|
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020 HB3521 Introduced , by Rep. Emanuel Chris Welch SYNOPSIS AS INTRODUCED: |
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Amends the Assisted Living and Shared Housing Act. Adds provisions concerning involuntary terminations of residency, hearings when residency is involuntarily terminated, and readmission of residents. Provides that an establishment shall notify a resident when the establishment's ability to meet the resident's needs may be affected. Provides that if an establishment initiates a termination of residency, then the resident shall be provided with written notice. Provides that the Department of Public Health shall (rather than may) offer assistance to an establishment and resident in preparation for a residency termination. Provides that an establishment that improperly terminates the residency of a resident shall be assessed a violation. Makes additions to provisions concerning resident rights. Makes other changes. Amends the Nursing Home Care Act. Makes changes to provisions concerning the involuntary transfer or discharge of a resident, hearings when a resident is involuntarily transferred or discharged, and the readmission of residents. Provides that a resident has a right not to be unlawfully transferred or discharged from a facility. Makes other changes. Amends the Assisted Living and Shared Housing Act and the Nursing Home Care Act. Provides that in certain circumstances the Department shall order immediate readmission of a resident. Provides that failure to readmit a resident after receiving an order to do so from the Department shall result in a specified daily fine. Provides that the Department shall adopt rules related to conflicts of interest for persons who conduct specified hearings. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Assisted Living and Shared Housing Act is |
5 | | amended by changing Sections 10, 15, 75, 80, 90, 95, and 110 as |
6 | | follows: |
7 | | (210 ILCS 9/10) |
8 | | Sec. 10. Definitions. For purposes of this Act: |
9 | | "Activities of daily living" means eating, dressing, |
10 | | bathing, toileting,
transferring, or personal
hygiene. |
11 | | "Assisted living establishment" or "establishment" means a |
12 | | home, building,
residence, or any
other place where sleeping |
13 | | accommodations are provided for at least 3
unrelated adults,
at |
14 | | least 80% of whom are 55 years of age or older and where the |
15 | | following are
provided
consistent with the purposes of this |
16 | | Act: |
17 | | (1) services consistent with a social model that is |
18 | | based on the premise
that the
resident's unit in assisted |
19 | | living and shared housing is his or her own home; |
20 | | (2) community-based residential care for persons who |
21 | | need assistance with
activities of
daily living, including |
22 | | personal, supportive, and intermittent
health-related |
23 | | services available 24 hours per day, if needed, to meet the
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1 | | scheduled
and
unscheduled needs of a resident; |
2 | | (3) mandatory services, whether provided directly by |
3 | | the establishment or
by another
entity arranged for by the |
4 | | establishment, with the consent of the resident or
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5 | | resident's
representative; and |
6 | | (4) a physical environment that is a homelike
setting |
7 | | that
includes the following and such other elements as |
8 | | established by the Department:
individual living units |
9 | | each of which shall accommodate small kitchen
appliances
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10 | | and contain private bathing, washing, and toilet |
11 | | facilities, or private washing
and
toilet facilities with a |
12 | | common bathing room readily accessible to each
resident.
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13 | | Units shall be maintained for single occupancy except in |
14 | | cases in which 2
residents
choose to share a unit. |
15 | | Sufficient common space shall exist to permit
individual |
16 | | and
group activities. |
17 | | "Assisted living establishment" or "establishment" does |
18 | | not mean any of the
following: |
19 | | (1) A home, institution, or similar place operated by |
20 | | the federal
government or the
State of Illinois. |
21 | | (2) A long term care facility licensed under the |
22 | | Nursing Home Care Act, a facility licensed under the |
23 | | Specialized Mental Health Rehabilitation Act of 2013, a |
24 | | facility licensed under the ID/DD Community Care Act, or a |
25 | | facility licensed under the MC/DD Act.
However, a
facility |
26 | | licensed under any of those Acts may convert distinct parts |
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1 | | of the facility to assisted
living. If
the facility elects |
2 | | to do so, the facility shall retain the
Certificate of
Need |
3 | | for its nursing and sheltered care beds that were |
4 | | converted. |
5 | | (3) A hospital, sanitarium, or other institution, the |
6 | | principal activity
or business of
which is the diagnosis, |
7 | | care, and treatment of human illness and that is
required |
8 | | to
be licensed under the Hospital Licensing Act. |
9 | | (4) A facility for child care as defined in the Child |
10 | | Care Act of 1969. |
11 | | (5) A community living facility as defined in the |
12 | | Community Living
Facilities
Licensing Act. |
13 | | (6) A nursing home or sanitarium operated solely by and |
14 | | for persons who
rely
exclusively upon treatment by |
15 | | spiritual means through prayer in accordance with
the creed |
16 | | or tenants of a well-recognized church or religious |
17 | | denomination. |
18 | | (7) A facility licensed by the Department of Human |
19 | | Services as a
community-integrated living arrangement as |
20 | | defined in the Community-Integrated
Living
Arrangements |
21 | | Licensure and Certification Act. |
22 | | (8) A supportive residence licensed under the |
23 | | Supportive Residences
Licensing Act. |
24 | | (9) The portion of a life care facility as defined in |
25 | | the Life Care Facilities Act not licensed as an assisted |
26 | | living establishment under this Act; a
life care facility |
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1 | | may
apply under this Act to convert sections of the |
2 | | community to assisted living. |
3 | | (10) A free-standing hospice facility licensed under |
4 | | the Hospice Program
Licensing Act. |
5 | | (11) A shared housing establishment. |
6 | | (12) A supportive living facility as described in |
7 | | Section 5-5.01a of the
Illinois Public Aid
Code. |
8 | | "Department" means the Department of Public Health. |
9 | | "Director" means the Director of Public Health. |
10 | | "Emergency situation" means imminent danger of death or |
11 | | serious physical
harm to a
resident of an establishment. |
12 | | "Involuntary termination of residency" means the full |
13 | | release of any resident from a facility, without the informed |
14 | | consent of the resident, freely given and not coerced. |
15 | | "Involuntary termination of residency" includes an assisted |
16 | | living or shared housing establishment's failure to readmit a |
17 | | resident following hospitalization, other medical leave, or |
18 | | other absence from the establishment. |
19 | | "License" means any of the following types of licenses |
20 | | issued to an applicant
or licensee by the
Department: |
21 | | (1) "Probationary license" means a license issued to an |
22 | | applicant or
licensee
that has not
held a license under |
23 | | this Act prior to its application or pursuant to a license
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24 | | transfer in accordance with Section 50 of this Act. |
25 | | (2) "Regular license" means a license issued by the |
26 | | Department to an
applicant or
licensee that is in
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1 | | substantial compliance with this Act and any rules |
2 | | promulgated
under this Act. |
3 | | "Licensee" means a person, agency, association, |
4 | | corporation, partnership, or
organization that
has been issued |
5 | | a license to operate an assisted living or shared housing
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6 | | establishment. |
7 | | "Licensed health care professional" means a registered |
