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Public Act 91-0656
HB0427 Re-Enrolled LRB9101210JSpc
AN ACT to create the Assisted Living and Shared Housing
Act, amending named Acts.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Assisted Living and Shared Housing Act.
Section 5. Legislative purpose. The purpose of this Act
is to permit the development and availability of assisted
living establishments and shared housing establishments based
on a social model that promotes the dignity, individuality,
privacy, independence, autonomy, and decision-making ability
and the right to negotiated risk of those persons; to
provide for the health, safety, and welfare of those
residents residing in assisted living and shared housing
establishments in this State; to promote continuous quality
improvement in assisted living; and to encourage the
development of innovative and affordable assisted living
establishments and shared housing with service
establishments for elderly persons of all income levels. It
is the public policy of this State that assisted living is
an important part of the continuum of long term care. In
support of the goal of aging in place within the parameters
established by this Act, assisted living and shared housing
establishments shall be operated as residential environments
with supportive services designed to meet the individual
resident's changing needs and preferences. The residential
environment shall be designed to encourage family and
community involvement. The services available to residents,
either directly or through contracts or agreements, are
intended to help residents remain as independent as
possible. Assisted living, which promotes resident choice,
autonomy, and decision making, should be based on a contract
model designed to result in a negotiated agreement between
the resident or the resident's representative and the
provider, clearly identifying the services to be provided.
This model assumes that residents are able to direct services
provided for them and will designate a representative to
direct these services if they themselves are unable to do so.
This model supports the principle that there is an
acceptable balance between consumer protection and
resident willingness to accept risk and that most consumers
are competent to make their own judgments about the services
they are obtaining. Regulation of assisted living
establishments and shared housing establishments must be
sufficiently flexible to allow residents to age in place
within the parameters of this Act. The administration of this
Act and services provided must therefore ensure that the
residents have the rights and responsibilities to direct the
scope of services they receive and to make individual choices
based on their needs and preferences. These establishments
shall be operated in a manner that provides the least
restrictive and most homelike environment and that promotes
independence, autonomy, individuality, privacy, dignity, and
the right to negotiated risk in residential surroundings. It
is not the intent of the State that establishments licensed
under this Act be used as halfway houses for alcohol and
substance abusers.
Section 10. Definitions. For purposes of this Act:
"Activities of daily living" means eating, dressing,
bathing, toileting, transferring, or personal hygiene.
"Advisory Board" means the Assisted Living and Shared
Housing Advisory Board.
"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 in conjunction
with the Assisted Living and Shared Housing Advisory
Board: 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. However, a long term care facility
may convert distinct parts of the facility to assisted
living. If the long term care 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) 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) A shared housing establishment.
(12) A supportive living facility as described in
Section 5-5.0la 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.
"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 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 12
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 long term care facility may,
however, convert sections of the facility to assisted
living. If the long term care 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-intergrated 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.
Section 15. Assessment and service plan requirements.
Prior to admission to any establishment covered by this Act,
a comprehensive assessment that includes an evaluation of the
prospective resident's physical, cognitive, and psychosocial
condition shall be completed. At least annually, a
comprehensive assessment shall be completed, and upon
identification of a significant change in the resident's
condition, the resident shall be reassessed. The Department
may by rule specify circumstances under which more frequent
assessments of skin integrity and nutritional status shall be
required. The comprehensive assessment shall be completed by
a physician. Based on the assessment, a written service plan
shall be developed and mutually agreed upon by the provider
and the resident. The service plan, which shall be reviewed
annually, or more often as the resident's condition,
preferences, or service needs change, shall serve as a basis
for the service delivery contract between the provider and
the resident. Based on the assessment, the service plan may
provide for the disconnection or removal of any appliance.
Section 20. Construction and operating standards. The
Department, in consultation with the Advisory Board, shall
prescribe minimum standards for establishments. These
standards shall include:
(1) the location and construction of the
establishment, including plumbing, heating, lighting,
ventilation, and other physical conditions which shall
ensure the health, safety, and comfort of residents and
their protection from fire hazards; these standards shall
include, at a minimum, compliance with the residential
board and care occupancies chapter of the National Fire
Protection Association's Life Safety Code, local and
State building codes for the building type, and
accessibility standards of the Americans with
Disabilities Act;
(2) the number and qualifications of all personnel
having responsibility for any part of the services
provided for residents;
(3) all sanitary conditions within the
establishment and its surroundings, including water
supply, sewage disposal, food handling, infection
control, and general hygiene, which shall ensure the
health and comfort of residents;
(4) a program for adequate maintenance of physical
plant and equipment;
(5) adequate accommodations, staff, and services
for the number and types of residents for whom the
establishment is licensed;
(6) the development of evacuation and other
appropriate safety plans for use during weather, health,
fire, physical plant, environmental, and national defense
emergencies; and
(7) the maintenance of minimum financial and other
resources necessary to meet the standards established
under this Section and to operate the establishment in
accordance with this Act.
Section 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 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 is being operated without a valid
license. 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.
Section 30. Licensing.
(a) The Department, in consultation with the Advisory
Board, shall establish by rule forms, procedures, and fees
for the annual licensing of assisted living and shared
housing establishments; shall establish and enforce sanctions
and penalties for operating in violation of this Act, as
provided in Section 135 of this Act and rules adopted under
Section 110 of this Act. The Department shall conduct an
annual on-site review for each establishment covered by this
Act, which shall include, but not be limited to, compliance
with this Act and rules adopted hereunder, focus on solving
resident issues and concerns, and the quality improvement
process implemented by the establishment to address resident
issues. The quality improvement process implemented by the
establishment must benchmark performance, be customer
centered, be data driven, and focus on resident satisfaction.
(b) An establishment shall provide the following
information to the Department to be considered for licensure:
(1) the business name, street address, mailing
address, and telephone number of the establishment;
(2) the name and mailing address of the owner or
owners of the establishment and if the owner or owners
are not natural persons, identification of the type of
business entity of the owners, and the names and
addresses of the officers and members of the governing
body, or comparable persons for partnerships, limited
liability companies, or other types of business
organizations;
(3) financial information, content and form to be
determined by rules which may provide different standards
for assisted living establishments and shared housing
establishments, establishing that the project is
financially feasible;
(4) the name and mailing address of the managing
agent of the establishment, whether hired under a
management agreement or lease agreement, if different
from the owner or owners, and the name of the full-time
director;
(5) verification that the establishment has
entered or will enter into a service delivery contract as
provided in Section 90, as required under this Act, with
each resident or resident's representative;
(6) the name and address of at least one natural
person who shall be responsible for dealing with the
Department on all matters provided for in this Act, on
whom personal service of all notices and orders shall be
made, and who shall be authorized to accept service on
behalf of the owner or owners and the managing agent.
Notwithstanding a contrary provision of the Code of Civil
Procedure, personal service on the person identified
pursuant to this subsection shall be considered service
on the owner or owners and the managing agent, and it
shall not be a defense to any action that personal
service was not made on each individual or entity;
(7) the signature of the authorized representative
of the owner or owners;
(8) proof of an ongoing quality improvement program
in accordance with rules adopted by the Department in
collaboration with the Advisory Board;
(9) information about the number and types of
units, the maximum census, and the services to be
provided at the establishment, proof of compliance with
applicable State and local residential standards, and a
copy of the standard contract offered to residents;
(10) documentation of adequate liability insurance;
and
(11) other information necessary to determine the
identity and qualifications of an applicant or licensee
to operate an establishment in accordance with this Act
as required by the Department by rule.
