Illinois General Assembly - Full Text of Public Act 095-0401
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Public Act 095-0401




Public Act 095-0401
SB0867 Enrolled LRB095 05612 DRJ 25702 b

    AN ACT concerning regulation.
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
    Section 5. The Hospital Licensing Act is amended by adding
Section 10.10 as follows:
    (210 ILCS 85/10.10 new)
    Sec. 10.10. Nurse Staffing by Patient Acuity.
    (a) Findings. The Legislature finds and declares all of the
        (1) The State of Illinois has a substantial interest in
    promoting quality care and improving the delivery of health
    care services.
        (2) Evidence-based studies have shown that the basic
    principles of staffing in the acute care setting should be
    based on the complexity of patients' care needs aligned
    with available nursing skills to promote quality patient
    care consistent with professional nursing standards.
        (3) Compliance with this Section promotes an
    organizational climate that values registered nurses'
    input in meeting the health care needs of hospital
    (b) Definitions. As used in this Section:
    "Acuity model" means an assessment tool selected and
implemented by a hospital, as recommended by a nursing care
committee, that assesses the complexity of patient care needs
requiring professional nursing care and skills and aligns
patient care needs and nursing skills consistent with
professional nursing standards.
    "Department" means the Department of Public Health.
    "Direct patient care" means care provided by a registered
professional nurse with direct responsibility to oversee or
carry out medical regimens or nursing care for one or more
    "Nursing care committee" means an existing or newly created
hospital-wide committee or committees of nurses whose
functions, in part or in whole, contribute to the development,
recommendation, and review of the hospital's nurse staffing
plan established pursuant to subsection (d).
    "Registered professional nurse" means a person licensed as
a Registered Nurse under the Nursing and Advanced Practice
Nursing Act.
    "Written staffing plan for nursing care services" means a
written plan for guiding the assignment of patient care nursing
staff based on multiple nurse and patient considerations that
yield minimum staffing levels for inpatient care units and the
adopted acuity model aligning patient care needs with nursing
skills required for quality patient care consistent with
professional nursing standards.
    (c) Written staffing plan.
        (1) Every hospital shall implement a written
    hospital-wide staffing plan, recommended by a nursing care
    committee or committees, that provides for minimum direct
    care professional registered nurse-to-patient staffing
    needs for each inpatient care unit. The written
    hospital-wide staffing plan shall include, but need not be
    limited to, the following considerations:
            (A) The complexity of complete care, assessment on
        patient admission, volume of patient admissions,
        discharges and transfers, evaluation of the progress
        of a patient's problems, ongoing physical assessments,
        planning for a patient's discharge, assessment after a
        change in patient condition, and assessment of the need
        for patient referrals.
            (B) The complexity of clinical professional
        nursing judgment needed to design and implement a
        patient's nursing care plan, the need for specialized
        equipment and technology, the skill mix of other
        personnel providing or supporting direct patient care,
        and involvement in quality improvement activities,
        professional preparation, and experience.
            (C) Patient acuity and the number of patients for
        whom care is being provided.
            (D) The ongoing assessments of a unit's patient
        acuity levels and nursing staff needed shall be
        routinely made by the unit nurse manager or his or her
            (E) The identification of additional registered
        nurses available for direct patient care when
        patients' unexpected needs exceed the planned workload
        for direct care staff.
        (2) In order to provide staffing flexibility to meet
    patient needs, every hospital shall identify an acuity
    model for adjusting the staffing plan for each inpatient
    care unit.
        (3) The written staffing plan shall be posted in a
    conspicuous and accessible location for both patients and
    direct care staff, as required under the Hospital Report
    Card Act.
    (d) Nursing care committee.
        (1) Every hospital shall have a nursing care committee.
    A hospital shall appoint members of a committee whereby at
    least 50% of the members are registered professional nurses
    providing direct patient care.
        (2) A nursing care committee's recommendations must be
    given significant regard and weight in the hospital's
    adoption and implementation of a written staffing plan.
        (3) A nursing care committee or committees shall
    recommend a written staffing plan for the hospital based on
    the principles from the staffing components set forth in
    subsection (c). In particular, a committee or committees
    shall provide input and feedback on the following:
            (A) Selection, implementation, and evaluation of
        minimum staffing levels for inpatient care units.
            (B) Selection, implementation, and evaluation of
        an acuity model to provide staffing flexibility that
        aligns changing patient acuity with nursing skills
            (C) Selection, implementation, and evaluation of a
        written staffing plan incorporating the items
        described in subdivisions (c)(1) and (c)(2) of this
            (D) Review the following: nurse-to-patient
        staffing guidelines for all inpatient areas; and
        current acuity tools and measures in use.
        (4) A nursing care committee must address the items
    described in subparagraphs (A) through (D) of paragraph (3)
    (e) Nothing is this Section 10.10 shall be construed to
limit, alter, or modify any of the terms, conditions, or
provisions of a collective bargaining agreement entered into by
the hospital.
    Section 99. Effective date. This Act takes effect January
1, 2008.

Effective Date: 1/1/2008