8 | | professional nurse,
an advanced practice registered nurse, a |
9 | | physician assistant, and a licensed practical
nurse. |
10 | | "Mandatory services" include the following: |
11 | | (1) 3 meals per day available to the residents prepared |
12 | | by the
establishment or an
outside contractor; |
13 | | (2) housekeeping services including, but not limited |
14 | | to, vacuuming,
dusting, and
cleaning the resident's unit; |
15 | | (3) personal laundry and linen services available to |
16 | | the residents
provided
or arranged
for by the |
17 | | establishment; |
18 | | (4) security provided 24 hours each day including, but |
19 | | not limited to,
locked entrances
or building or contract |
20 | | security personnel; |
21 | | (5) an emergency communication response system, which |
22 | | is a procedure in
place 24
hours each day by which a |
23 | | resident can notify building management, an emergency
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24 | | response vendor, or others able to respond to his or her |
25 | | need for assistance;
and |
26 | | (6) assistance with activities of daily living as |
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1 | | required by each
resident. |
2 | | "Negotiated risk" is the process by which a resident, or |
3 | | his or her
representative,
may formally
negotiate with |
4 | | providers what risks each are willing and unwilling to assume |
5 | | in
service provision
and the resident's living environment. The |
6 | | provider assures that the resident
and the
resident's |
7 | | representative, if any, are informed of the risks of these |
8 | | decisions
and of
the potential
consequences of assuming these |
9 | | risks. |
10 | | "Owner" means the individual, partnership, corporation, |
11 | | association, or other
person who owns
an assisted living or |
12 | | shared housing establishment. In the event an assisted
living |
13 | | or shared
housing establishment is operated by a person who |
14 | | leases or manages the
physical plant, which is
owned by another |
15 | | person, "owner" means the person who operates the assisted
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16 | | living or shared
housing establishment, except that if the |
17 | | person who owns the physical plant is
an affiliate of the
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18 | | person who operates the assisted living or shared housing |
19 | | establishment and has
significant
control over the day to day |
20 | | operations of the assisted living or shared housing
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21 | | establishment, the
person who owns the physical plant shall |
22 | | incur jointly and severally with the
owner all liabilities
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23 | | imposed on an owner under this Act. |
24 | | "Physician" means a person licensed
under the Medical |
25 | | Practice Act of 1987
to practice medicine in all of its
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26 | | branches. |
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1 | | "Resident" means a person residing in an assisted living or |
2 | | shared housing
establishment. |
3 | | "Resident's representative" means a person, other than the |
4 | | owner, agent, or
employee of an
establishment or of the health |
5 | | care provider unless related to the resident,
designated in |
6 | | writing by a
resident or a court to be his or her
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7 | | representative. This designation may be accomplished through |
8 | | the Illinois
Power of Attorney Act, pursuant to the |
9 | | guardianship process under the Probate
Act of 1975, or pursuant |
10 | | to an executed designation of representative form
specified by |
11 | | the Department. |
12 | | "Self" means the individual or the individual's designated |
13 | | representative. |
14 | | "Shared housing establishment" or "establishment" means a |
15 | | publicly or
privately operated free-standing
residence for 16 |
16 | | or fewer persons, at least 80% of whom are 55
years of age or |
17 | | older
and who are unrelated to the owners and one manager of |
18 | | the residence, where
the following are provided: |
19 | | (1) services consistent with a social model that is |
20 | | based on the premise
that the resident's unit is his or her |
21 | | own home; |
22 | | (2) community-based residential care for persons who |
23 | | need assistance with
activities of daily living, including |
24 | | housing and personal, supportive, and
intermittent |
25 | | health-related services available 24 hours per day, if |
26 | | needed, to
meet the scheduled and unscheduled needs of a |
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1 | | resident; and |
2 | | (3) mandatory services, whether provided directly by |
3 | | the establishment or
by another entity arranged for by the |
4 | | establishment, with the consent of the
resident or the |
5 | | resident's representative. |
6 | | "Shared housing establishment" or "establishment" does not |
7 | | mean any of the
following: |
8 | | (1) A home, institution, or similar place operated by |
9 | | the federal
government or the State of Illinois. |
10 | | (2) A long term care facility licensed under the |
11 | | Nursing Home Care Act, a facility licensed under the |
12 | | Specialized Mental Health Rehabilitation Act of 2013, a |
13 | | facility licensed under the ID/DD Community Care Act, or a |
14 | | facility licensed under the MC/DD Act.
A facility licensed |
15 | | under any of those Acts may, however, convert sections of |
16 | | the facility to
assisted living. If the facility elects to |
17 | | do so, the facility
shall retain the Certificate of Need |
18 | | for its nursing beds that were
converted. |
19 | | (3) A hospital, sanitarium, or other institution, the |
20 | | principal activity
or business of which is the diagnosis, |
21 | | care, and treatment of human illness and
that is required |
22 | | to be licensed under the Hospital Licensing Act. |
23 | | (4) A facility for child care as defined in the Child |
24 | | Care Act of 1969. |
25 | | (5) A community living facility as defined in the |
26 | | Community Living
Facilities Licensing Act. |
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1 | | (6) A nursing home or sanitarium operated solely by and |
2 | | for persons who
rely exclusively upon treatment by |
3 | | spiritual means through prayer in accordance
with the creed |
4 | | or tenants of a well-recognized church or religious
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5 | | denomination. |
6 | | (7) A facility licensed by the Department of Human |
7 | | Services as a
community-integrated
living arrangement as |
8 | | defined in the Community-Integrated
Living Arrangements |
9 | | Licensure and Certification Act. |
10 | | (8) A supportive residence licensed under the |
11 | | Supportive Residences
Licensing Act. |
12 | | (9) A life care facility as defined in the Life Care |
13 | | Facilities Act; a
life care facility may apply under this |
14 | | Act to convert sections of the
community to assisted |
15 | | living. |
16 | | (10) A free-standing hospice facility licensed under |
17 | | the Hospice Program
Licensing Act. |
18 | | (11) An assisted living establishment. |
19 | | (12) A supportive living facility as described in |
20 | | Section 5-5.01a of the
Illinois Public Aid Code. |
21 | | "Total assistance" means that staff or another individual |
22 | | performs the entire
activity of daily
living without |
23 | | participation by the resident. |
24 | | (Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18 .)
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25 | | (210 ILCS 9/15)
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1 | | Sec. 15. Assessment and service plan requirements. Prior to |
2 | | admission
to any establishment
covered by this Act, a |
3 | | comprehensive assessment that includes an evaluation of
the |
4 | | prospective
resident's physical, cognitive, and psychosocial |
5 | | condition shall be completed.
At least annually,
a |
6 | | comprehensive assessment shall be completed, and upon |
7 | | identification of a
significant change
in the resident's |
8 | | condition, including, but not limited to, a diagnosis of |
9 | | Alzheimer's disease or a related dementia, the resident shall |
10 | | be reassessed.
