State of Illinois
92nd General Assembly
Legislation

   [ Search ]   [ PDF text ]   [ Legislation ]   
[ Home ]   [ Back ]   [ Bottom ]


[ Introduced ][ House Amendment 001 ]


92_HB3129eng

 
HB3129 Engrossed                               LRB9204289LBmg

 1        AN ACT concerning health facilities.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  1.   Short  title.  This Act may be cited as the
 5    End Stage Renal Disease Facility Act.

 6        Section 5.  Definitions.  As used in this Act:
 7        "Committee" means the End Stage  Renal  Disease  Advisory
 8    Committee.
 9        "Department" means the Department of Public Health.
10        "Dialysis"  means a process by which dissolved substances
11    are removed from a patient's   body  by  diffusion  from  one
12    fluid compartment to another across a semipermeable membrane.
13        "Dialysis  technician"  means  an individual who is not a
14    registered nurse or physician and who provides dialysis  care
15    under the supervision of a registered nurse or physician.
16        "Director" means the Director of Public Health.
17        "End  stage  renal  disease"  means  the  stage  of renal
18    impairment that appears irreversible and permanent  and  that
19    requires   a   regular   course   of   dialysis   or   kidney
20    transplantation to maintain life.
21        "End  stage renal disease facility" means a facility that
22    provides  dialysis  treatment   or   dialysis   training   to
23    individuals with end stage renal disease.
24        "Licensee"  means an individual or entity licensed by the
25    Department to operate an end stage renal disease facility.
26        "Nurse" means an individual who is licensed  to  practice
27    nursing under the Nursing and Advanced Practice Nursing Act.
28        "Patient" means an individual receiving treatment from an
29    end stage renal disease facility.
30        "Person"   means   any   individual,  firm,  partnership,
31    corporation, company, association, or other legal entity.
 
HB3129 Engrossed            -2-                LRB9204289LBmg
 1        "Physician"  means  an  individual  who  is  licensed  to
 2    practice medicine in all of its branches  under  the  Medical
 3    Practice Act of 1987.

 4        Section  10.   License  required.   Except as provided by
 5    this Act, no  person  shall  open,  manage,  conduct,  offer,
 6    maintain,  or  advertise  an end stage renal disease facility
 7    without a valid license issued by the  Department.   All  end
 8    stage  renal  disease  facilities  in  existence  as  of  the
 9    effective  date  of  this Act shall obtain a valid license to
10    operate within one year after the effective date of this Act.

11        Section 15.  Exemptions from licensing requirement.   The
12    following  facilities  are  not required to be licensed under
13    this Act:
14             (1)  a  home health agency licensed under  the  Home
15        Health   Agency  Licensing  Act  that  provides  dialysis
16        services in the home under the supervision of a nurse;
17             (2)  a  hospital   licensed   under   the   Hospital
18        Licensing Act or the University of Illinois Hospital Act;
19             (3)  the office of a physician, unless the office is
20        used  primarily  as  an end stage renal disease facility;
21        and
22             (4) a facility licensed under the Nursing Home  Care
23        Act.

24        Section 20.  Issuance and renewal of license.
25        (a)  An  applicant  for  a  license  under this Act shall
26    submit an application on forms prescribed by the Department.
27        (b)  Each  application  shall   be   accompanied   by   a
28    non-refundable  license  fee,  as established by the rules of
29    the Department.
30        (c)  Each application shall contain evidence  that  there
31    is  at  least  one  qualified  physician  responsible for the
 
HB3129 Engrossed            -3-                LRB9204289LBmg
 1    medical direction of the  facility  and  that  each  dialysis
 2    technician  on  staff  has  completed  a  training program as
 3    required by this Act.
 4        (d)  The Department may grant a temporary initial license
 5    to an applicant.  A temporary initial license expires on  the
 6    earlier  of  (i) the date the Department issues or denies the
 7    license or  (ii)  the  date  6  months  after  the  date  the
 8    temporary initial license was issued.
 9        (e)  The  Department  shall  issue  a  license  if, after
10    application, inspection, and investigation, it finds that the
11    applicant  meets  the  requirements  of  this  Act  and   the
12    standards  adopted  pursuant to this Act.  The Department may
13    include participation  as  a  supplier  of  end  stage  renal
14    disease  services  under  Titles XVIII and XIX of the federal
15    Social Security Act as a condition of licensure.
16        (f)  The license is renewable annually  after  submission
17    of  (i)  the  renewal  application and fee and (ii) an annual
18    report on a form prescribed by the Department  that  includes
19    information related to quality of care at the end stage renal
20    disease  facility.   The  report  must  be  in  the  form and
21    documented by evidence as required by the  rules  adopted  by
22    the Department.

