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


Sen. Mattie Hunter

Filed: 3/21/2022





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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, or evaluate a facility. The Department shall
18offer continuing education opportunities at least quarterly.
19Employees of a State agency charged with inspecting,
20surveying, or evaluating a facility are required to complete
21at least 10 hours of continuing education annually on topics
22that support the survey process, including, but not limited
23to, trauma-informed care, infection control, abuse and
24neglect, and civil monetary penalties. Qualifying hours of
25continuing education intended to fulfill the requirements of
26this subsection shall only be offered by the Department.



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1Content presented during the continuing education shall be
2consistent throughout the State, regardless of survey region.
3The continuing education required under this subsection is
4separate from any continuing education required for any
5license that the employee holds.
6    (b) In determining whether to make more than the required
7number of unannounced inspections, surveys and evaluations of
8a facility the Department shall consider one or more of the
9following: previous inspection reports; the facility's history
10of compliance with standards, rules and regulations
11promulgated under this Act and correction of violations,
12penalties or other enforcement actions; the number and
13severity of complaints received about the facility; any
14allegations of resident abuse or neglect; weather conditions;
15health emergencies; other reasonable belief that deficiencies
17    (b-1) The Department shall not be required to determine
18whether a facility certified to participate in the Medicare
19program under Title XVIII of the Social Security Act, or the
20Medicaid program under Title XIX of the Social Security Act,
21and which the Department determines by inspection under this
22Section or under Section 3-702 of this Act to be in compliance
23with the certification requirements of Title XVIII or XIX, is
24in compliance with any requirement of this Act that is less
25stringent than or duplicates a federal certification
26requirement. In accordance with subsection (a) of this Section



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1or subsection (d) of Section 3-702, the Department shall
2determine whether a certified facility is in compliance with
3requirements of this Act that exceed federal certification
4requirements. If a certified facility is found to be out of
5compliance with federal certification requirements, the
6results of an inspection conducted pursuant to Title XVIII or
7XIX of the Social Security Act may be used as the basis for
8enforcement remedies authorized and commenced, with the
9Department's discretion to evaluate whether penalties are
10warranted, under this Act. Enforcement of this Act against a
11certified facility shall be commenced pursuant to the
12requirements of this Act, unless enforcement remedies sought
13pursuant to Title XVIII or XIX of the Social Security Act
14exceed those authorized by this Act. As used in this
15subsection, "enforcement remedy" means a sanction for
16violating a federal certification requirement or this Act.
17    (c) Upon completion of each inspection, survey and
18evaluation, the appropriate Department personnel who conducted
19the inspection, survey or evaluation shall submit a physical
20or electronic copy of their report to the licensee upon
21exiting the facility, and shall submit the actual report to
22the appropriate regional office of the Department. Such report
23and any recommendations for action by the Department under
24this Act shall be transmitted to the appropriate offices of
25the associate director of the Department, together with
26related comments or documentation provided by the licensee



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



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1with federal regulations and guidelines.
2    (f) Notwithstanding any other provision of this Act, the
3Department shall, no later than 180 days after the effective
4date of this amendatory Act of the 98th General Assembly,
5implement a single survey process that encompasses federal
6certification and State licensure requirements, health and
7life safety requirements, and an enhanced complaint
8investigation initiative.
9        (1) To meet the requirement of a single survey
10    process, the portions of the health and life safety survey
11    associated with federal certification and State licensure
12    surveys must be started within 7 working days of each
13    other. Nothing in this paragraph (1) of subsection (f) of
14    this Section applies to a complaint investigation.
15        (2) The enhanced complaint and incident report
16    investigation initiative shall permit the facility to
17    challenge the amount of the fine due to the excessive
18    length of the investigation which results in one or more
19    of the following conditions:
20            (A) prohibits the timely development and
21        implementation of a plan of correction;
22            (B) creates undue financial hardship impacting the
23        quality of care delivered to the resident;
24            (C) delays initiation of corrective training; and
25            (D) negatively impacts quality assurance and
26        patient improvement standards.



