Section 690.10  Delegation of Authority

 

The Director of Labor or his/her designated representative of the Department shall have the power and authority to enforce and administer the Illinois Nurse Agency Act, except the authority to make a final decision in a matter after a formal hearing, which authority remains with the Director. The decision of the Director shall be considered a Final Order.

 

Section 690.20  Definitions

 

In addition to those definitions found in Section 3 of the Act, the following definitions shall apply for the purpose of these regulations:

 

"Act" means the Nurse Agency Licensing Act (Ill. Rev. Stat. 1989, ch. 111, par. 951 et seq.).

 

"Applicant" means any nurse, licensed practical nurse or certified nurse aide who interviews for employment, assignment or referral to an Illinois health care facility by a nurse agency.

 

"Certified Nurse Aide" means a nursing assistant, including a nurse's aide, orderly, or nurse technician registered with the Department of Public Health in accordance with Section 3-206 of the Nursing Home Care Act (Ill. Rev. Stat. 1989, ch. 111½, par. 4153-206).

 

"Department" means the Illinois Department of Labor.

 

"Director" means the Director of the Illinois Department of Labor and/or his/her designated representative.

 

"Health care facility" means a facility as defined in Section 3 of the Illinois Health Facilities Planning Act (Ill. Rev. Stat. 1989, ch. 111½, par. 1153) and includes the following:

 

an ambulatory surgical treatment center required to be licensed pursuant to the Ambulatory Surgical Treatment Center Act (Ill. Rev. Stat. 1989, ch. 111½, par. 157-8.1 et seq.);

 

an institution, place, building or agency required to be licensed pursuant to the Hospital Licensing Act (Ill. Rev. Stat. 1989, ch. 111½, par. 142 et seq.);

 

any institution required to be licensed pursuant to the Nursing Home Care Reform Act of 1979 (Ill. Rev. Stat. 1989, ch. 111½, par. 4151-101 et seq.);

any kidney disease treatment center, including a free standing hemodialysis unit;

 

any health maintenance organization required to be operated pursuant to the Health Maintenance Organization Act (Ill. Rev. Stat. 1989, ch. 111½, par. 1401 et seq.) and which is a qualified health maintenance organization under Section 1320(d) of the Public Health Services Act (42 U.S.C. 300e-9) or provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services:  usual physician services, hospitalization, laboratory, x-ray, emergency and preventive services, and out of area coverage; is compensated (except for co-payments) for the provision of the basic health care services listed in clause to enrolled participants by a payment which is paid on a periodic basis without regard to the date the health care services are provided and which is fixed without regard to the frequency, extent, or kind of health service actually provided; and provide physicians' services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians (organized on a group practice or individual practice basis);

 

any hospital, nursing home, ambulatory surgical treatment center, kidney disease treatment center, or health maintenance organizations maintained by the State or any department or agency thereof, but not a federally owned facility.

 

"Licensed practical nurse" means a person licensed under the Illinois Nursing Act of 1989 (Ill. Rev. Stat. 1989, ch. 111, par. 3501 et seq.) as a licensed practical nurse and practices practical nursing, which is the performance for compensation of acts in the care of the ill, injured, or infirmed, selected by and performed under the direction of a registered professional nurse, licensed physician, dentist, or podiatrist, requiring the basic nursing skill, judgment, and knowledge acquired by means of a completed course of study in an approved practical nursing education program.

 

"Licensee" means any nurse agency which is properly licensed under this Act.

"Manage" means to be in charge of the day to day operations of the agency.

 

"Nurse" means a registered nurse or a licensed practical nurse as defined in the Illinois Nursing Act of 1989, as now or hereafter amended.

 

"Nurse Agency" means any individual, firm, corporation, partnership or other legal entity that employs, assigns or refers nurses or certified nurse aides to a Health Care Facility for a fee, but does not include:

 

home health agencies licensed and operated under the Home Health Agency Licensing Act (Ill. Rev. Stat. 1989, ch. 111½, par. 2801); or

a licensed or certified individual who provides his own services to a health care facility; or

 

a subsidiary, division or other organizational entity or corporation that is wholly owned by a health care facility that provides the services of nonsalaried employees only in that facility.

