Bill Amendment: IL SB1510 | 2019-2020 | 101st General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: NURSING HOME CARE ACT-VARIOUS
Status: 2021-01-13 - Passed Both Houses [SB1510 Detail]
Download: Illinois-2019-SB1510-Senate_Amendment_001.html
Bill Title: NURSING HOME CARE ACT-VARIOUS
Status: 2021-01-13 - Passed Both Houses [SB1510 Detail]
Download: Illinois-2019-SB1510-Senate_Amendment_001.html
| |||||||
| |||||||
| |||||||
1 | AMENDMENT TO SENATE BILL 1510
| ||||||
2 | AMENDMENT NO. ______. Amend Senate Bill 1510 by replacing | ||||||
3 | everything after the enacting clause with the following:
| ||||||
4 | "Section 5. The Nursing Home Care Act is amended by | ||||||
5 | changing Sections 2-106.1, 2-204, 3-202.05, 3-209, and 3-305 | ||||||
6 | and by adding Section 3-305.8 as follows:
| ||||||
7 | (210 ILCS 45/2-106.1)
| ||||||
8 | Sec. 2-106.1. Drug treatment.
| ||||||
9 | (a) A resident shall not be given unnecessary drugs. An
| ||||||
10 | unnecessary drug is any drug used in an excessive dose, | ||||||
11 | including in
duplicative therapy; for excessive duration; | ||||||
12 | without adequate
monitoring; without adequate indications for | ||||||
13 | its use; or in the
presence of adverse consequences that | ||||||
14 | indicate the drugs should be reduced or
discontinued. The | ||||||
15 | Department shall adopt, by rule, the standards
for unnecessary
| ||||||
16 | drugs
contained in interpretive guidelines issued by the United |
| |||||||
| |||||||
1 | States Department of
Health and Human Services for the purposes | ||||||
2 | of administering Titles XVIII and XIX of
the Social Security | ||||||
3 | Act.
| ||||||
4 | (b) Psychotropic medication shall not be prescribed | ||||||
5 | without the informed
consent of the resident, the resident's | ||||||
6 | guardian, or other authorized
representative. "Psychotropic | ||||||
7 | medication"
means medication that
is used for or listed as used | ||||||
8 | for antipsychotic, antidepressant, antimanic, or
antianxiety | ||||||
9 | behavior modification or behavior management purposes in the | ||||||
10 | latest
editions of the AMA Drug Evaluations or the Physician's | ||||||
11 | Desk Reference. No later than January 1, 2020, the
The | ||||||
12 | Department shall adopt, by rule, a protocol specifying how | ||||||
13 | informed consent for psychotropic medication may be obtained or | ||||||
14 | refused. The protocol shall require, at a minimum, a discussion | ||||||
15 | between (i) the resident or the resident's authorized | ||||||
16 | representative and (ii) the resident's physician, a registered | ||||||
17 | pharmacist (who is not a dispensing pharmacist for the facility | ||||||
18 | where the resident lives), or a licensed nurse about the | ||||||
19 | possible risks and benefits of a recommended medication and the | ||||||
20 | use of standardized consent forms designated by the Department. | ||||||
21 | Each form developed by the Department (i) shall be written in | ||||||
22 | plain language, (ii) shall be able to be downloaded from the | ||||||
23 | Department's official website, (iii) shall include information | ||||||
24 | specific to the psychotropic medication for which consent is | ||||||
25 | being sought, and (iv) shall be used for every resident for | ||||||
26 | whom psychotropic drugs are prescribed. In addition to creating |
| |||||||
| |||||||
1 | those forms, the Department shall approve the use of any other | ||||||
2 | informed consent forms that meet criteria developed by the | ||||||
3 | Department. | ||||||
4 | In addition to any other penalty prescribed by law, a | ||||||
5 | facility that is found to have violated this subsection, or the | ||||||
6 | federal certification requirement that informed consent be | ||||||
7 | obtained before administering a psychotropic medication, shall | ||||||
8 | thereafter be required to obtain the signatures of 2 licensed | ||||||
9 | health care professionals on every form purporting to give | ||||||
10 | informed consent for the administration of a psychotropic | ||||||
11 | medication, certifying the personal knowledge of each health | ||||||
12 | care professional that the consent was obtained in compliance | ||||||
13 | with the requirements of this subsection.
