Public Act 93-0141

HB1412 Enrolled                      LRB093 03446 AMC 08879 b

    AN ACT concerning assisted living.

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

    Section 5.  The Assisted Living and Shared Housing Act is
amended  by  changing Sections 25, 35, 75, and 150 and adding
Section 32 as follows:

    (210 ILCS 9/25)
    Sec. 25.  License requirement.  No person may  establish,
operate,  maintain,  or offer an establishment as an assisted
living  establishment  or  shared  housing  establishment  as
defined by the Act within this State unless and until  he  or
she  obtains  a  valid  license,  which  remains unsuspended,
unrevoked, and unexpired.   No  public  official,  agent,  or
employee  may  place  any  person  in,  or recommend that any
person be placed in, or  directly  or  indirectly  cause  any
person  to  be  placed  in  any  establishment that meets the
definition under this Act that is being  operated  without  a
valid  license.   No  public official, agent, or employee may
place  the  name  of  an  unlicensed  establishment  that  is
required to be licensed under this Act on a list of programs.
An entity that operates  as  an  assisted  living  or  shared
housing  establishment  as  defined  by  this  Act  without a
license  shall  be  subject  to  the  provisions,   including
penalties, of the Nursing Home Care Act.  No entity shall use
in its name or advertise "assisted living" unless licensed as
an  assisted  living  establishment  under  this  Act or as a
shelter care facility under the Nursing Home  Care  Act  that
also meets the definition of an assisted living establishment
under   this  Act,  except  a  shared  housing  establishment
licensed  under  this  Act  may  advertise  assisted   living
services.
(Source: P.A. 91-656, eff. 1-1-01.)

    (210 ILCS 9/32 new)
    Sec. 32.  Floating license. An establishment (i) in which
80%  of  the residents are at least 55 years of age or older,
(ii) that is operated as housing for the elderly,  and  (iii)
that meets the construction and operating standards contained
in  Section 20 of this Act may request a floating license for
any  number   of   individual   living   units   within   the
establishment  up  to, but not including, total capacity.  An
establishment requesting a floating license must specify  the
number of individual living units within the establishment to
be licensed.  Living units designated by the establishment as
a  licensed  living  unit  shall,  for  the  purposes of this
Section, be referred  to  as  a  licensed  living  unit.   An
establishment  utilizing  a  floating license must have staff
adequate to meet the scheduled and unscheduled needs  of  the
residents  residing  in  licensed  living  units  within  the
establishment.   All  staff  providing  services  to licensed
living units must meet the requirements of this Act  and  its
rules.   A  living  unit may only be designated as a licensed
unit if the living unit and the living unit's  resident  meet
the  requirements  of  this Act and its rules.  All mandatory
services must be made  available  to  residents  of  licensed
living  units,  and  residents  of  licensed living units may
receive   any   optional   services   permitted   under   the
establishment's license.   Establishments  may  only  provide
services  under  this  Act  in  the  individual  living units
designated as licensed units.  Designation as a licensed unit
may be temporary to accommodate a resident's  changing  needs
without requiring the resident to move.
    An  establishment  with  a  floating  license must keep a
current written list of  those  units  designated  under  the
floating  license.   If a resident elects to receive services
in a unit that is not licensed and  the  unit  qualifies  for
licensure,  the  establishment  must notify the resident that
the unit must be licensed and the requirements  of  this  Act
must  be  met before services can be provided to residents in
that unit.  Upon  the  initiation  of  an  initial  licensing
inspection,  annual  inspection,  or complaint investigation,
the establishment shall provide to the Department a  list  of
the  units  designated  under  the  floating license in which
residents are receiving services subject to this Act.

