Public Act 0844 103RD GENERAL ASSEMBLY
 

 
Public Act 103-0844
 
HB5000 EnrolledLRB103 38511 CES 68647 b

    AN ACT concerning regulation.
 
    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 10, 75, and 76 as follows:
 
    (210 ILCS 9/10)
    Sec. 10. Definitions. For purposes of this Act:
    "Activities of daily living" means eating, dressing, 
bathing, toileting, transferring, or personal hygiene.
    "Assisted living establishment" or "establishment" means a 
home, building, residence, or any other place where sleeping 
accommodations are provided for at least 3 unrelated adults, 
at least 80% of whom are 55 years of age or older and where the 
following are provided consistent with the purposes of this 
Act:
        (1) services consistent with a social model that is 
    based on the premise that the resident's unit in assisted 
    living and shared housing is his or her own home;
        (2) community-based residential care for persons who 
    need assistance with activities of daily living, including 
    personal, supportive, and intermittent health-related 
    services available 24 hours per day, if needed, to meet 
    the scheduled and unscheduled needs of a resident;
        (3) mandatory services, whether provided directly by 
    the establishment or by another entity arranged for by the 
    establishment, with the consent of the resident or 
    resident's representative; and
        (4) a physical environment that is a homelike setting 
    that includes the following and such other elements as 
    established by the Department: individual living units 
    each of which shall accommodate small kitchen appliances 
    and contain private bathing, washing, and toilet 
    facilities, or private washing and toilet facilities with 
    a common bathing room readily accessible to each resident. 
    Units shall be maintained for single occupancy except in 
    cases in which 2 residents choose to share a unit. 
    Sufficient common space shall exist to permit individual 
    and group activities.
    "Assisted living establishment" or "establishment" does 
not mean any of the following:
        (1) A home, institution, or similar place operated by 
    the federal government or the State of Illinois.
        (2) A long term care facility licensed under the 
    Nursing Home Care Act, a facility licensed under the 
    Specialized Mental Health Rehabilitation Act of 2013, a 
    facility licensed under the ID/DD Community Care Act, or a 
    facility licensed under the MC/DD Act. However, a facility 
    licensed under any of those Acts may convert distinct 
    parts of the facility to assisted living. If the facility 
    elects to do so, the facility shall retain the Certificate 
    of Need for its nursing and sheltered care beds that were 
    converted.
        (3) A hospital, sanitarium, or other institution, the 
    principal activity or business of which is the diagnosis, 
    care, and treatment of human illness and that is required 
    to be licensed under the Hospital Licensing Act.
        (4) A facility for child care as defined in the Child 
    Care Act of 1969.
        (5) A community living facility as defined in the 
    Community Living Facilities Licensing Act.
        (6) A nursing home or sanitarium operated solely by 
    and for persons who rely exclusively upon treatment by 
    spiritual means through prayer in accordance with the 
    creed or tenants of a well-recognized church or religious 
    denomination.
        (7) A facility licensed by the Department of Human 
    Services as a community-integrated living arrangement as 
    defined in the Community-Integrated Living Arrangements 
    Licensure and Certification Act.
        (8) A supportive residence licensed under the 
    Supportive Residences Licensing Act.
        (9) The portion of a life care facility as defined in 
    the Life Care Facilities Act not licensed as an assisted 
    living establishment under this Act; a life care facility 
    may apply under this Act to convert sections of the 
    community to assisted living.
        (10) A free-standing hospice facility licensed under 
    the Hospice Program Licensing Act.
        (11) A shared housing establishment.
        (12) A supportive living facility as described in 
    Section 5-5.01a of the Illinois Public Aid Code.
    "Department" means the Department of Public Health.
    "Director" means the Director of Public Health.
    "Emergency situation" means imminent danger of death or 
serious physical harm to a resident of an establishment.
    "Infection control committee" means persons, including an 
infection preventionist, who develop and implement policies 
governing control of infections and communicable diseases and 
are qualified through education, training, experience, or 
certification or a combination of such qualifications. 
    "Infection preventionist" means a registered nurse who 
develops and implements policies governing control of 
infections and communicable diseases and is qualified through 
education, training, experience, or certification or a 
combination of such qualifications. 
    "License" means any of the following types of licenses 
issued to an applicant or licensee by the Department:
        (1) "Probationary license" means a license issued to 
    an applicant or licensee that has not held a license under 
    this Act prior to its application or pursuant to a license 
    transfer in accordance with Section 50 of this Act.
        (2) "Regular license" means a license issued by the 
    Department to an applicant or licensee that is in 
    substantial compliance with this Act and any rules 
    promulgated under this Act.
    "Licensee" means a person, agency, association, 
corporation, partnership, or organization that has been issued 
a license to operate an assisted living or shared housing 
establishment. 
    "Licensed health care professional" means a registered 
professional nurse, an advanced practice registered nurse, a 
physician assistant, and a licensed practical nurse.
    "Mandatory services" include the following:
        (1) 3 meals per day available to the residents 