 

"Registered nurse" means a person who is licensed as a professional nurse under the Illinois Nursing Act of 1987 and practices professional nursing, in all its specialties, which is the performance for compensation of any nursing act, in the nursing evaluation, observation, care and counsel of the ill, injured, or infirmed; in the maintenance of health or prevention of illness of others; the administration of medications and treatments as prescribed by a licensed physician, dentist, or podiatrist; or any act in the supervision or teaching of nursing, which requires substantial, specialized judgment and skill the proper performance of which is based on knowledge and application of the principles of biological, physical, and social science acquired by means of a completed course in an approved school of professional nursing, except those acts of medical diagnosis or prescription of therapeutic or corrective measures which are properly performed only by physicians licensed in the State of Illinois.

 

"Supervising Nurse" means a registered nurse who is responsible for overseeing the assignment of nurses and certified nurse aides to a health care facility.

 

"Transfer of Ownership" means a sale and/or transfer of a majority interest in the ownership of a nurse agency.

 

Section 690.30  Licensure

 

a)         No nurse agency, whether located within or outside the boundaries of the State of Illinois, assigning or referring nurses or certified nurse aides to Illinois health care facilities, shall be established, operated, maintained or advertised until such agency has been issued a license by the Department.

 

b)         A separate license must be issued for each location from which a nurse agency will be operated unless the nurse agency is owned and managed by the same individual, firm, corporation, partnership or other legal entity.

 

c)         An agency that is licensed as a home health care agency must also be licensed as a nurse agency if it is referring or assigning nurses or certified nurse aides to health care facilities unless the assignment or referral is as a private duty nurse or certified nurse aide for the benefit of a particular individual with payment for the services made by, or on behalf of, that individual.

 

d)         An agency that is licensed as a private employment agency must also be licensed as a nurse agency if it refers nurses or certified nurse aides to health care facilities unless such referral is only for purposes of full time employment by the health care facility.

 

Section 690.40  Contents of Application

 

An application to operate a nurse agency shall be made on a form provided by the Department.  The application and information submitted with an application are considered exempt from disclosure under Section 7(b)(iii) of the Freedom of Information Act (Ill. Rev. Stat. 1989, ch. 116, par. 207).  The application shall contain but is not limited to the following:

 

a)         Name and address, of the person, partnership, corporation or other entity that is the prospective licensee;

 

b)         If the prospective licensee is a corporation, a copy of its articles of incorporation, a copy of its current bylaws and the names and addresses of its officers and directors and the names and addresses of shareholders owning more than 5% of the corporation's stock shall be provided for an initial license.  Applications for license renewal shall contain any amendments to the articles of incorporation and bylaws.

 

c)         The name and locations of premises from which the prospective licensee will provide services;

 

d)         The name and address of the person under whose management or supervision the nurse agency will be operated;

 

e)         If the applicant has ever been convicted of a felony;

 

f)         The name of the supervising nurse, if not the same as the person who is responsible for management;

 

g)         A statement of financial solvency declaring:

 

1)         That the Nurse Agency or its owners have not been adjudged insolvent or bankrupt in a State or Federal court; and

 

2)         That a court proceeding to make a judgment of bankruptcy or insolvency with respect to the Nurse Agency or its owners is not pending in a State or Federal court.

 

In addition, the Nurse Agency agrees to inform the Director of Labor prior to a court proceeding to make judgment of insolvency or bankruptcy which will be instituted with respect to the Nurse Agency or its owners.

 

h)         A statement detailing the experience and qualifications of the prospective licensee to operate a nurse agency;

 

i)          Evidence of compliance or intent to comply with State or Federal law relating to employee compensation (Illinois Minimum Wage Law, Ill. Rev. Stat. 1989, ch. 48, par. 1001 et seq.), including but not limited to, social security taxes, State and Federal income taxes, workers' compensation (Workers' Compensation Law, Ill. Rev. Stat. 1989, ch. 48, par. 138 et seq.), unemployment taxes (Illinois Unemployment Insurance Act, (Ill. Rev. Stat. 1989, ch. 48, par. 300 et seq.), and state (Illinois Minimum Wage Law, Ill. Rev. Stat. 1989, ch. 48, par. 1001 et seq.) and federal overtime compensation laws.