(c) The information in the statement of ownership shall
be public information and shall be available from the
Department.
Section 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.
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.
Section 40. Probationary licenses. If the applicant
has not been previously licensed under this Act or if the
establishment is not in operation at the time the application
is made, the Department may issue a probationary license. A
probationary license shall be valid for 120 days unless
sooner suspended or revoked. Within 30 days prior to the
termination of a probationary license, the Department shall
fully and completely review the establishment and, if the
establishment meets the applicable requirements for
licensure, shall issue a license. If the Department finds
that the establishment does not meet the requirements for
licensure, but has made substantial progress toward meeting
those requirements, the license may be renewed once for a
period not to exceed 120 days from the expiration date of the
initial probationary license.
Section 45. Renewal of licenses. At least 120 days,
but not more than 150 days prior to license expiration, the
licensee shall submit an application for renewal of the
license in such form and containing such information as the
Department requires. If the application is approved, the
license shall be renewed for an additional one-year period.
If appropriate, the renewal application shall not be approved
unless the applicant has provided to the Department an
accurate disclosure document in accordance with the
Alzheimer's Special Care Disclosure Act. If the application
for renewal is not timely filed, the Department shall so
inform the licensee.
Section 50. Transfer of ownership.
(a) Whenever ownership of an establishment is
transferred from the person named in the license to any other
person, the transferee must obtain a new probationary
license. The transferee shall notify the Department of the
transfer and apply for a new license at least 30 days prior
to final transfer.
(b) The transferor shall notify the Department at least
30 days prior to final transfer. The transferor shall remain
responsible for the operation of the establishment until such
time as a license is issued to the transferee.
Section 55. Grounds for denial of a license. An
application for a license may be denied for any of the
following reasons:
(1) failure to meet any of the standards set forth
in this Act or by rules adopted by the Department under
this Act;
(2) conviction of the applicant, or if the
applicant is a firm, partnership, or association, of any
of its members, or if a corporation, the conviction of
the corporation or any of its officers or stockholders,
or of the person designated to manage or supervise the
establishment, of a felony or of 2 or more misdemeanors
involving moral turpitude during the previous 5 years as
shown by a certified copy of the record of the court of
conviction;
(3) personnel insufficient in number or unqualified
by training or experience to properly care for the
residents;
(4) insufficient financial or other resources to
operate and conduct the establishment in accordance with
standards adopted by the Department under this Act;
(5) revocation of a license during the previous 5
years, if such prior license was issued to the individual
applicant, a controlling owner or controlling combination
of owners of the applicant; or any affiliate of the
individual applicant or controlling owner of the
applicant and such individual applicant, controlling
owner of the applicant or affiliate of the applicant was
a controlling owner of the prior license; provided,
however, that the denial of an application for a license
pursuant to this Section must be supported by evidence
that the prior revocation renders the applicant
unqualified or incapable of meeting or maintaining an
establishment in accordance with the standards and rules
adopted by the Department under this Act; or
(6) the establishment is not under the direct
supervision of a full-time director, as defined by rule.
Section 60. Notice of denial; request for hearing;
hearing.
(a) Immediately upon the denial of any application or
reapplication for a license under this Act, the Department
shall notify the applicant in writing. Notice of denial
shall include a clear and concise statement of the violations
of this Act on which the denial is based and notice of the
opportunity for a hearing. If the applicant or licensee
wishes to contest the denial of a license, it shall provide
written notice to the Department of a request for a hearing
within 10 days after receipt of the notice of denial. The
Department shall commence a hearing under this Section.
(b) A request for a hearing by aggrieved persons shall
be taken to the Department as follows:
(1) Upon the receipt of a request in writing for a
hearing, the Director or a person designated in writing
by the Director to act as a hearing officer shall conduct
a hearing to review the decision.
(2) Before the hearing is held notice of the
hearing shall be sent by the Department to the person
making the request for the hearing and to the person
making the decision which is being reviewed. In the
notice the Department shall specify the date, time, and
place of the hearing, which shall be held not less than
10 days after the notice is mailed or delivered. The
notice shall designate the decision being reviewed. The
notice may be served by delivering it personally to the
parties or their representatives or by mailing it by
certified mail to the parties' addresses.
(3) The Department shall commence the hearing
within 30 days after the receipt of request for hearing.
The hearing shall proceed as expeditiously as
practicable, but in all cases shall conclude within 90
days after commencement.
(c) The Director or hearing officer shall permit any
party to appear in person and to be represented by counsel at
the hearing, at which time the applicant or licensee shall be
afforded an opportunity to present all relevant matter in
support of his or her position. In the event of the
inability of any party or the Department to procure the
attendance of witnesses to give testimony or produce books
and papers, any party or the Department may take the
deposition of witnesses in accordance with the provisions of
the laws of this State. All testimony shall be reduced to
writing, and all testimony and other evidence introduced at
the hearing shall be a part of the record of the hearing.
(d) The Director or hearing officer shall make findings
of fact in the hearing, and the Director shall render his or
her decision within 30 days after the termination of the
hearing, unless additional time not to exceed 90 days is
required by him or her for a proper disposition of the
matter. When the hearing has been conducted by a hearing
officer, the Director shall review the record and findings of
fact before rendering a decision. All decisions rendered by
the Director shall be binding upon and complied with by the
Department, the establishment, or the persons involved in the
hearing, as appropriate to each case.
Section 65. Revocation, suspension, or refusal to renew
license.
(a) The Department, after notice to the applicant or
licensee, may suspend, revoke, or refuse to renew a license
in any case in which the Department finds any of the
following:
(1) that there has been a substantial failure to
comply with this Act or the rules promulgated by the
Department under this Act;
(2) that there has been a conviction of the
licensee, or of the person designated to manage or
supervise the establishment, of a felony or of 2 or more
misdemeanors involving moral turpitude during the
previous 5 years as shown by a certified copy of the
record of the court of conviction;
(3) that the personnel is insufficient in number or
unqualified by training or experience to properly care
for the number and type of residents served by the
establishment;
(4) that the financial or other resources are
insufficient to conduct and operate the establishment in
accordance with standards promulgated by the Department
under this Act; or
(5) that the establishment is not under the direct
supervision of a full-time director, as defined by rule.
(b) Notice under this Section shall include a clear and
concise statement of the violations on which the nonrenewal
or revocation is based, the statute or rule violated, and
notice of the opportunity for a hearing under Section 60.
(c) If an establishment desires to contest the
nonrenewal or revocation of a license, the establishment
shall, within 10 days after receipt of notice under
subsection (b) of this Section, notify the Department in
writing of its request for a hearing under Section 60. Upon
receipt of the request the Department shall send notice to
the establishment and hold a hearing as provided under
Section 60.
(d) The effective date of nonrenewal or revocation of a
license by the Department shall be any of the following:
(1) until otherwise ordered by the circuit court,
revocation is effective on the date set by the Department
in the notice of revocation, or upon final action after
hearing under Section 60, whichever is later;
(2) until otherwise ordered by the circuit court,
nonrenewal is effective on the date of expiration of any
existing license, or upon final action after hearing
under Section 60, whichever is later; however, a license
shall not be deemed to have expired if the Department
fails to timely respond to a timely request for renewal
under this Act or for a hearing to contest nonrenewal; or
(3) the Department may extend the effective date of
license revocation or expiration in any case in order to
permit orderly removal and relocation of residents.