23        Section  25.   Minimum  staffing.   An  end  stage  renal
24    disease  facility  shall  be under the medical direction of a
25    qualified physician experienced in renal  disease  treatment,
26    as required for licensure under this Act.  Additionally, at a
27    minimum,  every facility licensed under this Act shall ensure
28    that whenever patients are undergoing  dialysis  all  of  the
29    following are met:
30             (1)  one  currently  licensed  physician, registered
31        nurse,  or  licensed  practical  nurse   experienced   in
32        rendering  end  stage  renal  disease  care is physically
33        present on the premises to oversee patient care;
 
HB3129 Engrossed            -4-                LRB9204289LBmg
 1             (2)  adequate staff is present to meet  the  medical
 2        and  non-medical  needs  of  each patient, as provided by
 3        this Act and the rules adopted pursuant to this Act, in a
 4        ratio of at least one staff member to  every  3  patients
 5        receiving  end  stage  renal disease services at the same
 6        time; and
 7             (3)  if  the  facility  offers  self-care   dialysis
 8        training,   a  qualified  nurse  is  in  charge  of  that
 9        training.

10        Section 30.  Minimum standards.
11        (a)  The rules adopted pursuant to this Act shall contain
12    minimum standards to protect  the  health  and  safety  of  a
13    patient  of  an  end  stage renal disease facility, including
14    standards for:
15             (1)  the  qualifications  and  supervision  of   the
16        professional staff and other personnel;
17             (2)  the  equipment  used  by the facility to insure
18        that it is compatible with the health and safety  of  the
19        patients;
20             (3)  the  sanitary  and  hygienic  conditions in the
21        facility;
22             (4)  quality assurance for patient care;
23             (5)  clinical records maintained by the facility;
24             (6)  design and space requirements for the  facility
25        to  insure  safe  access by patients and personnel and to
26        insure patient privacy;
27             (7)  indicators of the quality of care  provided  by
28        the facility; and
29             (8)  water treatment and reuse by the facility.
30        (b)  The  standards  described  in item (8) of subsection
31    (a) of this Section shall apply only (i) to a  facility  that
32    initiates  the  provision of end stage renal disease services
33    on or after January 1, 2003 or (ii) to the area of a facility
 
HB3129 Engrossed            -5-                LRB9204289LBmg
 1    affected by design and  space  modifications  or  renovations
 2    completed after  January 1, 2004.

 3        Section  35.   Training;  minimum  requirements.   An end
 4    stage renal disease facility shall establish and implement  a
 5    policy  to  ensure  appropriate  training  and  competency of
 6    individuals  employed  as  dialysis  technicians  within  the
 7    licensed facility.  The policy shall, at  a  minimum,  define
 8    the  acts  and  practices  that are allowed or prohibited for
 9    such employees, establish how training will be conducted, and
10    illustrate how initial competency will be established.  Proof
11    of initial and annual competency testing shall be  maintained
12    in  the  personnel  file  of  each employee and shall be made
13    available to the Department upon request.  An individual  may
14    not  act  as  a  dialysis  technician  in  an end stage renal
15    disease facility unless that individual has been trained  and
16    competency  tested  in accordance with this Act and the rules
17    adopted thereunder.  Persons  training  to  act  as  dialysis
18    technicians  must  be  under  the  direct  supervision  of  a
19    physician or an appropriately trained nurse.

20        Section 40.  Inspections.
21        (a)  The  Department,  whenever  it  deems necessary, may
22    conduct an inspection, survey, or evaluation of an end  stage
23    renal disease facility to determine compliance with licensure
24    requirements  and standards or a plan of correction submitted
25    as a result of deficiencies cited by the Department.
26        (b)  An inspection conducted under this Section shall  be
27    unannounced.
28        (c)  Areas  in  a  facility  identified  as  deficient in
29    compliance with the requirements of this Act or the standards
30    adopted under this Act shall be presented to the facility.
31        (d)  Upon  completion  of  each  inspection,  survey,  or
32    evaluation,  the   appropriate   Department   personnel   who
 