| ||||||
14 | (b-5) A prescribing clinician must obtain voluntary | ||||||
15 | informed consent, in writing, from a resident or the resident's | ||||||
16 | legal representative before authorizing the administration of | ||||||
17 | a psychotropic medication to that resident. Voluntary informed | ||||||
18 | consent shall, at minimum, consist of a written and signed | ||||||
19 | affirmation from the resident or the resident's legal | ||||||
20 | representative that he or she has been informed of all | ||||||
21 | pertinent information concerning the administration of | ||||||
22 | psychotropic medication in language that the signer can | ||||||
23 | reasonably be expected to understand. The pertinent | ||||||
24 | information shall include, but not be limited to: | ||||||
25 | (1) the reason for the drug's prescription and the | ||||||
26 | intended effect of the drug on the resident's condition; |
| |||||||
| |||||||
1 | (2) the nature of the drug and the procedure for its | ||||||
2 | administration, including dosage, administration schedule, | ||||||
3 | method of delivery, and expected duration for the drug to | ||||||
4 | be administered; | ||||||
5 | (3) the probable degree of improvement expected from | ||||||
6 | the recommended administration of the drug; | ||||||
7 | (4) the risks and likely side effects associated with | ||||||
8 | administration of the drug; | ||||||
9 | (5) the right of the resident or the resident's legal | ||||||
10 | representative to refuse the administration of the | ||||||
11 | psychotropic medication and the medical and clinical | ||||||
12 | consequences of such refusal; and | ||||||
13 | (6) an explanation of care alternatives to the | ||||||
14 | administration of psychotropic medication and the | ||||||
15 | resident's right to choose such alternatives. | ||||||
16 | A prescribing clinician shall inform the resident or the | ||||||
17 | resident's legal representative of the existence of the | ||||||
18 | resident's managed care plan and of the facility's policies and | ||||||
19 | procedures for compliance with informed consent requirements | ||||||
20 | and shall make these available to the resident or resident's | ||||||
21 | legal representative prior to administering any antipsychotic | ||||||
22 | drug and upon request. | ||||||
23 | (b-10) No facility or managed care plan shall deny | ||||||
24 | admission or continued residency to a person on the basis of | ||||||
25 | the person's or resident's, or the person's or resident's legal | ||||||
26 | representative's, refusal of the administration of |
| |||||||
| |||||||
1 | psychotropic medication, unless the prescribing clinician or | ||||||
2 | facility can demonstrate that the resident's refusal would | ||||||
3 | place the health and safety of the resident, the facility | ||||||
4 | staff, other residents, or visitors at risk. | ||||||
5 | A facility that alleges that the resident's refusal to | ||||||
6 | consent to the administration of psychotropic medication will | ||||||
7 | place the health and safety of the resident, the facility | ||||||
8 | staff, other residents, or visitors at risk must: (1) document | ||||||
9 | the alleged risk in detail; (2) present this documentation to | ||||||
10 | the resident or the resident's legal representative, to the | ||||||
11 | Department, and to the Office of the State Long Term Care | ||||||
12 | Ombudsman; and (3) inform the resident or his or her legal | ||||||
13 | representative of his or her right to appeal to the Department. | ||||||
14 | The documentation of the alleged risk shall include a | ||||||
15 | description of all nonpharmacological or alternative care | ||||||
16 | options attempted and why they were unsuccessful. | ||||||
17 | (b-15) Within 100 days after the effective date of this | ||||||
18 | amendatory Act of the 101st General Assembly, all facilities | ||||||
19 | must submit to the Department written policies and procedures | ||||||
20 | for compliance with this Section. The Department shall review | ||||||
21 | these written policies and procedures and either: | ||||||
22 | (1) give written notice to the facility that the | ||||||
23 | policies or procedures are sufficient to demonstrate the | ||||||
24 | facility's intent to comply this Section; or | ||||||
25 | (2) provide written notice to the facility that the | ||||||
26 | proposed policies and procedures are deficient, identify |
| |||||||
| |||||||
1 | the areas that are deficient, and provide 30 days for the | ||||||
