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| Public Act 102-0947 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Nursing Home Care Act is amended by | ||||
changing Sections 3-212 and 3-702 as follows:
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(210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
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Sec. 3-212. Inspection.
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(a) The Department, whenever it deems necessary in
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accordance with subsection (b), shall inspect, survey and | ||||
evaluate every
facility to determine compliance with | ||||
applicable licensure requirements and
standards. Submission of | ||||
a facility's current Consumer Choice Information Report | ||||
required by Section 2-214 shall be verified at time of | ||||
inspection. An inspection should occur within 120 days prior
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to license renewal. The Department may periodically visit a | ||||
facility for the
purpose of consultation. An inspection, | ||||
survey, or evaluation, other than
an inspection of financial | ||||
records, shall be conducted without prior notice
to the | ||||
facility. A visit for the sole purpose of consultation may be
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announced.
The Department shall provide training to surveyors | ||||
about the appropriate
assessment, care planning, and care of | ||||
persons with mental illness (other than
Alzheimer's disease or | ||||
related disorders) to enable its surveyors to
determine | ||||
whether a facility is complying with State and federal | ||
requirements
about the assessment, care planning, and care of | ||
those persons.
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(a-1) An employee of a State or unit of local government | ||
agency
charged with inspecting, surveying, and evaluating | ||
facilities who directly
or indirectly gives prior notice of an | ||
inspection, survey, or evaluation,
other than an inspection of | ||
financial records, to a facility or to an
employee of a | ||
facility is guilty of a Class A misdemeanor.
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An inspector or an employee of the Department who | ||
intentionally prenotifies
a facility,
orally or in writing, of | ||
a pending complaint investigation or inspection shall
be | ||
guilty of a Class A misdemeanor.
Superiors of persons who have | ||
prenotified a facility shall be subject to the
same penalties, | ||
if they have knowingly allowed the prenotification. A person
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found guilty of prenotifying a facility shall be subject to | ||
disciplinary action
by his or her employer.
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If the Department has a good faith belief, based upon | ||
information that comes
to its attention, that a violation of | ||
this subsection has occurred, it must
file a complaint with | ||
the Attorney General or the State's Attorney in the
county | ||
where the violation
took place within 30 days after discovery | ||
of the information.
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(a-2) An employee of a State or unit of local government | ||
agency charged with
inspecting, surveying, or evaluating | ||
facilities who willfully profits from
violating the | ||
confidentiality of the inspection, survey, or evaluation
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process shall be guilty of a Class 4 felony and that conduct | ||
shall be deemed
unprofessional conduct that may subject a | ||
person to loss of his or her
professional license. An action to | ||
prosecute a person for violating this
subsection (a-2) may be | ||
brought by either the Attorney General or the State's
Attorney | ||
in the county where the violation took place.
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(a-3) The Department shall, by rule, establish guidelines | ||
for required continuing education of all employees who | ||
inspect, survey, or evaluate a facility. The Department shall | ||
offer continuing education opportunities at least quarterly. | ||
Employees of a State agency charged with inspecting, | ||
surveying, or evaluating a facility are required to complete | ||
at least 10 hours of continuing education annually on topics | ||
that support the survey process, including, but not limited | ||
to, trauma-informed care, infection control, abuse and | ||
neglect, and civil monetary penalties. Qualifying hours of | ||
continuing education intended to fulfill the requirements of | ||
this subsection shall only be offered by the Department. | ||
Content presented during the continuing education shall be | ||
consistent throughout the State, regardless of survey region. | ||
At least 5 of the 10 hours of continuing education required | ||
under this subsection shall be separate and distinct from any | ||
continuing education hours required for any license that the | ||
employee holds. Any continuing education hours provided by the | ||
Department in addition to the 10 hours of continuing education | ||
required under this subsection may count towards continuing | ||
education hours required for any license that the employee | ||
holds. | ||
(b) In determining whether to make more than the required | ||
number of
unannounced inspections, surveys and evaluations of | ||
a facility the
Department shall consider one or more of the | ||
following: previous inspection
reports; the facility's history | ||
of compliance with standards, rules and
regulations | ||
promulgated under this Act and correction of violations,
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penalties or other enforcement actions; the number and | ||
severity of
complaints received about the facility; any | ||
allegations of resident abuse
or neglect; weather conditions; | ||
health emergencies; other reasonable belief
that deficiencies | ||
exist.
