State of Illinois
2015 and 2016


Introduced , by Rep. Pamela Reaves-Harris


20 ILCS 3960/3  from Ch. 111 1/2, par. 1153
210 ILCS 85/4  from Ch. 111 1/2, par. 145

    Amends the Illinois Health Facilities Planning Act. Provides that the term "health care facilities" does not include a facility licensed as a hospital under the Hospital Licensing Act that reopens under new ownership at the same location within 36 months of the facility's closure. Amends the Hospital Licensing Act. Provides that any hospital that has closed for any reason, except for license revocation by the Department of Public Health for failure to comply with the Act, may reopen under new ownership or management, or both, within 3 years of its closing date without reapplying for a license under the Act if the facility is reopening at the same location and in the same physical structure. Effective immediately.

LRB099 10152 RPS 30375 b






HB3222LRB099 10152 RPS 30375 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 Illinois Health Facilities Planning Act is
5amended by changing Section 3 as follows:
6    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 3. Definitions. As used in this Act:
9    "Health care facilities" means and includes the following
10facilities, organizations, and related persons:
11        (1) An ambulatory surgical treatment center required
12    to be licensed pursuant to the Ambulatory Surgical
13    Treatment Center Act.
14        (2) An institution, place, building, or agency
15    required to be licensed pursuant to the Hospital Licensing
16    Act.
17        (3) Skilled and intermediate long term care facilities
18    licensed under the Nursing Home Care Act.
19            (A) If a demonstration project under the Nursing
20        Home Care Act applies for a certificate of need to
21        convert to a nursing facility, it shall meet the
22        licensure and certificate of need requirements in
23        effect as of the date of application.



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1            (B) Except as provided in item (A) of this
2        subsection, this Act does not apply to facilities
3        granted waivers under Section 3-102.2 of the Nursing
4        Home Care Act.
5        (3.5) Skilled and intermediate care facilities
6    licensed under the ID/DD Community Care Act. (A) No permit
7    or exemption is required for a facility licensed under the
8    ID/DD Community Care Act prior to the reduction of the
9    number of beds at a facility. If there is a total reduction
10    of beds at a facility licensed under the ID/DD Community
11    Care Act, this is a discontinuation or closure of the
12    facility. If a facility licensed under the ID/DD Community
13    Care Act reduces the number of beds or discontinues the
14    facility, that facility must notify the Board as provided
15    in Section 14.1 of this Act.
16        (3.7) Facilities licensed under the Specialized Mental
17    Health Rehabilitation Act of 2013.
18        (4) Hospitals, nursing homes, ambulatory surgical
19    treatment centers, or kidney disease treatment centers
20    maintained by the State or any department or agency
21    thereof.
22        (5) Kidney disease treatment centers, including a
23    free-standing hemodialysis unit required to be licensed
24    under the End Stage Renal Disease Facility Act.
25            (A) This Act does not apply to a dialysis facility
26        that provides only dialysis training, support, and



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1        related services to individuals with end stage renal
2        disease who have elected to receive home dialysis.
3            (B) This Act does not apply to a dialysis unit
4        located in a licensed nursing home that offers or
5        provides dialysis-related services to residents with
6        end stage renal disease who have elected to receive
7        home dialysis within the nursing home.
8            (C) The Board, however, may require dialysis
9        facilities and licensed nursing homes under items (A)
10        and (B) of this subsection to report statistical
11        information on a quarterly basis to the Board to be
12        used by the Board to conduct analyses on the need for
13        proposed kidney disease treatment centers.
14        (6) An institution, place, building, or room used for
15    the performance of outpatient surgical procedures that is
16    leased, owned, or operated by or on behalf of an
17    out-of-state facility.
18        (7) An institution, place, building, or room used for
19    provision of a health care category of service, including,
20    but not limited to, cardiac catheterization and open heart
21    surgery.
22        (8) An institution, place, building, or room housing
23    major medical equipment used in the direct clinical
24    diagnosis or treatment of patients, and whose project cost
25    is in excess of the capital expenditure minimum.
26    "Health care facilities" does not include the following