The Department may by rule specify circumstances |
11 | | under which more frequent
assessments of skin integrity and |
12 | | nutritional status shall be required.
The
comprehensive |
13 | | assessment shall be completed by a physician. Based on the
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14 | | assessment, the resident's interests and preferences, |
15 | | dislikes, and any known triggers for behavior that endangers |
16 | | the resident or others, a written
service plan shall be
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17 | | developed and mutually agreed upon by the provider , and the |
18 | | resident , and the resident's representative, if any . The
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19 | | service plan, which
shall be reviewed annually, or more often |
20 | | as the resident's condition,
preferences, or service needs
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21 | | change, shall serve as a basis for the service delivery |
22 | | contract between the
provider and the
resident. The resident |
23 | | and the resident's representative, if any, shall be given a |
24 | | copy of the most recent assessment; supplemental assessment, if |
25 | | any, done by the establishment; and service plan. Based on the |
26 | | assessment, the service plan may provide for the
disconnection |
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1 | | or
removal of any appliance.
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2 | | (Source: P.A. 91-656, eff. 1-1-01.)
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3 | | (210 ILCS 9/75)
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4 | | Sec. 75. Residency Requirements.
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5 | | (a) No individual shall be accepted for residency or remain |
6 | | in residence if
the
establishment cannot provide or secure |
7 | | appropriate
services, if the individual
requires a level of |
8 | | service or type of service for which the establishment is
not |
9 | | licensed or
which the establishment does not provide, or if the |
10 | | establishment does not have
the staff
appropriate in numbers |
11 | | and with appropriate skill to provide such services.
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12 | | (b) Only adults may be accepted for residency.
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13 | | (c) A person shall not be accepted for residency if:
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14 | | (1) the person poses a serious threat to himself or |
15 | | herself or to others;
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16 | | (2) the person is not able to communicate his or her |
17 | | needs and no
resident representative
residing in the |
18 | | establishment, and with a prior relationship to the person,
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19 | | has been appointed to direct the provision of
services;
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20 | | (3) the person requires total assistance with 2 or more |
21 | | activities of
daily
living;
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22 | | (4) the person requires the assistance of more than one |
23 | | paid caregiver at
any given time
with an activity of daily |
24 | | living;
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25 | | (5) the person requires more than minimal assistance in |
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1 | | moving to a safe
area in an
emergency;
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2 | | (6) the person has a severe mental illness, which for |
3 | | the purposes of
this Section
means a condition that is |
4 | | characterized by the presence of a major mental
disorder
as |
5 | | classified in the Diagnostic and Statistical Manual of |
6 | | Mental Disorders,
Fourth
Edition (DSM-IV) (American |
7 | | Psychiatric Association, 1994), where the individual
is a |
8 | | person with a substantial disability due to mental illness |
9 | | in the areas of
self-maintenance,
social functioning, |
10 | | activities of community living and work skills, and the
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11 | | disability
specified is expected to be present for a period |
12 | | of not less than one year, but
does not
mean Alzheimer's |
13 | | disease and other forms of dementia based on organic or
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14 | | physical disorders;
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15 | | (7) the person requires intravenous therapy or |
16 | | intravenous feedings
unless self-administered or |
17 | | administered by a qualified, licensed health care
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18 | | professional;
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19 | | (8) the person requires gastrostomy feedings unless |
20 | | self-administered or
administered
by a licensed health |
21 | | care professional;
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22 | | (9) the person requires insertion, sterile irrigation, |
23 | | and replacement of
catheter, except
for routine |
24 | | maintenance of urinary catheters, unless the catheter care |
25 | | is
self-administered or administered by a licensed health |
26 | | care professional;
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1 | | (10) the person requires sterile wound care unless care |
2 | | is
self-administered or
administered by a licensed health |
3 | | care professional;
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4 | | (11) the person requires sliding scale insulin |
5 | | administration unless
self-performed or
administered by a |
6 | | licensed health care professional;
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7 | | (12) the person is a diabetic requiring routine insulin |
8 | | injections unless
the injections
are self-administered or |
9 | | administered by a licensed health care professional;
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10 | | (13) the person requires treatment of stage 3 or stage |
11 | | 4 decubitus ulcers
or exfoliative
dermatitis;
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12 | | (14) the person requires 5 or more skilled nursing |
13 | | visits per week for
conditions other
than those listed in |
14 | | items (13) and (15) of this subsection for a
period of 3
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15 | | consecutive weeks or more except when the course of |
16 | | treatment is expected to
extend beyond a 3 week period for |
17 | | rehabilitative purposes and is certified as
temporary by a |
18 | | physician; or
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19 | | (15) other reasons prescribed by the Department by |
20 | | rule.
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21 | | (d) A resident with a condition listed in items (1) through |
22 | | (15) of
subsection (c) shall have
his or her residency |
23 | | terminated.
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24 | | (e) Residency shall be terminated when services available |
25 | | to the resident
in
the establishment
are no longer adequate to |
26 | | meet the needs of the resident. The establishment shall notify |
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1 | | the resident and the resident's representative, if any, when |
2 | | there is a significant change in the resident's condition that |
3 | | affects the establishment's ability to meet the resident's |
4 | | needs. The requirements of subsection (c) of Section 80 shall |
5 | | then apply. This provision shall
not
be interpreted as
limiting |
6 | | the authority of the Department to require the residency |
7 | | termination
of individuals.
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8 | | (f) Subsection (d) of this Section shall not apply to
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9 | | terminally
ill residents who
receive or would qualify for |
10 | | hospice care and such care is coordinated by
a hospice program |
11 | | licensed
under the Hospice
Program
Licensing Act or other |
12 | | licensed health care professional employed by a
licensed home |
13 | | health
agency and the establishment and all parties agree to |
14 | | the continued residency.
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15 | | (g) Items (3), (4), (5), and (9) of subsection (c) shall |
16 | | not apply to
a quadriplegic, paraplegic, or
individual with |
17 | | neuro-muscular diseases, such as muscular dystrophy and
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18 | | multiple
sclerosis, or other chronic diseases and conditions as |
19 | | defined by rule if the
individual is able
to communicate his or |
20 | | her needs and does not require assistance with complex
medical
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21 | | problems, and the establishment is able to accommodate the |
22 | | individual's needs.
The Department shall prescribe rules |
23 | | pursuant to this Section that address
special safety and |
24 | | service needs of these individuals.
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25 | | (h) For the purposes of items (7) through (10) of |
26 | | subsection (c), a
licensed health care professional may not
be |
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1 | | employed by the owner or operator of the establishment, its |
2 | | parent entity,
or any other entity with ownership common to |
3 | | either the owner or operator of
the establishment or parent |
4 | | entity, including but not limited to an affiliate
of the owner |
5 | | or operator of the establishment. Nothing in this Section is
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6 | | meant to limit a resident's right to
choose his or her health |
7 | | care provider.
