HB4751ham002 98TH GENERAL ASSEMBLY

Rep. Elgie R. Sims, Jr.

Filed: 3/24/2014

09800HB4751ham002 LRB098 16945 RPS 57314 a

AMENDMENT TO HOUSE BILL 4751

AMENDMENT NO. ______. Amend House Bill 4751 by replacing everything after the enacting clause with the following:

"Section 5. The Nursing Home Care Act is amended by changing Sections 3-304, 3-304.2, 3-402, 3-501, and 3-502 as follows:

(210 ILCS 45/3-304) (from Ch. 111 1/2, par. 4153-304)

Sec. 3-304. (a) The Department shall prepare on a quarterly basis a list containing the names and addresses of all facilities against which the Department during the previous quarter has:

(1) sent a notice under Section 3-307 regarding a penalty assessment under subsection (1) of Section 3-305;

(2) sent a notice of license revocation under Section 3-119;

(3) sent a notice refusing renewal of a license under Section 3-119;

(4) sent a notice to suspend a license under Section 3-119;

(5) issued a conditional license for violations that have not been corrected under Section 3-303 or penalties or fines described under Section 3-305 have been assessed under Section 3-307 or 3-308;

(6) placed a monitor under Section 3-304.2 subsections (a), (b) and (c) of Section 3-501 and under subsection (d) of such Section where license revocation or nonrenewal notices have also been issued;

(7) initiated an action to appoint a receiver;

(8) recommended to the Director of Healthcare and Family Services (formerly Director of the Department of Public Aid), or the Secretary of the United States Department of Health and Human Services, the decertification for violations in relation to patient care of a facility pursuant to Titles XVIII and XIX of the federal Social Security Act.

(b) In addition to the name and address of the facility, the list shall include the name and address of the person or licensee against whom the action has been initiated, a self-explanatory summary of the facts which warranted the initiation of each action, the type of action initiated, the date of the initiation of the action, the amount of the penalty sought to be assessed, if any, and the final disposition of the action, if completed.

(c) The list shall be available to any member of the public upon oral or written request without charge.

(Source: P.A. 95-331, eff. 8-21-07.)

(210 ILCS 45/3-304.2)

Sec. 3-304.2. Designation of distressed facilities.

(a) Placement of monitors and receivers. Notwithstanding any other provision of this Act, all monitors and receivers placed in facilities licensed under this Act shall be assigned in compliance with this Section. Costs associated with the placement of monitors and receivers shall be paid from civil monetary penalties collected by the Department.

(b) Identification of distressed facilities. The Department shall adopt by rule criteria for identifying facilities as distressed and for the placement of monitors, which shall include the events set forth in Section 3-501 of this Act.

(c) Notice. The Department shall notify each facility in writing of its designation as a distressed facility and of the calculation on which it is based. The notice shall provide the form and manner by which a facility may seek an appeal of this designation. No further action shall be taken against the facility until all rights of appeal have been exhausted.

(d) Plan of improvement. A facility identified as a distressed facility shall have 30 days from the date that all appeals rights have been exhausted to submit a plan of improvement to the Department. Modification to the physical structure of the facility included in the plan of improvement shall not require action of the Health Facilities and Services Review Board.

(e) Compliance. The facility shall have 180 days from the date the facility receives notice of the approval of the plan of improvement to comply with the contents of the plan. The facility may seek an amendment to the plan of improvement at any time prior to achieving compliance. A facility determined by the Department to have met the terms of the plan of improvement shall no longer be identified as a distressed facility.

(f) Equity grant. The Department may award a grant under the Equity in Long-term Care Quality Act to a facility to assist the facility in achieving compliance with the plan of improvement. Grant applications shall be submitted to the Department in the form and manner prescribed by the Department. The application may be submitted with the plan of improvement or at some later date, but must be submitted prior to compliance with the plan of improvement.

(g) Failure to implement a plan of improvement. A facility that has been determined by the Department to have failed to achieve compliance with an approved plan of improvement at the end of the 180 day period provided in subsection (e) or (l) may, at the Department's discretion, have its name published on the Department's website as a distressed facility. If the Department determines that the facility is showing a good faith effort to achieve compliance, the Department may, at its discretion, extend the compliance period by an additional 180 days.