(e) The Department may refuse to issue or may suspend
the license of any person who fails to file a return, or to
pay the tax, penalty or interest shown in a filed return, or
to pay any final assessment of tax, penalty or interest, as
required by any tax Act administered by the Illinois
Department of Revenue, until such time as the requirements of
any such tax Act are satisfied.
Section 70. Service requirements. An establishment must
provide all mandatory services and may provide optional
services, including medication reminders, supervision of
self-administered medication and medication administration as
defined by this Section and nonmedical services defined by
rule, 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.
For the purposes of this Section, "medication reminders"
means reminding residents to take pre-dispensed,
self-administered medication, observing the resident, and
documenting whether or not the resident took the medication.
For the purposes of this Section, "supervision of
self-administered medication" means assisting the resident
with self-administered medication using any combination of
the following: reminding residents to take medication,
reading the medication label to residents, checking the
self-administered medication dosage against the label of the
medication, confirming that residents have obtained and are
taking the dosage as prescribed, and documenting in writing
that the resident has taken (or refused to take) the
medication. If residents are physically unable to open the
container, the container may be opened for them. Supervision
of self-administered medication shall be under the direction
of a licensed health care professional.
For the purposes of this Section, "medication
administration" refers to a licensed health care professional
employed by an establishment engaging in administering
routine insulin and vitamin B-12 injections, oral
medications, topical treatments, eye and ear drops, or
nitroglycerin patches. Non-licensed staff may not administer
any medication.
The Department shall specify by rule procedures for
medication reminders, supervision of self-administered
medication, and medication administration.
Nothing in this Act shall preclude a physician licensed
to practice medicine in all its branches from providing
services to any resident.
Section 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 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.
Section 80. Involuntary termination of residency.
(a) Residency shall be involuntarily terminated only for
the following reasons:
(1) as provided in Section 75 of this Act;
(2) nonpayment of contracted charges after the
resident and the resident's representative have received
a minimum of 30-days written notice of the delinquency
and the resident or the resident's representative has had
at least 15 days to cure the delinquency; or
(3) failure to execute a service delivery contract
or to substantially comply with its terms and conditions,
failure to comply with the assessment requirements
contained in Section 15, or failure to substantially
comply with the terms and conditions of the lease
agreement.
(b) A 30 day written notice of residency termination
shall be provided to the resident, the resident's
representative, or both, and the long term care ombudsman,
which shall include the reason for the pending action, the
date of the proposed move, and a notice, the content and form
to be set forth by rule, of the resident's right to appeal,
the steps that the resident or the resident's representative
must take to initiate an appeal, and a statement of the
resident's right to continue to reside in the establishment
until a decision is rendered. The notice shall include a
toll free telephone number to initiate an appeal and a
written hearing request form, together with a postage paid,
pre-addressed envelope to the Department. If the resident or
the resident's representative, if any, cannot read English,
the notice must be provided in a language the individual
receiving the notice can read or the establishment must
provide a translator who has been trained to assist the
resident or the resident's representative in the appeal
process. In emergency situations as defined in Section 10 of
this Act, the 30-day provision of the written notice may be
waived.
(c) The establishment shall attempt to resolve with the
resident or the resident's representative, if any,
circumstances that if not remedied have the potential of
resulting in an involuntary termination of residency and
shall document those efforts in the resident's file. This
action may occur prior to or during the 30 day notice period,
but must occur prior to the termination of the residency. In
emergency situations as defined in Section 10 of this Act,
the requirements of this subsection may be waived.
(d) A request for a hearing shall stay an involuntary
termination of residency until a decision has been rendered
by the Department, according to a process adopted by rule.
During this time period, the establishment may not terminate
or reduce any service for the purpose of making it more
difficult or impossible for the resident to remain in the
establishment.
(e) The establishment shall offer the resident and the
resident's representative, if any, residency termination and
relocation assistance including information on available
alternative placement. Residents shall be involved in
planning the move and shall choose among the available
alternative placements except when an emergency situation
makes prior resident involvement impossible. Emergency
placements are deemed temporary until the resident's input
can be sought in the final placement decision. No resident
shall be forced to remain in a temporary or permanent
placement.
(f) The Department may offer assistance to the
establishment and the resident in the preparation of
residency termination and relocation plans to assure safe and
orderly transition and to protect the resident's health,
safety, welfare, and rights. In nonemergencies, and where
possible in emergencies, the transition plan shall be
designed and implemented in advance of transfer or residency
termination.
Section 85. Contract requirements. No entity may
establish, operate, conduct, or maintain an establishment in
this State unless a written service delivery contract is
executed between the establishment and each resident or
resident's representative in accordance with Section 90 and
unless the establishment operates in accordance with the
terms of the contract. The resident or the resident's
representative shall be given a complete copy of the contract
and all supporting documents and attachments and any changes
whenever changes are made. If the resident does not
understand English and if translated documents are not
available, the establishment must explain its policies to a
responsible relative or friend or another individual who has
agreed to communicate the information to the resident.
Section 90. Contents of service delivery contract. A
contract between an establishment and a resident must be
entitled "assisted living establishment contract" or "shared
housing establishment contract" as applicable, shall be
printed in no less than 12 point type, and shall include at
least the following elements in the body or through
supporting documents or attachments:
(1) the name, street address, and mailing address
of the establishment;
(2) the name and mailing address of the owner or
owners of the establishment and, if the owner or owners
are not natural persons, the type of business entity of
the owner or owners;
(3) the name and mailing address of the managing
agent of the establishment, whether hired under a
management agreement or lease agreement, if the managing
agent is different from the owner or owners;
(4) the name and address of at least one natural
person who is authorized to accept service on behalf of
the owners and managing agent;
(5) a statement describing the license status of
the establishment and the license status of all providers
of health-related or supportive services to a resident
under arrangement with the establishment;
(6) the duration of the contract;
(7) the base rate to be paid by the resident and a
description of the services to be provided as part of
this rate;
(8) a description of any additional services to be
provided for an additional fee by the establishment
directly or by a third party provider under arrangement
with the establishment;
(9) the fee schedules outlining the cost of any
additional services;
(10) a description of the process through which the
contract may be modified, amended, or terminated;
(11) a description of the establishment's complaint
resolution process available to residents and notice of
the availability of the Department on Aging's Senior
Helpline for complaints;
(12) the name of the resident's designated
representative, if any;
(13) the resident's obligations in order to
maintain residency and receive services including
compliance with all assessments required under Section
15;
(14) the billing and payment procedures and
requirements;
(15) a statement affirming the resident's freedom
to receive services from service providers with whom the
establishment does not have a contractual arrangement,
which may also disclaim liability on the part of the
establishment for those services;
(16) a statement that medical assistance under
Article V or Article VI of the Illinois Public Aid Code
is not available for payment for services provided in an
establishment;
(17) a statement detailing the admission, risk
management, and residency termination criteria and
procedures;
(18) a statement listing the rights specified in
Section 95 and acknowledging that, by contracting with
the assisted living or shared housing establishment, the
resident does not forfeit those rights; and
(19) a statement detailing the Department's annual
on-site review process including what documents contained
in a resident's personal file shall be reviewed by the
on-site reviewer as defined by rule.
