093_HB1412 LRB093 03446 AMC 08879 b 1 AN ACT concerning assisted living. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Assisted Living and Shared Housing Act is 5 amended by changing Sections 25, 35, 75, and 150 and adding 6 Section 32 as follows: 7 (210 ILCS 9/25) 8 Sec. 25. License requirement. No person may establish, 9 operate, maintain, or offer an establishment as an assisted 10 living establishment or shared housing establishment as 11 defined by the Act within this State unless and until he or 12 she obtains a valid license, which remains unsuspended, 13 unrevoked, and unexpired. No public official, agent, or 14 employee may place any person in, or recommend that any 15 person be placed in, or directly or indirectly cause any 16 person to be placed in any establishment that meets the 17 definition under this Act that is being operated without a 18 valid license. No public official, agent, or employee may 19 place the name of an unlicensed establishment that is 20 required to be licensed under this Act on a list of programs. 21 An entity that operates as an assisted living or shared 22 housing establishment as defined by this Act without a 23 license shall be subject to the provisions, including 24 penalties, of the Nursing Home Care Act. No entity shall use 25 in its name or advertise "assisted living" unless licensed as 26 an assisted living establishment under this Act or as a 27 shelter care facility under the Nursing Home Care Act that 28 also meets the definition of an assisted living establishment 29 under this Act, except a shared housing establishment 30 licensed under this Act may advertise assisted living 31 services. -2- LRB093 03446 AMC 08879 b 1 (Source: P.A. 91-656, eff. 1-1-01.) 2 (210 ILCS 9/32 new) 3 Sec. 32. Floating license. An establishment may request 4 a floating license for any number of individual living units 5 within a building up to the total number of units. An 6 establishment requesting a floating license must specify the 7 number of individual living units within a building to be 8 licensed. An establishment utilizing a floating license must 9 have staff adequate to meet the scheduled and unscheduled 10 needs of residents residing in designated licensed units. 11 All staff providing services to licensed units must meet the 12 requirement of this Act. A unit may only be designated as a 13 licensed unit if the unit and the unit's resident meet the 14 requirements of this Act and its rules. The resident of the 15 living units specified in a floating license may receive 16 mandatory and optional services under the establishment's 17 license. Establishments may only provide services under this 18 Act in the individual living units designated as licensed 19 units. Designation as a licensed unit may be temporary to 20 accommodate a resident's changing needs without requiring the 21 resident to move. 22 An establishment with a floating license must keep a 23 current written list of those units designated under the 24 floating license. If a resident elects to receive services 25 in a unit that is not licensed and the unit qualifies for 26 licensure, the establishment must notify the resident that 27 the unit must be licensed and the requirements of this Act 28 must be met before services can be provided to residents in 29 that unit. Upon the initiation of an initial licensing 30 inspection, annual inspection, or complaint investigation, 31 the establishment shall provide to the Department a list of 32 the units designated under the floating license in which 33 residents are receiving services subject to this Act. -3- LRB093 03446 AMC 08879 b 1 (210 ILCS 9/35) 2 Sec. 35. Issuance of license. 3 (a) Upon receipt and review of an application for a 4 license and review of the applicant establishment, the 5 Director may issue a license if he or she finds: 6 (1) that the individual applicant, or the 7 corporation, partnership, or other entity if the 8 applicant is not an individual, is a person responsible 9 and suitable to operate or to direct or participate in 10 the operation of an establishment by virtue of financial 11 capacity, appropriate business or professional 12 experience, a record of lawful compliance with lawful 13 orders of the Department and lack of revocation of a 14 license issued under this Act or the Nursing Home Care 15 Act during the previous 5 years; 16 (2) that the establishment is under the supervision 17 of a full-time director who is at least 21 years of age 18 with ability, training, and education appropriate to meet 19 the needs of the residents and to manage the operations 20 of the establishment and who participates in ongoing 21 training for these purposes; 22 (3) that the establishment has staff sufficient in 23 number with qualifications, adequate skills, education, 24 and experience to meet the 24 hour scheduled and 25 unscheduled needs of residents and who participate in 26 ongoing training to serve the resident