2 | facility to submit amended policies and procedures that | ||||||
3 | demonstrate its intent to comply with this Section. | ||||||
4 | A facility's failure to submit the documentation | ||||||
5 | sufficient to demonstrate its intent to comply with this | ||||||
6 | Section shall be grounds for review under the Department's | ||||||
7 | facility licensure and survey process, the imposition of | ||||||
8 | sanctions by the State, or both. | ||||||
9 | All facilities must provide training and education, as | ||||||
10 | required under this Section, to all personnel involved in | ||||||
11 | providing care to residents and train and educate such | ||||||
12 | personnel on the methods and procedures to effectively | ||||||
13 | implement the facility's policies. Training and education | ||||||
14 | provided under this Section must be documented in each | ||||||
15 | personnel file. | ||||||
16 | (b-20) Any violation of this Section may be reported to the | ||||||
17 | Department for review. At its discretion, the Department may | ||||||
18 | proceed with disciplinary action against the licensee of the | ||||||
19 | facility and facility administrative personnel. | ||||||
20 | (b-25) A violation of informed consent under this Section | ||||||
21 | is, at minimum, a Type "A" violation. | ||||||
22 | (b-30) Any violation of this Section by a prescribing | ||||||
23 | clinician or facility may be prosecuted by an action brought by | ||||||
24 | the Attorney General of Illinois for injunctive relief, civil | ||||||
25 | penalties, or both injunctive relief and civil penalties in the | ||||||
26 | name of the People of Illinois. The Attorney General may |
| |||||||
| |||||||
1 | initiate such action upon his or her own complaint or the | ||||||
2 | complaint of any other interested party. | ||||||
3 | (b-35) Any resident who has been prescribed or has been | ||||||
4 | administered a psychotropic medication in violation of this | ||||||
5 | Section may bring an action for injunctive relief, civil | ||||||
6 | damages, and costs and attorney's fees against any person and | ||||||
7 | facility responsible for the violation. Such claim is separate | ||||||
8 | and distinct from any claims of negligence, malpractice, or any | ||||||
9 | other claims arising from or related to the resident's care. A | ||||||
10 | claim under this Section may be brought by the resident, the | ||||||
11 | resident's legal representative on behalf of the resident, the | ||||||
12 | resident's estate, or any of the resident's survivors. | ||||||
13 | (b-40) An action pursuant to this Section must be filed | ||||||
14 | within 2 years of either the date of discovery of the violation | ||||||
15 | that gave rise to the claim or the last date of an instance of a | ||||||
16 | noncompliant administration of an antipsychotic drug to the | ||||||
17 | resident, whichever is later. | ||||||
18 | (b-45) A prescribing clinician or facility subject to | ||||||
19 | action under this Section shall be liable for damages of up to | ||||||
20 | $500 for each day that the facility or person violates the | ||||||
21 | requirements of this Section, as well as costs and attorney's | ||||||
22 | fees. | ||||||
23 | (b-50) Any violation of this Section shall serve as prima | ||||||
24 | facie evidence of abuse or criminal neglect of a person in a | ||||||
25 | long-term care facility under Section 12-4.4a of the Criminal | ||||||
26 | Code of 2012. |
| |||||||
| |||||||
1 | (b-55) The rights provided for in this Section are | ||||||
2 | cumulative to existing resident rights. No part of this Section | ||||||
3 | shall be interpreted as abridging, abrogating, or otherwise | ||||||
4 | diminishing existing resident rights or causes of action at law | ||||||
5 | or equity. | ||||||
6 | (c) The requirements of
this Section are intended to | ||||||
7 | control in a conflict
with the requirements of Sections 2-102 | ||||||
8 | and 2-107.2
of the Mental Health and Developmental Disabilities | ||||||
9 | Code with respect to the
administration of psychotropic | ||||||
10 | medication.
| ||||||
11 | (Source: P.A. 95-331, eff. 8-21-07; 96-1372, eff. 7-29-10.)
| ||||||
12 | (210 ILCS 45/2-204) (from Ch. 111 1/2, par. 4152-204)
| ||||||
13 | Sec. 2-204. The Director shall appoint a Long-Term Care | ||||||
14 | Facility Advisory
Board to consult with the Department and the | ||||||
15 | residents' advisory councils
created under Section 2-203.
