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


Rep. Maurice A. West, II

Filed: 2/24/2022





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2    AMENDMENT NO. ______. Amend House Bill 4674 by replacing
3everything after the enacting clause with the following:
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,



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1survey, or evaluation, other than an inspection of financial
2records, shall be conducted without prior notice to the
3facility. A visit for the sole purpose of consultation may be
4announced. The Department shall provide training to surveyors
5about the appropriate assessment, care planning, and care of
6persons with mental illness (other than Alzheimer's disease or
7related disorders) to enable its surveyors to determine
8whether a facility is complying with State and federal
9requirements about the assessment, care planning, and care of
10those persons.
11    (a-1) An employee of a State or unit of local government
12agency charged with inspecting, surveying, and evaluating
13facilities who directly or indirectly gives prior notice of an
14inspection, survey, or evaluation, other than an inspection of
15financial records, to a facility or to an employee of a
16facility is guilty of a Class A misdemeanor.
17    An inspector or an employee of the Department who
18intentionally prenotifies a facility, orally or in writing, of
19a pending complaint investigation or inspection shall be
20guilty of a Class A misdemeanor. Superiors of persons who have
21prenotified a facility shall be subject to the same penalties,
22if they have knowingly allowed the prenotification. A person
23found guilty of prenotifying a facility shall be subject to
24disciplinary action by his or her employer.
25    If the Department has a good faith belief, based upon
26information that comes to its attention, that a violation of



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1this subsection has occurred, it must file a complaint with
2the Attorney General or the State's Attorney in the county
3where the violation took place within 30 days after discovery
4of the information.
5    (a-2) An employee of a State or unit of local government
6agency charged with inspecting, surveying, or evaluating
7facilities who willfully profits from violating the
8confidentiality of the inspection, survey, or evaluation
9process shall be guilty of a Class 4 felony and that conduct
10shall be deemed unprofessional conduct that may subject a
11person to loss of his or her professional license. An action to
12prosecute a person for violating this subsection (a-2) may be
13brought by either the Attorney General or the State's Attorney
14in the county where the violation took place.
15    (a-3) The Department shall by rule establish guidelines
16for required continuing education of all employees who
17inspect, survey, review, or evaluate a facility. The
18Department shall offer continuing education opportunities at
19least quarterly. Employees of a State or unit of local
20government agency charged with inspecting, surveying,
21reviewing, or evaluating a facility are required to complete
22at least 10 hours of continuing education annually on topics
23including, but not limited to, trauma-informed care, infection
24control, abuse and neglect, and civil monetary penalties.
25Qualifying hours of continuing education shall only be offered
26by the Department. Content presented during the continuing



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1education shall be consistent throughout the State, regardless
2of survey region. The continuing education required by this
3subsection is separate from any continuing education required
4for any license that the employee holds.
5    (b) In determining whether to make more than the required
6number of unannounced inspections, surveys and evaluations of
7a facility the Department shall consider one or more of the
8following: previous inspection reports; the facility's history
9of compliance with standards, rules and regulations
10promulgated under this Act and correction of violations,
11penalties or other enforcement actions; the number and
12severity of complaints received about the facility; any
13allegations of resident abuse or neglect; weather conditions;
14health emergencies; other reasonable belief that deficiencies
16    (b-1) The Department shall not be required to determine
17whether a facility certified to participate in the Medicare
18program under Title XVIII of the Social Security Act, or the
19Medicaid program under Title XIX of the Social Security Act,
20and which the Department determines by inspection under this
21Section or under Section 3-702 of this Act to be in compliance
22with the certification requirements of Title XVIII or XIX, is
23in compliance with any requirement of this Act that is less
24stringent than or duplicates a federal certification
25requirement. In accordance with subsection (a) of this Section
26or subsection (d) of Section 3-702, the Department shall



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1determine whether a certified facility is in compliance with
2requirements of this Act that exceed federal certification
3requirements. If a certified facility is found to be out of
4compliance with federal certification requirements, the
5results of an inspection conducted pursuant to Title XVIII or
6XIX of the Social Security Act may be used as the basis for
7enforcement remedies authorized and commenced, with the
8Department's discretion to evaluate whether penalties are
9warranted, under this Act. Enforcement of this Act against a
10certified facility shall be commenced pursuant to the
11requirements of this Act, unless enforcement remedies sought
12pursuant to Title XVIII or XIX of the Social Security Act
13exceed those authorized by this Act. As used in this
14subsection, "enforcement remedy" means a sanction for
15violating a federal certification requirement or this Act.
16    (c) Upon completion of each inspection, survey and
17evaluation, the appropriate Department personnel who conducted
18the inspection, survey or evaluation shall submit a physical
19or electronic copy of their report to the licensee upon
20exiting the facility, and shall submit the actual report to
21the appropriate regional office of the Department. Such report
22and any recommendations for action by the Department under
23this Act shall be transmitted to the appropriate offices of
24the associate director of the Department, together with
25related comments or documentation provided by the licensee
26which may refute findings in the report, which explain