population; 27 (4) that direct care staff meet the requirements of 28 the Health Care Worker Background Check Act; 29 (5) that the applicant is in substantial compliance 30 with this Act and such other requirements for a license 31 as the Department by rule may establish under this Act; 32 (6) that the applicant pays all required fees; 33 (7) that the applicant has provided to the 34 Department an accurate disclosure document in accordance -4- LRB093 03446 AMC 08879 b 1 with the Alzheimer's Special Care Disclosure Act and in 2 substantial compliance with Section 150 of this Act. 3 Any license issued by the Director shall state the 4 physical location of the establishment, the date the license 5 was issued, and the expiration date. All licenses shall be 6 valid for one year, except as provided in Section 40. Each 7 license shall be issued only for the premises and persons 8 named in the application, and shall not be transferable or 9 assignable. 10 (Source: P.A. 91-656, eff. 1-1-01.) 11 (210 ILCS 9/75) 12 Sec. 75. Residency Requirements. 13 (a) No individual shall be accepted for residency or 14 remain in residence if the establishment cannot provide or 15 secure appropriate services, if the individual requires a 16 level of service or type of service for which the 17 establishment is not licensed or which the establishment does 18 not provide, or if the establishment does not have the staff 19 appropriate in numbers and with appropriate skill to provide 20 such services. 21 (b) Only adults may be accepted for residency. 22 (c) A person shall not be accepted for residency if: 23 (1) the person poses a serious threat to himself or 24 herself or to others; 25 (2) the person is not able to communicate his or 26 her needs and no resident representative residing in the 27 establishment, and with a prior relationship to the 28 person, has been appointed to direct the provision of 29 services; 30 (3) the person requires total assistance with 2 or 31 more activities of daily living; 32 (4) the person requires the assistance of more than 33 one paid caregiver at any given time with an activity of -5- LRB093 03446 AMC 08879 b 1 daily living; 2 (5) the person requires more than minimal 3 assistance in moving to a safe area in an emergency; 4 (6) the person has a severe mental illness, which 5 for the purposes of this Section means a condition that 6 is characterized by the presence of a major mental 7 disorder as classified in the Diagnostic and Statistical 8 Manual of Mental Disorders, Fourth Edition (DSM-IV) 9 (American Psychiatric Association, 1994), where the 10 individual is substantially disabled due to mental 11 illness in the areas of self-maintenance, social 12 functioning, activities of community living and work 13 skills, and the disability specified is expected to be 14 present for a period of not less than one year, but does 15 not mean Alzheimer's disease and other forms of dementia 16 based on organic or physical disorders; 17 (7) the person requires intravenous therapy or 18 intravenous feedings unless self-administered or 19 administered by a qualified, licensed health care 20 professional; 21 (8) the person requires gastrostomy feedings unless 22 self-administered or administered by a licensed health 23 care professional; 24 (9) the person requires insertion, sterile 25 irrigation, and replacement of catheter, except for 26 routine maintenance of urinary catheters, unless the 27 catheter care is self-administered or administered by a 28 licensed health care professional; 29 (10) the person requires sterile wound care unless 30 care is self-administered or administered by a licensed 31 health care professional; 32 (11) the person requires sliding scale insulin 33 administration unless self-performed or administered by a 34 licensed health care professional; -6- LRB093 03446 AMC 08879 b 1 (12) the person is a diabetic requiring routine 2 insulin injections unless the injections are 3 self-administered or administered by a licensed health 4 care professional; 5 (13) the person requires treatment of stage 3 or 6 stage 4 decubitus ulcers or exfoliative dermatitis; 7 (14) the person requires 5 or more skilled nursing 8 visits per week for conditions other than those listed in 9 items (13) and (15) of this subsection for a period of 3 10 consecutive weeks or more except when the course of 11 treatment is expected to extend beyond a 3 week period 12 for rehabilitative purposes and is certified as temporary 13 by a physician; or 14 (15) other reasons prescribed by the Department by 15 rule. 16 (d) A resident with a condition listed in items (1) 17 through (15) of subsection (c) shall have his or her 18 residency terminated. 19 (e) Residency shall be terminated when services 20 available to the resident in the establishment are no longer 21 adequate to meet the needs of the resident. This provision 22 shall not be interpreted as limiting the authority of the 23 Department to require the residency termination of 24 individuals. 