Full Text of SB0026 94th General Assembly
SB0026eng 94TH GENERAL ASSEMBLY
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SB0026 Engrossed |
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LRB094 03673 DRJ 33678 b |
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| AN ACT concerning regulation.
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| WHEREAS, The General Assembly intends to provide one | 3 |
| standard definition of "hospice" by establishing minimum | 4 |
| standards for all providers of hospice care in Illinois; and | 5 |
| WHEREAS, The General Assembly does not intend to force any | 6 |
| volunteer hospice program out of business but instead intends | 7 |
| to bring such programs into compliance with certain minimum | 8 |
| standards applicable to all providers of hospice care in | 9 |
| Illinois; therefore | 10 |
| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Hospice Program Licensing Act is amended by | 13 |
| changing Sections 3, 4, 5, 8, and 9 and by adding Section 8.5 | 14 |
| as follows:
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| (210 ILCS 60/3) (from Ch. 111 1/2, par. 6103)
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| Sec. 3. Definitions. As used in this Act, unless the | 17 |
| context otherwise
requires:
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| (a) "Bereavement" means the period of time during which the | 19 |
| hospice
patient's family experiences and adjusts to the death | 20 |
| of the hospice patient.
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| (b) "Department" means the Illinois Department of Public | 22 |
| Health.
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| (c) "Director" means the Director of the Illinois | 24 |
| Department of Public
Health.
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| (d) " Hospice
Full hospice " means a coordinated program of | 26 |
| palliative care that provides for the physical, emotional, and | 27 |
| spiritual care needs of a terminally ill patient and his or her | 28 |
| family. The goal of such care is to achieve the highest quality | 29 |
| of life as defined by the patient and his or her family through | 30 |
| the relief of suffering and control of symptoms.
home and | 31 |
| inpatient care
providing directly, or through agreement, |
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| palliative and supportive medical,
health and other services to | 2 |
| terminally ill patients and their families.
A full hospice | 3 |
| utilizes a medically directed interdisciplinary hospice care
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| team of professionals and volunteers. The program provides care | 5 |
| to meet
the physical, psychological, social, spiritual and | 6 |
| other special needs which
are experienced during the final | 7 |
| stages of illness and during dying and
bereavement. Home care | 8 |
| is to be provided on a part-time, intermittent,
regularly | 9 |
| scheduled basis, and on an on-call around-the-clock basis
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| according to patient and family need.
To the maximum extent | 11 |
| possible, care shall be furnished in the patient's
home. Should | 12 |
| in-patient care be required, services are to be provided with
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| the intent of minimizing the length of such care and shall only | 14 |
| be provided
in a hospital licensed under the Hospital Licensing | 15 |
| Act, or a skilled nursing
facility licensed under the Nursing | 16 |
| Home Care Act.
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| (e) "Hospice care team" means an interdisciplinary working | 18 |
| unit composed
of but not limited to a physician licensed to | 19 |
| practice medicine in all of
its branches, a nurse licensed
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| pursuant to the Nursing and
Advanced Practice Nursing Act, a | 21 |
| social worker, a pastoral or
other
counselor, and trained
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| volunteers. The patient and the patient's family are considered | 23 |
| members of
the hospice care team when development or revision | 24 |
| of the patient's plan of
care takes place.
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| (f) "Hospice patient" means a terminally ill person | 26 |
| receiving hospice
services.
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| (g) "Hospice patient's family" means a hospice patient's | 28 |
| immediate family
consisting of a spouse, sibling, child, parent | 29 |
| and those individuals designated
as such by the patient for the | 30 |
| purposes of this Act.
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| (g-1) "Hospice residence" means a home, apartment | 32 |
| building, or similar
building providing living quarters:
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| (1) that is owned or operated by a person licensed to | 34 |
| operate as a full
hospice; and
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| (2) at which hospice services are provided to facility | 36 |
| residents.
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| A building that is licensed under the Hospital Licensing | 2 |
| Act or the Nursing
Home Care Act is not a hospice residence.