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8 | | (i) Subsection (h) is not applicable to residents admitted |
9 | | to an assisted living establishment under a life care contract |
10 | | as defined in the Life Care Facilities Act if the life care |
11 | | facility has both an assisted living establishment and a |
12 | | skilled nursing facility. A licensed health care professional |
13 | | providing health-related or supportive services at a life care |
14 | | assisted living or shared housing establishment must be |
15 | | employed by an entity licensed by the Department under the |
16 | | Nursing Home Care Act or the Home Health, Home Services, and |
17 | | Home Nursing Agency Licensing Act.
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18 | | (Source: P.A. 99-143, eff. 7-27-15.)
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19 | | (210 ILCS 9/80)
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20 | | Sec. 80. Involuntary termination of residency.
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21 | | (a) Residency shall be involuntarily terminated only
for |
22 | | the following reasons:
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23 | | (1) as provided in Section 75 of this Act;
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24 | | (2) nonpayment of contracted charges after the |
25 | | resident and the
resident's
representative have received a |
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1 | | minimum of 30 days' 30-days written notice of the
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2 | | delinquency and the resident or the resident's |
3 | | representative has had at least
15 days
to cure the |
4 | | delinquency; or
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5 | | (3) failure to execute a service delivery contract or |
6 | | to substantially
comply with its
terms and conditions, |
7 | | failure to comply with the assessment requirements
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8 | | contained in Section 15,
or failure to substantially comply |
9 | | with the terms and
conditions of the lease agreement.
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10 | | (b) A 30-day 30 day written notice of residency termination |
11 | | shall be provided to
the resident, the resident's |
12 | | representative, or both, the Department, and the long term care
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13 | | ombudsman, which shall include the reason for the pending |
14 | | action, the date of
the proposed move, and a notice,
the |
15 | | content and form to be set forth by rule, of the resident's |
16 | | right to
appeal, the steps that the resident or the resident's |
17 | | representative must take
to
initiate an appeal, and a statement |
18 | | of the resident's right to continue to
reside in the |
19 | | establishment until a decision is rendered. The notice shall
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20 | | include a toll free telephone number to initiate an appeal and |
21 | | a written
hearing request form, together with a postage paid, |
22 | | pre-addressed envelope to
the Department. If the resident or |
23 | | the resident's representative, if any,
cannot read English, the |
24 | | notice must be provided in a language the individual
receiving |
25 | | the notice can read or the establishment must provide a |
26 | | translator
who
has been trained to assist the resident or the |
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1 | | resident's representative in the
appeal process. In emergency |
2 | | situations as defined in Section 10 of this Act,
the 30-day |
3 | | provision of the written notice may be waived.
|
4 | | (b-5) If an establishment initiates a termination of |
5 | | residency due to an emergency situation, then the resident and |
6 | | resident's representative, if any, the Department, and the |
7 | | Office of State Long Term Care Ombudsman, shall be provided |
8 | | with a written notice of residency termination, in a form to be |
9 | | specified by the Department, containing all of the information |
10 | | specified in subsection (b) prior to the establishment |
11 | | initiating a termination of residency. |
12 | | (c) The establishment shall attempt to resolve with the |
13 | | resident or the
resident's representative, if any, |
14 | | circumstances that if not remedied have the
potential of |
15 | | resulting in an involuntary termination of residency and shall
|
16 | | document those efforts in the resident's file. This action may |
17 | | occur prior to
or during the 30 day notice period, but must
|
18 | | occur prior to the termination of the residency. In emergency |
19 | | situations as
defined in Section 10 of this Act, the
|
20 | | requirements of this subsection may be waived.
|
21 | | (d) A request for a hearing shall stay an involuntary |
22 | | termination of
residency until a decision has been rendered by |
23 | | the Department, according to a
process adopted by rule. During |
24 | | this time period, the establishment may not
terminate or reduce |
25 | | any service without the consent of the resident or the |
26 | | resident's representative, if any for the purpose of making it |
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1 | | more difficult or
impossible for the resident to remain in the |
2 | | establishment .
|
3 | | (e) The establishment shall offer the resident and the |
4 | | resident's
representative, if any, residency termination and |
5 | | relocation assistance
including information on available |
6 | | alternative placement. Residents , and the residents' |
7 | | representatives, if any, shall be
involved in planning the move |
8 | | and shall choose among the available alternative
placements |
9 | | except when an emergency situation makes prior resident |
10 | | involvement
impossible. Emergency placements are deemed |
11 | | temporary until the resident's
input can be sought in the final |
12 | | placement decision. No resident shall be
forced to remain in a |
13 | | temporary or permanent placement.
|
14 | | (f) The Department shall may offer assistance to the |
15 | | establishment and the
resident in the preparation of residency |
16 | | termination and relocation plans to
assure safe and orderly |
17 | | transition and to protect the resident's health,
safety, |
18 | | welfare, and rights. In nonemergencies, and where possible in
|
19 | | emergencies, the transition plan shall be designed and |
20 | | implemented in advance
of transfer or residency termination.