Section 95. Resident rights. No resident shall be
deprived of any rights, benefits, or privileges guaranteed by
law, the Constitution of the State of Illinois, or the
Constitution of the United States solely on account of his or
her status as a resident of an establishment, nor shall a
resident forfeit any of the following rights:
(1) the right to retain and use personal property
and a place to store personal items that is locked and
secure;
(2) the right to refuse services and to be advised
of the consequences of that refusal;
(3) the right to respect for bodily privacy and
dignity at all times, especially during care and
treatment;
(4) the right to the free exercise of religion;
(5) the right to privacy with regard to mail, phone
calls, and visitors;
(6) the right to uncensored access to the State
Ombudsman or his or her designee;
(7) the right to be free of retaliation for
criticizing the establishment or making complaints to
appropriate agencies;
(8) the right to be free of chemical and physical
restraints;
(9) the right to be free of abuse or neglect or to
refuse to perform labor;
(10) the right to confidentiality of the resident's
medical records;
(11) the right of access and the right to copy the
resident's personal files maintained by the
establishment;
(12) the right to 24 hours access to the
establishment;
(13) the right to a minimum of 90-days notice of a
planned establishment closure;
(14) the right to a minimum of 30-days notice of an
involuntary residency termination, except where the
resident poses a threat to himself or others, or in other
emergency situations, and the right to appeal such
termination; and
(15) the right to a 30-day notice of delinquency
and at least 15 days right to cure delinquency.
Section 100. Notice of closure. An owner of an
establishment licensed under this Act shall give 90 days
notice prior to voluntarily closing the establishment or
prior to closing any part of the establishment if closing the
part will require residency termination. The notice shall be
given to the Department, to any resident who must have their
residency terminated, the resident's representative, and to a
member of the resident's family, where practicable. The
notice shall state the proposed date of closing and the
reason for closing. The establishment shall offer to assist
the resident in securing an alternative placement and shall
advise the resident on available alternatives. Where the
resident is unable to choose an alternative placement and is
not under guardianship, the Department shall be notified of
the need for relocation assistance. The establishment shall
comply with all applicable laws and rules until the date of
closing, including those related to residency termination.
Section 105. Record retention. Service delivery
contracts and related documents executed by each resident or
resident's representative shall be maintained by an
establishment subject to this Act from the date of execution
until 3 years after the contract is terminated. The
establishment shall also maintain and retain records to
support compliance with each individual contract and with
applicable federal and State rules. The records and
supporting documents, as defined by rule, shall be made
available for on-site inspection by the Department upon
request at any time.
Section 110. Powers and duties of the Department.
(a) The Department shall conduct an annual unannounced
on-site visit at each assisted living and shared housing
establishment to determine compliance with applicable
licensure requirements and standards. Additional visits may
be conducted without prior notice to the assisted living or
shared housing establishment.
(b) Upon receipt of information that may indicate the
failure of the assisted living or shared housing
establishment or a service provider to comply with a
provision of this Act, the Department shall investigate the
matter or make appropriate referrals to other government
agencies and entities having jurisdiction over the subject
matter of the possible violation. The Department may also
make referrals to any public or private agency that the
Department considers available for appropriate assistance to
those involved. The Department may oversee and coordinate the
enforcement of State consumer protection policies affecting
residents residing in an establishment licensed under this
Act.
(c) The Department shall establish by rule complaint
receipt, investigation, resolution, and involuntary
residency termination procedures. Resolution procedures
shall provide for on-site review and evaluation of an
assisted living or shared housing establishment found to be
in violation of this Act within a specified period of time
based on the gravity and severity of the violation and any
pervasive pattern of occurrences of the same or similar
violations.
(d) The Governor shall establish an Assisted Living and
Shared Housing Advisory Board.
(e) The Department shall by rule establish penalties and
sanctions, which shall include, but need not be limited to,
the creation of a schedule of graduated penalties and
sanctions to include closure.
(f) The Department shall by rule establish procedures
for disclosure of information to the public, which shall
include, but not be limited to, ownership, licensure status,
frequency of complaints, disposition of substantiated
complaints, and disciplinary actions.
(g) The Department shall cooperate with, seek the advice
of, and collaborate with the Assisted Living and Shared
Housing Quality of Life Advisory Committee in the Department
on Aging on matters related to the responsibilities of the
Committee. Consistent with subsection (d) of Section 125,
the Department shall provide to the Department on Aging for
distribution to the committee copies of all administrative
rules and changes to administrative rules for review and
comment prior to notice being given to the public. If the
Committee, having been asked for its review, fails to respond
within 90 days, the rules shall be considered acted upon.
(h) Beginning January 1, 2000, the Department shall
begin drafting rules necessary for the administration of this
Act.
Section 115. Reports and access to information. The
Department may require periodic reports and shall have access
to and may reproduce or photocopy at its cost any books,
records or other documents maintained by the establishment to
the extent necessary to carry out this Act and shall not
divulge or disclose the contents of a resident's record
obtained under this Section in violation of this Act.
Section 120. Consent to review. A licensee or applicant
for a license shall be deemed to have given consent to any
authorized officer, employee, or agent of the Department to
enter and review the establishment in accordance with this
Act, except that entrance to individual rooms shall only be
given with the consent of the resident or the resident's
representative. Refusal to permit entry or review shall
constitute grounds for denial, nonrenewal, or revocation of a
license.
Section 125. Assisted Living and Shared Housing Advisory
Board.
(a) The Governor shall appoint the Assisted Living and
Shared Housing Advisory Board which shall be responsible for
advising the Director in all aspects of the administration of
the Act.
(b) The Board shall be comprised of the following
persons:
(1) the Director who shall serve as chair, ex
officio and nonvoting;
(2) the Director of Aging who shall serve as
vice-chair, ex officio and nonvoting;
(3) one representative each of the Departments of
Public Health, Public Aid, and Human Services, the
Department on Aging, the Office of the State Fire
Marshal, and the Illinois Housing Development Authority,
all nonvoting members;
(4) the State Ombudsman or his or her designee;
(5) one representative of the Association of Area
Agencies on Aging;
(6) four members selected from the recommendations
by provider organizations whose membership consist of
nursing care or assisted living establishments;
(7) one member selected from the recommendations of
provider organizations whose membership consists of home
health agencies;
(8) two residents of assisted living or shared
housing establishments;
(9) three members selected from the
recommendations of consumer organizations which engage
solely in advocacy or legal representation on behalf of
the senior population;
(10) one member who shall be a physician;
(11) one member who shall be a registered
professional nurse selected from the recommendations of
professional nursing associations; and
(12) two citizen members with expertise in the area
of gerontology research or legal research regarding
implementation of assisted living statutes.
(c) Members of the Board created by this Act shall be
appointed to serve for terms of 3 years. All members shall be
appointed by January 1, 2001. One third of the Board
members' initial terms shall expire in one year; one third in
2 years, and one third in 3 years. A member's term does not
expire until a successor is appointed by the Governor. Any
member appointed to fill a vacancy occurring prior to the
expiration of the term for which his or her predecessor was
appointed shall be appointed for the remainder of that term.