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1entities or facility transactions:
2        (1) Federally-owned facilities.
3        (2) Facilities used solely for healing by prayer or
4    spiritual means.
5        (3) An existing facility located on any campus facility
6    as defined in Section 5-5.8b of the Illinois Public Aid
7    Code, provided that the campus facility encompasses 30 or
8    more contiguous acres and that the new or renovated
9    facility is intended for use by a licensed residential
10    facility.
11        (4) Facilities licensed under the Supportive
12    Residences Licensing Act or the Assisted Living and Shared
13    Housing Act.
14        (5) Facilities designated as supportive living
15    facilities that are in good standing with the program
16    established under Section 5-5.01a of the Illinois Public
17    Aid Code.
18        (6) Facilities established and operating under the
19    Alternative Health Care Delivery Act as a children's
20    community-based health care center children's respite care
21    center alternative health care model demonstration program
22    or as an Alzheimer's Disease Management Center alternative
23    health care model demonstration program.
24        (7) The closure of an entity or a portion of an entity
25    licensed under the Nursing Home Care Act, the Specialized
26    Mental Health Rehabilitation Act of 2013, or the ID/DD



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1    Community Care Act, with the exception of facilities
2    operated by a county or Illinois Veterans Homes, that elect
3    to convert, in whole or in part, to an assisted living or
4    shared housing establishment licensed under the Assisted
5    Living and Shared Housing Act and with the exception of a
6    facility licensed under the Specialized Mental Health
7    Rehabilitation Act of 2013 in connection with a proposal to
8    close a facility and re-establish the facility in another
9    location.
10        (8) Any change of ownership of a health care healthcare
11    facility that is licensed under the Nursing Home Care Act,
12    the Specialized Mental Health Rehabilitation Act of 2013,
13    or the ID/DD Community Care Act, with the exception of
14    facilities operated by a county or Illinois Veterans Homes.
15    Changes of ownership of facilities licensed under the
16    Nursing Home Care Act must meet the requirements set forth
17    in Sections 3-101 through 3-119 of the Nursing Home Care
18    Act. children's community-based health care center of 2013
19    and with the exception of a facility licensed under the
20    Specialized Mental Health Rehabilitation Act of 2013 in
21    connection with a proposal to close a facility and
22    re-establish the facility in another location of 2013
23        (9) Any facility licensed as a hospital under the
24    Hospital Licensing Act that reopens under new ownership at
25    the same location within 36 months of the facility's
26    closure.



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1    With the exception of those health care facilities
2specifically included in this Section, nothing in this Act
3shall be intended to include facilities operated as a part of
4the practice of a physician or other licensed health care
5professional, whether practicing in his individual capacity or
6within the legal structure of any partnership, medical or
7professional corporation, or unincorporated medical or
8professional group. Further, this Act shall not apply to
9physicians or other licensed health care professional's
10practices where such practices are carried out in a portion of
11a health care facility under contract with such health care
12facility by a physician or by other licensed health care
13professionals, whether practicing in his individual capacity
14or within the legal structure of any partnership, medical or
15professional corporation, or unincorporated medical or
16professional groups, unless the entity constructs, modifies,
17or establishes a health care facility as specifically defined
18in this Section. This Act shall apply to construction or
19modification and to establishment by such health care facility
20of such contracted portion which is subject to facility
21licensing requirements, irrespective of the party responsible
22for such action or attendant financial obligation.
23    "Person" means any one or more natural persons, legal
24entities, governmental bodies other than federal, or any
25combination thereof.
26    "Consumer" means any person other than a person (a) whose



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1major occupation currently involves or whose official capacity
2within the last 12 months has involved the providing,
3administering or financing of any type of health care facility,
4(b) who is engaged in health research or the teaching of
5health, (c) who has a material financial interest in any
6activity which involves the providing, administering or
7financing of any type of health care facility, or (d) who is or
8ever has been a member of the immediate family of the person
9defined by (a), (b), or (c).
10    "State Board" or "Board" means the Health Facilities and
11Services Review Board.
12    "Construction or modification" means the establishment,
13erection, building, alteration, reconstruction, modernization,
14improvement, extension, discontinuation, change of ownership,
15of or by a health care facility, or the purchase or acquisition
16by or through a health care facility of equipment or service
17for diagnostic or therapeutic purposes or for facility
18administration or operation, or any capital expenditure made by
19or on behalf of a health care facility which exceeds the
20capital expenditure minimum; however, any capital expenditure
21made by or on behalf of a health care facility for (i) the
22construction or modification of a facility licensed under the
23Assisted Living and Shared Housing Act or (ii) a conversion
24project undertaken in accordance with Section 30 of the Older
25Adult Services Act shall be excluded from any obligations under
26this Act.