 

j)          A certificate of insurance showing the prospective licensee has professional liability insurance in the amounts of at least $500,000 per incident and $1,000,000 in aggregate;

 

k)         An application must be signed and notarized.

 

Section 690.50  Fee Schedule

 

a)         The application must be accompanied by a $250.00 fee.  This fee is subject to change through rulemaking.

 

b)         The fee shall be paid by certified check, cashier's check or money order made payable to the Illinois Department of Labor.

 

Section 690.60  Expiration and Renewal

 

a)         Each license shall be for a term of one year and shall expire one year from the date of issuance unless the Department revokes or suspends the license sooner or the nurse agency changes ownership.  A period of suspension does not extend the license for any period of time.

 

b)         A licensee must apply for renewal at least 90 days prior to the expiration.

 

Section 690.70  Standards For Operation of an Agency

 

a)         Each licensee shall have a registered nurse serving as manager or supervisor of all nurses and certified nurses aides.

 

b)         Each licensee shall develop and maintain written personnel policies and procedures with regard to its nurses and certified nurse aides. Policies and Procedures must be available in each location from which an agency is operated.  Minimum standards shall include, but are not limited to:

 

1)         An in-person interview of an applicant performed or supervised by a registered nurse;

 

2)         Reference checks of an applicant:

 

A)        Every licensee shall check at least two recent references and dates of employment listed on the application unless the applicant has not had two previous employers;

 

B)        Such verification may be in writing, in person or by telephone. The licensee shall keep a written record of such reference checks in the personnel file for a period of two (2) calendar years;

 

3)         Licensee will verify with the Department of Public Health or the Department of Professional Regulation that each applicant is certified or registered as stated on application;

 

4)         An annual health examination, which shall include a Mantoux tuberculosis test, to determine the nurse or certified nurse aide is free of communicable, contagious or infectious diseases.  A physician or a RN shall administer and read the Mantoux tuberculosis test;

 

5)         An annual evaluation of each nurse or certified nurse aide; such evaluation shall be maintained in personnel file for a period of 2 years;

 

6)         CPR certification;

 

7)         Orientation procedures.

 

Section 690.80  Application for Employment, Assignment, or Referral

 

Each licensee shall require an applicant to complete in writing an application form which contains, but is not limited to the following:

 

a)         Name and address of the applicant with verification of the applicant's identity by means of a valid driver's license, Secretary of State's identification card, passport or other appropriate identification which includes a photograph of the applicant;

 

b)         Written verification from the Department of Professional Regulation indicating the license and licensure status of a RN or LPN;

 

c)         Written verification from the Department of Public Health that a CNA has been registered as having completed a course which has been certified by that agency;

 

d)         Dates and places of the most recent previous employment references;

 

e)         A statement completed within the last twelve (12) months, that the applicant:

 

1)         has been administered the Mantoux tuberculosis test by a physician or a RN.  The date the test results were read shall be indicated in writing on the application form;

 

2)         has completed a CPR training course - date of certification shall be indicated in writing on the application form;

 

3)         has completed skill inventory and listed clinical areas of competence.

 

Section 690.90  Prerequisites for Employment, Assignment, or Referral

 

a)         Every licensee shall verify:

 

1)         with the Department of Professional Regulation that each applicant RN or LPN holds a valid license; and

 

2)         with the Department of Public Health that each applicant CNA has completed certification requirements (77 Ill. Adm. Code U.C. 395).

 

b)         No licensee shall employ, assign or refer any applicant until the licensee has checked the applicant's references.