    prepared by the establishment or an outside contractor;
        (2) housekeeping services including, but not limited 
    to, vacuuming, dusting, and cleaning the resident's unit;
        (3) personal laundry and linen services available to 
    the residents provided or arranged for by the 
    establishment;
        (4) security provided 24 hours each day including, but 
    not limited to, locked entrances or building or contract 
    security personnel;
        (5) an emergency communication response system, which 
    is a procedure in place 24 hours each day by which a 
    resident can notify building management, an emergency 
    response vendor, or others able to respond to his or her 
    need for assistance; and
        (6) assistance with activities of daily living as 
    required by each resident.
    "Negotiated risk" is the process by which a resident, or 
his or her representative, may formally negotiate with 
providers what risks each are willing and unwilling to assume 
in service provision and the resident's living environment. 
The provider assures that the resident and the resident's 
representative, if any, are informed of the risks of these 
decisions and of the potential consequences of assuming these 
risks.
    "Owner" means the individual, partnership, corporation, 
association, or other person who owns an assisted living or 
shared housing establishment. In the event an assisted living 
or shared housing establishment is operated by a person who 
leases or manages the physical plant, which is owned by 
another person, "owner" means the person who operates the 
assisted living or shared housing establishment, except that 
if the person who owns the physical plant is an affiliate of 
the person who operates the assisted living or shared housing 
establishment and has significant control over the day to day 
operations of the assisted living or shared housing 
establishment, the person who owns the physical plant shall 
incur jointly and severally with the owner all liabilities 
imposed on an owner under this Act.
    "Physician" means a person licensed under the Medical 
Practice Act of 1987 to practice medicine in all of its 
branches.
    "Resident" means a person residing in an assisted living 
or shared housing establishment.
    "Resident's representative" means a person, other than the 
owner, agent, or employee of an establishment or of the health 
care provider unless related to the resident, designated in 
writing by a resident to be his or her representative. This 
designation may be accomplished through the Illinois Power of 
Attorney Act, pursuant to the guardianship process under the 
Probate Act of 1975, or pursuant to an executed designation of 
representative form specified by the Department.
    "Self" means the individual or the individual's designated 
representative.
    "Shared housing establishment" or "establishment" means a 
publicly or privately operated free-standing residence for 16 
or fewer persons, at least 80% of whom are 55 years of age or 
older and who are unrelated to the owners and one manager of 
the residence, where the following are provided:
        (1) services consistent with a social model that is 
    based on the premise that the resident's unit is his or her 
    own home;
        (2) community-based residential care for persons who 
    need assistance with activities of daily living, including 
    housing and personal, supportive, and intermittent 
    health-related services available 24 hours per day, if 
    needed, to meet the scheduled and unscheduled needs of a 
    resident; and
        (3) mandatory services, whether provided directly by 
    the establishment or by another entity arranged for by the 
    establishment, with the consent of the resident or the 
    resident's representative.
    "Shared housing establishment" or "establishment" does not 
mean any of the following:
        (1) A home, institution, or similar place operated by 
    the federal government or the State of Illinois.
        (2) A long term care facility licensed under the 
    Nursing Home Care Act, a facility licensed under the 
    Specialized Mental Health Rehabilitation Act of 2013, a 
    facility licensed under the ID/DD Community Care Act, or a 
    facility licensed under the MC/DD Act. A facility licensed 
    under any of those Acts may, however, convert sections of 
    the facility to assisted living. If the facility elects to 
    do so, the facility shall retain the Certificate of Need 
    for its nursing beds that were converted.
        (3) A hospital, sanitarium, or other institution, the 
    principal activity or business of which is the diagnosis, 
    care, and treatment of human illness and that is required 
    to be licensed under the Hospital Licensing Act.
        (4) A facility for child care as defined in the Child 
    Care Act of 1969.
        (5) A community living facility as defined in the 
    Community Living Facilities Licensing Act.
        (6) A nursing home or sanitarium operated solely by 
    and for persons who rely exclusively upon treatment by 
    spiritual means through prayer in accordance with the 
    creed or tenants of a well-recognized church or religious 
    denomination.
        (7) A facility licensed by the Department of Human 
    Services as a community-integrated living arrangement as 
    defined in the Community-Integrated Living Arrangements 
    Licensure and Certification Act.
        (8) A supportive residence licensed under the 
    Supportive Residences Licensing Act.
        (9) A life care facility as defined in the Life Care 
    Facilities Act; a life care facility may apply under this 
    Act to convert sections of the community to assisted 
    living.
        (10) A free-standing hospice facility licensed under 
    the Hospice Program Licensing Act.
        (11) An assisted living establishment.
        (12) A supportive living facility as described in 
    Section 5-5.01a of the Illinois Public Aid Code.
    "Total assistance" means that staff or another individual 
performs the entire activity of daily living without 
participation by the resident.
(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
 