|
21 | | (g) An establishment may not initiate a termination of |
22 | | residency due to an emergency situation if (1) a resident has |
23 | | been hospitalized and the resident's physician states that |
24 | | returning to the establishment would not create an imminent |
25 | | danger of death or serious physical harm to a resident; or (2) |
26 | | the emergency can be negated by changes in staffing, |
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1 | | activities, health care, personal care, or rooming |
2 | | accommodations, consistent with the license of the |
3 | | establishment. The Department may not find an establishment to |
4 | | be in violation of Section 75 of this Act for failing to |
5 | | initiate an emergency discharge in these circumstances. |
6 | | (h) If the Department determines that an involuntary |
7 | | termination of residency does not meet the requirements of this |
8 | | Act, the Department shall issue a written decision stating that |
9 | | the involuntary termination of residency is denied. If the |
10 | | action of the establishment giving rise to the request for |
11 | | hearings is the establishment's failure to readmit the resident |
12 | | following hospitalization, other medical leave of absence, or |
13 | | other absence, the Department shall order the immediate |
14 | | readmission of the resident to the establishment. |
15 | | (i) If an order to readmit is entered pursuant to |
16 | | subsection (h), the establishment shall immediately comply. A |
17 | | surveyor shall make an on-site inspection of the |
18 | | establishment's compliance with the order within 3 days of the |
19 | | order's entry, unless the resident notifies the Department in |
20 | | writing that there is compliance. As used in this subsection, |
21 | | "compliance" means the resident is living in the establishment |
22 | | or the establishment and the resident have agreed on a schedule |
23 | | for readmission. If the resident or resident's representative |
24 | | notifies the Department that the establishment is not complying |
25 | | with an agreed-upon schedule, or that the establishment is not |
26 | | complying with the representation described in subsection (k), |
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1 | | a surveyor shall make an on-site inspection to determine |
2 | | compliance within 3 days of the notification. |
3 | | (j) An establishment that does not readmit a resident after |
4 | | the Department has ordered readmission shall be assessed a |
5 | | daily fine of $1,250 beginning on the day of the surveyor's |
6 | | inspection or on the third day after the readmission order was |
7 | | issued by the Department, whichever occurs first. The fine |
8 | | shall be imposed for every day thereafter, until the |
9 | | establishment notifies the Department that it is in compliance |
10 | | with the order and a surveyor makes an on-site inspection to |
11 | | determine if there is compliance or the resident confirms to |
12 | | the Department that there is compliance, as defined in |
13 | | subsection (i) of this Section. The on-site inspection shall be |
14 | | made within 3 days of the notification by the establishment. |
15 | | (k) Once a notice of appeal is filed, the Department shall |
16 | | hold a hearing unless the notice of appeal is withdrawn. If the |
17 | | notice of appeal is withdrawn based upon a representation made |
18 | | by the establishment to the resident and the Department, |
19 | | including the hearing officer, that a resident who has been |
20 | | previously denied readmission will be readmitted, failure to |
21 | | comply with the representation shall be considered a failure to |
22 | | comply with a Department order pursuant to subsection (h) and |
23 | | shall result in the imposition of a daily fine as provided in |
24 | | subsection (j) of this Section. |
25 | | (l) In addition to any other penalty, an establishment that |
26 | | has improperly terminated the residency of a resident shall be |
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1 | | assessed no less than a Type 1 violation. The establishment |
2 | | shall be required to submit an acceptable plan of correction to |
3 | | the Department within 30 days after the violation is affirmed. |
4 | | As used in this subsection, "improperly terminated that |
5 | | residency" does not include issuing a notice of residency |
6 | | termination that the Department finds does not meet the |
7 | | statutory requirements for termination of residency if the |
8 | | establishment complied with the procedural requirements of |
9 | | this Act. |
10 | | (m) A long term care ombudsman may request a hearing on |
11 | | behalf of a resident and secure representation of a resident |
12 | | if, in the judgment of the long term care ombudsman, doing so |
13 | | is in the best interests of the resident and the resident does |
14 | | not object. |
15 | | (Source: P.A. 91-656, eff. 1-1-01.)
|
16 | | (210 ILCS 9/90)
|
17 | | Sec. 90. Contents of service delivery contract. A contract |
18 | | between an
establishment and a resident must be entitled |
19 | | "assisted living
establishment
contract" or "shared housing |
20 | | establishment contract" as applicable, shall be
printed in no |
21 | | less
than 12 point type, and shall include at least the |
22 | | following elements in the
body or through
supporting documents |
23 | | or attachments:
|
24 | | (1) the name, street address, and mailing address of |
25 | | the establishment;
|
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1 | | (2) the name and mailing address of the owner or owners |
2 | | of the
establishment and, if
the owner or owners are not |
3 | | natural persons, the type of business entity of the
owner
|
4 | | or owners;
|
5 | | (3) the name and mailing address of the managing agent |
6 | | of the
establishment, whether
hired under a management |
7 | | agreement or lease agreement, if the managing agent is
|
8 | | different from the owner or owners;
|
9 | | (4) the name and address of at least one natural person |
10 | | who is authorized
to accept
service on behalf of the owners |
11 | | and managing agent;
|
12 | | (5) a statement describing the license status of the |
13 | | establishment and the
license status
of all providers of |
14 | | health-related or supportive services to a resident under
|
15 | | arrangement with the establishment;
|
16 | | (6) the duration of the contract;
|
17 | | (7) the base rate to be paid by the resident and a |
18 | | description of the
services to be
provided as part of this |
19 | | rate;
|
20 | | (8) a description of any additional services to be |
21 | | provided for an
additional fee by the
establishment |
22 | | directly or by a third party provider under arrangement |
23 | | with the
establishment;
|
24 | | (9) the fee schedules outlining the cost of any |
25 | | additional services;
|
26 | | (10) a description of the process through which the |
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1 | | contract may be
modified, amended,
or terminated;
|
2 | | (11) a description of the establishment's complaint |
3 | | resolution process
available to
residents and notice of the |
4 | | availability of the Department on Aging's Senior
Helpline
|
5 | | for
complaints;
|
6 | | (12) the name of the resident's designated |
7 | | representative, if any;
|
8 | | (13) the resident's obligations in order to maintain |
9 | | residency and
receive
services including compliance with |
10 | | all assessments required under Section 15;
|
11 | | (14) the billing and payment procedures and |
12 | | requirements;
|
13 | | (15) a statement affirming the resident's freedom to |
14 | | receive services from
service
providers with whom the |
15 | | establishment does not have a contractual arrangement,
|
16 | | which may also disclaim liability on the part of the
|
17 | | establishment for those services;
|
18 | | (16) a statement that medical assistance under Article |
19 | | V or Article VI of
the Illinois
Public Aid Code is not |
20 | | available for payment for services provided in an
|
21 | | establishment, excluding contracts executed with residents |
22 | | residing in licensed establishments participating in the |
23 | | Department on Aging's Comprehensive Care in Residential |
24 | | Settings Demonstration Project;
|
25 | | (17) a statement detailing the admission, risk |
26 | | management, and residency
termination
criteria and |
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1 | | procedures;
|
2 | | (18) a written explanation, prepared by the Office of |
3 | | State Long Term Care Ombudsman, of statement listing the |
4 | | rights specified in Sections 80 and Section 95 , including |
5 | | an acknowledgment by the establishment and
acknowledging |
6 | | that, by contracting with the assisted
living or shared
|
7 | | housing establishment, the resident does not forfeit those |
8 | | rights;
|
9 | | (19) a statement detailing the Department's annual |
10 | | on-site review process
including
what documents contained |
11 | | in a resident's personal file shall be reviewed by
the |
12 | | on-site reviewer as defined by rule; and |
13 | | (20) a statement outlining whether the establishment |
14 | | charges a community fee and, if so, the amount of the fee |
15 | | and whether it is refundable; if the fee is refundable, the |
16 | | contract must describe the conditions under which it is |
17 | | refundable and how the amount of the refund is determined ; |
18 | | and . |
19 | | (21) educational material from the Office of State Long |
20 | | Term Care Ombudsman, written in consultation with a State |
21 | | association dedicated to Alzheimer's care, support, and |
22 | | research with information on Alzheimer's disease and |
23 | | dementia for residents who have been diagnosed with a |
24 | | dementia, including signs and symptoms, stages, and |
25 | | behaviors, and on a statewide helpline with resources for |
26 | | those affected by Alzheimer's and other dementia operated |
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1 | | by a State association dedicated to Alzheimer's care, |
2 | | support, and research; receipt of these educational |
3 | | materials shall require signatures of acknowledgment of |
4 | | receipt by a representative of the establishment, the |
5 | | resident, and the resident's representative, if any.