HB3129 Engrossed            -6-                LRB9204289LBmg
 1    conducted  the inspection, survey, or evaluation shall submit
 2    a copy of their report  to  the  licensee  upon  exiting  the
 3    facility,   and   shall  submit  the  actual  report  to  the
 4    appropriate   regional   office.    The   report   and    any
 5    recommendation  for  action  by the Department under this Act
 6    shall be sent to the  Department's  central  office  together
 7    with  a  plan  of  correction from the facility.  The plan of
 8    correction may  contain  related  comments  or  documentation
 9    provided  by  the  licensee  that  may refute findings in the
10    report, explain extenuating circumstances that  the  facility
11    could  not reasonably have prevented, or indicate methods and
12    timetables for correction of deficiencies  described  in  the
13    report.   A  licensee  has  10  days  to  submit  a  plan  of
14    correction.
15        (e)  Violations shall be determined under this Section no
16    later  than  60  days  after  completion  of each inspection,
17    survey, evaluation, or plan of correction.
18        (f)  The  Department  shall  maintain   all   inspection,
19    survey,  or  evaluation  reports  for  at  least 5 years in a
20    manner accessible to the public.

21        Section 45.  Civil penalties.
22        (a)  The license of a facility that is  in  violation  of
23    this Act or any rule adopted thereunder may be subject to the
24    penalties  or  fines levied by the Department as specified in
25    this Section.
26        (b)  A Class I  violation  is  one  that  the  Department
27    determines presents an imminent danger to the patients of the
28    facility  or  a substantial probability that death or serious
29    physical harm could result therefrom.  A  physical  condition
30    or  one  or  more practices, means, methods, or operations in
31    use in a facility  may  constitute  such  a  violation.   The
32    condition  or practice constituting a Class I violation shall
33    be abated or eliminated immediately unless a fixed period  of
 
HB3129 Engrossed            -7-                LRB9204289LBmg
 1    time,  as  stipulated  by  the  Department,  is  required for
 2    correction.   Each  day  such  a   violation   exists   after
 3    expiration  of  the  stipulated  time  shall  be considered a
 4    subsequent violation.   The  civil  penalty  for  a  Class  I
 5    violation is as follows:
 6             (1)  $1,500  for a first violation within a 24 month
 7        period;
 8             (2)  $3,000 for a second violation within a 24 month
 9        period;
10             (3)  $5,000 for a third violation within a 24  month
11        period; and
12             (4)  $10,000  for  a  fourth or subsequent violation
13        within a 24 month period.
14        (c)  A Class II violation  is  one  that  the  Department
15    determines  has  a  direct  or  immediate relationship to the
16    health, safety, or security of the facility's  patients,  but
17    is  not  a  Class  I  violation.  The citation for a Class II
18    violation shall specify the time within which  the  violation
19    is  required  to  be  corrected.   Each  day such a violation
20    exists after the expiration of the specified  time  shall  be
21    considered  a  subsequent violation.  The civil penalty for a
22    Class II violation is as follows:
23             (1)  $250 for a first violation within  a  24  month
24        period;
25             (2)  $500  for  a second violation within a 24 month
26        period;
27             (3)  $1,000 for a third violation within a 24  month
28        period;
29             (4)  $2,500 for a fourth violation within a 24 month
30        period; and
31             (5)  $5,000  for  a  fifth  or  subsequent violation
32        within a 24 month period.
33        (d)  A Class III violation is one that is not  classified
34    as  serious  by  the  Department  or that is against the best
 
HB3129 Engrossed            -8-                LRB9204289LBmg
 1    practices as interpreted by the Department.  The citation  of
 2    a  Class  III violation shall specify a time within which the
 3    violation is required  to  be  corrected.  Each  day  such  a
 4    violation  exists  after the expiration of the specified time
 5    shall be considered a subsequent violation.  A civil  penalty
 6    shall not be assessed for a first violation within a 24 month
 7    period.   The  civil  penalty for a Class III violation is as
 8    follows:
 9             (1)  $200 for a second violation within a  24  month
10        period;
11             (2)  $500  for  a  third violation within a 24 month
12        period;
13             (3)  $750 for a fourth violation within a  24  month
14        period; and
15             (4)  $1,000  for  a  fifth  or  subsequent violation
16        within a 24 month period.
17        (e)  For purposes of assessing fines under this  Section,
18    a  repeat violation is a violation that has been cited during
19    one inspection of a facility for which an  accepted  plan  of
20    correction  was  not  complied with.  A new citation is not a
21    repeat violation unless the  licensee  is  not  substantially
22    addressing the issue routinely throughout the facility.