(h) Monitors. The Department may place a monitor in a facility that has failed to achieve compliance with the approved plan of improvement to oversee and assist the facility in coming into compliance with the plan. The monitor shall meet weekly with the facility administrator to discuss progress towards achieving compliance and to agree on additional steps needed for compliance. The monitor shall report to the Department in writing on the outcomes of the meeting and the action steps agreed to for the following week. The report shall be signed by the monitor and the facility administrator. The facility administrator may add comments to the report or may file a separate report with the Department explaining any special circumstances related to achieving full compliance with the plan of improvement.

(i) Compliance review. The facility may seek the removal of a monitor by requesting a compliance review pursuant to the plan of improvement at any time after a monitor has been placed in the facility. Upon receiving the request, the Department shall have 30 days to respond. A facility that has achieved compliance with the plan of improvement shall have its name removed from the distressed facility list and the monitor shall be removed from the facility.

(j) Appointment of a court–ordered receiver. The Department, at its discretion, may seek the appointment of a court-ordered receiver pursuant to Part 5 of Article III of this Act.

(k) Mentors. The Department, at the request of an owner of a facility identified as distressed, shall seek a mentor to assist the owner in achieving compliance with a plan of improvement.

(l) Purchase of a distressed facility. An individual who purchases a facility that has been designated as distressed shall have 60 days from the date of purchase to file a plan of improvement and an additional 180 days from receipt of the Department's approval to prove compliance with the plan. The Department may extend this period for an additional 180 days if the new owner has shown a good faith effort to achieve compliance. The facility may seek approval of an amendment to the plan of improvement at any time prior to compliance. The facility's name shall be removed from any published list of distressed facilities upon the purchase of the facility until the owner has exhausted all attempts at compliance. The facility may be awarded a grant as provided in subsection (f) of this Section to assist in achieving compliance with the plan.

(a) By May 1, 2011, and quarterly thereafter, the Department shall generate and publish quarterly a list of distressed facilities. Criteria for inclusion of certified facilities on the list shall be those used by the U.S. General Accounting Office in report 9-689, until such time as the Department by rule modifies the criteria.

(b) In deciding whether and how to modify the criteria used by the General Accounting Office, the Department shall complete a test run of any substitute criteria to determine their reliability by comparing the number of facilities identified as distressed against the number of distressed facilities generated using the criteria contained in the General Accounting Office report. The Department may not adopt substitute criteria that generate fewer facilities with a distressed designation than are produced by the General Accounting Office criteria during the test run.

(c) The Department shall, by rule, adopt criteria to identify non-Medicaid-certified facilities that are distressed and shall publish this list quarterly beginning October 1, 2011.

(d) The Department shall notify each facility of its distressed designation, and of the calculation on which it is based.

(e) A distressed facility may contract with an independent consultant meeting criteria established by the Department. If the distressed facility does not seek the assistance of an independent consultant, the Department shall place a monitor or a temporary manager in the facility, depending on the Department's assessment of the condition of the facility.

(f) Independent consultant. A facility that has been designated a distressed facility may contract with an independent consultant to develop and assist in the implementation of a plan of improvement to bring and keep the facility in compliance with this Act and, if applicable, with federal certification requirements. A facility that contracts with an independent consultant shall have 90 days to develop a plan of improvement and demonstrate a good faith effort at implementation, and another 90 days to achieve compliance and take whatever additional actions are called for in the improvement plan to maintain compliance. A facility that the Department determines has a plan of improvement likely to bring and keep the facility in compliance and that has demonstrated good faith efforts at implementation within the first 90 days may be eligible to receive a grant under the Equity in Long-term Care Quality Act to assist it in achieving and maintaining compliance. In this subsection, "independent" consultant means an individual who has no professional or financial relationship with the facility, any person with a reportable ownership interest in the facility, or any related parties. In this subsection, "related parties" has the meaning attributed to it in the instructions for completing Medicaid cost reports.

(f-5) Monitor and temporary managers. A distressed facility that does not contract with a consultant shall be assigned a monitor or a temporary manager at the Department's discretion. The cost of the temporary manager shall be paid by the facility. The temporary manager shall have the authority determined by the Department, which may grant the temporary manager any or all of the authority a court may grant a receiver. The temporary manager may apply to the Equity in Long-term Care Quality Fund for grant funds to implement the plan of improvement.

(g) The Department shall by rule establish a mentor program for owners of distressed facilities.