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1    "Establish" means the construction of a health care
2facility or the replacement of an existing facility on another
3site or the initiation of a category of service.
4    "Major medical equipment" means medical equipment which is
5used for the provision of medical and other health services and
6which costs in excess of the capital expenditure minimum,
7except that such term does not include medical equipment
8acquired by or on behalf of a clinical laboratory to provide
9clinical laboratory services if the clinical laboratory is
10independent of a physician's office and a hospital and it has
11been determined under Title XVIII of the Social Security Act to
12meet the requirements of paragraphs (10) and (11) of Section
131861(s) of such Act. In determining whether medical equipment
14has a value in excess of the capital expenditure minimum, the
15value of studies, surveys, designs, plans, working drawings,
16specifications, and other activities essential to the
17acquisition of such equipment shall be included.
18    "Capital Expenditure" means an expenditure: (A) made by or
19on behalf of a health care facility (as such a facility is
20defined in this Act); and (B) which under generally accepted
21accounting principles is not properly chargeable as an expense
22of operation and maintenance, or is made to obtain by lease or
23comparable arrangement any facility or part thereof or any
24equipment for a facility or part; and which exceeds the capital
25expenditure minimum.
26    For the purpose of this paragraph, the cost of any studies,



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1surveys, designs, plans, working drawings, specifications, and
2other activities essential to the acquisition, improvement,
3expansion, or replacement of any plant or equipment with
4respect to which an expenditure is made shall be included in
5determining if such expenditure exceeds the capital
6expenditures minimum. Unless otherwise interdependent, or
7submitted as one project by the applicant, components of
8construction or modification undertaken by means of a single
9construction contract or financed through the issuance of a
10single debt instrument shall not be grouped together as one
11project. Donations of equipment or facilities to a health care
12facility which if acquired directly by such facility would be
13subject to review under this Act shall be considered capital
14expenditures, and a transfer of equipment or facilities for
15less than fair market value shall be considered a capital
16expenditure for purposes of this Act if a transfer of the
17equipment or facilities at fair market value would be subject
18to review.
19    "Capital expenditure minimum" means $11,500,000 for
20projects by hospital applicants, $6,500,000 for applicants for
21projects related to skilled and intermediate care long-term
22care facilities licensed under the Nursing Home Care Act, and
23$3,000,000 for projects by all other applicants, which shall be
24annually adjusted to reflect the increase in construction costs
25due to inflation, for major medical equipment and for all other
26capital expenditures.



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1    "Non-clinical service area" means an area (i) for the
2benefit of the patients, visitors, staff, or employees of a
3health care facility and (ii) not directly related to the
4diagnosis, treatment, or rehabilitation of persons receiving
5services from the health care facility. "Non-clinical service
6areas" include, but are not limited to, chapels; gift shops;
7news stands; computer systems; tunnels, walkways, and
8elevators; telephone systems; projects to comply with life
9safety codes; educational facilities; student housing;
10patient, employee, staff, and visitor dining areas;
11administration and volunteer offices; modernization of
12structural components (such as roof replacement and masonry
13work); boiler repair or replacement; vehicle maintenance and
14storage facilities; parking facilities; mechanical systems for
15heating, ventilation, and air conditioning; loading docks; and
16repair or replacement of carpeting, tile, wall coverings,
17window coverings or treatments, or furniture. Solely for the
18purpose of this definition, "non-clinical service area" does
19not include health and fitness centers.
20    "Areawide" means a major area of the State delineated on a
21geographic, demographic, and functional basis for health
22planning and for health service and having within it one or
23more local areas for health planning and health service. The
24term "region", as contrasted with the term "subregion", and the
25word "area" may be used synonymously with the term "areawide".
26    "Local" means a subarea of a delineated major area that on