|
6 | | (Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)
|
7 | | (210 ILCS 9/95)
|
8 | | Sec. 95. Resident rights. No resident shall be deprived of |
9 | | any rights,
benefits, or privileges guaranteed by law, the |
10 | | Constitution of the State of
Illinois, or the Constitution of |
11 | | the United States solely on account of his or
her status as a |
12 | | resident of an establishment, nor shall a resident forfeit any
|
13 | | of the following rights:
|
14 | | (1) the right to retain and use personal property and a |
15 | | place to store
personal
items that is locked and secure;
|
16 | | (2) the right to refuse services and to be advised of |
17 | | the consequences
of
that
refusal;
|
18 | | (3) the right to respect for bodily privacy and dignity |
19 | | at all times,
especially
during care and treatment;
|
20 | | (4) the right to the free exercise of religion;
|
21 | | (5) the right to privacy with regard to mail, phone |
22 | | calls, and visitors;
|
23 | | (6) the right to uncensored access to the State |
24 | | Ombudsman or his or her
designee;
|
25 | | (7) the right to be free of retaliation for criticizing |
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1 | | the
establishment
or
making
complaints to appropriate |
2 | | agencies;
|
3 | | (8) the right to be free of chemical and physical |
4 | | restraints;
|
5 | | (9) the right to be free of abuse or neglect or to |
6 | | refuse to perform
labor;
|
7 | | (10) the right to confidentiality of the resident's |
8 | | medical records;
|
9 | | (11) the right of access and the right to copy the |
10 | | resident's personal
files
maintained
by the establishment;
|
11 | | (12) the right to 24 hours access to the establishment;
|
12 | | (13) the right to a minimum of 90 days' 90-days notice |
13 | | of a planned
establishment
closure;
|
14 | | (14) the right to a minimum of 30 days' 30-days notice |
15 | | of an involuntary
residency
termination ,
except where the |
16 | | resident poses a threat to himself or others, or in other
|
17 | | emergency situations, and the right to appeal such |
18 | | termination ; if an establishment withdraws a notice of |
19 | | involuntary termination of residency, then the resident |
20 | | has the right to maintain residency at the establishment ; |
21 | | and
|
22 | | (15) the right to a 30-day notice of delinquency and at |
23 | | least 15 days
right to cure
delinquency ; . |
24 | | (16) the right to not be unlawfully transferred or |
25 | | discharged; |
26 | | (17) the right to retain residency during any hospital |
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1 | | stay totaling 10 days or less following a hospital |
2 | | admission; and |
3 | | (18) the right not to be charged for any period during |
4 | | which the resident was unlawfully denied residency.
|
5 | | (Source: P.A. 91-656, eff. 1-1-01.)
|
6 | | (210 ILCS 9/110) |
7 | | Sec. 110. Powers and duties of the Department. |
8 | | (a) The Department shall conduct an annual unannounced |
9 | | on-site visit at
each
assisted living and shared
housing |
10 | | establishment to determine compliance with applicable |
11 | | licensure
requirements and
standards. Additional visits may be |
12 | | conducted without prior notice to the
assisted living
or shared |
13 | | housing
establishment. |
14 | | (b) Upon receipt of information that may indicate the |
15 | | failure of the
assisted living or shared housing
establishment |
16 | | or a service provider to comply with a provision of this Act,
|
17 | | the Department shall
investigate the matter or make appropriate |
18 | | referrals to other government
agencies and entities having
|
19 | | jurisdiction over the subject matter of the possible violation. |
20 | | The Department
may also make
referrals to any public or private |
21 | | agency that the Department considers
available for appropriate
|
22 | | assistance to those involved. The Department may oversee and |
23 | | coordinate the
enforcement of State
consumer protection |
24 | | policies affecting residents residing in an establishment
|
25 | | licensed under this Act. |
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1 | | (c) The Department shall establish by rule complaint |
2 | | receipt,
investigation,
resolution, and involuntary
residency |
3 | | termination procedures. Resolution procedures shall provide |
4 | | for
on-site review and
evaluation of an assisted living or |
5 | | shared housing establishment found to be
in violation of this |
6 | | Act
within a specified period of time based on the gravity and |
7 | | severity of the
violation and any pervasive
pattern of |
8 | | occurrences of the same or similar violations. |
9 | | (d) (Blank). |
10 | | (e) The Department shall by rule establish penalties and |
11 | | sanctions, which
shall include, but need not be limited to,
the |
12 | | creation of a schedule of graduated penalties and sanctions to |
13 | | include
closure. |
14 | | (f) The Department shall by rule establish procedures for |
15 | | disclosure of
information to the public, which
shall include, |
16 | | but not be limited to, ownership, licensure status, frequency |
17 | | of
complaints, disposition of
substantiated complaints, and |
18 | | disciplinary actions. |
19 | | (g) (Blank). |
20 | | (h) Beginning January 1, 2000, the Department shall begin |
21 | | drafting rules
necessary for the administration
of this Act. |
22 | | (i) The Department shall by rule provide for a prohibition |
23 | | on conflicts of interest for surveyors and all persons who |
24 | | conduct involuntary transfer or discharge hearings. As used in |
25 | | this subsection, "conflict of interest" includes, but is not |
26 | | limited to, (1) the existence of any professional relationship |
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1 | | within 2 years prior to conducting the survey or the hearing or |
2 | | (2) a financial relationship between a surveyor or person |
3 | | conducting an involuntary transfer or discharge hearing or his |
4 | | or her immediate family and an establishment regulated by the |
5 | | Department. As used in this subsection, "immediate family" |
6 | | means a husband or wife, natural or adoptive parents, children, |
7 | | siblings, stepparents, stepchildren, stepbrothers, |
8 | | stepsisters, father-in-law, mother-in-law, brothers-in-law, |
9 | | sisters-in-law, grandparents, and grandchildren. |
10 | | (Source: P.A. 96-975, eff. 7-2-10.) |
11 | | Section 10. The Nursing Home Care Act is amended by |
12 | | changing Sections 1-111, 1-114.005, 1-128, 2-104, 2-111, |
13 | | 3-401, 3-401.1, 3-402, 3-404, 3-405, 3-410, 3-411, and 3-413 |
14 | | and by adding Sections 3-305.6, 3-413.1, and 3-424 as follows:
|
15 | | (210 ILCS 45/1-111) (from Ch. 111 1/2, par. 4151-111)
|
16 | | Sec. 1-111. "Discharge" means the full release of any |
17 | | resident from a facility. "Discharge" includes a nursing |
18 | | facility's failure to readmit following hospitalization, other |
19 | | medical leave, or other absence. |
20 | | (Source: P.A. 81-223.)
|
21 | | (210 ILCS 45/1-114.005) |
22 | | Sec. 1-114.005. High risk designation. "High risk |
23 | | designation" means a violation of a provision of the Illinois |
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1 | | Administrative Code or statute that has been identified by the |
2 | | Department through rulemaking or designated in statute to be |
3 | | inherently necessary to protect the health, safety, and welfare |
4 | | of a resident. "High risk designation" includes an unlawful |
5 | | discharge of a resident.
|
6 | | (Source: P.A. 96-1372, eff. 7-29-10.)
|
7 | | (210 ILCS 45/1-128) (from Ch. 111 1/2, par. 4151-128)
|
8 | | Sec. 1-128.
