physical
18or electronic copy of their report to the licensee upon
19exiting the facility, and shall submit the actual report to
20the appropriate regional office of the Department. Such report
21and any recommendations for action by the Department under
22this Act shall be transmitted to the appropriate offices of
23the associate director of the Department, together with
24related comments or documentation provided by the licensee
25which may refute findings in the report, which explain
26extenuating circumstances that the facility could not



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1reasonably have prevented, or which indicate methods and
2timetables for correction of deficiencies described in the
3report. Without affecting the application of subsection (a) of
4Section 3-303, any documentation or comments of the licensee
5shall be provided within 10 days of receipt of the copy of the
6report. Such report shall recommend to the Director
7appropriate action under this Act with respect to findings
8against a facility. The Director shall then determine whether
9the report's findings constitute a violation or violations of
10which the facility must be given notice. Such determination
11shall be based upon the severity of the finding, the danger
12posed to resident health and safety, the comments and
13documentation provided by the facility, the diligence and
14efforts to correct deficiencies, correction of the reported
15deficiencies, the frequency and duration of similar findings
16in previous reports and the facility's general inspection
17history. Violations shall be determined under this subsection
18no later than 75 days after completion of each inspection,
19survey and evaluation.
20    (d) The Department shall maintain all inspection, survey
21and evaluation reports for at least 5 years in a manner
22accessible to and understandable by the public.
23    (e) Revisit surveys. The Department shall conduct a
24revisit to its licensure and certification surveys, consistent
25with federal regulations and guidelines.
26    (f) Notwithstanding any other provision of this Act, the



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1Department shall, no later than 180 days after the effective
2date of this amendatory Act of the 98th General Assembly,
3implement a single survey process that encompasses federal
4certification and State licensure requirements, health and
5life safety requirements, and an enhanced complaint
6investigation 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.)
3    (210 ILCS 45/3-702)  (from Ch. 111 1/2, par. 4153-702)
4    Sec. 3-702. (a) A person who believes that this Act or a
5rule promulgated under this Act may have been violated may
6request an investigation. The request may be submitted to the
7Department in writing, by telephone, by electronic means, or
8by personal visit. An oral complaint shall be reduced to
9writing by the Department. The Department shall make
10available, through its website and upon request, information
11regarding the oral and phone intake processes and the list of
12questions that will be asked of the complainant. The
13Department shall request information identifying the
14complainant, including the name, address and telephone number,
15to help enable appropriate follow-up. The Department shall act
16on such complaints via on-site visits or other methods deemed
17appropriate to handle the complaints with or without such
18identifying information, as otherwise provided under this
19Section. The complainant shall be informed that compliance
20with such request is not required to satisfy the procedures
21for filing a complaint under this Act. The Department must
22notify complainants that complaints with less information
23provided are far more difficult to respond to and investigate.
24    (b) The substance of the complaint shall be provided in
25writing to the licensee, owner, or administrator no earlier



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1than at the commencement of an on-site inspection of the
2facility which takes place pursuant to the complaint.
3    (c) The Department shall not disclose the name of the
4complainant unless the complainant consents in writing to the
5disclosure or the investigation results in a judicial
6proceeding, or unless disclosure is essential to the
7investigation. The complainant shall be given the opportunity
8to withdraw the complaint before disclosure. Upon the request
9of the complainant, the Department may permit the complainant
10or a representative of the complainant to accompany the person
11making the on-site inspection of the facility.
12    (d) Upon receipt of a complaint, the Department shall
13determine whether this Act or a rule promulgated under this
14Act has been or is being violated. The Department shall
15investigate all complaints alleging abuse or neglect within 7
16days after the receipt of the complaint except that complaints
17of abuse or neglect which indicate that a resident's life or
18safety is in imminent danger shall be investigated within 24
19hours after receipt of the complaint. All other complaints
20shall be investigated within 30 days after the receipt of the
21complaint. The Department employees investigating a complaint
22shall conduct a brief, informal exit conference with the
23facility to alert its administration of any suspected serious
24deficiency that poses a direct threat to the health, safety or
25welfare of a resident to enable an immediate correction for
26the alleviation or elimination of such threat. Such