25 (f) Subsection (d) of this Section shall not apply to 26 terminally ill residents who receive or would qualify for 27 hospice care and such care is coordinated by a hospice 28 licensed under the Hospice Program Licensing Act or other 29 licensed health care professional employed by a licensed home 30 health agency and the establishment and all parties agree to 31 the continued residency. 32 (g) Items (3), (4), (5), and (9) of subsection (c) shall 33 not apply to a quadriplegic, paraplegic, or individual with 34 neuro-muscular diseases, such as muscular dystrophy and -7- LRB093 03446 AMC 08879 b 1 multiple sclerosis, or other chronic diseases and conditions 2 as defined by rule if the individual is able to communicate 3 his or her needs and does not require assistance with complex 4 medical problems, and the establishment is able to 5 accommodate the individual's needs. The Department shall 6 prescribe rules pursuant to this Section that address special 7 safety and service needs of these individuals. 8 (h) For the purposes of items (7) through (11) of 9 subsection (c), a licensed health care professional may not 10 be employed by the owner or operator of the establishment, 11 its parent entity, or any other entity with ownership common 12 to either the owner or operator of the establishment or 13 parent entity, including but not limited to an affiliate of 14 the owner or operator of the establishment. Nothing in this 15 Section is meant to limit a resident's right to choose his or 16 her health care provider. 17 (Source: P.A. 91-656, eff. 1-1-01.) 18 (210 ILCS 9/150) 19 Sec. 150. Alzheimer and dementia programs. 20 (a) In addition toExcept as provided inthis Section, 21 Alzheimer and dementia programs shall comply with all of the 22 other provisions of this Act. 23 (b) No person shall be admitted or retained if the 24 assisted living or shared housing establishment cannot 25 provide or secure appropriate care, if the resident requires 26 a level of service or type of service for which the 27 establishment is not licensed or which the establishment does 28 not provide, or if the establishment does not have the staff 29 appropriate in numbers and with appropriate skill to provide 30 such services. 31 (c) No person shall be accepted for residency or remain 32 in residence if the person's mental or physical condition has 33 so deteriorated to render residency in such a program to be -8- LRB093 03446 AMC 08879 b 1 detrimental to the health, welfare or safety of the person or 2 of other residents of the establishment. The Department by 3 rule shall identify a validated dementia-specific standard 4 with inter-rater reliability that will be used to assess 5 individual residents. The assessment must be approved by the 6 resident's physician and shall occur prior to acceptance for 7 residency, annually, and at such time that a change in the 8 resident's condition is identified by a family member, staff 9 of the establishment, or the resident's physician. 10 (d) No person shall be accepted for residency or remain 11 in residence if the person is dangerous to self or others and 12 the establishment would be unable to eliminate the danger 13 through the use of appropriate treatment modalities. 14 (e) No person shall be accepted for residency or remain 15 in residence if the person meets the criteria provided in 16 subsections (b) through (g) of Section 75 of this Act. 17 (f) An establishment that offers to provide a special 18 program or unit for persons with Alzheimer's disease and 19 related disorders shall: 20 (1) disclose to the Department and to a potential 21 or actual resident of the establishment information as 22 specified under the Alzheimer's Special Care Disclosure 23 Act; 24 (2) ensure that a resident's representative is 25 designated for the resident; 26 (3) develop and implement policies and procedures 27 that ensure the continued safety of all residents in the 28 establishment including, but not limited to, those who: 29 (A) may wander; and 30 (B) may need supervision and assistance when 31 evacuating the building in an emergency; 32 (4) provide coordination of communications with 33 each resident, resident's representative, relatives and 34 other persons identified in the resident's service plan; -9- LRB093 03446 AMC 08879 b 1 (5) provide cognitive stimulation and activities to 2 maximize functioning; 3 (6) provide an appropriate number of staff for its 4 resident population, as established by rule; 5 (7) require the director or administrator and 6 direct care staff to complete sufficient comprehensive 7 and ongoing dementia and cognitive deficit training, the 8 content of which shall be established by rule; and 9 (8) develop emergency procedures and staffing 10 patterns to respond to the needs of residents. 11 (Source: P.A. 91-656, eff. 1-1-01.) 12 Section 99. Effective date. This Act takes effect upon 13 becoming law.