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.