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| (h) "Hospice services" means palliative and supportive | 4 |
| care provided to
a hospice patient and his or her family to | 5 |
| meet the special need arising out of
the physical, emotional, | 6 |
| spiritual and social stresses which are experienced
during the | 7 |
| final stages of illness and during dying and bereavement. | 8 |
| Services
provided to the terminally ill patient shall be | 9 |
| furnished, to the maximum
extent possible, in the patient's | 10 |
| home. Should inpatient care be required,
services are to be | 11 |
| provided with the intent of minimizing the length of such
care.
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| (i) "Palliative care" means the management of pain and | 13 |
| other distressing symptoms that incorporates medical, nursing, | 14 |
| psychosocial, and spiritual care according to the needs, | 15 |
| values, beliefs, and culture or cultures of the patient and his | 16 |
| or her family. The evaluation and treatment is | 17 |
| patient-centered, with a focus on the central role of the | 18 |
| family unit in decision-making.
treatment to provide for the | 19 |
| reduction or
abatement of pain and other troubling symptoms, | 20 |
| rather than treatment aimed
at investigation and intervention | 21 |
| for the purpose of cure or inappropriate
prolongation of life.
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| (j) "Hospice service plan" means a plan detailing the | 23 |
| specific hospice
services offered by a full or volunteer
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| hospice, and the administrative
and direct care personnel | 25 |
| responsible for those services. The plan shall
include but not | 26 |
| be limited to:
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| (1) Identification of the person or persons | 28 |
| administratively responsible
for the program.
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| (2) The estimated average monthly patient census.
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| (3) The proposed geographic area the hospice will | 31 |
| serve.
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| (4) A listing of those hospice services provided | 33 |
| directly by the hospice,
and those hospice services | 34 |
| provided indirectly through a contractual agreement.
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| (5) The name and qualifications of those persons or | 36 |
| entities under
contract
to provide indirect hospice |
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| services.
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| (6) The name and qualifications of those persons | 3 |
| providing direct hospice
services, with the exception of | 4 |
| volunteers.
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| (7) A description of how the hospice plans to utilize | 6 |
| volunteers in the
provision of hospice services.
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| (8) A description of the program's record keeping | 8 |
| system.
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| (k) "Terminally ill" means a medical prognosis by a | 10 |
| physician licensed
to practice medicine in all of its branches | 11 |
| that a patient has an anticipated
life expectancy of one year | 12 |
| or less.
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| (l) "Volunteer" means a person who offers his or her | 14 |
| services to a hospice
without compensation. Reimbursement for a | 15 |
| volunteer's expenses in providing
hospice service shall not be | 16 |
| considered compensation.
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| (m) "Volunteer hospice" means a program which provides | 18 |
| hospice services
to patients regardless of their ability to | 19 |
| pay, with emphasis on the
utilization of volunteers to provide | 20 |
| services, under the administration of
a not-for-profit agency. | 21 |
| This definition does not prohibit the employment of
staff.
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| (Source: P.A. 93-319, eff. 7-23-03.)
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| (210 ILCS 60/4) (from Ch. 111 1/2, par. 6104)
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| Sec. 4. License.
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| (a) No person shall establish, conduct or maintain a
full | 26 |
| or volunteer hospice without first obtaining a license from the
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| Department. A hospice residence may be operated only at the | 28 |
| locations listed
on the license. A full hospice owning or | 29 |
| operating a hospice residence is not
subject to the provisions | 30 |
| of the Nursing Home Care Act in owning or operating a
hospice | 31 |
| residence.
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| (b) No public or private agency shall advertise or present | 33 |
| itself to the
public as a full or volunteer hospice which | 34 |
| provides hospice services without
meeting the provisions of | 35 |
| subsection (a).
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| (c) The license shall be valid only in the possession
of | 2 |
| the hospice to which it was originally issued and shall not be
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| transferred or assigned to any other person, agency, or | 4 |
| corporation.
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| (d) The license shall be renewed annually.
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| (e) The license shall be displayed in a conspicuous place | 7 |
| inside the hospice
program office.