| ||||||
16 | (a) The Board shall be comprised of the following persons:
| ||||||
17 | (1) The Director who shall serve as chairman, ex | ||||||
18 | officio and nonvoting;
and
| ||||||
19 | (2) One representative each of the Department of | ||||||
20 | Healthcare and Family Services, the
Department of Human | ||||||
21 | Services, the Department on
Aging, and the Office of the | ||||||
22 | State Fire Marshal, all nonvoting members;
| ||||||
23 | (3) One member who shall be a physician licensed to | ||||||
24 | practice medicine
in all its branches;
| ||||||
25 | (4) One member who shall be a registered nurse selected |
| |||||||
| |||||||
1 | from the
recommendations of professional nursing | ||||||
2 | associations;
| ||||||
3 | (5) Four members who shall be selected from the | ||||||
4 | recommendations by
organizations whose membership consists | ||||||
5 | of facilities;
| ||||||
6 | (6) Two members who shall represent the general public | ||||||
7 | who are not members
of a residents' advisory council | ||||||
8 | established under Section 2-203 and who
have no | ||||||
9 | responsibility for management or formation of policy or | ||||||
10 | financial
interest in a facility;
| ||||||
11 | (7) One member who is a member of a residents' advisory | ||||||
12 | council
established under Section 2-203 and is capable of | ||||||
13 | actively participating on the
Board; and
| ||||||
14 | (8) One member who shall be selected from the | ||||||
15 | recommendations of
consumer organizations which engage | ||||||
16 | solely in advocacy or legal
representation on behalf of | ||||||
17 | residents and their immediate families ; . | ||||||
18 | (9) One member who is from a nongovernmental statewide | ||||||
19 | organization that advocates for seniors and Illinois | ||||||
20 | residents over the age of 50; | ||||||
21 | (10) One member who is from a statewide association | ||||||
22 | dedicated to Alzheimer's disease care, support, and | ||||||
23 | research; | ||||||
24 | (11) One member who is a member of a trade or labor | ||||||
25 | union representing persons who provide care services in | ||||||
26 | facilities; and |
| |||||||
| |||||||
1 | (12) One member who advocates for the welfare, rights, | ||||||
2 | and care of long-term care residents and represents family | ||||||
3 | caregivers of residents in facilities.
| ||||||
4 | (b) The terms of those members of the Board appointed prior | ||||||
5 | to the
effective date of this amendatory Act of 1988 shall | ||||||
6 | expire on December 31,
1988. Members of the Board created by | ||||||
7 | this amendatory Act of 1988 shall be
appointed to serve for | ||||||
8 | terms as follows: 3 for 2 years, 3 for 3 years
and 3 for 4 | ||||||
9 | years. The member of the Board added by this amendatory Act
of | ||||||
10 | 1989 shall be appointed to serve for a term of 4 years. Each | ||||||
11 | successor
member shall be appointed for a term of 4 years. Any | ||||||
12 | member appointed to fill
a vacancy occurring prior to the | ||||||
13 | expiration of the term for which his
predecessor was appointed | ||||||
14 | shall be appointed for the remainder of such term.
The Board | ||||||
15 | shall meet as frequently as the chairman deems necessary, but | ||||||
16 | not
less than 4 times each year. Upon request by 4 or more | ||||||
17 | members the chairman
shall call a meeting of the Board. The | ||||||
18 | affirmative vote of 7 6 members of the
Board shall be necessary | ||||||
19 | for Board action. A member of the Board can designate
a | ||||||
20 | replacement to serve at the Board meeting and vote in place of | ||||||
21 | the member by
submitting a letter of designation to the | ||||||
22 | chairman prior to or at the
Board meeting. The Board members | ||||||
23 | shall be reimbursed for their actual
expenses incurred in the | ||||||
24 | performance of their duties.
| ||||||
25 | (c) The Advisory Board shall advise the Department of | ||||||
26 | Public Health on
all aspects of its responsibilities under this |
| |||||||
| |||||||
1 | Act and the Specialized Mental Health Rehabilitation Act of | ||||||
2 | 2013, including the format
and content of any rules promulgated | ||||||
3 | by the Department of Public Health.
Any such rules, except | ||||||
4 | emergency rules promulgated pursuant to Section 5-45 of
the | ||||||
5 | Illinois Administrative Procedure Act, promulgated without
| ||||||
6 | obtaining the advice of the Advisory Board are null and void. | ||||||
7 | In the event
that the Department fails to follow the advice of | ||||||
8 | the Board, the Department
shall, prior to the promulgation of | ||||||
9 | such rules, transmit a written explanation
of the reason | ||||||
10 | thereof to the Board. During its review of rules, the Board
| ||||||
11 | shall analyze the economic and regulatory impact of those | ||||||
12 | rules. If the
Advisory Board, having been asked for its advice, | ||||||
13 | fails to advise the
Department within 90 days, the rules shall | ||||||
14 | be considered acted upon.
| ||||||
15 | (Source: P.A. 97-38, eff. 6-28-11; 98-104, eff. 7-22-13; | ||||||
16 | 98-463, eff. 8-16-13.)