23        Section  50.   Department  access  to and reproduction of
24    documents.  The Department  shall  have  access  to  and  may
25    reproduce  or  photocopy  at its cost any books, records, and
26    other documents maintained by  the  facility  to  the  extent
27    necessary to carry out the purposes of this Act and the rules
28    promulgated under this Act.  The Department shall not divulge
29    or  disclose the identity of any patient or other information
30    prohibited from disclosure by the laws of this State.

31        Section 55.  Refusal to allow inspections.  Any licensee,
32    applicant for a license, or person operating what may  be  an
 
HB3129 Engrossed            -9-                LRB9204289LBmg
 1    end  stage  renal  disease  facility  shall be deemed to have
 2    given consent to any authorized officer, employee,  or  agent
 3    of  the  Department  to  enter  and  inspect  the facility in
 4    accordance with this Act.  Refusal to permit  such  entry  or
 5    inspection  shall  constitute grounds for denial, nonrenewal,
 6    or revocation of a license.

 7        Section  60.   Denial,  suspension,  or   revocation   of
 8    license.
 9        (a)  The  Department  may  deny,  suspend,  or  revoke  a
10    license  for  a  violation  of  this  Act  or  a rule adopted
11    pursuant to this Act.
12        (b)  The denial, suspension, or revocation of  a  license
13    by  the  Department  and  the  appeal  from  that  action are
14    governed by the Illinois Administrative Procedure Act.
15        (c)  Immediately  upon   the   denial,   suspension,   or
16    revocation  of  a  license,  the  Department shall notify the
17    applicant or licensee in  writing.   Notice  of  the  denial,
18    suspension,  or  revocation  shall include a statement of the
19    violations of the Act or rules on which the denial  is  based
20    and  notice  of  the  opportunity  for  a  hearing  under the
21    Illinois Administrative  Procedure  Act.   If  the  applicant
22    desires to contest the Department's action, a written request
23    for  a  hearing shall be provided to the Department within 10
24    days after receipt of the Department's notice.

25        Section 65.  Probationary license.  If the applicant  has
26    not  been  previously  licensed  or if the facility is not in
27    operation at the time application  is  made,  the  Department
28    shall  issue  a probationary license.  A probationary license
29    shall be valid  for  120  days  unless  sooner  suspended  or
30    revoked  under  this  Act.   Within  30  days  prior  to  the
31    termination  of  a probationary license, the Department shall
32    fully  and  completely  inspect  the  facility  and,  if  the
 
HB3129 Engrossed            -10-               LRB9204289LBmg
 1    facility meets the  applicable  requirements  for  licensure,
 2    shall  issue  a  license  under  this Act.  If the Department
 3    finds that the facility does not meet  the  requirements  for
 4    licensure  but  has  made substantial progress toward meeting
 5    those requirements, the license may be  renewed  once  for  a
 6    period not to exceed 120 days from the expiration date of the
 7    initial probationary license.

 8        Section 70.  Change of ownership.
 9        (a)  Whenever ownership of a facility is transferred from
10    the  person  named  in  the  license to any other person, the
11    transferee  must  obtain  a  new  probationary  license.  The
12    transferee shall notify the Department of  the  transfer  and
13    apply  for  a  new  license  at  least 30 days prior to final
14    transfer.
15        (b)  The transferor shall notify the Department at  least
16    30 days prior to final transfer.  The transferor shall remain
17    responsible for the operation of the facility until such time
18    as a license is issued to the transferee.
19        (c)  The  license  granted  to  the  transferee  shall be
20    subject to any plan of correction submitted by  the  previous
21    owner  and  approved  by  the  Department  and any conditions
22    contained in a conditional license  issued  to  the  previous
23    owner.   If  there are outstanding violations and no approved
24    plan of correction has been implemented, the  Department  may
25    issue  a  conditional  license  and  plan  of  correction  as
26    provided in this Act.
27        (d)  The transferor shall remain liable for all penalties
28    assessed against the facility that are imposed for violations
29    occurring prior to transfer of ownership.

30        Section   75.   Access  to  information.   The  following
31    information is subject to disclosure to  the  public  by  the
32    Department:
 
HB3129 Engrossed            -11-               LRB9204289LBmg
 1             (1)  records  of  license  inspections, surveys, and
 2        evaluations of facilities; and
 3             (2)  complaints and complaint investigation reports,
 4        except that a complaint or complaint investigation report
 5        shall not  be  disclosed  to  a  person  other  than  the
 6        complainant  or complainant's representative before it is
 7        disclosed to a facility and except that  a  complainant's
 8        or patient's name shall not be disclosed.

