093_HB1412enr HB1412 Enrolled 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. HB1412 Enrolled -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 (i) in which 4 80% of the residents are at least 55 years of age or older, 5 (ii) that is operated as housing for the elderly, and (iii) 6 that meets the construction and operating standards contained 7 in Section 20 of this Act may request a floating license for 8 any number of individual living units within the 9 establishment up to, but not including, total capacity. An 10 establishment requesting a floating license must specify the 11 number of individual living units within the establishment to 12 be licensed. Living units designated by the establishment as 13 a licensed living unit shall, for the purposes of this 14 Section, be referred to as a licensed living unit. An 15 establishment utilizing a floating license must have staff 16 adequate to meet the scheduled and unscheduled needs of the 17 residents residing in licensed living units within the 18 establishment. All staff providing services to licensed 19 living units must meet the requirements of this Act and its 20 rules. A living unit may only be designated as a licensed 21 unit if the living unit and the living unit's resident meet 22 the requirements of this Act and its rules. All mandatory 23 services must be made available to residents of licensed 24 living units, and residents of licensed living units may 25 receive any optional services permitted under the 26 establishment's license. Establishments may only provide 27 services under this Act in the individual living units 28 designated as licensed units. Designation as a licensed unit 29 may be temporary to accommodate a resident's changing needs 30 without requiring the resident to move. 31 An establishment with a floating license must keep a 32 current written list of those units designated under the 33 floating license. If a resident elects to receive services HB1412 Enrolled -3- LRB093 03446 AMC 08879 b 1 in a unit that is not licensed and the unit qualifies for 2 licensure, the establishment must notify the resident that 3 the unit must be licensed and the requirements of this Act 4 must be met before services can be provided to residents in 5 that unit. Upon the initiation of an initial licensing 6 inspection, annual inspection, or complaint investigation, 7 the establishment shall provide to the Department a list of 8 the units designated under the floating license in which 9 residents are receiving services subject to this Act. 10 (210 ILCS 9/35) 11 Sec. 35. Issuance of license. 12 (a) Upon receipt and review of an application for a 13 license and review of the applicant establishment, the 14 Director may issue a license if he or she finds: 15 (1) that the individual applicant, or the 16 corporation, partnership, or other entity if the 17 applicant is not an individual, is a person responsible 18 and suitable to operate or to direct or participate in 19 the operation of an establishment by virtue of financial 20 capacity, appropriate business or professional 21 experience, a record of lawful compliance with lawful 22 orders of the Department and lack of revocation of a 23 license issued under this Act or the Nursing Home Care 24 Act during the previous 5 years; 25 (2) that the establishment is under the supervision 26 of a full-time director who is at least 21 years of age 27 with ability, training, and education appropriate to meet 28 the needs of the residents and to manage the operations 29 of the establishment and who participates in ongoing 30 training for these purposes; 31 (3) that the establishment has staff sufficient in 32 number with qualifications, adequate skills, education, 33 and experience to meet the 24 hour scheduled and HB1412 Enrolled -4- LRB093 03446 AMC 08879 b 1 unscheduled needs of residents and who participate in 2 ongoing training to serve the resident population; 3 (4) that direct care staff meet the requirements of 4 the Health Care Worker Background Check Act; 5 (5) that the applicant is in substantial compliance 6 with this Act and such other requirements for a license 7 as the Department by rule may establish under this Act; 8 (6) that the applicant pays all required fees; 9 (7) that the applicant has provided to the 10 Department an accurate disclosure document in accordance 11 with the Alzheimer's Special Care Disclosure Act and in 12 substantial compliance with Section 150 of this Act. 13 Any license issued by the Director shall state the 14 physical location of the establishment, the date the license 15 was issued, and the expiration date. All licenses shall be 16 valid for one year, except as provided in Section 40. Each 17 license shall be issued only for the premises and persons 18 named in the application, and shall not be transferable or 19 assignable. 20 (Source: P.A. 91-656, eff. 1-1-01.) 21 (210 ILCS 9/75) 22 Sec. 75. Residency Requirements. 23 (a) No individual shall be accepted for residency or 24 remain in residence if the establishment cannot provide or 25 secure appropriate services, if the individual requires a 26 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 (b) Only adults may be accepted for residency. 32 (c) A person shall not be accepted for residency if: 33 (1) the person poses a serious threat to himself or HB1412 Enrolled -5- LRB093 03446 AMC 08879 b 1 herself or to others; 2 (2) the person is not able to communicate his or 3 her needs and no resident representative residing in the 4 establishment, and with a prior relationship to the 5 person, has been appointed to direct the provision of 6 services; 7 (3) the person requires total assistance with 2 or 8 more activities of daily living; 9 (4) the person requires the assistance of more than 10 one paid caregiver at any given time with an activity of 11 daily living; 12 (5) the person requires more than minimal 13 assistance in moving to a safe area in an emergency; 14 (6) the person has a severe mental illness, which 15 for the purposes of this Section means a condition that 16 is characterized by the presence of a major mental 17 disorder as classified in the Diagnostic and Statistical 18 Manual of Mental Disorders, Fourth Edition (DSM-IV) 19 (American Psychiatric Association, 1994), where the 20 individual is substantially disabled due to mental 21 illness in the areas of self-maintenance, social 22 functioning, activities of community living and work 23 skills, and the disability specified is expected to be 24 present for a period of not less than one year, but does 25 not mean Alzheimer's disease and other forms of dementia 26 based on organic or physical disorders; 27 (7) the person requires intravenous therapy or 28 intravenous feedings unless self-administered or 29 administered by a qualified, licensed health care 30 