| ||||||
17 | (210 ILCS 45/3-202.05) | ||||||
18 | Sec. 3-202.05. Staffing ratios effective July 1, 2010 and | ||||||
19 | thereafter. | ||||||
20 | (a) For the purpose of computing staff to resident ratios, | ||||||
21 | direct care staff shall include: | ||||||
22 | (1) registered nurses; | ||||||
23 | (2) licensed practical nurses; | ||||||
24 | (3) certified nurse assistants; | ||||||
25 | (4) psychiatric services rehabilitation aides; |
| |||||||
| |||||||
1 | (5) rehabilitation and therapy aides; | ||||||
2 | (6) psychiatric services rehabilitation coordinators; | ||||||
3 | (7) assistant directors of nursing; | ||||||
4 | (8) 50% of the Director of Nurses' time; and | ||||||
5 | (9) 30% of the Social Services Directors' time. | ||||||
6 | The Department shall, by rule, allow certain facilities | ||||||
7 | subject to 77 Ill. Admin. Code 300.4000 and following (Subpart | ||||||
8 | S) to utilize specialized clinical staff, as defined in rules, | ||||||
9 | to count towards the staffing ratios. | ||||||
10 | Within 120 days of the effective date of this amendatory | ||||||
11 | Act of the 97th General Assembly, the Department shall | ||||||
12 | promulgate rules specific to the staffing requirements for | ||||||
13 | facilities federally defined as Institutions for Mental | ||||||
14 | Disease. These rules shall recognize the unique nature of | ||||||
15 | individuals with chronic mental health conditions, shall | ||||||
16 | include minimum requirements for specialized clinical staff, | ||||||
17 | including clinical social workers, psychiatrists, | ||||||
18 | psychologists, and direct care staff set forth in paragraphs | ||||||
19 | (4) through (6) and any other specialized staff which may be | ||||||
20 | utilized and deemed necessary to count toward staffing ratios. | ||||||
21 | Within 120 days of the effective date of this amendatory | ||||||
22 | Act of the 97th General Assembly, the Department shall | ||||||
23 | promulgate rules specific to the staffing requirements for | ||||||
24 | facilities licensed under the Specialized Mental Health | ||||||
25 | Rehabilitation Act of 2013. These rules shall recognize the | ||||||
26 | unique nature of individuals with chronic mental health |
| |||||||
| |||||||
1 | conditions, shall include minimum requirements for specialized | ||||||
2 | clinical staff, including clinical social workers, | ||||||
3 | psychiatrists, psychologists, and direct care staff set forth | ||||||
4 | in paragraphs (4) through (6) and any other specialized staff | ||||||
5 | which may be utilized and deemed necessary to count toward | ||||||
6 | staffing ratios. | ||||||
7 | (b) (Blank). Beginning January 1, 2011, and thereafter, | ||||||
8 | light intermediate care shall be staffed at the same staffing | ||||||
9 | ratio as intermediate care. | ||||||
10 | (b-5) For purposes of the minimum staffing ratios in this | ||||||
11 | Section, all residents shall be classified as requiring either | ||||||
12 | skilled care or intermediate care. | ||||||
13 | As used in this subsection: | ||||||
14 | "Intermediate care" means basic nursing care and other | ||||||
15 | restorative services under periodic medical direction. | ||||||
16 | "Skilled care" means skilled nursing care, continuous | ||||||
17 | skilled nursing observations, restorative nursing, and other | ||||||
18 | services under professional direction with frequent medical | ||||||
19 | supervision. | ||||||
20 | (c) Facilities shall notify the Department within 60 days | ||||||
21 | after the effective date of this amendatory Act of the 96th | ||||||
22 | General Assembly, in a form and manner prescribed by the | ||||||
23 | Department, of the staffing ratios in effect on the effective | ||||||
24 | date of this amendatory Act of the 96th General Assembly for | ||||||
25 | both intermediate and skilled care and the number of residents | ||||||
26 | receiving each level of care. |
| |||||||
| |||||||
1 | (d)(1) Effective July 1, 2010, for each resident needing | ||||||
2 | skilled care, a minimum staffing ratio of 2.5 hours of nursing | ||||||
3 | and personal care each day must be provided; for each resident | ||||||
4 | needing intermediate care, 1.7 hours of nursing and personal | ||||||
5 | care each day must be provided. | ||||||
6 | (2) Effective January 1, 2011, the minimum staffing ratios | ||||||
7 | shall be increased to 2.7 hours of nursing and personal care | ||||||
8 | each day for a resident needing skilled care and 1.9 hours of | ||||||
9 | nursing and personal care each day for a resident needing | ||||||
10 | intermediate care. | ||||||
11 | (3) Effective January 1, 2012, the minimum staffing ratios | ||||||
12 | shall be increased to 3.0 hours of nursing and personal care | ||||||
13 | each day for a resident needing skilled care and 2.1 hours of | ||||||
14 | nursing and personal care each day for a resident needing | ||||||
15 | intermediate care. | ||||||
16 | (4) Effective January 1, 2013, the minimum staffing ratios | ||||||
17 | shall be increased to 3.4 hours of nursing and personal care | ||||||
18 | each day for a resident needing skilled care and 2.3 hours of | ||||||
19 | nursing and personal care each day for a resident needing | ||||||
20 | intermediate care. | ||||||
21 | (5) Effective January 1, 2014, the minimum staffing ratios | ||||||
22 | shall be increased to 3.8 hours of nursing and personal care | ||||||
23 | each day for a resident needing skilled care and 2.5 hours of | ||||||
24 | nursing and personal care each day for a resident needing | ||||||
25 | intermediate care.