The Board shall meet at the call of the Director. The
affirmative vote of 9 members of the Board shall be
necessary for Board action. Members of this Board shall
receive no compensation for their services, however,
resident members shall be reimbursed for their actual
expenses.
(d) The Board shall be provided copies of all
administrative rules and changes to administrative rules for
review and comment prior to notice being given to the public.
If the Board, having been asked for its review, fails to
advise the Department within 90 days, the rules shall be
considered acted upon.
Section 130. Assisted Living and Shared Housing Quality
of Life Advisory Committee.
(a) For the purpose of this Section only, "Department"
means the Department on Aging and "Director" means the
Director of Aging.
(b) There shall be established within the Department on
Aging the Assisted Living and Shared Housing Quality of Life
Advisory Committee. The committee shall give advice to the
Department on activities of the assisted living ombudsman and
all other matters deemed relevant by the Director and to the
Director of Public Health on the delivery of personal care
services, the unique needs and concerns of seniors residing
in housing projects, and all other issues affecting the
quality of life of residents. At least 3 members of the
committee must serve on the Assisted Living and Shared
Housing Advisory Board. The committee shall be comprised of
19 members appointed by the Governor and composed of the
following persons or their designees: the State Ombudsman;
the Director of the Division of Long Term Care; the Director
of the Division of Older American Services; one member
representing the Department of Public Health; one member
representing the Area Agencies on Aging; one member
representing agencies providing case coordination services; 3
members each representing different provider organizations
whose membership consists of residential facilities serving
seniors; 2 members representing providers of community care
services; one member representing the Community Based
Residential Facility projects; one member representing the
Department of Public Aid's Supportive Living Facilities; two
residents of assisted living or shared housing
establishments; 2 members representing consumer groups that
engage solely in advocacy or legal representation on behalf
of the senior population; and 2 citizen members with
expertise in either gerontology research or legal research
regarding the implementation of assisted living statutes.
The Director or his or her designee shall serve as the ex
officio and nonvoting chair. The Director of Public Health
or his or her designee shall serve as the ex officio and
nonvoting vice-chair. A quorum shall consist of 10 voting
members and all decisions shall be made by simple majority.
Members of the committee shall serve for 3 years or until a
replacement has been named. Initial appointments shall have
staggered terms to permit no more than one-third of the
committee to be reappointed each year. Members of the
committee shall not receive compensation for their services
or expenses, except resident members, who shall be reimbursed
for actual expenses. The committee shall review and comment
on proposed rules to be promulgated pursuant to this Act by
the Director or the Director of Public Health. The Director
of Public Health shall provide copies of rules pursuant to
subsection (h) of Section 110. The Director shall provide
the committee copies of all administrative rules and changes
to administrative rules for review and comment prior to
notice being given to the public. If the committee, having
been asked for its review, fails to respond within 90 days,
the rules shall be considered acted upon.
(c) The Department shall conduct a study or contract for
the conducting of a study to review the effects of this Act
on the availability of housing for seniors. The study shall
evaluate whether (i) sufficient housing exists to meet the
needs of Illinois seniors for housing, (ii) the services
available under this Act meet the needs of Illinois seniors,
(iii) the private sector marketplace is an adequate supplier
of housing with services for seniors, and (iv) any other
consideration the Department and the Department of Public
Health deem relevant. The Department of Public Health
Assisted Living and Shared Housing Advisory Board shall serve
in an advisory capacity to the Department and the Committee
in the development of this report.
(d) The study mandated by subsection (c) shall be
completed and its findings and recommendations reported to
the General Assembly no later than January 1, 2003.
Section 135. Civil penalties.
(a) The Department may assess a civil penalty not to
exceed $5,000 against any establishment subject to this Act
for violations of this Act. Each day a violation continues
shall be deemed a separate violation.
(b) Beginning 180 days after the adoption of rules
under this Act, the Department may assess a civil penalty
not to exceed $3,000 against any establishment subject to
this Act for caring for a resident who exceeds the care needs
defined in this Act. Each day a violation continues shall be
deemed a separate violation.
(c) The Department is authorized to hold hearings in
contested cases regarding appeals of the penalties assessed
pursuant to this Section.
Section 140. State and private funding. Nothing in this
Act shall:
(1) require or authorize the State agency
responsible for the administration of the medical
assistance program established under Article V and
Article VI of the Illinois Public Aid Code to approve,
supply, or cover services provided in an assisted living
or shared housing establishment;
(2) require an agency or a managed care
organization to approve, supply, or cover services
provided in an assisted living or shared housing
establishment; or
(3) require any other third party payer to approve,
supply or cover medically necessary home care services
provided in an assisted living establishment.
Section 145. Conversion of facilities. Entities
licensed as facilities under the Nursing Home Care Act may
elect to convert to a license under this Act. Any facility
that chooses to convert, in whole or in part, shall follow
the requirements in the Nursing Home Care Act and rules
promulgated under that Act regarding voluntary closure and
notice to residents. Any conversion of existing beds
licensed under the Nursing Home Care Act to licensure under
this Act is exempt from review by the Health Facilities
Planning Board.
Section 150. Alzheimer and dementia programs.
(a) Except as provided in this Section, Alzheimer and
dementia programs shall comply with 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.
Section 155. Application of Act. An establishment
licensed under this Act shall obtain and maintain all other
licenses, permits, certificates, and other governmental
approvals required of it, except that a licensed assisted
living or shared housing establishment is exempt from the
provisions of the Illinois Health Facilities Planning Act.
An establishment licensed under this Act shall comply with
the requirements of all local, State, federal, and other
applicable laws, rules, and ordinances and the National Fire
Protection Association's Life Safety Code.
Section 160. Assisted Living and Shared Housing
Regulatory Fund. There is created in the State treasury a
special fund to be known as the Assisted Living and Shared
Housing Regulatory Fund. All moneys received by the
Department under this Act shall be deposited into the Fund.
Subject to appropriation, moneys in the Fund shall be used
for the administration of this Act. Interest earned on moneys
in the Fund shall be deposited into the Fund.
Section 165. Severability. The provisions of this Act
are severable under Section 1.31 of the Statute on Statutes.
Section 189. The Illinois Act on the Aging is amended by
changing Section 4.04 as follows:
(20 ILCS 105/4.04) (from Ch. 23, par. 6104.04)
Sec. 4.04. Long Term Care Ombudsman Program.
(a) Long Term Care Ombudsman Program. The Department
shall establish a Long Term Care Ombudsman Program, through
the Office of State Long Term Care Ombudsman ("the Office"),
in accordance with the provisions of the Older Americans Act
of 1965, as now or hereafter amended.
(b) Definitions. As used in this Section, unless the
context requires otherwise:
(1) "Access" has the same meaning as in Section
1-104 of the Nursing Home Care Act, as now or hereafter
amended; that is, it means the right to:
(i) Enter any long term care facility or
assisted living or shared housing establishment;
(ii) Communicate privately and without
restriction with any resident who consents to the
communication;
(iii) Seek consent to communicate privately
and without restriction with any resident;
(iv) Inspect the clinical and other records of
a resident with the express written consent of the
resident;
(v) Observe all areas of the long term care
facility or assisted living or shared housing
establishment except the living area of any resident
who protests the observation.
(2) "Long Term Care Facility" means any facility as
defined by Section 1-113 of the Nursing Home Care Act, as
now or hereafter amended.
