Illinois General Assembly - Full Text of HB4674
Illinois General Assembly

Previous General Assemblies

Full Text of HB4674  102nd General Assembly


Sen. Mattie Hunter

Filed: 3/24/2022





10200HB4674sam003LRB102 23801 CPF 37982 a


2    AMENDMENT NO. ______. Amend House Bill 4674, AS AMENDED,
3by replacing everything after the enacting clause with the
5    "Section 5. The Nursing Home Care Act is amended by
6changing Sections 3-212 and 3-702 as follows:
7    (210 ILCS 45/3-212)  (from Ch. 111 1/2, par. 4153-212)
8    Sec. 3-212. Inspection.
9    (a) The Department, whenever it deems necessary in
10accordance with subsection (b), shall inspect, survey and
11evaluate every facility to determine compliance with
12applicable licensure requirements and standards. Submission of
13a facility's current Consumer Choice Information Report
14required by Section 2-214 shall be verified at time of
15inspection. An inspection should occur within 120 days prior
16to license renewal. The Department may periodically visit a



10200HB4674sam003- 2 -LRB102 23801 CPF 37982 a

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



10200HB4674sam003- 3 -LRB102 23801 CPF 37982 a

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



10200HB4674sam003- 4 -LRB102 23801 CPF 37982 a

1this subsection shall only be offered by the Department.
2Content presented during the continuing education shall be
3consistent throughout the State, regardless of survey region.
4At least 5 of the 10 hours of continuing education required
5under this subsection shall be separate and distinct from any
6continuing education hours required for any license that the
7employee holds. Any continuing education hours provided by the
8Department in addition to the 10 hours of continuing education
9required under this subsection may count towards continuing
10education hours required for any license that the employee
12    (b) In determining whether to make more than the required
13number of unannounced inspections, surveys and evaluations of
14a facility the Department shall consider one or more of the
15following: previous inspection reports; the facility's history
16of compliance with standards, rules and regulations
17promulgated under this Act and correction of violations,
18penalties or other enforcement actions; the number and
19severity of complaints received about the facility; any
20allegations of resident abuse or neglect; weather conditions;
21health emergencies; other reasonable belief that deficiencies
23    (b-1) The Department shall not be required to determine
24whether a facility certified to participate in the Medicare
25program under Title XVIII of the Social Security Act, or the
26Medicaid program under Title XIX of the Social Security Act,



10200HB4674sam003- 5 -LRB102 23801 CPF 37982 a

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



10200HB4674sam003- 6 -LRB102 23801 CPF 37982 a

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



10200HB4674sam003- 7 -LRB102 23801 CPF 37982 a

1survey and evaluation.
2    (d) The Department shall maintain all inspection, survey
3and evaluation reports for at least 5 years in a manner
4accessible to and understandable by the public.
5    (e) Revisit surveys. The Department shall conduct a
6revisit to its licensure and certification surveys, consistent
7with federal regulations and guidelines.
8    (f) Notwithstanding any other provision of this Act, the
9Department shall, no later than 180 days after the effective
10date of this amendatory Act of the 98th General Assembly,
11implement a single survey process that encompasses federal
12certification and State licensure requirements, health and
13life safety requirements, and an enhanced complaint
14investigation initiative.
15        (1) To meet the requirement of a single survey
16    process, the portions of the health and life safety survey
17    associated with federal certification and State licensure
18    surveys must be started within 7 working days of each
19    other. Nothing in this paragraph (1) of subsection (f) of
20    this Section applies to a complaint investigation.
21        (2) The enhanced complaint and incident report
22    investigation initiative shall permit the facility to
23    challenge the amount of the fine due to the excessive
24    length of the investigation which results in one or more
25    of the following conditions:
26            (A) prohibits the timely development and



10200HB4674sam003- 8 -LRB102 23801 CPF 37982 a

1        implementation of a plan of correction;
2            (B) creates undue financial hardship impacting the
3        quality of care delivered to the resident;
4            (C) delays initiation of corrective training; and
5            (D) negatively impacts quality assurance and
6        patient improvement standards.
7    This paragraph (2) does not apply to complaint
8    investigations exited within 14 working days or a
9    situation that triggers an extended survey.
10(Source: P.A. 98-104, eff. 7-22-13.)
11    (210 ILCS 45/3-702)  (from Ch. 111 1/2, par. 4153-702)
12    Sec. 3-702. (a) A person who believes that this Act or a
13rule promulgated under this Act may have been violated may
14request an investigation. The request may be submitted to the
15Department in writing, by telephone, by electronic means, or
16by personal visit. An oral complaint shall be reduced to
17writing by the Department. The Department shall make
18available, through its website and upon request, information
19regarding the oral and phone intake processes and the list of
20questions that will be asked of the complainant. The
21Department shall request information identifying the
22complainant, including the name, address and telephone number,
23to help enable appropriate follow-up. The Department shall act
24on such complaints via on-site visits or other methods deemed
25appropriate to handle the complaints with or without such