| ||||||
26 | (e) Ninety days after the effective date of this amendatory |
| |||||||
| |||||||
1 | Act of the 97th General Assembly, a minimum of 25% of nursing | ||||||
2 | and personal care time shall be provided by licensed nurses, | ||||||
3 | with at least 10% of nursing and personal care time provided by | ||||||
4 | registered nurses. These minimum requirements shall remain in | ||||||
5 | effect until an acuity based registered nurse requirement is | ||||||
6 | promulgated by rule concurrent with the adoption of the | ||||||
7 | Resource Utilization Group classification-based payment | ||||||
8 | methodology, as provided in Section 5-5.2 of the Illinois | ||||||
9 | Public Aid Code. Registered nurses and licensed practical | ||||||
10 | nurses employed by a facility in excess of these requirements | ||||||
11 | may be used to satisfy the remaining 75% of the nursing and | ||||||
12 | personal care time requirements. Notwithstanding this | ||||||
13 | subsection, no staffing requirement in statute in effect on the | ||||||
14 | effective date of this amendatory Act of the 97th General | ||||||
15 | Assembly shall be reduced on account of this subsection. | ||||||
16 | (f) The Department shall adopt rules on or before January | ||||||
17 | 1, 2020 establishing a system for determining compliance with | ||||||
18 | minimum direct care staffing standards. Compliance shall be | ||||||
19 | determined at least quarterly using the Centers for Medicare | ||||||
20 | and Medicaid Services' payroll-based journal and the | ||||||
21 | facility's census and payroll data, which shall be obtained | ||||||
22 | quarterly by the Department. The Department shall, at minimum, | ||||||
23 | use the quarterly payroll-based journal and census and payroll | ||||||
24 | data to calculate the number of hours provided per resident per | ||||||
25 | day and compare this ratio to the minimums required by this | ||||||
26 | Section. The Department shall publish the data quarterly on its |
| |||||||
| |||||||
1 | website. | ||||||
2 | (g) The Department shall adopt rules by January 1, 2020 | ||||||
3 | establishing monetary penalties for facilities not in | ||||||
4 | compliance with minimum staffing standards under this Section. | ||||||
5 | Monetary penalties shall be imposed beginning no later than | ||||||
6 | October 1, 2020 and quarterly thereafter and shall be based on | ||||||
7 | the latest quarter for which the Department has data. | ||||||
8 | Monetary penalties shall be established based on a formula | ||||||
9 | that calculates the cost of wages and benefits for the missing | ||||||
10 | staff hours and shall be no less than twice the calculated cost | ||||||
11 | of wages and benefits for the missing staff hours during the | ||||||
12 | quarter or the minimum penalty for a Type "B" violation, | ||||||
13 | whichever is greater. The penalty shall be imposed regardless | ||||||
14 | of whether the facility has committed other violations of this | ||||||
15 | Act during the same quarter. The penalty may not be waived. | ||||||
16 | Nothing in this Section precludes a facility from being given a | ||||||
17 | high risk designation for failing to comply with this Section | ||||||
18 | that, when cited with other violations of this Act, increases | ||||||
19 | the otherwise-applicable penalty. | ||||||
20 | (h) A violation of the minimum staffing requirements under | ||||||
21 | this Section is, at minimum, a Type "B" violation. | ||||||
22 | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
| ||||||
23 | (210 ILCS 45/3-209) (from Ch. 111 1/2, par. 4153-209)
| ||||||
24 | Sec. 3-209. Required posting of information. | ||||||
25 | (a) Every facility shall conspicuously post for display in |
| |||||||
| |||||||
1 | an
area of its offices accessible to residents, employees, and | ||||||
2 | visitors the
following:
| ||||||
3 | (1) Its current license;
| ||||||
4 | (2) A description, provided by the Department, of | ||||||