(2.5) "Assisted living establishment" and "shared
housing establishment" have the meanings given those
terms in Section 10 of the Assisted Living and Shared
Housing Act.
(3) "Ombudsman" means any person employed by the
Department to fulfill the requirements of the Office, or
any representative of a sub-State long term care
ombudsman program; provided that the representative,
whether he is paid for or volunteers his ombudsman
services, shall be qualified and authorized by the
Department to perform the duties of an ombudsman as
specified by the Department in rules.
(c) Ombudsman; rules. The Office of State Long Term Care
Ombudsman shall be composed of at least one full-time
ombudsman within the Department and shall include a system of
designated sub-State long term care ombudsman programs. Each
sub-State program shall be designated by the Department as a
subdivision of the Office and any representative of a
sub-State program shall be treated as a representative of the
Office.
The Department shall promulgate administrative rules to
establish the responsibilities of the Department and the
Office of State Long Term Care Ombudsman. The administrative
rules shall include the responsibility of the Office to
investigate and resolve complaints made by or on behalf of
residents of long term care facilities and assisted living
and shared housing establishments relating to actions,
inaction, or decisions of providers, or their
representatives, of long term care facilities, of assisted
living and shared housing establishments, of public agencies,
or of social services agencies, which may adversely affect
the health, safety, welfare, or rights of such residents.
When necessary and appropriate, representatives of the Office
shall refer complaints to the appropriate regulatory State
agency.
(d) Access and visitation rights.
(1) In accordance with subparagraphs (A) and (E) of
paragraph (3) of subsection (c) of Section 1819 and
subparagraphs (A) and (E) of paragraph (3) of subsection
(c) of Section 1919 of the Social Security Act, as now or
hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E)
and 42 U.S.C. 1396r-3 (c)(3)(A) and (E)), and Section
307(a)(12) of the Older Americans Act of 1965, as now or
hereafter amended, a long term care facility, assisted
living establishment, and shared housing establishment
must:
(i) permit immediate access to any resident by
an ombudsman; and
(ii) permit representatives of the Office,
with the permission of the resident's legal
representative or legal guardian, to examine a
resident's clinical and other records, and if a
resident is unable to consent to such review, and
has no legal guardian, permit representatives of the
Office appropriate access, as defined by the
Department in administrative rules, to the
resident's records.
(2) Each long term care facility, assisted living
establishment, and shared housing establishment shall
display, in multiple, conspicuous public places within
the facility accessible to both visitors and patients and
in an easily readable format, the address and phone
number of the Office, in a manner prescribed by the
Office.
(e) Immunity. An ombudsman or any other representative
of the Office participating in the good faith performance of
his or her official duties shall have immunity from any
liability (civil, criminal or otherwise) in any proceedings
(civil, criminal or otherwise) brought as a consequence of
the performance of his official duties.
(f) Business offenses.
(1) No person shall:
(i) Intentionally prevent, interfere with, or
attempt to impede in any way any representative of
the Office in the performance of his official duties
under this Act and the Older Americans Act of 1965;
or
(ii) Intentionally retaliate, discriminate
against, or effect reprisals against any long term
care facility resident or employee for contacting or
providing information to any representative of the
Office.
(2) A violation of this Section is a business
offense, punishable by a fine not to exceed $501.
(3) The Director of Aging shall notify the State's
Attorney of the county in which the long term care
facility is located, or the Attorney General, of any
violations of this Section.
(g) Confidentiality of records and identities. No files
or records maintained by the Office of State Long Term Care
Ombudsman shall be disclosed unless the State Ombudsman or
the ombudsman having the authority over the disposition of
such files authorizes the disclosure in writing. The
ombudsman shall not disclose the identity of any complainant,
resident, witness or employee of a long term care provider
involved in a complaint or report unless such person or such
person's guardian or legal representative consents in writing
to the disclosure, or the disclosure is required by court
order.
(h) Legal representation. The Attorney General shall
provide legal representation to any representative of the
Office against whom suit or other legal action is brought in
connection with the performance of the representative's
official duties, in accordance with the State Employee
Indemnification Act "An Act to provide for representation and
indemnification in certain civil law suits", approved
December 3, 1977, as now or hereafter amended.
(i) Treatment by prayer and spiritual means. Nothing in
this Act shall be construed to authorize or require the
medical supervision, regulation, or control of remedial care
or treatment of any resident in a long term care facility
operated exclusively by and for members or adherents of any
church or religious denomination the tenets and practices of
which include reliance solely upon spiritual means through
prayer for healing.
(Source: P.A. 90-639, eff. 1-1-99.)
Section 191. The Illinois Health Facilities Planning Act
is amended by changing Section 3 as follows:
(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
Sec. 3. As used in this Act:
"Health care facilities" means and includes the following
facilities and organizations:
1. An ambulatory surgical treatment center required
to be licensed pursuant to the Ambulatory Surgical
Treatment Center Act;
2. An institution, place, building, or agency
required to be licensed pursuant to the Hospital
Licensing Act;
3. Skilled and intermediate long term care
facilities Any institution required to be licensed under
pursuant to the Nursing Home Care Act;
4. Hospitals, nursing homes, ambulatory surgical
treatment centers, or kidney disease treatment centers
maintained by the State or any department or agency
thereof; and
5. Kidney disease treatment centers, including a
free-standing hemodialysis unit.
No federally owned facility shall be subject to the
provisions of this Act, nor facilities used solely for
healing by prayer or spiritual means.
No facility licensed under the Supportive Residences
Licensing Act or the Assisted Living and Shared Housing Act
shall be subject to the provisions of this Act.
A facility designated as a supportive living facility
that is in good standing with the demonstration project
established under Section 5-5.01a of the Illinois Public Aid
Code shall not be subject to the provisions of this Act.
This Act does not apply to facilities granted waivers
under Section 3-102.2 of the Nursing Home Care Act. However,
if a demonstration project under that Act applies for a
certificate of need to convert to a nursing facility, it
shall meet the licensure and certificate of need requirements
in effect as of the date of application.
This Act shall not apply to the closure of an entity or a
portion of an entity licensed under the Nursing Home Care Act
that elects to convert, in whole or in part, to an assisted
living or shared housing establishment licensed under the
Assisted Living and Shared Housing Establishment Act.
With the exception of those health care facilities
specifically included in this Section, nothing in this Act
shall be intended to include facilities operated as a part of
the practice of a physician or other licensed health care
professional, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional group. Further, this Act shall not apply to
physicians or other licensed health care professional's
practices where such practices are carried out in a portion
of a health care facility under contract with such health
care facility by a physician or by other licensed health care
professionals, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups. This Act shall apply to construction or
modification and to establishment by such health care
facility of such contracted portion which is subject to
facility licensing requirements, irrespective of the party
responsible for such action or attendant financial
obligation.
"Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.
"Consumer" means any person other than a person (a) whose
major occupation currently involves or whose official
capacity within the last 12 months has involved the
providing, administering or financing of any type of health
care facility, (b) who is engaged in health research or the
teaching of health, (c) who has a material financial interest
in any activity which involves the providing, administering
or financing of any type of health care facility, or (d) who
is or ever has been a member of the immediate family of the
person defined by (a), (b), or (c).
"State Board" means the Health Facilities Planning Board.