"Transfer" means a change in status of a |
9 | | resident's living
arrangements from one facility to another |
10 | | facility. "Transfer" includes a nursing facility's failure to |
11 | | readmit a resident following hospitalization, other medical |
12 | | leave, or other absence, resulting in the resident being moved |
13 | | to another institutional setting.
|
14 | | (Source: P.A. 81-223.)
|
15 | | (210 ILCS 45/2-104) (from Ch. 111 1/2, par. 4152-104)
|
16 | | Sec. 2-104.
(a) A resident shall be permitted to retain the |
17 | | services
of his own personal physician at his own expense or |
18 | | under an individual or
group plan of health insurance, or under |
19 | | any public or private
assistance program providing such |
20 | | coverage. However, the facility is
not liable for the |
21 | | negligence of any such personal physician. Every
resident shall |
22 | | be permitted to obtain from his own physician or the
physician |
23 | | attached to the facility complete and current information
|
24 | | concerning his medical diagnosis, treatment and prognosis in |
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1 | | terms and
language the resident can reasonably be expected to |
2 | | understand. Every
resident shall be permitted to participate in |
3 | | the planning of his total
care and medical treatment to the |
4 | | extent that his condition permits. No
resident shall be |
5 | | subjected to experimental research or treatment
without first |
6 | | obtaining his informed, written consent. The conduct of
any |
7 | | experimental research or treatment shall be authorized and |
8 | | monitored
by an institutional review board appointed by the |
9 | | Director. The
membership, operating procedures and review |
10 | | criteria for the institutional
review board shall be prescribed |
11 | | under rules and regulations of the
Department and shall comply |
12 | | with the requirements for institutional review boards |
13 | | established by the federal Food and Drug Administration. No |
14 | | person who has received compensation in the prior 3 years from |
15 | | an entity that manufactures, distributes, or sells |
16 | | pharmaceuticals, biologics, or medical devices may serve on the |
17 | | institutional review board. |
18 | | The institutional review board may approve only research or |
19 | | treatment that meets the standards of the federal Food and Drug |
20 | | Administration with respect to (i) the protection of human |
21 | | subjects and (ii) financial disclosure by clinical |
22 | | investigators. The Office of State Long Term Care Ombudsman and |
23 | | the State Protection and Advocacy organization shall be given |
24 | | an opportunity to comment on any request for approval before |
25 | | the board makes a decision. Those entities shall not be |
26 | | provided information that would allow a potential human subject |
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1 | | to be individually identified, unless the board asks the |
2 | | Ombudsman for help in securing information from or about the |
3 | | resident. The board shall require frequent reporting of the |
4 | | progress of the approved research or treatment and its impact |
5 | | on residents, including immediate reporting of any adverse |
6 | | impact to the resident, the resident's representative, the |
7 | | Office of the State Long Term Care Ombudsman, and the State |
8 | | Protection and Advocacy organization. The board may not approve |
9 | | any retrospective study of the records of any resident about |
10 | | the safety or efficacy of any care or treatment if the resident |
11 | | was under the care of the proposed researcher or a business |
12 | | associate when the care or treatment was given, unless the |
13 | | study is under the control of a researcher without any business |
14 | | relationship to any person or entity who could benefit from the |
15 | | findings of the study. |
16 | | No facility shall permit experimental research or |
17 | | treatment to be conducted on a resident, or give access to any |
18 | | person or person's records for a retrospective study about the |
19 | | safety or efficacy of any care or treatment, without the prior |
20 | | written approval of the institutional review board. No nursing |
21 | | home administrator, or person licensed by the State to provide |
22 | | medical care or treatment to any person, may assist or |
23 | | participate in any experimental research on or treatment of a |
24 | | resident, including a retrospective study, that does not have |
25 | | the prior written approval of the board. Such conduct shall be |
26 | | grounds for professional discipline by the Department of |
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1 | | Financial and
Professional Regulation. |
2 | | The institutional review board may exempt from ongoing |
3 | | review research or treatment initiated on a resident before the |
4 | | individual's admission to a facility and for which the board |
5 | | determines there is adequate ongoing oversight by another |
6 | | institutional review board. Nothing in this Section shall |
7 | | prevent a facility, any facility employee, or any other person |
8 | | from assisting or participating in any experimental research on |
9 | | or treatment of a resident, if the research or treatment began |
10 | | before the person's admission to a facility, until the board |
11 | | has reviewed the research or treatment and decided to grant or |
12 | | deny approval or to exempt the research or treatment from |
13 | | ongoing review.
|
14 | | The institutional review board requirements of this |
15 | | subsection (a) do not apply to investigational drugs, |
16 | | biological products, or devices used by a resident with a |
17 | | terminal illness as set forth in the Right to Try Act. |
18 | | (b) All medical treatment and procedures shall be |
19 | | administered as
ordered by a physician. All new physician |
20 | | orders shall be reviewed by the
facility's director of nursing |
21 | | or charge nurse designee within 24 hours
after such orders have |
22 | | been issued to assure facility compliance with such orders.
|
23 | | All physician's orders and plans of treatment shall have |
24 | | the authentication of the physician. For the purposes of this |
25 | | subsection (b), "authentication" means an original written |
26 | | signature or an electronic signature system that allows for the |
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1 | | verification of a signer's credentials. A stamp signature, with |
2 | | or without initials, is not sufficient. |
3 | | According to rules adopted by the Department, every woman |
4 | | resident of
child-bearing age shall receive routine |
5 | | obstetrical and gynecological
evaluations as well as necessary |
6 | | prenatal care.
|
7 | | (c) Every resident shall be permitted to refuse medical |
8 | | treatment
and to know the consequences of such action, unless |
9 | | such refusal would
be harmful to the health and safety of |
10 | | others and such harm is
documented by a physician in the |
11 | | resident's clinical record. The
resident's refusal shall free |
12 | | the facility from the obligation to
provide the treatment. If a |
13 | | resident's refusal of treatment does not endanger other |
14 | | residents or staff, then the refusal of treatment is not |
15 | | grounds for discharge.
|
16 | | (d) Every resident, resident's guardian, or parent if the |
17 | | resident
is a minor shall be permitted to inspect and copy all |
18 | | his clinical and
other records concerning his care and |
19 | | maintenance kept by the facility
or by his physician. The |
20 | | facility may charge a reasonable fee for
duplication of a |
21 | | record.
|
22 | | (Source: P.A. 99-270, eff. 1-1-16 .)
|
23 | | (210 ILCS 45/2-111) (from Ch. 111 1/2, par. 4152-111)
|
24 | | Sec. 2-111.