    (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 a 
    person with a substantial disability 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 or a nurse in compliance with education, 
    certification, and training in catheter care or infection 
    control by the Centers for Disease Control and Prevention 
    with oversight from an infection preventionist or 
    infection control committee;
        (10) the person requires sterile wound care unless 
    care is self-administered or administered by a licensed 
    health care professional;
        (11) (blank);
        (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 program 
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 (10) 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.
    (i) Subsection (h) is not applicable to residents admitted 
to an assisted living establishment under a life care contract 
as defined in the Life Care Facilities Act if the life care 
facility has both an assisted living establishment and a 
skilled nursing facility. A licensed health care professional 
providing health-related or supportive services at a life care 
assisted living or shared housing establishment must be 
employed by an entity licensed by the Department under the 
Nursing Home Care Act or the Home Health, Home Services, and 
Home Nursing Agency Licensing Act. 
(Source: P.A. 103-444, eff. 1-1-24.)
 
    (210 ILCS 9/76)
    Sec. 76. Vaccinations. 
    (a) Before a prospective resident's admission to an 
assisted living establishment or shared housing establishment 
that does not provide medication administration as an optional 
service, the establishment shall advise the prospective 
resident to consult a physician to determine whether the 
prospective resident should obtain a vaccination against 
pneumococcal pneumonia or influenza, or both.
    (b) An assisted living establishment or shared housing 
establishment that provides medication administration as an 
optional service shall annually administer or arrange for 
administration of a vaccination against influenza to each 
resident, in accordance with the recommendations of the 
Advisory Committee on Immunization Practices of the Centers 
for Disease Control and Prevention that are most recent to the 
time of vaccination, unless the vaccination is medically 
contraindicated or the resident has refused the vaccine. 
Influenza vaccinations for all residents age 65 or over shall 
be completed by November 30 of each year or as soon as 
practicable if vaccine supplies are not available before 
November 1. Residents admitted after November 30, during the 
flu season, and until February 1 shall, as medically 
appropriate, receive an influenza vaccination prior to or upon 
admission or as soon as practicable if vaccine supplies are 
not available at the time of the admission, unless the vaccine 
is medically contraindicated or the resident has refused the 
vaccine. In the event that the Advisory Committee on 
Immunization Practices of the Centers for Disease Control and 
Prevention determines that dates of administration other than 
those stated in this Section are optimal to protect the health 
of residents, the Department is authorized to adopt rules to 
require vaccinations at those times rather than the times 
stated in this Section. An establishment shall document in the 
resident's medication record that an annual vaccination 
against influenza was administered, arranged, refused, or 
medically contraindicated.
    An assisted living establishment or shared housing 
establishment that provides medication administration as an 
optional service shall administer or arrange for 
administration of a pneumococcal vaccination to each resident 
who is age 65 or over, in accordance with the recommendations 
of the Advisory Committee on Immunization Practices of the 
Centers for Disease Control and Prevention, who has not 
received this immunization prior to or upon admission to the 
establishment, unless the resident refuses the offer for 
vaccination or the vaccination is medically contraindicated. 
An establishment shall document in each resident's medication 
record that a vaccination against pneumococcal pneumonia was 
offered and administered, arranged, refused, or medically 
contraindicated. 
    An assisted living establishment or shared housing 
establishment that provides catheter care to one or more 
residents shall designate at least one person as an Infection 
Prevention and Control Professional to develop and implement 
policies governing control of infections and communicable 
diseases. The Infection Prevention and Control Professionals 
shall be qualified through education, training, experience, or 
certification or a combination of such qualifications. The 
Infection Prevention and Control Professional's qualifications 
shall be documented and shall be made available for inspection 
by the Department. The Department shall adopt rules to 
implement the changes made by this amendatory Act of the 103rd 
General Assembly. 
(Source: P.A. 93-1003, eff. 8-23-04; 94-429, eff. 8-2-05.)
 
    Section 99. Effective date. This Act takes effect July 1, 
2025.