5 | complaint
procedures established under this Act and the | ||||||
6 | name, address, and
telephone number of a person authorized | ||||||
7 | by the Department to receive
complaints;
| ||||||
8 | (3) A copy of any order pertaining to the facility | ||||||
9 | issued by the
Department or a court; and
| ||||||
10 | (4) A list of the material available for public | ||||||
11 | inspection under
Section 3-210. | ||||||
12 | (b) A facility that has received a notice of violation for | ||||||
13 | having violated the minimum staffing requirements under | ||||||
14 | Section 3-202.05 shall display, for 3 months following the date | ||||||
15 | that the notice of violation was issued, a notice stating that | ||||||
16 | the facility did not have enough staff to meet the needs of the | ||||||
17 | facility's residents during the quarter cited in the notice of | ||||||
18 | violation. Notices must be posted, at a minimum, at all | ||||||
19 | exterior and interior entryways into the facility for easily | ||||||
20 | accessible viewing.
| ||||||
21 | (Source: P.A. 81-1349.)
| ||||||
22 | (210 ILCS 45/3-305) (from Ch. 111 1/2, par. 4153-305)
| ||||||
23 | Sec. 3-305.
The license of a facility which is in violation | ||||||
24 | of this Act
or any rule adopted thereunder may be subject to | ||||||
25 | the penalties or fines
levied by the Department as specified in |
| |||||||
| |||||||
1 | this Section.
| ||||||
2 | (1) A licensee who commits a Type "AA" violation as defined | ||||||
3 | in Section 1-128.5
is automatically issued a conditional | ||||||
4 | license for a period of 6 months
to coincide with an acceptable | ||||||
5 | plan of correction and assessed a fine up to $25,000 per | ||||||
6 | violation.
| ||||||
7 | (1.5) A licensee who commits a Type "A" violation as | ||||||
8 | defined in Section 1-129 is automatically issued a conditional | ||||||
9 | license for a period of 6 months to coincide with an acceptable | ||||||
10 | plan of correction and assessed a fine of up to $12,500 per | ||||||
11 | violation. | ||||||
12 | (2) A licensee who commits a Type "B" violation as defined | ||||||
13 | in Section 1-130 shall be assessed a fine of up to $1,100 per | ||||||
14 | violation or the monetary penalty specified in subsection (g) | ||||||
15 | of Section 3-202.05, whichever is greater .
| ||||||
16 | (2.5) A licensee who commits 10 or more Type "C" | ||||||
17 | violations, as defined in Section 1-132, in a single survey | ||||||
18 | shall be assessed a fine of up to $250 per violation. A | ||||||
19 | licensee who commits one or more Type "C" violations with a | ||||||
20 | high risk designation, as defined by rule, shall be assessed a | ||||||
21 | fine of up to $500 per violation. | ||||||
22 | (3) A licensee who commits a Type "AA" or Type "A" | ||||||
23 | violation as defined in Section 1-128.5 or
1-129 which | ||||||
24 | continues beyond the time specified in paragraph (a) of Section
| ||||||
25 | 3-303 which is cited as a repeat violation shall have its | ||||||
26 | license revoked
and shall be assessed a fine of 3 times the |
| |||||||
| |||||||
1 | fine computed per resident per
day under subsection (1).
| ||||||
2 | (4) A licensee who fails to satisfactorily comply with an | ||||||
3 | accepted
plan of correction for a Type "B" violation or an | ||||||
4 | administrative warning
issued pursuant to Sections 3-401 | ||||||
5 | through 3-413 or the rules promulgated
thereunder shall be | ||||||
6 | automatically issued a conditional license for a period
of not | ||||||
7 | less than 6 months. A second or subsequent acceptable plan of
| ||||||
8 | correction shall be filed. A fine shall be assessed in | ||||||
9 | accordance with
subsection (2) when cited for the repeat | ||||||
10 | violation. This fine shall be
computed for all days of the | ||||||
11 | violation, including the duration of the first
plan of | ||||||
12 | correction compliance time.