 

c)         A licensee may conditionally employ, assign, or refer a RN or LPN if the licensee has requested such verification (see subsection (a)(1)) of the current license of an applicant RN and LPN in writing from the Department of Professional Regulation; a licensee may conditionally employ, assign, or refer an applicant CNA if the licensee has requested such verification (see subsection (a)(2)) in writing from the Department of Public Health that the applicant is registered as having completed a course as approved by the Department of Public Health (77 Ill. Adm. Code U.C. 395). The length of conditional employment, referral, or assignment of the applicant is subject to approval by the Department of Labor if written verification has not been received by the Nurse Agency within 20 working days.  The length of conditional employment shall be extended to more than 20 working days only if the delay in response from the Department of Professional Regulation or the Department of Public Health was as a result of a staffing problem or clerical error.

 

d)         No nurse agency shall assign or refer an applicant to a health care facility unless the health care facility has provided the clinical area of skills required for job assignment.

 

Section 690.100  Continuing Verifications

 

a)         Monthly, the Nurse Agency shall review the disciplinary report published by the Department of Professional Regulation to determine whether any nurse it employs, assigns or refers has had his/her license suspended or revoked.

 

b)         When a RN or LPN is found to be on the disciplinary report, the nurse agency shall determine if the RN or LPN has had his/her practice limited and/or conditioned.  It shall be the responsibility of the nurse agency to advise the health care facility in writing of the limitation and/or condition.

 

            When established, the nurse agency shall monthly review the abuse report published by the Department of Public Health to determine whether any CNA it employs has appeared on the report.

 

c)         After July 1 of every even numbered year, the nurse agency shall verify with the Department of Professional Regulation that a RN continues to hold a valid, unencumbered license.  Such verification shall be in writing.

 

d)         After April 1 of every odd numbered year, the nurse agency shall verify with the Department of Professional Regulation that a LPN continues to hold a valid, unencumbered license.  Such verification shall be in writing.

 

Section 690.110  Evaluation Forms

 

a)         After first shift, licensee shall mail to the health care facility a form on which the applicant may be evaluated for:

 

1)         applicant's qualifications to perform job for which referred.

 

2)         performance of applicant.

 

b)         Licensee shall complete an annual performance evaluation of applicant. Information provided by the health care facility may be used for this purpose.

 

Section 690.120  Conditions of Employment, Assignment and Referral

 

a)         No licensee shall require, as a condition of employment, assignment or referral, that any nurse and certified nurse aide recruit nurses or certified nurse aides for the licensee from among the permanent employees of the health care facility to which the licensee's nurses or certified nurse aides have been assigned or referred.

 

b)         Health care facilities are prohibited from requiring, as a condition of employment, that their employees recruit new employees from these nurse agency employees.

 

Section 690.130  Reporting Changes in Management and Stockholders

 

a)         Each licensee shall report in writing to the Department within thirty (30) business days any changes in personnel who manage or supervise RN's, LPN's or CNA's.

 

b)         Each licensee which is a corporation shall report in writing within 30 days any changes in the list of stockholders who own more than 5% of its stock.

 

Section 690.140  Transfer of Ownership

 

a)         Each licensee whose ownership is to be tranferred shall report in writing to the Department the name of the transferee and the anticipated date of the transfer.

 

b)         The anticipated transferee shall apply for a license at least 45 days before the anticipated transfer.

 

c)         The Department may issue a license to a transferee to become effective on the date of the transfer, and the transferor's license will become void on the date the transferee's license becomes effective.  The transferor shall notify the Department in writing the day the transfer is effected.

 

Section 690.150  Inspections and Records

 

a)         The Director shall have the right to make surveys and inspections of the facilities and records of any licensee as are necessary in order to determine the status of compliance with the Act and this Part.

 

b)         All applications for employment, assignment, or referral shall be kept on the premises of the licensee and shall be open to inspection during regular business hours by the Department.

 

Section 690.160  Complaints and Investigations

 

a)         Upon complaint, the Department shall investigate an applicant or licensee.  Such complaint may be filed by any person or health facility or other nurse agency and may be in writing, in person or by telephone.  Any complaint made in person or by telephone must also be made in writing.  The Department may institute an investigation based on a nonwritten complaint if the Department determines that the public interest, safety or welfare is at risk.