    (210 ILCS 9/35)
    Sec. 35.  Issuance of license.
    (a)  Upon receipt and review  of  an  application  for  a
license  and  review  of  the  applicant  establishment,  the
Director  may issue a license if he or she finds:
         (1)  that   the   individual   applicant,   or   the
    corporation,   partnership,   or   other  entity  if  the
    applicant is not an individual, is a  person  responsible
    and  suitable  to  operate or to direct or participate in
    the operation of an establishment by virtue of  financial
    capacity,    appropriate    business    or   professional
    experience, a record of  lawful  compliance  with  lawful
    orders  of  the  Department  and  lack of revocation of a
    license issued under this Act or the  Nursing  Home  Care
    Act during the previous 5 years;
         (2)  that the establishment is under the supervision
    of  a  full-time director who is at least 21 years of age
    with ability, training, and education appropriate to meet
    the needs of the residents and to manage  the  operations
    of  the  establishment  and  who  participates in ongoing
    training for these purposes;
         (3)  that the establishment has staff sufficient  in
    number  with  qualifications, adequate skills, education,
    and  experience  to  meet  the  24  hour  scheduled   and
    unscheduled  needs  of  residents  and who participate in
    ongoing training to serve the resident population;
         (4)  that direct care staff meet the requirements of
    the Health Care Worker Background Check Act;
         (5)  that the applicant is in substantial compliance
    with this Act and such other requirements for  a  license
    as the Department by rule may establish under this Act;
         (6)  that the applicant pays all required fees;
         (7)  that   the   applicant   has  provided  to  the
    Department an accurate disclosure document in  accordance
    with  the  Alzheimer's Special Care Disclosure Act and in
    substantial compliance with Section 150 of this Act.
    Any license  issued  by  the  Director  shall  state  the
physical  location of the establishment, the date the license
was issued, and the expiration date.  All licenses  shall  be
valid  for  one year, except as provided in Section 40.  Each
license shall be issued only for  the  premises  and  persons
named  in  the  application, and shall not be transferable or
assignable.
(Source: P.A. 91-656, eff. 1-1-01.)

    (210 ILCS 9/75)
    Sec. 75.  Residency Requirements.
    (a)  No individual shall be  accepted  for  residency  or
remain  in  residence  if the establishment cannot provide or
secure appropriate services, if  the  individual  requires  a
level   of   service   or  type  of  service  for  which  the
establishment is not licensed or which the establishment does
not provide, or if the establishment does not have the  staff
appropriate  in numbers and with appropriate skill to provide
such services.
    (b)  Only adults may be accepted for residency.
    (c)  A person shall not be accepted for residency if:
         (1)  the person poses a serious threat to himself or
    herself or to others;
         (2)  the person is not able to  communicate  his  or
    her  needs and no resident representative residing in the
    establishment, and  with  a  prior  relationship  to  the
    person,  has  been  appointed  to direct the provision of
    services;
         (3)  the person requires total assistance with 2  or
    more activities of daily living;
         (4)  the person requires the assistance of more than
    one  paid caregiver at any given time with an activity of
    daily living;
         (5)  the  person   requires   more   than    minimal
    assistance in moving to a safe area in an emergency;
         (6)  the  person  has a severe mental illness, which
    for the purposes of this Section means a  condition  that
    is  characterized  by  the  presence  of  a  major mental
    disorder as classified in the Diagnostic and  Statistical
    Manual  of  Mental  Disorders,  Fourth  Edition  (DSM-IV)
    (American   Psychiatric  Association,  1994),  where  the
    individual  is  substantially  disabled  due  to   mental
    illness   in   the   areas  of  self-maintenance,  social
    functioning, activities  of  community  living  and  work
    skills,  and  the  disability specified is expected to be
    present for a period of not less than one year, but  does
    not mean  Alzheimer's disease and other forms of dementia
    based on organic or physical disorders;
         (7)  the  person  requires  intravenous  therapy  or
    intravenous    feedings   unless   self-administered   or
    administered  by  a  qualified,  licensed   health   care
    professional;
         (8)  the person requires gastrostomy feedings unless
    self-administered   or  administered by a licensed health
    care professional;
         (9)  the   person   requires   insertion,    sterile
    irrigation,  and  replacement  of  catheter,  except  for
    routine  maintenance  of   urinary catheters,  unless the
    catheter care is self-administered or administered  by  a
    licensed health care professional;
         (10)  the  person requires sterile wound care unless
    care is self-administered or administered by  a  licensed
    health care professional;
         (11)  the  person  requires  sliding  scale  insulin
    administration unless self-performed or administered by a
    licensed health care professional;
         (12)  the  person  is  a  diabetic requiring routine
    insulin   injections   unless    the    injections    are
    self-administered  or  administered  by a licensed health
    care professional;
         (13)  the person requires treatment of  stage  3  or
    stage 4 decubitus ulcers or exfoliative dermatitis;
         (14)  the  person requires 5 or more skilled nursing
    visits per week for conditions other than those listed in
    items (13) and (15) of this subsection for a period of  3
    consecutive weeks or  more  except  when  the  course  of
    treatment  is  expected  to extend beyond a 3 week period
    for rehabilitative purposes and is certified as temporary
    by a physician; or
         (15)  other reasons prescribed by the Department  by
    rule.
    (d)  A  resident  with  a  condition  listed in items (1)
through  (15)  of  subsection  (c)  shall  have  his  or  her
residency terminated.
    (e)  Residency   shall   be   terminated   when  services
available to the resident in the establishment are no  longer
adequate  to  meet the needs of the resident. This  provision
shall not be interpreted as limiting  the  authority  of  the
Department   to   require  the   residency  termination    of
individuals.
    (f)  Subsection (d) of this Section shall  not  apply  to
terminally  ill  residents  who  receive or would qualify for
hospice care and such care  is  coordinated  by    a  hospice
licensed  under  the Hospice Program  Licensing Act  or other
licensed health care professional employed by a licensed home
health agency and the establishment and all parties agree  to
the continued residency.
    (g)  Items (3), (4), (5), and (9) of subsection (c) shall
not  apply  to a quadriplegic, paraplegic, or individual with
neuro-muscular  diseases,  such  as  muscular  dystrophy  and
multiple sclerosis, or other chronic diseases and  conditions
as  defined  by rule if the individual is able to communicate
his or her needs and does not require assistance with complex
medical  problems,  and  the   establishment   is   able   to
accommodate  the  individual's  needs.   The Department shall
prescribe rules pursuant to this Section that address special
safety and service needs of these individuals.
    (h)  For the  purposes  of  items  (7)  through  (11)  of
subsection  (c),  a licensed health care professional may not
be employed by the owner or operator  of  the  establishment,
its  parent entity, or any other entity with ownership common
to either the owner  or  operator  of  the  establishment  or
parent  entity,  including but not limited to an affiliate of
the owner or operator of the establishment.  Nothing in  this
Section is meant to limit a resident's right to choose his or
her health care provider.
(Source: P.A. 91-656, eff. 1-1-01.)