| ||||||
13 | (5) For the purpose of computing a penalty under | ||||||
14 | subsections (2) through
(4), the number of residents per day | ||||||
15 | shall be based on the average number
of residents in the | ||||||
16 | facility during the 30 days preceding the discovery
of the | ||||||
17 | violation.
| ||||||
18 | (6) When the Department finds that a provision of Article | ||||||
19 | II has been
violated with regard to a particular resident, the | ||||||
20 | Department shall issue
an order requiring the facility to | ||||||
21 | reimburse the resident for injuries
incurred, or $100, | ||||||
22 | whichever is greater. In the case of a violation
involving any | ||||||
23 | action other than theft of money belonging to a resident,
| ||||||
24 | reimbursement shall be ordered only if a provision of Article | ||||||
25 | II has been
violated with regard to that or any other resident | ||||||
26 | of the facility within
the 2 years immediately preceding the |
| |||||||
| |||||||
1 | violation in question.
| ||||||
2 | (7) For purposes of assessing fines under this Section, a | ||||||
3 | repeat
violation shall be a violation which has been cited | ||||||
4 | during one inspection
of the facility for which an accepted | ||||||
5 | plan of correction was not complied
with or a new citation of | ||||||
6 | the same rule if the licensee is not substantially addressing | ||||||
7 | the issue routinely
throughout the facility.
| ||||||
8 | (7.5) If an occurrence results in more than one type of | ||||||
9 | violation as defined in this Act (that is, a Type "AA", Type | ||||||
10 | "A", Type "B", or Type "C" violation), the Department shall | ||||||
11 | assess only one fine, which shall not exceed the maximum fine | ||||||
12 | that may be assessed for the most serious type of violation | ||||||
13 | charged. For purposes of the preceding sentence, a Type "AA" | ||||||
14 | violation is the most serious type of violation that may be | ||||||
15 | charged, followed by a Type "A", Type "B", or Type "C" | ||||||
16 | violation, in that order. | ||||||
17 | (8) The minimum and maximum fines that may be assessed | ||||||
18 | pursuant to this Section shall be twice those otherwise | ||||||
19 | specified for any facility that willfully makes a misstatement | ||||||
20 | of fact to the Department, or willfully fails to make a | ||||||
21 | required notification to the Department, if that misstatement | ||||||
22 | or failure delays the start of a surveyor or impedes a survey. | ||||||
23 | (9) High risk designation. If the Department finds that a | ||||||
24 | facility has violated a provision of the Illinois | ||||||
25 | Administrative Code that has a high risk designation, or that a | ||||||
26 | facility has violated the same provision of the Illinois |
| |||||||
| |||||||
1 | Administrative Code 3 or more times in the previous 12 months, | ||||||
2 | the Department may assess a fine of up to 2 times the maximum | ||||||
3 | fine otherwise allowed. | ||||||
4 | (10) If a licensee has paid a civil monetary penalty | ||||||
5 | imposed pursuant to the Medicare and Medicaid Certification | ||||||
6 | Program for the equivalent federal violation giving rise to a | ||||||
7 | fine under this Section, the Department shall offset the fine | ||||||
8 | by the amount of the civil monetary penalty. The offset may not | ||||||
9 | reduce the fine by more than 75% of the original fine, however. | ||||||
10 | (Source: P.A. 98-104, eff. 7-22-13.)
| ||||||
11 | (210 ILCS 45/3-305.8 new) | ||||||
12 | Sec. 3-305.8. Database of nursing home quarterly reports | ||||||
13 | and citations. The Department shall publish the quarterly | ||||||
14 | reports of facilities in violation of this Act in an easily | ||||||
15 | searchable, comprehensive, and downloadable electronic | ||||||
16 | database on the Department's website in language that is easily | ||||||
17 | understood. The database shall include quarterly reports of all | ||||||
18 | facilities that have violated this Act starting from 2005 and | ||||||
19 | shall continue indefinitely. The database shall be in an | ||||||
20 | electronic format with active hyperlinks to individual | ||||||
21 | facility citations. The database shall be updated quarterly and | ||||||
22 | shall be electronically searchable using a facility's name and | ||||||
23 | address, the facility owner's name and address, and the House | ||||||
24 | and Senate legislative districts in which the facility is | ||||||
25 | located.
|
| |||||||
| |||||||
1 | Section 99. Effective date. This Act takes effect upon | ||||||
2 | becoming law.".
|