 

b)         The Department shall notify the applicant or licensee in writing of the complaint and the applicant or licensee may submit comments and information.

 

c)         The name of persons who file complaints are considered confidential and are exempt from disclosure under section 7(b)(iii) of the Freedom of Information Act (Ill. Rev. Stat. 1989, ch. 116, par. 207).

 

Section 690.170  Denial of Initial License

 

A license shall be denied for any, but not limited to the following:

 

a)         failure to comply with the minimum standards set forth by the Act or Section 690.70;

 

b)         a felony conviction of the prospective licensee;

 

c)         statement of financial solvency (see Section 690.40(g));

 

d)         failure to establish personnel policies and procedures for selecting nurses and certified nurse aides for employment, assignment or referral.

 

Section 690.180  Denial of Renewal or Revocation of License

 

a)         An application for a renewal of a license shall be denied for, but not limited to:

 

1)         any of the reasons for denial of the original license listed in Section 690.170;

 

2)         for any violations of provisions of the Act or of this Part;

 

3)         for refusal to pay a fine.

 

b)         A license shall be revoked for, but not limited to, any of the following reasons:

 

1)         for any of the reasons for which a license may be denied as listed in Section 690.170;

 

2)         for violations of provisions of the Act or of this Part;

 

3)         for refusal to pay a fine; or

 

4)         for any conduct or practice found as a result of an administrative hearing, to be detrimental to the public's right to high quality health care.

 

Section 690.190  Hearings

 

a)         Before denying any application or refusing to renew a license, revoking or suspending a license, or imposing a fine, the Department shall notify the applicant or licensee in writing by certified mail, setting forth the particular reason for the proposed action and fixing a date, not less than 14 days from the date of such mailing, at which time the applicant or licensee shall be given an opportunity for a hearing.

 

b)         Hearings conducted under this Part are formal in nature and subject to the Departmental hearing rules at 56 Ill. Adm. Code 120.

 

(Source:  Amended at 25 Ill. Reg. 874, effective January 5, 2001)

 

Section 690.200  Considerations in Reaching a Decision

 

In determining whether to revoke, suspend, refuse to issue or to renew a license, or to impose a fine and the amount of the fine the Director shall consider:

 

a)         Whether the finding constitutes a technical error;

 

b)         Whether the finding is serious enough to constitute an actual violation of the intent and purpose of a particular provision of the Act or this Part;

 

c)         Whether the violation could pose any direct or potential harm to a patient in a health care facility;

 

d)         Whether the applicant or licensee has taken steps to correct the noted violations; and

 

e)         Whether the same violation or similar violations relating to the same conditions or occurrences have been included in previous reports and the licensee has allowed the condition or occurrence to continue or to recur.

 

Section 690.210  Fines

 

a)         The Director may impose a fine not to exceed $1000 for operating a nurse agency without a license; referring or assigning a person who does not hold a currently valid license as a nurse issued by the Department of Professional Regulation, or is not registered with the Department of Public Health as a certified nurse aide; or for failure to have and maintain sufficient liability insurance.

 

b)         The Director may impose a fine not to exceed $500 for submission of false or misleading information, or a fine not to exceed $300 for the failure to provide or maintain information in accordance with the Act or this Part.

 

c)         The Director may impose a fine not to exceed $500 for violation of any other Section of this Part.

 

d)         A fine may be imposed in addition to a suspension, revocation or refusal to renew a license.

 

Section 690.220  Subpoena

 

The Director shall, upon his/her own motion or on the written request of any party to a proceeding, issue subpoenas requiring the attendance and the giving of testimony by witnesses and subpoenas duces tecum requiring the production of books, papers, records or memoranda.

 

Section 690.230  Determination

 

Any determination based on investigation by the Illinois Department of Labor shall be considered a contested case subject to the Administrative Procedure Act (Ill. Rev. Stat. 1991, ch. 127, par. 1001-1 et seq.) and the final decision will be in writing.

 

Section 690.240  Administrative Review

 

The decision may be reviewed under the Administrative Review Law (Ill. Rev. Stat. 1989, ch. 110, par. 3-101 et seq.).