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1extenuating circumstances that the facility could not
2reasonably have prevented, or which indicate methods and
3timetables for correction of deficiencies described in the
4report. Without affecting the application of subsection (a) of
5Section 3-303, any documentation or comments of the licensee
6shall be provided within 10 days of receipt of the copy of the
7report. Such report shall recommend to the Director
8appropriate action under this Act with respect to findings
9against a facility. The Director shall then determine whether
10the report's findings constitute a violation or violations of
11which the facility must be given notice. Such determination
12shall be based upon the severity of the finding, the danger
13posed to resident health and safety, the comments and
14documentation provided by the facility, the diligence and
15efforts to correct deficiencies, correction of the reported
16deficiencies, the frequency and duration of similar findings
17in previous reports and the facility's general inspection
18history. Violations shall be determined under this subsection
19no later than 75 calendar days after completion of each
20inspection, survey and evaluation.
21    (d) The Department shall maintain all inspection, survey
22and evaluation reports for at least 5 years in a manner
23accessible to and understandable by the public.
24    (e) Revisit surveys. The Department shall conduct a
25revisit to its licensure and certification surveys, consistent
26with federal regulations and guidelines.



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1    (f) Notwithstanding any other provision of this Act, the
2Department shall, no later than 180 days after the effective
3date of this amendatory Act of the 98th General Assembly,
4implement a single survey process that encompasses federal
5certification and State licensure requirements, health and
6life safety requirements, and an enhanced complaint
7investigation initiative.
8        (1) To meet the requirement of a single survey
9    process, the portions of the health and life safety survey
10    associated with federal certification and State licensure
11    surveys must be started within 7 working days of each
12    other. Nothing in this paragraph (1) of subsection (f) of
13    this Section applies to a complaint investigation.
14        (2) The enhanced complaint and incident report
15    investigation initiative shall permit the facility to
16    challenge the amount of the fine due to the excessive
17    length of the investigation which results in one or more
18    of the following conditions:
19            (A) prohibits the timely development and
20        implementation of a plan of correction;
21            (B) creates undue financial hardship impacting the
22        quality of care delivered to the resident;
23            (C) delays initiation of corrective training; and
24            (D) negatively impacts quality assurance and
25        patient improvement standards.
26    This paragraph (2) does not apply to complaint



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1    investigations exited within 14 working days or a
2    situation that triggers an extended survey.
3(Source: P.A. 98-104, eff. 7-22-13.)
4    (210 ILCS 45/3-702)  (from Ch. 111 1/2, par. 4153-702)
5    Sec. 3-702. (a) A person who believes that this Act or a
6rule promulgated under this Act may have been violated may
7request an investigation. The request may be submitted to the
8Department in writing, by telephone, by electronic means, or
9by personal visit. An oral complaint shall be reduced to
10writing by the Department. The Department shall make
11available, through its website and upon request, information
12regarding the oral and phone intake processes and the list of
13questions that will be asked of the complainant. The
14Department shall request information identifying the
15complainant, including the name, address and telephone number,
16to help enable appropriate follow-up. The Department shall act
17on such complaints via on-site visits or other methods deemed
18appropriate to handle the complaints with or without such
19identifying information, as otherwise provided under this
20Section. The complainant shall be informed that compliance
21with such request is not required to satisfy the procedures
22for filing a complaint under this Act. The Department must
23notify complainants that complaints with less information
24provided are far more difficult to respond to and investigate.
25    (b) The substance of the complaint shall be provided in



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1writing to the licensee, owner, or administrator upon no
2earlier than at the commencement of an on-site inspection of
3the facility which takes place pursuant to the complaint.
4    (c) The Department shall not disclose the name of the
5complainant unless the complainant consents in writing to the
6disclosure or the investigation results in a judicial
7proceeding, or unless disclosure is essential to the
8investigation. The complainant shall be given the opportunity
9to withdraw the complaint before disclosure. Upon the request
10of the complainant, the Department may permit the complainant
11or a representative of the complainant to accompany the person
12making the on-site inspection of the facility.
13    (d) Upon receipt of a complaint, the Department shall
14determine whether this Act or a rule promulgated under this
15Act has been or is being violated. The Department shall
16investigate all complaints alleging abuse or neglect within 7
17days after the receipt of the complaint except that complaints
18of abuse or neglect which indicate that a resident's life or
19safety is in imminent danger shall be investigated within 24
20hours after receipt of the complaint. All other complaints
21shall be investigated within 30 days after the receipt of the
22complaint. The Department employees investigating a complaint
23shall conduct a brief, informal exit conference with the
24facility to alert its administration of any suspected serious
25deficiency that poses a direct threat to the health, safety or
26welfare of a resident to enable an immediate correction for