(h) The Department shall by rule establish sanctions (in addition to those authorized elsewhere in this Article) against distressed facilities that are not in compliance with this Act and (if applicable) with federal certification requirements. Criteria for imposing sanctions shall take into account a facility's actions to address the violations and deficiencies that caused its designation as a distressed facility, and its compliance with this Act and with federal certification requirements (if applicable), subsequent to its designation as a distressed facility, including mandatory revocations if criteria can be agreed upon by the Department, resident advocates, and representatives of the nursing home profession. By February 1, 2011, the Department shall report to the General Assembly on the results of negotiations about creating criteria for mandatory license revocations of distressed facilities and make recommendations about any statutory changes it believes are appropriate to protect the health, safety, and welfare of nursing home residents.

(i) The Department may establish by rule criteria for restricting the owner of a facility on the distressed list from acquiring additional skilled nursing facilities.

(Source: P.A. 96-1372, eff. 7-29-10; 97-813, eff. 7-13-12.)

(210 ILCS 45/3-402) (from Ch. 111 1/2, par. 4153-402)

Sec. 3-402. Involuntary transfer or discharge of a resident from a facility shall be preceded by the discussion required under Section 3-408 and by a minimum written notice of 21 days, except in one of the following instances:

(a) When an emergency transfer or discharge is ordered by the resident's attending physician because of the resident's physical or mental health care needs.

(b) When the transfer or discharge is mandated by the physical safety of other residents, the facility staff, or facility visitors, as documented in the clinical record. The Department shall be notified prior to any such involuntary transfer or discharge. The Department shall immediately offer transfer, or discharge and relocation assistance to residents transferred or discharged under this subparagraph (b), and the Department may place relocation teams as provided in Section 3-419 of this Act.

(c) When an identified offender is within the provisional admission period defined in Section 1-120.3. If the Identified Offender Report and Recommendation prepared under Section 2-201.6 shows that the identified offender poses a serious threat or danger to the physical safety of other residents, the facility staff, or facility visitors in the admitting facility and the facility determines that it is unable to provide a safe environment for the other residents, the facility staff, or facility visitors, the facility shall transfer or discharge the identified offender within 3 days after its receipt of the Identified Offender Report and Recommendation.

(Source: P.A. 96-1372, eff. 7-29-10.)

(210 ILCS 45/3-501) (from Ch. 111 1/2, par. 4153-501)

Sec. 3-501. The Department may place an employee or agent to serve as a monitor in a facility or may petition the circuit court for appointment of a receiver for a facility, or both, when any of the following conditions exist:

(a) The facility is operating without a license;

(b) The Department has suspended, revoked or refused to renew the existing license of the facility;

(c) The facility is closing or has informed the Department that it intends to close and adequate arrangements for relocation of residents have not been made at least 30 days prior to closure;

(d) The Department determines that an emergency exists, whether or not it has initiated revocation or nonrenewal procedures, if because of the unwillingness or inability of the licensee to remedy the emergency the Department believes a monitor or receiver is necessary;

(e) The Department is notified that the facility is terminated or will not be renewed for participation in the federal reimbursement program under either Title XVIII or Title XIX of the Social Security Act; or

(f) (Blank). The facility has been designated a distressed facility by the Department and does not have a consultant employed pursuant to subsection (f) of Section 3-304.2 and an acceptable plan of improvement, or the Department has reason to believe the facility is not complying with the plan of improvement. Nothing in this paragraph (f) shall preclude the Department from placing a monitor in a facility if otherwise justified by law.

As used in subsection (d) and Section 3-503, "emergency" means a threat to the health, safety or welfare of a resident that the facility is unwilling or unable to correct.

(Source: P.A. 96-1372, eff. 7-29-10.)

(210 ILCS 45/3-502) (from Ch. 111 1/2, par. 4153-502)

Sec. 3-502. Pursuant to Section 3-304.2 of this Act and taking into account In any situation described in Section 3-501, the Department may place a qualified person to act as monitor in the facility. The monitor shall, in compliance with Section 3-304.2 of this Act and all rules adopted thereunder, observe operation of the facility, assist the facility by advising it on how to comply with the State regulations, and shall report periodically to the Department on the operation of the facility.

(Source: P.A. 81-223.)

Section 99. Effective date. This Act takes effect upon becoming law.".