"Construction or modification" means the establishment,
erection, building, alteration, reconstruction,
modernization, improvement, extension, discontinuation,
change of ownership, of or by a health care facility, or the
purchase or acquisition by or through a health care facility
of equipment or service for diagnostic or therapeutic
purposes or for facility administration or operation, or any
capital expenditure made by or on behalf of a health care
facility which exceeds the capital expenditure minimum.
"Establish" means the construction of a health care
facility or the replacement of an existing facility on
another site.
"Major medical equipment" means medical equipment which
is used for the provision of medical and other health
services and which costs in excess of the capital expenditure
minimum, except that such term does not include medical
equipment acquired by or on behalf of a clinical laboratory
to provide clinical laboratory services if the clinical
laboratory is independent of a physician's office and a
hospital and it has been determined under Title XVIII of the
Social Security Act to meet the requirements of paragraphs
(10) and (11) of Section 1861(s) of such Act. In determining
whether medical equipment has a value in excess of the
capital expenditure minimum, the value of studies, surveys,
designs, plans, working drawings, specifications, and other
activities essential to the acquisition of such equipment
shall be included.
"Capital Expenditure" means an expenditure: (A) made by
or on behalf of a health care facility (as such a facility is
defined in this Act); and (B) which under generally accepted
accounting principles is not properly chargeable as an
expense of operation and maintenance, or is made to obtain by
lease or comparable arrangement any facility or part thereof
or any equipment for a facility or part; and which exceeds
the capital expenditure minimum.
For the purpose of this paragraph, the cost of any
studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the
acquisition, improvement, expansion, or replacement of any
plant or equipment with respect to which an expenditure is
made shall be included in determining if such expenditure
exceeds the capital expenditures minimum. Donations of
equipment or facilities to a health care facility which if
acquired directly by such facility would be subject to review
under this Act shall be considered capital expenditures, and
a transfer of equipment or facilities for less than fair
market value shall be considered a capital expenditure for
purposes of this Act if a transfer of the equipment or
facilities at fair market value would be subject to review.
"Capital expenditure minimum" means $1,000,000 for major
medical equipment and $2,000,000 for all other capital
expenditures, both of which shall be annually adjusted to
reflect the increase in construction costs due to inflation.
"Areawide" means a major area of the State delineated on
a geographic, demographic, and functional basis for health
planning and for health service and having within it one or
more local areas for health planning and health service. The
term "region", as contrasted with the term "subregion", and
the word "area" may be used synonymously with the term
"areawide".
"Local" means a subarea of a delineated major area that
on a geographic, demographic, and functional basis may be
considered to be part of such major area. The term
"subregion" may be used synonymously with the term "local".
"Areawide health planning organization" or "Comprehensive
health planning organization" means the health systems agency
designated by the Secretary, Department of Health and Human
Services or any successor agency.
"Local health planning organization" means those local
health planning organizations that are designated as such by
the areawide health planning organization of the appropriate
area.
"Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
"Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.
"Director" means the Director of the Illinois Department
of Public Health.
"Agency" means the Illinois Department of Public Health.
"Comprehensive health planning" means health planning
concerned with the total population and all health and
associated problems that affect the well-being of people and
that encompasses health services, health manpower, and health
facilities; and the coordination among these and with those
social, economic, and environmental factors that affect
health.
"Alternative health care model" means a facility or
program authorized under the Alternative Health Care Delivery
Act.
(Source: P.A. 89-499, eff. 6-28-96; 89-530, eff. 7-19-96;
90-14, eff. 7-1-97.)
Section 192. The State Finance Act is amended by adding
Section 5.490 as follows:
(30 ILCS 105/5.490 new)
Sec. 5.490. The Assisted Living and Shared Housing
Regulatory Fund.
Section 193. The Alzheimer's Special Care Disclosure Act
is amended by changing Section 10 as follows:
(210 ILCS 4/10)
Sec. 10. Facility defined. As used in this Act,
"facility" means a facility licensed or permitted under the
Nursing Home Care Act, the Life Care Facility Act, the
Assisted Living and Shared Housing Act, or the Community
Living Facilities Licensing Act.
(Source: P.A. 90-341, eff. 1-1-98.)
Section 194. The Abused and Neglected Long Term Care
Facility Residents Reporting Act is amended by changing
Section 4 as follows:
(210 ILCS 30/4) (from Ch. 111 1/2, par. 4164)
Sec. 4. Any long term care facility administrator, agent
or employee or any physician, hospital, surgeon, dentist,
osteopath, chiropractor, podiatrist, Christian Science
practitioner, coroner, social worker, social services
administrator, registered nurse, law enforcement officer,
field personnel of the Illinois Department of Public Aid,
field personnel of the Illinois Department of Public Health
and County or Municipal Health Departments, personnel of the
Department of Human Services (acting as the successor to the
Department of Mental Health and Developmental Disabilities or
the Department of Public Aid), personnel of the Guardianship
and Advocacy Commission, personnel of the State Fire Marshal,
local fire department inspectors or other personnel, or
personnel of the Illinois Department on Aging, or its
subsidiary Agencies on Aging, or employee of a facility
licensed under the Assisted Living and Shared Housing Act,
having reasonable cause to believe any resident with whom
they have direct contact has been subjected to abuse or
neglect shall immediately report or cause a report to be made
to the Department. Persons required to make reports or cause
reports to be made under this Section include all employees
of the State of Illinois who are involved in providing
services to residents, including professionals providing
medical or rehabilitation services and all other persons
having direct contact with residents; and further include all
employees of community service agencies who provide services
to a resident of a public or private long term care facility
outside of that facility. Any long term care surveyor of the
Illinois Department of Public Health who has reasonable cause
to believe in the course of a survey that a resident has been
abused or neglected and initiates an investigation while on
site at the facility shall be exempt from making a report
under this Section but the results of any such investigation
shall be forwarded to the central register in a manner and
form described by the Department.
The requirement of this Act shall not relieve any long
term care facility administrator, agent or employee of
responsibility to report the abuse or neglect of a resident
under Section 3-610 of the Nursing Home Care Act.
In addition to the above persons required to report
suspected resident abuse and neglect, any other person may
make a report to the Department, or to any law enforcement
officer, if such person has reasonable cause to suspect a
resident has been abused or neglected.
This Section also applies to residents whose death occurs
from suspected abuse or neglect before being found or brought
to a hospital.
A person required to make reports or cause reports to be
made under this Section who fails to comply with the
requirements of this Section is guilty of a Class A
misdemeanor.
(Source: P.A. 89-507, eff. 7-1-97.)
Section 195. The Nursing Home Care Act is amended by
changing Section 1-113 as follows:
(210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
Sec. 1-113. "Facility" or "long-term care facility"
means a private home, institution, building, residence, or
any other place, whether operated for profit or not, or a
county home for the infirm and chronically ill operated
pursuant to Division 5-21 or 5-22 of the Counties Code, or
any similar institution operated by a political subdivision
of the State of Illinois, which provides, through its
ownership or management, personal care, sheltered care or
nursing for 3 or more persons, not related to the applicant
or owner by blood or marriage. It includes skilled nursing
facilities and intermediate care facilities as those terms
are defined in Title XVIII and Title XIX of the Federal
Social Security Act. It also includes homes, institutions, or
other places operated by or under the authority of the
Illinois Department of Veterans' Affairs.