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



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1any; the warning notice, if any; the inspection report; or the
2State licensure form on which the violation is listed.
3    (f) A written determination, correction order, or warning
4notice concerning a complaint, together with the facility's
5response, shall be available for public inspection, but the
6name of the complainant or resident shall not be disclosed
7without his consent.
8    (g) A complainant who is dissatisfied with the
9determination or investigation by the Department may request a
10hearing under Section 3-703. The facility shall be given
11notice of any such hearing and may participate in the hearing
12as a party. If a facility requests a hearing under Section
133-703 which concerns a matter covered by a complaint, the
14complainant shall be given notice and may participate in the
15hearing as a party. A request for a hearing by either a
16complainant or a facility shall be submitted in writing to the
17Department within 30 days after the mailing of the
18Department's findings as described in subsection (e) of this
19Section. Upon receipt of the request the Department shall
20conduct a hearing as provided under Section 3-703.
21    (g-5) The Department shall conduct an annual review of all
22survey activity from the preceding calendar year and make a
23report concerning the complaint and survey process. The report
24shall include, but not be limited to: that includes the total
25number of complaints received; the total number of 24-hour,
267-day, and 30-day complaints; , the breakdown of anonymous and



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1non-anonymous complaints; and whether the number of complaints
2that were substantiated versus unsubstantiated; or not, the
3total number of substantiated complaints that were completed
4in the time frame determined under subsection (d); the total
5number of informal dispute resolutions requested; the total
6number of informal dispute resolution requests approved; the
7total number of informal dispute resolutions that were
8overturned or reduced in severity; the total number of
9independent informal dispute resolutions requested; the total
10number of independent informal dispute resolution requests
11approved; the total number of independent informal dispute
12resolutions that were overturned or reduced in severity; the
13total number of revisits not completed within the statutorily
14mandated time frames; the total number of nurse surveyors
15hired during the calendar year; the total number of nurse
16surveyors who left Department employment; the total number of
17times the Department recommended a discretionary denial of
18payment for new Medicare or Medicaid admissions with an
19effective date that is (i) less than 15 days after the date of
20the Department's notice to the facility, (ii) at least 15 days
21and less than 31 days after the date of the Department's notice
22to the facility, (iii) at least 31 days and less than 60 days
23after the date of the Department's notice to the facility, and
24(iv) at least 60 days after the date of the Department's notice
25to the facility; the total number of Department employees who
26entered long-term care facilities for any reason who were



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1fully vaccinated for influenza and COVID-19; the total number
2of Department employees who entered long-term care facilities
3for any reason who were not fully vaccinated for influenza and
4COVID-19 and the number of instances in which Department
5employees not fully vaccinated against influenza and COVID-19
6entered a long-term care facility; the total number of
7Department employees who entered long-term care facilities and
8who tested positive for COVID-19 within 7 calendar days after
9entering a long-term care facility and the number of instances
10in which a Department employee entered a long-term care
11facility within 7 calendar days after testing positive for
12COVID-19; , and any other complaint information requested by
13the Long-Term Care Facility Advisory Board created under
14Section 2-204 of this Act or the Illinois Long-Term Care
15Council created under Section 4.04a of the Illinois Act on the
16Aging. All of the listed reporting criteria in this subsection
17and additional complaint information requested by the
18Long-Term Care Facility Advisory Board, the Illinois Long-Term
19Care Council, or the General Assembly shall be provided in
20aggregate and broken down by Office of Health Care Regulation
21region. In addition, the Department shall provide health
22vaccine and health equity report findings, information about
23continued progress toward correcting identified deficiencies,
24and annual Centers for Medicare and Medicaid Services' State
25Performance Standards System results for the State of
26Illinois. This report shall be provided to the Long-Term Care



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1Facility Advisory Board, the Illinois Long-Term Care Council,
2and the General Assembly. The Long-Term Care Facility Advisory
3Board and the Illinois Long-Term Care Council shall review the
4report and suggest any changes deemed necessary to the
5Department for review and action, including how to investigate
6and substantiate anonymous complaints.
7    (h) Any person who knowingly transmits a false report to
8the Department commits the offense of disorderly conduct under
9subsection (a)(8) of Section 26-1 of the Criminal Code of
11(Source: P.A. 102-432, eff. 8-20-21.)".