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| (Source: P.A. 93-319, eff. 7-23-03.)
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| (210 ILCS 60/5) (from Ch. 111 1/2, par. 6105)
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| Sec. 5. Application for License. An application for license | 11 |
| or renewal
thereof to operate as a full or volunteer hospice | 12 |
| shall be made to the
Department upon forms provided by it, and | 13 |
| shall contain information
reasonably required by the | 14 |
| Department , taking into consideration the
different categories | 15 |
| of hospice programs . The application shall be accompanied by:
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| (1) The hospice service plan;
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| (2) A financial statement containing information deemed | 18 |
| appropriate by
the Department for the category of the | 19 |
| applicant; and
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| (3) A uniform license fee determined by the Department | 21 |
| based on the hospice
program's category .
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| (Source: P.A. 84-427.)
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| (210 ILCS 60/8) (from Ch. 111 1/2, par. 6108)
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| Sec. 8. General Requirements for Full Hospices. Hospices
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| Full hospices shall comply
with the following requirements of | 26 |
| this Act, including the standards adopted by the Department | 27 |
| under Section 9 .
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| (a) The hospice program's services shall include physician | 29 |
| services, nursing
services, medical social services, | 30 |
| counseling, and volunteer services.
These services shall be
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| coordinated with those of the hospice patient's primary or | 32 |
| attending physician.
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| (b) The hospice program shall coordinate its services with | 34 |
| professional
and nonprofessional services already in the |
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| community. The program may
contract out for elements of its | 2 |
| services; however, direct patient contact
and overall | 3 |
| coordination of hospice services shall be maintained by the
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| hospice care team. Any contract entered into between a hospice | 5 |
| and
a health care facility or service provider shall specify | 6 |
| that the hospice
retain the responsibility for planning and | 7 |
| coordinating hospice services
and care on behalf of a hospice | 8 |
| patient and his family. All contracts shall
be in compliance | 9 |
| with this Act. No hospice which contracts for any hospice
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| service shall charge fees for services provided directly by the | 11 |
| hospice
care team which duplicate contractual services | 12 |
| provided to the individual
patient or his family.
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| (c) The hospice care team shall be responsible for the | 14 |
| coordination of
home and inpatient care.
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| (d) The hospice program shall have a medical director who | 16 |
| shall be a physician
licensed to practice medicine in all of | 17 |
| its branches. The medical
director shall have overall | 18 |
| responsibility for medical direction of the
care and treatment | 19 |
| of patients and their families rendered by the hospice
care | 20 |
| team, and shall consult and cooperate with the patient's | 21 |
| attending physician.
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| (e) The hospice program shall have a bereavement program | 23 |
| which shall provide
a continuum of supportive services for the | 24 |
| family.
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| (f) The hospice program shall foster independence of the | 26 |
| patient and his
family by providing training, encouragement and | 27 |
| support so that the patient
and family can care for themselves | 28 |
| as much as possible.
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| (g) The hospice program shall not impose the dictates of | 30 |
| any value or
belief system on its patients and their families.
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| (h) The hospice program shall clearly define its admission | 32 |
| criteria.
Decisions on admissions shall be made by a hospice | 33 |
| care team and shall be
dependent upon the expressed request and | 34 |
| informed consent of the patient
or the patient's legal | 35 |
| guardian.
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| (i) The hospice program shall keep accurate, current and |
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| confidential
records on all hospice patients and their | 2 |
| families.
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| (j) The hospice program shall utilize the services of | 4 |
| trained volunteers.
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| (k) The hospice program shall consist of both home care and | 6 |
| inpatient
care which incorporates the following | 7 |
| characteristics:
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| (1) The home care component shall be the primary form of | 9 |
| care, and shall
be available on a part-time, intermittent, | 10 |
| regularly scheduled basis and
on an on-call around-the-clock | 11 |
| basis, according to patient and family need.
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| (2) The inpatient component shall primarily be used only | 13 |
| for short-term stays.