10200HB4674sam003- 9 -LRB102 23801 CPF 37982 a

1identifying information, as otherwise provided under this
2Section. The complainant shall be informed that compliance
3with such request is not required to satisfy the procedures
4for filing a complaint under this Act. The Department must
5notify complainants that complaints with less information
6provided are far more difficult to respond to and investigate.
7    (b) The substance of the complaint shall be provided in
8writing to the licensee, owner, or administrator no earlier
9than at the commencement of an on-site inspection of the
10facility which takes place pursuant to the complaint.
11    (c) The Department shall not disclose the name of the
12complainant unless the complainant consents in writing to the
13disclosure or the investigation results in a judicial
14proceeding, or unless disclosure is essential to the
15investigation. The complainant shall be given the opportunity
16to withdraw the complaint before disclosure. Upon the request
17of the complainant, the Department may permit the complainant
18or a representative of the complainant to accompany the person
19making the on-site inspection of the facility.
20    (d) Upon receipt of a complaint, the Department shall
21determine whether this Act or a rule promulgated under this
22Act has been or is being violated. The Department shall
23investigate all complaints alleging abuse or neglect within 7
24days after the receipt of the complaint except that complaints
25of abuse or neglect which indicate that a resident's life or
26safety is in imminent danger shall be investigated within 24



10200HB4674sam003- 10 -LRB102 23801 CPF 37982 a

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



10200HB4674sam003- 11 -LRB102 23801 CPF 37982 a

1include comments or documentation provided by either the
2complainant or the licensee pertaining to the complaint. The
3Department shall also notify the facility of such findings
4within 10 days of the determination, but the name of the
5complainant or residents shall not be disclosed in this notice
6to the facility. The notice of such findings shall include a
7copy of the written determination; the correction order, if
8any; the warning notice, if any; the inspection report; or the
9State licensure form on which the violation is listed.
10    (f) A written determination, correction order, or warning
11notice concerning a complaint, together with the facility's
12response, shall be available for public inspection, but the
13name of the complainant or resident shall not be disclosed
14without his consent.
15    (g) A complainant who is dissatisfied with the
16determination or investigation by the Department may request a
17hearing under Section 3-703. The facility shall be given
18notice of any such hearing and may participate in the hearing
19as a party. If a facility requests a hearing under Section
203-703 which concerns a matter covered by a complaint, the
21complainant shall be given notice and may participate in the
22hearing as a party. A request for a hearing by either a
23complainant or a facility shall be submitted in writing to the
24Department within 30 days after the mailing of the
25Department's findings as described in subsection (e) of this
26Section. Upon receipt of the request the Department shall



10200HB4674sam003- 12 -LRB102 23801 CPF 37982 a

1conduct a hearing as provided under Section 3-703.
2    (g-5) The Department shall conduct an annual review of all
3survey activity from the preceding fiscal year and make a
4report concerning the complaint and survey process. The report
5shall include, but not be limited to: that includes the total
6number of complaints received; the breakdown of 24-hour,
77-day, and 30-day complaints; , the breakdown of anonymous and
8non-anonymous complaints; and whether the number of complaints
9that were substantiated versus unsubstantiated; or not, the
10total number of substantiated complaints that were completed
11in the time frame determined under subsection (d); the total
12number of informal dispute resolutions requested; the total
13number of informal dispute resolution requests approved; the
14total number of informal dispute resolutions that were
15overturned or reduced in severity; the total number of nurse
16surveyors hired during the calendar year; the total number of
17nurse surveyors who left Department employment; the average
18length of tenure for nurse surveyors employed by the
19Department at the time the report is created; the total number
20of times the Department imposed discretionary denial of
21payment within 15 days of notice and within 2 days of notice as
22well as the number of times the discretionary denial of
23payment took effect; , and any other complaint information
24requested by the Long-Term Care Facility Advisory Board
25created under Section 2-204 of this Act or the Illinois
26Long-Term Care Council created under Section 4.04a of the



10200HB4674sam003- 13 -LRB102 23801 CPF 37982 a

1Illinois Act on the Aging. This report shall be provided to the
2Long-Term Care Facility Advisory Board, the Illinois Long-Term
3Care Council, and the General Assembly. The Long-Term Care
4Facility Advisory Board and the Illinois Long-Term Care
5Council shall review the report and suggest any changes deemed
6necessary to the Department for review and action, including
7how to investigate and substantiate anonymous complaints.
8    (h) Any person who knowingly transmits a false report to
9the Department commits the offense of disorderly conduct under
10subsection (a)(8) of Section 26-1 of the Criminal Code of
12(Source: P.A. 102-432, eff. 8-20-21.)".