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(b-1) The Department shall not be required to determine | ||
whether a
facility certified to participate in the Medicare | ||
program under Title XVIII of
the Social Security Act, or the | ||
Medicaid program under Title XIX of the Social
Security Act, | ||
and which the Department determines by inspection under this
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Section or under Section 3-702 of this Act to be in compliance | ||
with the
certification requirements of Title XVIII or XIX, is | ||
in compliance with any
requirement of this Act that is less | ||
stringent than or duplicates a federal
certification | ||
requirement. In accordance with subsection (a) of this Section
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or subsection (d) of Section 3-702, the Department shall | ||
determine whether a
certified facility is in
compliance with | ||
requirements of this Act that exceed federal certification
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requirements. If a certified facility is found to be out of | ||
compliance with
federal certification requirements, the | ||
results of an inspection conducted
pursuant to Title XVIII or | ||
XIX of the Social Security Act may be used as the
basis for | ||
enforcement remedies authorized and commenced, with the | ||
Department's discretion to evaluate whether penalties are | ||
warranted, under this Act.
Enforcement of this Act against a | ||
certified facility shall be commenced
pursuant to the | ||
requirements of this Act, unless enforcement remedies sought
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pursuant to Title XVIII or XIX of the Social Security Act | ||
exceed those
authorized by this Act. As used in this | ||
subsection, "enforcement remedy"
means a sanction for | ||
violating a federal certification requirement or this
Act.
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(c) Upon completion of each inspection, survey and | ||
evaluation, the
appropriate Department personnel who conducted | ||
the inspection, survey or
evaluation shall submit a physical | ||
or electronic copy of their report to the licensee upon | ||
exiting
the facility, and shall submit the actual report to | ||
the appropriate
regional office of the Department. Such report | ||
and any recommendations for
action by the Department under | ||
this Act shall be transmitted to the
appropriate offices of | ||
the associate director of the Department, together
with | ||
related comments or documentation provided by the licensee | ||
which may
refute findings in the report, which explain | ||
extenuating circumstances that
the facility could not | ||
reasonably have prevented, or which indicate methods
and | ||
timetables for correction of deficiencies described in the | ||
report.
Without affecting the application of subsection (a) of | ||
Section 3-303, any
documentation or comments of the licensee | ||
shall be provided within 10
days of receipt of the copy of the | ||
report. Such report shall recommend to
the Director | ||
appropriate action under this Act with respect to findings
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against a facility. The Director shall then determine whether | ||
the report's
findings constitute a violation or violations of | ||
which the facility must be
given notice. Such determination | ||
shall be based upon the severity of the
finding, the danger | ||
posed to resident health and safety, the comments and
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documentation provided by the facility, the diligence and | ||
efforts to
correct deficiencies, correction of the reported | ||
deficiencies, the
frequency and duration of similar findings | ||
in previous reports and the
facility's general inspection | ||
history. Violations shall be determined
under this subsection | ||
no later than 75 days after completion of each
inspection, | ||
survey and evaluation.
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(d) The Department shall maintain all inspection, survey | ||
and evaluation
reports for at least 5 years in a manner | ||
accessible to and understandable
by the public.