professional; 31 (8) the person requires gastrostomy feedings unless 32 self-administered or administered by a licensed health 33 care professional; 34 (9) the person requires insertion, sterile HB1412 Enrolled -6- LRB093 03446 AMC 08879 b 1 irrigation, and replacement of catheter, except for 2 routine maintenance of urinary catheters, unless the 3 catheter care is self-administered or administered by a 4 licensed health care professional; 5 (10) the person requires sterile wound care unless 6 care is self-administered or administered by a licensed 7 health care professional; 8 (11) the person requires sliding scale insulin 9 administration unless self-performed or administered by a 10 licensed health care professional; 11 (12) the person is a diabetic requiring routine 12 insulin injections unless the injections are 13 self-administered or administered by a licensed health 14 care professional; 15 (13) the person requires treatment of stage 3 or 16 stage 4 decubitus ulcers or exfoliative dermatitis; 17 (14) the person requires 5 or more skilled nursing 18 visits per week for conditions other than those listed in 19 items (13) and (15) of this subsection for a period of 3 20 consecutive weeks or more except when the course of 21 treatment is expected to extend beyond a 3 week period 22 for rehabilitative purposes and is certified as temporary 23 by a physician; or 24 (15) other reasons prescribed by the Department by 25 rule. 26 (d) A resident with a condition listed in items (1) 27 through (15) of subsection (c) shall have his or her 28 residency terminated. 29 (e) Residency shall be terminated when services 30 available to the resident in the establishment are no longer 31 adequate to meet the needs of the resident. This provision 32 shall not be interpreted as limiting the authority of the 33 Department to require the residency termination of 34 individuals. HB1412 Enrolled -7- LRB093 03446 AMC 08879 b 1 (f) Subsection (d) of this Section shall not apply to 2 terminally ill residents who receive or would qualify for 3 hospice care and such care is coordinated by a hospice 4 licensed under the Hospice Program Licensing Act or other 5 licensed health care professional employed by a licensed home 6 health agency and the establishment and all parties agree to 7 the continued residency. 8 (g) Items (3), (4), (5), and (9) of subsection (c) shall 9 not apply to a quadriplegic, paraplegic, or individual with 10 neuro-muscular diseases, such as muscular dystrophy and 11 multiple sclerosis, or other chronic diseases and conditions 12 as defined by rule if the individual is able to communicate 13 his or her needs and does not require assistance with complex 14 medical problems, and the establishment is able to 15 accommodate the individual's needs. The Department shall 16 prescribe rules pursuant to this Section that address special 17 safety and service needs of these individuals. 18 (h) For the purposes of items (7) through (11) of 19 subsection (c), a licensed health care professional may not 20 be employed by the owner or operator of the establishment, 21 its parent entity, or any other entity with ownership common 22 to either the owner or operator of the establishment or 23 parent entity, including but not limited to an affiliate of 24 the owner or operator of the establishment. Nothing in this 25 Section is meant to limit a resident's right to choose his or 26 her health care provider. 27 (Source: P.A. 91-656, eff. 1-1-01.) 28 (210 ILCS 9/150) 29 Sec. 150. Alzheimer and dementia programs. 30 (a) In addition toExcept as provided inthis Section, 31 Alzheimer and dementia programs shall comply with all of the 32 other provisions of this Act. 33 (b) No person shall be admitted or retained if the HB1412 Enrolled -8- LRB093 03446 AMC 08879 b 1 assisted living or shared housing establishment cannot 2 provide or secure appropriate care, if the resident requires 3 a level of service or type of service for which the 4 establishment is not licensed or which the establishment does 5 not provide, or if the establishment does not have the staff 6 appropriate in numbers and with appropriate skill to provide 7 such services. 8 (c) No person shall be accepted for residency or remain 9 in residence if the person's mental or physical condition has 10 so deteriorated to render residency in such a program to be 11 detrimental to the health, welfare or safety of the person or 12 of other residents of the establishment. The Department by 13 rule shall identify a validated dementia-specific standard 14 with inter-rater reliability that will be used to assess 15 individual residents. The assessment must be approved by the 16 resident's physician and shall occur prior to acceptance for 17 residency, annually, and at such time that a change in the 18 resident's condition is identified by a family member, staff 19 of the establishment, or the resident's physician. 20 (d) No person shall be accepted for residency or remain 21 in residence if the person is dangerous to self or others and 22 the establishment would be unable to eliminate the danger 23 through the use of appropriate treatment modalities. 24 (e) No person shall be accepted for residency or remain 25 in residence if the person meets the criteria provided in 26 subsections (b) through (g) of Section 75 of this Act. 27 (f) An establishment that offers to provide a special 28 program or unit for persons with Alzheimer's disease and 29 related disorders shall: 30 (1) disclose to the Department and to a potential 31 or actual resident of the establishment information as 32 specified under the Alzheimer's Special Care Disclosure 33 Act; 34 (2) ensure that a resident's representative is HB1412 Enrolled -9- LRB093 03446 AMC 08879 b 1 designated for the resident; 2 (3) develop and implement policies and procedures 3 that ensure the continued safety of all residents in the 4 establishment including, but not limited to, those who: 5 (A) may wander; and 6 (B) may need supervision and assistance when 7 evacuating the building in an emergency; 8 (4) provide coordination of communications with 9 each resident, resident's representative, relatives and 10 other persons identified in the resident's service plan; 11 (5) provide cognitive stimulation and activities to 12 maximize functioning; 13 (6) provide an appropriate number of staff for its 14 resident population, as established by rule; 15 (7) require the director or administrator and 16 direct care staff to complete sufficient comprehensive 17 and ongoing dementia and cognitive deficit training, the 18 content of which shall be established by rule; and 19 (8) develop emergency procedures and staffing 20 patterns to respond to the needs of residents. 21 (Source: P.A. 91-656, eff. 1-1-01.) 22 Section 99. Effective date. This Act takes effect upon 23 becoming law.