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1a geographic, demographic, and functional basis may be
2considered to be part of such major area. The term "subregion"
3may be used synonymously with the term "local".
4    "Physician" means a person licensed to practice in
5accordance with the Medical Practice Act of 1987, as amended.
6    "Licensed health care professional" means a person
7licensed to practice a health profession under pertinent
8licensing statutes of the State of Illinois.
9    "Director" means the Director of the Illinois Department of
10Public Health.
11    "Agency" means the Illinois Department of Public Health.
12    "Alternative health care model" means a facility or program
13authorized under the Alternative Health Care Delivery Act.
14    "Out-of-state facility" means a person that is both (i)
15licensed as a hospital or as an ambulatory surgery center under
16the laws of another state or that qualifies as a hospital or an
17ambulatory surgery center under regulations adopted pursuant
18to the Social Security Act and (ii) not licensed under the
19Ambulatory Surgical Treatment Center Act, the Hospital
20Licensing Act, or the Nursing Home Care Act. Affiliates of
21out-of-state facilities shall be considered out-of-state
22facilities. Affiliates of Illinois licensed health care
23facilities 100% owned by an Illinois licensed health care
24facility, its parent, or Illinois physicians licensed to
25practice medicine in all its branches shall not be considered
26out-of-state facilities. Nothing in this definition shall be



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1construed to include an office or any part of an office of a
2physician licensed to practice medicine in all its branches in
3Illinois that is not required to be licensed under the
4Ambulatory Surgical Treatment Center Act.
5    "Change of ownership of a health care facility" means a
6change in the person who has ownership or control of a health
7care facility's physical plant and capital assets. A change in
8ownership is indicated by the following transactions: sale,
9transfer, acquisition, lease, change of sponsorship, or other
10means of transferring control.
11    "Related person" means any person that: (i) is at least 50%
12owned, directly or indirectly, by either the health care
13facility or a person owning, directly or indirectly, at least
1450% of the health care facility; or (ii) owns, directly or
15indirectly, at least 50% of the health care facility.
16    "Charity care" means care provided by a health care
17facility for which the provider does not expect to receive
18payment from the patient or a third-party payer.
19    "Freestanding emergency center" means a facility subject
20to licensure under Section 32.5 of the Emergency Medical
21Services (EMS) Systems Act.
22    "Category of service" means a grouping by generic class of
23various types or levels of support functions, equipment, care,
24or treatment provided to patients or residents, including, but
25not limited to, classes such as medical-surgical, pediatrics,
26or cardiac catheterization. A category of service may include



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1subcategories or levels of care that identify a particular
2degree or type of care within the category of service. Nothing
3in this definition shall be construed to include the practice
4of a physician or other licensed health care professional while
5functioning in an office providing for the care, diagnosis, or
6treatment of patients. A category of service that is subject to
7the Board's jurisdiction must be designated in rules adopted by
8the Board.
9    "State Board Staff Report" means the document that sets
10forth the review and findings of the State Board staff, as
11prescribed by the State Board, regarding applications subject
12to Board jurisdiction.
13(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813,
14eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14;
1598-629, eff. 1-1-15; 98-651, eff. 6-16-14; 98-1086, eff.
168-26-14; revised 10-22-14.)
17    Section 10. The Hospital Licensing Act is amended by
18changing Section 4 as follows:
19    (210 ILCS 85/4)  (from Ch. 111 1/2, par. 145)
20    Sec. 4. No person shall establish a hospital without first
21obtaining a permit from the Department and no person shall
22open, conduct, operate, or maintain a hospital without first
23obtaining a license from the Department.
24    Any hospital that has closed for any reason, except for



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1license revocation by the Department for failure to comply with
2this Act, may reopen under new ownership or management, or
3both, within 3 years of the hospital's closing date without
4reapplying for a license under this Act if the hospital is
5reopening at the same location and in the same physical
7    Nothing in this Act shall be construed to impair or abridge
8the power of municipalities to license and regulate hospitals,
9provided that the municipal ordinance substantially complies
10with the minimum standards and regulations developed by the
11Department pursuant to the provisions of this Act. Such
12compliance shall be determined by the Department subject to
13review as provided in Section 13 of this Act. Section 13 of
14this Act shall also be applicable to the judicial review of
15final administrative decisions of the regulatory agency of the
16municipality. Any municipality having an ordinance licensing
17and regulating hospitals which provides for minimum standards
18and regulations substantially in compliance with those
19developed pursuant to this Act shall make such periodic reports
20to the Department as the Department deems necessary. This
21report shall include a list of hospitals meeting standards
22substantially equivalent to those promulgated by the
23Department under this Act, and upon the receipt of such report
24the Department may then issue a license to such hospital.
25(Source: Laws 1965, p. 2350.)
26    Section 99. Effective date. This Act takes effect upon



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1becoming law.