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(e) Revisit surveys. The Department shall conduct a | ||
revisit to its licensure and certification surveys, consistent | ||
with federal regulations and guidelines. | ||
(f) Notwithstanding any other provision of this Act, the | ||
Department shall, no later than 180 days after the effective | ||
date of this amendatory Act of the 98th General Assembly, | ||
implement a single survey process that encompasses federal | ||
certification and State licensure requirements, health and | ||
life safety requirements, and an enhanced complaint | ||
investigation initiative. | ||
(1) To meet the requirement of a single survey | ||
process, the portions of the health and life safety survey | ||
associated with federal certification and State licensure | ||
surveys must be started within 7 working days of each | ||
other. Nothing in this paragraph (1) of subsection (f) of | ||
this Section applies to a complaint investigation. | ||
(2) The enhanced complaint and incident report | ||
investigation initiative shall permit the facility to | ||
challenge the amount of the fine due to the excessive | ||
length of the investigation which results in one or more | ||
of the following conditions: | ||
(A) prohibits the timely development and | ||
implementation of a plan of correction; | ||
(B) creates undue financial hardship impacting the | ||
quality of care delivered to the resident; | ||
(C) delays initiation of corrective training; and | ||
(D) negatively impacts quality assurance and | ||
patient improvement standards. | ||
This paragraph (2) does not apply to complaint | ||
investigations exited within 14 working days or a | ||
situation that triggers an extended survey. | ||
(Source: P.A. 98-104, eff. 7-22-13.)
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(210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
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Sec. 3-702.
(a) A person who believes that this Act or a | ||
rule promulgated
under this Act may have been violated may | ||
request an investigation. The
request may be submitted to the | ||
Department in writing, by telephone, by electronic means, or | ||
by
personal visit. An oral complaint shall be reduced to | ||
writing by the
Department. The Department shall make | ||
available, through its website and upon request, information | ||
regarding the oral and phone intake processes and the list of | ||
questions that will be asked of the complainant. The | ||
Department shall request information identifying the
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complainant, including the name, address and telephone number, | ||
to help
enable appropriate follow-up. The Department shall act | ||
on such complaints
via on-site visits or other methods deemed | ||
appropriate to handle the
complaints with or without such | ||
identifying information, as otherwise
provided under this | ||
Section. The complainant shall be informed that
compliance | ||
with such request is not required to satisfy the procedures | ||
for
filing a complaint under this Act. The Department must | ||
notify complainants that complaints with less information | ||
provided are far more difficult to respond to and investigate.
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(b) The substance of the complaint shall be provided in | ||
writing to the
licensee, owner, or administrator no earlier | ||
than at the commencement of an
on-site inspection of the | ||
facility which takes place pursuant to the complaint.
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(c) The Department shall not disclose the name of the | ||
complainant unless
the complainant consents in writing to the | ||
disclosure or the investigation
results in a judicial | ||
proceeding, or unless disclosure is essential to the
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investigation. The complainant shall be given the opportunity | ||
to withdraw
the complaint before disclosure. Upon the request | ||
of the complainant, the
Department may permit the complainant | ||
or a representative of the complainant
to accompany the person | ||
making the on-site inspection of the facility.
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(d) Upon receipt of a complaint, the Department shall | ||
determine whether this
Act or a rule promulgated under this | ||
Act has been or is being violated. The
Department shall | ||
investigate all complaints alleging abuse or neglect within
7 | ||
days after the receipt of the complaint except that complaints | ||
of abuse
or neglect which indicate that a resident's life or | ||
safety is in imminent
danger shall be investigated within 24 | ||
hours after receipt of the
complaint. All other complaints | ||
shall be investigated within 30 days after
the receipt of the | ||
complaint. The Department employees investigating a
complaint | ||
shall conduct a brief, informal exit conference with the | ||
facility
to alert its administration of any suspected serious | ||
deficiency that poses
a direct threat to the health, safety or | ||
welfare of a resident to enable an
immediate correction for | ||
the alleviation or elimination of such threat.
Such | ||
information and findings discussed in the brief exit | ||
conference shall
become a part of the investigating record but | ||
shall not in any way
constitute an official or final notice of | ||
violation as provided under
Section 3-301. All complaints | ||
shall be classified as
"an invalid report", "a valid report", | ||
or "an undetermined
report". For any complaint classified as | ||
"a valid report", the
Department must determine within 30 | ||
working days after any Department employee enters a facility | ||
to begin an on-site inspection
if any rule or provision of this | ||
Act has been or is being violated.