 9        Section 80.  Information available for public inspection.
10        (a)  A  facility  shall  post in plain view of the public
11    (i) its current license, (ii) a description, provided by  the
12    Department,  of  complaint  procedures established under this
13    Act, and (iii) the name, address, and telephone number  of  a
14    person authorized by the Department to receive complaints.
15        (b)  A  facility  shall make the following information or
16    documents available upon request for public inspection:
17             (1)  a copy of any order pertaining to the  facility
18        issued by the Department or a court;
19             (2)  a  complete  copy of every inspection report of
20        the facility received from the Department during the past
21        5 years;
22             (3)  a  copy  of  every  order  pertaining  to   the
23        facility  issued  by the Department or a court during the
24        past 5 years;
25             (4)  a description of the services provided  by  the
26        facility and the rates charged for those services;
27             (5)  a  copy  of the statement of ownership required
28        by this Act;
29             (6)  a record of personnel employed or  retained  by
30        the  facility  who are licensed, certified, or registered
31        by the Department of Professional Regulation; and
32             (7)  a complete copy of the most  recent  inspection
33        report of the facility received from the Department.
 
HB3129 Engrossed            -12-               LRB9204289LBmg
 1        Section 85.  End Stage Renal Disease Advisory Committee.
 2        (a)  The  Director  shall  appoint  an  End  Stage  Renal
 3    Disease  Advisory  Committee  to  advise and consult with the
 4    Director in the administration of this  Act.   The  Committee
 5    shall be composed of the following members:
 6             (1)  3 members who represent end stage renal disease
 7        facilities,  one  of  whom shall represent not-for-profit
 8        facilities,  one  of  whom  shall  represent   for-profit
 9        facilities,    and    one   of   whom   shall   represent
10        institution-based facilities;
11             (2)  2  members  who  are  physicians  licensed   to
12        practice medicine in all its  branches;
13             (3)  one    member    who   is   a   board-certified
14        nephrologist;
15             (4)  one member who represents licensed hospitals;
16             (5)  one member who  is  a  registered  professional
17        nurse with experience treating  end stage renal disease;
18             (6)  3 members of the general public, one of whom is
19        currently receiving dialysis.
20        The  recommendations of professional organizations may be
21    considered in selecting individuals for  appointment  to  the
22    End Stage Renal Disease Advisory Committee.
23        (b)  Each  member  shall  be  appointed  for  a term of 3
24    years, except that  of  the  original  members,  3  shall  be
25    appointed  for a term of one year, 4 shall be appointed for a
26    term of 2 years, and 4 shall be appointed for  a  term  of  3
27    years.  The term of office of each of the original appointees
28    shall commence on July 1, 2002.  A member appointed to fill a
29    vacancy  occurring  prior  to  the expiration of the term for
30    which his or her predecessor was appointed shall be appointed
31    for the remainder of that term.
32        (c)  The  Committee  shall  meet  as  frequently  as  the
33    Director deems necessary.  Committee members,  while  serving
34    on  business  of  the  Committee,  shall  receive  actual and
 
HB3129 Engrossed            -13-               LRB9204289LBmg
 1    necessary travel and subsistence expenses  while  so  serving
 2    away from their places of residence.

 3        Section  90.   Adoption  of  rules.  The Department shall
 4    adopt rules to implement this Act, including requirements for
 5    physical plant  standards  and  for  the  issuance,  renewal,
 6    denial, suspension, and revocation of a license to operate an
 7    end stage renal disease facility.

 8        Section  95.   Fees.   The  Department  may establish and
 9    collect fees in amounts reasonable and  necessary  to  defray
10    the  cost  of  administering this Act.  In setting fees under
11    this Act, the Department shall consider setting  a  range  of
12    license  and  renewal  fees  based  on the number of dialysis
13    stations at the end stage renal disease facility, the patient
14    census, and the  average  costs  involved  in  surveying  the
15    facility.

16        Section  100.  Deposit  of  fees and penalties.  Fees and
17    penalties collected under this Act shall  be  deposited  into
18    the End Stage Renal Disease Facility Licensing Fund, which is
19    hereby  created  as  a  special  fund  in the State treasury.
20    Moneys in the Fund may be used, subject to appropriation,  by
21    the Department for the administration of this Act.

22        Section  105.  The State Finance Act is amended by adding
23    Section 5.545 as follows:

24        (30 ILCS 105/5.545 new)
25        Sec.  5.545.   The  End  Stage  Renal  Disease   Facility
26    Licensing Fund.

27        Section  999.   Effective  date.  This  Act  takes effect
28    January 1, 2002.

[ Top ]