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



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



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



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1notice to the facility. The notice or statement of deficiency
2of such findings shall include a copy of the written
3determination; the correction order, if any; the warning
4notice, if any; the inspection report; or the State licensure
5form on which the violation is listed. If a facility is found
6to have violated any provision of this Act or rule adopted
7under this Act, the facility shall develop a plan of
8correction to address deficiencies indicated in a statement of
9deficiency. The facility shall submit the plan of correction
10to the Department for approval. The Department must approve or
11deny the plan of correction within 72 hours after receiving
12the plan of correction. If the facility's plan of correction
13is denied, the Department must notify the facility within 48
14hours after the denial determination and provide specific
15reasons for the denial, a process to remedy the denial, and
16requests for additional information, as needed, and complete
17the plan of correction determination process within 48 hours
18after receiving requested information from the facility. The
19Department shall complete an on-site revisit or desk revisit
20within 7 calendar days after approval of the facility's plan
21of correction. During the on-site or desk revisit, the
22Department must address the approved plan of correction and
23clear any outstanding violation for which a plan of correction
24has been approved before beginning a new complaint
25investigation or annual review. If the Department receives an
26abuse or neglect complaint that indicates a resident is in



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1immediate danger within the same time frame during which an
2on-site revisit must be completed, the Department must conduct
3the on-site revisit simultaneously with the new complaint
4investigation. Under no circumstance may a violation remain
5open if the Department has approved the facility's plan of
6correction. If a facility fails to remedy the violation for
7which an on-site revisit is being conducted, the facility must
8correct any outstanding violation. Once the facility has
9notified the Department that the facility is in compliance
10with the plan of correction, the Department must complete an
11on-site revisit within 7 calendar days. If the Department
12fails to complete a revisit within 7 calendar days after
13approving a facility's plan of correction, the facility shall
14be considered to be in substantial compliance.
15    (f) A written determination, correction order, or warning
16notice concerning a complaint, together with the facility's
17response, shall be available for public inspection, but the
18name of the complainant or resident shall not be disclosed
19without his consent.
20    (g) A complainant who is dissatisfied with the
21determination or investigation by the Department may request a
22hearing under Section 3-703. The facility shall be given
23notice of any such hearing and may participate in the hearing
24as a party. If a facility requests a hearing under Section
253-703 which concerns a matter covered by a complaint, the
26complainant shall be given notice and may participate in the



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1hearing as a party. A request for a hearing by either a
2complainant or a facility shall be submitted in writing to the
3Department within 30 days after the mailing of the
4Department's findings as described in subsection (e) of this
5Section. Upon receipt of the request the Department shall
6conduct a hearing as provided under Section 3-703.
7    (g-5) The Department shall conduct an annual review of all
8survey activity from the preceding fiscal year and make a
9report concerning the complaint and survey process. The report
10shall include, but not be limited to: that includes the total
11number of complaints received; the breakdown of 24-hour,
127-day, and 30-day complaints; , the breakdown of anonymous and
13non-anonymous complaints; and whether the number of complaints
14that were substantiated versus unsubstantiated; or not, the
15total number of substantiated complaints that were completed
16in the time frame determined under subsection (d); the total
17number of informal dispute resolutions requested; the total
18number of informal dispute resolution requests approved; the
19total number of informal dispute resolutions that were
20overturned or reduced in severity; the total number of nurse
21surveyors hired during the calendar year; the total number of
22nurse surveyors who left Department employment; the average
23length of tenure for nurse surveyors employed by the
24Department at the time the report is created; the total number
25of times the Department recommended a discretionary denial of
26payment for new Medicare or Medicaid admissions and how much



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1time existed between the start of that denial and when the
2facility was notified, with a start date for the denial of
3payment that is (i) less than 15 days after the date of the
4Department's notice to the facility, (ii) at least 15 days and
5less than 31 days after the date of the Department's notice to
6the facility, (iii) at least 31 days and less than 60 days
7after the date of the Department's notice to the facility, and
8(iv) at least 60 days after the date of the Department's notice
9to the facility; , and any other complaint information
10requested by the Long-Term Care Facility Advisory Board
11created under Section 2-204 of this Act or the Illinois
12Long-Term Care Council created under Section 4.04a of the
13Illinois Act on the Aging. This report shall be provided to the
14Long-Term Care Facility Advisory Board, the Illinois Long-Term
15Care Council, and the General Assembly. The Long-Term Care
16Facility Advisory Board and the Illinois Long-Term Care
17Council shall review the report and suggest any changes deemed
18necessary to the Department for review and action, including
19how to investigate and substantiate anonymous complaints.
20    (h) Any person who knowingly transmits a false report to
21the Department commits the offense of disorderly conduct under
22subsection (a)(8) of Section 26-1 of the Criminal Code of
24(Source: P.A. 102-432, eff. 8-20-21.)".