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(d-1) The Department shall, whenever possible, combine an | ||
on-site
investigation of a complaint in a facility with other | ||
inspections in order
to avoid duplication of inspections.
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(e) In all cases, the Department shall inform the | ||
complainant of its
findings within 10 days of its | ||
determination unless otherwise indicated
by the complainant, | ||
and the complainant may direct the Department to
send a copy of | ||
such findings to another person. The Department's findings
may | ||
include comments or documentation provided by either the | ||
complainant
or the licensee pertaining to the complaint. The | ||
Department shall also
notify the facility of such findings | ||
within 10 days of the determination,
but the name of the | ||
complainant or residents shall not be disclosed in this
notice | ||
to the facility. The notice of such
findings shall include a | ||
copy of the written determination; the
correction order, if | ||
any; the warning notice, if any; the inspection
report; or the | ||
State licensure form on which the violation is listed.
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(f) A written determination, correction order, or warning | ||
notice
concerning a complaint, together with the facility's | ||
response, shall be
available for public inspection, but the | ||
name of the complainant or
resident shall not be disclosed | ||
without his consent.
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(g) A complainant who is dissatisfied with the | ||
determination or
investigation by the Department may request a | ||
hearing under Section
3-703. The facility shall be given | ||
notice of any such
hearing and may participate in the hearing | ||
as a party. If a facility
requests a hearing under Section | ||
3-703 which
concerns a matter covered by a complaint, the | ||
complainant shall be given
notice and may participate in the | ||
hearing as a party. A request
for a hearing by either a | ||
complainant or a facility shall be
submitted in writing to the | ||
Department within 30 days after the mailing
of the | ||
Department's findings as described in subsection (e) of this
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Section. Upon receipt of the request the Department shall | ||
conduct a hearing
as provided under Section 3-703.
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(g-5) The Department shall conduct an annual review of all | ||
survey activity from the preceding fiscal year and make a | ||
report concerning the complaint and survey process. The report | ||
shall include, but not be limited to: that includes the total | ||
number of complaints received; the breakdown of 24-hour, | ||
7-day, and 30-day complaints; , the breakdown of anonymous and | ||
non-anonymous complaints; and whether the number of complaints | ||
that were substantiated versus unsubstantiated; or not, the | ||
total number of substantiated complaints that were completed | ||
in the time frame determined under subsection (d); the total | ||
number of informal dispute resolutions requested; the total | ||
number of informal dispute resolution requests approved; the | ||
total number of informal dispute resolutions that were | ||
overturned or reduced in severity; the total number of nurse | ||
surveyors
hired during the calendar year; the total number of | ||
nurse
surveyors who left Department employment; the average | ||
length of tenure for nurse surveyors employed by the | ||
Department at the time the report is created; the total number | ||
of times the Department imposed discretionary denial of | ||
payment within 15 days of notice and within 2 days of notice as | ||
well as the number of times the discretionary denial of | ||
payment took effect; , and any other complaint information | ||
requested by the Long-Term Care Facility Advisory Board | ||
created under Section 2-204 of this Act or the Illinois | ||
Long-Term Care Council created under Section 4.04a of the | ||
Illinois Act on the Aging. This report shall be provided to the | ||
Long-Term Care Facility Advisory Board, the Illinois Long-Term | ||
Care Council, and the General Assembly. The Long-Term Care | ||
Facility Advisory Board and the Illinois Long-Term Care | ||
Council shall review the report and suggest any changes deemed | ||
necessary to the Department for review and action, including | ||
how to investigate and substantiate anonymous complaints. | ||
(h) Any person who knowingly transmits a false report to | ||
the
Department commits the offense of disorderly conduct under | ||
subsection
(a)(8) of Section 26-1 of the Criminal Code of | ||
2012.
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(Source: P.A. 102-432, eff. 8-20-21.)
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