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| If possible, inpatient care should closely approximate a | 15 |
| home-like environment,
and provide overnight family visitation | 16 |
| within the facility.
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| (Source: P.A. 83-457.)
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| (210 ILCS 60/8.5 new)
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| Sec. 8.5. Volunteer hospice. The changes made by this | 20 |
| amendatory Act of the 94th General Assembly do not apply to a | 21 |
| volunteer hospice until July 1, 2006.
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| (210 ILCS 60/9) (from Ch. 111 1/2, par. 6109)
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| Sec. 9. Standards. The Department shall prescribe, by | 24 |
| regulation,
minimum standards for licensed hospice programs.
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| (a) (Blank).
The standards for full hospices shall
include | 26 |
| but not be limited to:
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| (1) Compliance with the requirements in Section 8.
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| (2) The number and qualifications of persons providing | 29 |
| direct hospice
services.
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| (3) The qualifications of those persons contracted | 31 |
| with to provide
indirect
hospice services.
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| (4) The palliative and supportive care and bereavement | 33 |
| counseling provided
to a hospice patient and his family.
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| (5) Hospice services provided on an inpatient basis.
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| (6) Utilization review of patient care.
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| (7) The quality of care provided to patients.
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| (8) Procedures for the accurate and centralized | 4 |
| maintenance of records
on hospice services provided to | 5 |
| patients and their families.
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| (9) The use of volunteers in the hospice program, and | 7 |
| the training of
those volunteers.
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| (10) The rights of the patient and the patient's | 9 |
| family.
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| (b)
The standards for volunteer hospice programs shall | 11 |
| include but not be
limited to:
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| (1) The direct and indirect services provided by the | 13 |
| hospice, including
the qualifications of personnel | 14 |
| providing medical care.
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| (2) Quality review of the services provided by the | 16 |
| hospice program.
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| (3) Procedures for the accurate and centralized | 18 |
| maintenance of records
on hospice services provided to | 19 |
| patients and their families.
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| (4) The rights of the patient and the patient's family.
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| (5) The use of volunteers in the hospice program.
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| (6) The disclosure to the patients of the range of | 23 |
| hospice services
provided and not provided by the hospice | 24 |
| program.
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| This subsection (b) is inoperative after June 30, 2006.
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| (c) The standards for hospices owning or operating hospice | 27 |
| residences
shall address the following:
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| (1) The safety, cleanliness, and general adequacy of | 29 |
| the premises,
including provision for maintenance of fire | 30 |
| and health standards that conform
to State laws and | 31 |
| municipal codes, to provide for the physical comfort,
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| well-being, care, and protection of the residents.
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| (2) Provisions and criteria for admission, discharge, | 34 |
| and transfer of
residents.
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| (3) Fee and other contractual agreements with | 36 |
| residents.
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| (4) Medical and supportive services for residents.
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| (5) Maintenance of records and residents' right of | 3 |
| access of those
records.
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| (6) Procedures for reporting abuse or neglect of | 5 |
| residents.
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| (7) The number of persons who may be served in a | 7 |
| residence, which shall
not exceed 16 persons per location.
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| (8) The ownership, operation, and maintenance of | 9 |
| buildings containing a
hospice residence.
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| (9) The number of licensed hospice residences
shall not | 11 |
| exceed 6 before December
31, 1996 and shall not exceed 12 | 12 |
| before December 31, 1997. The Department
shall conduct a | 13 |
| study of the benefits of hospice residences and make a
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| recommendation to the General Assembly as to the need to | 15 |
| limit the number of
hospice residences after June 30, 1997.
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| (d) A hospice program must meet the minimum standards for | 17 |
| certification under the Medicare program and set forth in the | 18 |
| Conditions of Participation under 42 CFR Part 418.
In | 19 |
| developing the standards for hospices, the Department shall | 20 |
| take
into consideration the category of the hospice programs.
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| (Source: P.A. 89-278, eff. 8-10-95.)
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| Section 99. Effective date. This Act takes effect July 1, | 23 |
| 2005.
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