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1information and findings discussed in the brief exit
2conference shall become a part of the investigating record but
3shall not in any way constitute an official or final notice of
4violation as provided under Section 3-301. All complaints
5shall be classified as "an invalid report", "a valid report",
6or "an undetermined report". For any complaint classified as
7"a valid report", the Department must determine within 30
8working days after any Department employee enters a facility
9to begin an on-site inspection if any rule or provision of this
10Act has been or is being violated.
11    (d-1) The Department shall, whenever possible, combine an
12on-site investigation of a complaint in a facility with other
13inspections in order to avoid duplication of inspections.
14    (e) In all cases, the Department shall inform the
15complainant of its findings within 10 days of its
16determination unless otherwise indicated by the complainant,
17and the complainant may direct the Department to send a copy of
18such findings to another person. The Department's findings may
19include comments or documentation provided by either the
20complainant or the licensee pertaining to the complaint. The
21Department shall also notify the facility of such findings
22within 10 days of the determination, but the name of the
23complainant or residents shall not be disclosed in this notice
24to the facility. The notice of such findings shall include a
25copy of the written determination; the correction order, if
26any; the warning notice, if any; the inspection report; or the



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1State licensure form on which the violation is listed.
2    (f) A written determination, correction order, or warning
3notice concerning a complaint, together with the facility's
4response, shall be available for public inspection, but the
5name of the complainant or resident shall not be disclosed
6without his consent.
7    (g) A complainant who is dissatisfied with the
8determination or investigation by the Department may request a
9hearing under Section 3-703. The facility shall be given
10notice of any such hearing and may participate in the hearing
11as a party. If a facility requests a hearing under Section
123-703 which concerns a matter covered by a complaint, the
13complainant shall be given notice and may participate in the
14hearing as a party. A request for a hearing by either a
15complainant or a facility shall be submitted in writing to the
16Department within 30 days after the mailing of the
17Department's findings as described in subsection (e) of this
18Section. Upon receipt of the request the Department shall
19conduct a hearing as provided under Section 3-703.
20    (g-5) The Department shall conduct an annual review of all
21survey activity from the preceding fiscal year and make a
22report concerning the complaint and survey process. The report
23shall include, but not be limited to: that includes the total
24number of complaints received; the breakdown of 24-hour,
257-day, and 30-day complaints; , the breakdown of anonymous and
26non-anonymous complaints; and whether the number of complaints



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1that were substantiated versus unsubstantiated; or not, the
2total number of substantiated complaints that were completed
3in the time frame determined under subsection (d); the total
4number of informal dispute resolutions requested; the total
5number of informal dispute resolution requests approved; the
6total number of informal dispute resolutions that were
7overturned or reduced in severity; the total number of nurse
8surveyors hired during the calendar year; the total number of
9nurse surveyors who left Department employment; the average
10length of tenure for nurse surveyors employed by the
11Department at the time the report is created; the total number
12of times the Department imposed discretionary denial of
13payment within 15 days of notice and within 2 days of notice as
14well as the number of times the discretionary denial of
15payment took effect; , and any other complaint information
16requested by the Long-Term Care Facility Advisory Board
17created under Section 2-204 of this Act or the Illinois
18Long-Term Care Council created under Section 4.04a of the
19Illinois Act on the Aging. This report shall be provided to the
20Long-Term Care Facility Advisory Board, the Illinois Long-Term
21Care Council, and the General Assembly. The Long-Term Care
22Facility Advisory Board and the Illinois Long-Term Care
23Council shall review the report and suggest any changes deemed
24necessary to the Department for review and action, including
25how to investigate and substantiate anonymous complaints.
26    (h) Any person who knowingly transmits a false report to



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1the Department commits the offense of disorderly conduct under
2subsection (a)(8) of Section 26-1 of the Criminal Code of
4(Source: P.A. 102-432, eff. 8-20-21.)