    (210 ILCS 9/150)
    Sec. 150.  Alzheimer and dementia programs.
    (a)  In  addition  to Except as provided in this Section,
Alzheimer and dementia programs shall comply with all of  the
other provisions of this Act.
    (b)  No  person  shall  be  admitted  or  retained if the
assisted  living  or  shared  housing  establishment   cannot
provide  or secure appropriate care, if the resident requires
a  level  of  service  or  type  of  service  for  which  the
establishment is not licensed or which the establishment does
not provide, or if the establishment does not have the  staff
appropriate  in numbers and with appropriate skill to provide
such services.
    (c)  No person shall be accepted for residency or  remain
in residence if the person's mental or physical condition has
so  deteriorated  to render residency in such a program to be
detrimental to the health, welfare or safety of the person or
of other residents of the establishment.  The  Department  by
rule  shall  identify  a validated dementia-specific standard
with inter-rater reliability that  will  be  used  to  assess
individual  residents. The assessment must be approved by the
resident's physician and shall occur prior to acceptance  for
residency,  annually,  and  at such time that a change in the
resident's condition is identified by a family member,  staff
of the establishment, or the resident's physician.
    (d)  No  person shall be accepted for residency or remain
in residence if the person is dangerous to self or others and
the establishment would be unable  to  eliminate  the  danger
through the use of appropriate treatment modalities.
    (e)  No  person shall be accepted for residency or remain
in residence if the person meets  the  criteria  provided  in
subsections (b) through (g) of Section 75 of this Act.
    (f)  An  establishment  that  offers to provide a special
program or unit for  persons  with  Alzheimer's  disease  and
related disorders shall:
         (1)  disclose  to  the Department and to a potential
    or actual resident of the  establishment  information  as
    specified  under  the Alzheimer's Special Care Disclosure
    Act;
         (2)  ensure  that  a  resident's  representative  is
    designated for the resident;
         (3)  develop and implement policies  and  procedures
    that  ensure the continued safety of all residents in the
    establishment including, but not limited to, those who:
              (A)  may wander; and
              (B)  may need supervision and  assistance  when
         evacuating the building in an emergency;
         (4)  provide  coordination  of  communications  with
    each  resident,  resident's representative, relatives and
    other persons identified in the resident's service plan;
         (5)  provide cognitive stimulation and activities to
    maximize functioning;
         (6)  provide an appropriate number of staff for  its
    resident population, as established by rule;
         (7)  require   the  director  or  administrator  and
    direct care staff to  complete  sufficient  comprehensive
    and  ongoing dementia and cognitive deficit training, the
    content of which shall be established by rule; and
         (8)  develop  emergency  procedures   and   staffing
    patterns to respond to the needs of residents.
(Source: P.A. 91-656, eff. 1-1-01.)

    Section  99.  Effective date.  This Act takes effect upon
becoming law.