"Facility" does not include the following:
(1) A home, institution, or other place operated by the
federal government or agency thereof, or by the State of
Illinois, other than homes, institutions, or other places
operated by or under the authority of the Illinois Department
of Veterans' Affairs;
(2) A hospital, sanitarium, or other institution whose
principal activity or business is the diagnosis, care, and
treatment of human illness through the maintenance and
operation as organized facilities therefor, which is required
to be licensed under the Hospital Licensing Act;
(3) Any "facility for child care" as defined in the
Child Care Act of 1969;
(4) Any "Community Living Facility" as defined in the
Community Living Facilities Licensing Act;
(5) Any "community residential alternative" as defined
in the Community Residential Alternatives Licensing Act;
(6) Any nursing home or sanatorium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer, in accordance with the creed
or tenets of any well-recognized church or religious
denomination. However, such nursing home or sanatorium shall
comply with all local laws and rules relating to sanitation
and safety;
(7) Any 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) Any "Supportive Residence" licensed under the
Supportive Residences Licensing Act; or
(9) Any "supportive living facility" in good standing
with the demonstration project established under Section
5-5.01a of the Illinois Public Aid Code; or.
(10) Any assisted living or shared housing establishment
licensed under the Assisted Living and Shared Housing Act.
(Source: P.A. 89-499, eff. 6-28-96; 89-507, eff. 7-1-97;
90-14, eff. 7-1-97; 90-763, eff. 8-14-98.)
Section 196. The Health Care Worker Background Check Act
is amended by changing Section 15 as follows:
(225 ILCS 46/15)
Sec. 15. Definitions. For the purposes of this Act, the
following definitions apply:
"Applicant" means an individual seeking employment with a
health care employer who has received a bona fide conditional
offer of employment.
"Conditional offer of employment" means a bona fide offer
of employment by a health care employer to an applicant,
which is contingent upon the receipt of a report from the
Department of State Police indicating that the applicant does
not have a record of conviction of any of the criminal
offenses enumerated in Section 25.
"Direct care" means the provision of nursing care or
assistance with meals, dressing, movement, bathing, or other
personal needs or maintenance, or general supervision and
oversight of the physical and mental well-being of an
individual who is incapable of managing his or her person
whether or not a guardian has been appointed for that
individual.
"Health care employer" means:
(1) the owner or licensee of any of the following:
(i) a community living facility, as defined in the
Community Living Facilities Act;
(ii) a life care facility, as defined in the Life
Care Facilities Act;
(iii) a long-term care facility, as defined in the
Nursing Home Care Act;
(iv) a home health agency, as defined in the Home
Health Agency Licensing Act;
(v) a full hospice, as defined in the Hospice
Program Licensing Act;
(vi) a hospital, as defined in the Hospital
Licensing Act;
(vii) a community residential alternative, as
defined in the Community Residential Alternatives
Licensing Act;
(viii) a nurse agency, as defined in the Nurse
Agency Licensing Act;
(ix) a respite care provider, as defined in the
Respite Program Act;
(x) an establishment licensed under the Assisted
Living and Shared Housing Act;
(xi) a supportive living program, as defined in the
Illinois Public Aid Code;
(2) a day training program certified by the Department
of Human Services; or
(3) a community integrated living arrangement operated
by a community mental health and developmental service
agency, as defined in the Community-Integrated Living
Arrangements Licensing and Certification Act.
"Initiate" means the obtaining of the authorization for a
record check from a student, applicant, or employee. The
educational entity or health care employer or its designee
shall transmit all necessary information and fees to the
Illinois State Police within 10 working days after receipt of
the authorization.
(Source: P.A. 89-197, eff. 7-21-95; 89-507, eff. 7-1-97;
89-674, eff. 8-14-96; 90-14, eff. 7-1-97; 90-776, eff.
1-1-99.)
Section 197. The Criminal Code of 1961 is amended by
changing Section 12-19 as follows:
(720 ILCS 5/12-19) (from Ch. 38, par. 12-19)
Sec. 12-19. Abuse and Gross Neglect of a Long Term Care
Facility Resident.
(a) Any person or any owner or licensee of a long term
care facility who abuses a long term care facility resident
is guilty of a Class 3 felony. Any person or any owner or
licensee of a long term care facility who grossly neglects a
long term care facility resident is guilty of a Class 4
felony. However, nothing herein shall be deemed to apply to
a physician licensed to practice medicine in all its branches
or a duly licensed nurse providing care within the scope of
his or her professional judgment and within the accepted
standards of care within the community.
(b) Notwithstanding the penalties in subsections (a) and
(c) and in addition thereto, if a licensee or owner of a long
term care facility or his or her employee has caused neglect
of a resident, the licensee or owner is guilty of a petty
offense. An owner or licensee is guilty under this
subsection (b) only if the owner or licensee failed to
exercise reasonable care in the hiring, training, supervising
or providing of staff or other related routine administrative
responsibilities.
(c) Notwithstanding the penalties in subsections (a) and
(b) and in addition thereto, if a licensee or owner of a long
term care facility or his or her employee has caused gross
neglect of a resident, the licensee or owner is guilty of a
business offense for which a fine of not more than $10,000
may be imposed. An owner or licensee is guilty under this
subsection (c) only if the owner or licensee failed to
exercise reasonable care in the hiring, training, supervising
or providing of staff or other related routine administrative
responsibilities.
(d) For the purpose of this Section:
(1) "Abuse" means intentionally or knowingly
causing any physical or mental injury or committing any
sexual offense set forth in this Code.
(2) "Gross neglect" means recklessly failing to
provide adequate medical or personal care or maintenance,
which failure results in physical or mental injury or the
deterioration of a physical or mental condition.
(3) "Neglect" means negligently failing to provide
adequate medical or personal care or maintenance, which
failure results in physical or mental injury or the
deterioration of a physical or mental condition.
(4) "Resident" means a person residing in a long
term care facility.
(5) "Owner" means the person who owns a long term
care facility as provided under the Nursing Home Care Act
or an assisted living or shared housing establishment
under the Assisted Living and Shared Housing Act.
(6) "Licensee" means the individual or entity
licensed to operate a facility under the Nursing Home
Care Act or the Assisted Living and Shared Housing Act.
(7) "Facility" or "long term care facility" means a
private home, institution, building, residence, or any
other place, whether operated for profit or not, or a
county home for the infirm and chronically ill operated
pursuant to Division 5-21 or 5-22 of the Counties Code,
or any similar institution operated by the State of
Illinois or a political subdivision thereof, which
provides, through its ownership or management, personal
care, sheltered care or nursing for 3 or more persons not
related to the owner by blood or marriage. The term also
includes skilled nursing facilities and intermediate care
facilities as defined in Title XVIII and Title XIX of the
federal Social Security Act and assisted living
establishments and shared housing establishments licensed
under the Assisted Living and Shared Housing Act.
(e) Nothing contained in this Section shall be deemed to
apply to the medical supervision, regulation or control of
the remedial care or treatment of residents in a facility
conducted for those who rely upon treatment by prayer or
spiritual means in accordance with the creed or tenets of any
well recognized church or religious denomination and which is
licensed in accordance with Section 3-803 of the Nursing Home
Care Act.
(Source: P.A. 86-820; 86-1475.)
Section 199. Effective date. This Act takes effect on
January 1, 2001.
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