A resident shall not be transferred or |
25 | | discharged in violation of this Act. A resident may not be |
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1 | | charged for any period during which the resident was unlawfully |
2 | | denied the right to reside in a facility. A resident may be |
3 | | discharged from a facility after he gives
the administrator, a |
4 | | physician, or a nurse of the facility
written notice of his |
5 | | desire to be discharged. If a guardian has been appointed
for a |
6 | | resident or if the resident is a minor, the resident shall be |
7 | | discharged
upon written consent of his guardian or if the |
8 | | resident is a minor, his
parent unless there is a court order |
9 | | to the contrary. In such cases, upon
the resident's
discharge, |
10 | | the facility is relieved from any responsibility for the |
11 | | resident's
care, safety or well-being. A resident has the right |
12 | | to not be unlawfully transferred or discharged. An unlawful |
13 | | transfer or discharge is, at minimum, a type A violation.
|
14 | | (Source: P.A. 81-223.)
|
15 | | (210 ILCS 45/3-305.6 new) |
16 | | Sec. 3-305.6. Failure to readmit a resident. A facility |
17 | | that fails to comply with an order of the Department to readmit |
18 | | a resident, shall be assessed a daily fine of $1,250. The fine |
19 | | shall be assessed beginning on the date of the surveyor |
20 | | inspection required by Section 3-413.1. The fine shall be |
21 | | imposed for every day thereafter until the facility notifies |
22 | | the Department that the facility is in compliance with the |
23 | | order and a surveyor makes an on-site inspection that confirms |
24 | | compliance or the resident or resident's representative |
25 | | confirms to the Department in writing that there is compliance. |
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1 | | The on-site inspection shall be made within 3 days of the |
2 | | notification by the facility. |
3 | | As used in this Section, "compliance with the order" means |
4 | | a resident is living in a facility, or a facility and a |
5 | | resident have agreed on a schedule for readmission. If a |
6 | | resident subsequently notifies the Department that a facility |
7 | | is not complying with an agreed-upon schedule, a surveyor shall |
8 | | make an on-site inspection to determine compliance within 3 |
9 | | days of the notification.
|
10 | | (210 ILCS 45/3-401) (from Ch. 111 1/2, par. 4153-401)
|
11 | | Sec. 3-401.
A facility may involuntarily transfer or |
12 | | discharge a resident
only for one or more of the following |
13 | | reasons:
|
14 | | (a) the facility is unable to meet the medical needs of |
15 | | the resident, as documented in the resident's clinical |
16 | | record by his or her physician for medical reasons ;
|
17 | | (b) for the resident's physical safety;
|
18 | | (c) for the physical safety of other residents, the |
19 | | facility staff or
facility visitors; or
|
20 | | (d) for either late payment or nonpayment for the |
21 | | resident's stay, except
as prohibited by Titles XVIII and |
22 | | XIX of the federal Social
Security Act. For purposes of |
23 | | this Section, "late payment" means non-receipt
of payment |
24 | | after submission of a bill. If payment is not received |
25 | | within 45
days after submission of a bill, a facility may |
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1 | | send a notice to the resident
and responsible party |
2 | | requesting payment within 30 days. If payment is not
|
3 | | received within such 30 days, the facility may thereupon |
4 | | institute transfer
or discharge proceedings by
sending a |
5 | | notice of transfer or discharge to the resident and |
6 | | responsible
party by registered or certified mail. The |
7 | | notice shall state, in addition
to the requirements of |
8 | | Section 3-403 of this Act, that the responsible
party has |
9 | | the right to pay the amount of the bill in full up to the |
10 | | date
the transfer or discharge is to be made and then the |
11 | | resident shall have
the right to remain in the facility. |
12 | | Such payment shall terminate the
transfer or discharge |
13 | | proceedings. This subsection does not apply to those
|
14 | | residents whose care is provided for under the Illinois |
15 | | Public Aid Code.
The Department shall adopt rules setting |
16 | | forth the criteria and procedures
to be applied in cases of |
17 | | involuntary transfer or discharge permitted
under this |
18 | | Section.
|
19 | | Prior to issuing the notice of transfer or discharge of a |
20 | | resident under subsection (a), (b), or (c) of this Section, an |
21 | | attending physician shall conduct an in-person assessment, |
22 | | with the findings documented in the resident's clinical record. |
23 | | In the absence of other bases for transfer or discharge |
24 | | listed in this Section, and unless it has complied with the |
25 | | prior notice and other procedural requirements of this Act, a |
26 | | facility may not refuse to readmit a resident following a |
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1 | | medical leave of absence if the resident's need for care does |
2 | | not exceed the provisions of the facility's license. |
3 | | (Source: P.A. 91-357, eff. 7-29-99.)
|
4 | | (210 ILCS 45/3-401.1) (from Ch. 111 1/2, par. 4153-401.1)
|
5 | | Sec. 3-401.1. (a) A facility participating in the Medical |
6 | | Assistance
Program is prohibited from failing or refusing to |
7 | | retain as a resident any
person because he or she is a |
8 | | recipient of or an applicant for the Medical
Assistance |
9 | | Program. A resident who is in the process of appealing the |
10 | | denial of his or her application for the Medical Assistance |
11 | | Program is considered to be a Medicaid applicant under this |
12 | | Section.
|
13 | | (a-5) After the effective date of this amendatory Act of |
14 | | 1997, a facility
of which only a distinct part is certified to |
15 | | participate in the Medical
Assistance Program may refuse to |
16 | | retain as a resident any person who resides in
a part of the |
17 | | facility that does not participate in the Medical Assistance
|
18 | | Program and who is unable to pay for his or her care in the |
19 | | facility without
Medical Assistance only if:
|
20 | | (1) the facility, no later than at the time of |
21 | | admission
and at the time of the resident's contract
|
22 | | renewal,
explains to the
resident (unless he or she is |
23 | | incompetent), and to the resident's
representative, and to |
24 | | the person making payment on behalf of the resident for
the |
25 | | resident's stay, in writing, that the facility may |
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1 | | discharge the resident
if the
resident is no longer able to |
2 | | pay for his or her care in the facility without
Medical |
3 | | Assistance;
|
4 | | (2) the resident (unless he or she is incompetent), the |
5 | | resident's
representative, and the person making payment |
6 | | on behalf of the resident for the
resident's stay, |
7 | | acknowledge in writing that they have received the written
|
8 | | explanation.
|
9 | | (a-10) For the purposes of this Section, a recipient or
|
10 | | applicant shall be considered a resident in the facility during |
11 | | any
hospital stay totaling 10 days or less following a hospital |
12 | | admission.
The Department of Healthcare and Family Services |
13 | | shall recoup funds from a facility
when, as a result of the |
14 | | facility's refusal to readmit a recipient after
|
15 | | hospitalization for 10 days or less, the recipient incurs |
16 | | hospital bills in
an amount greater than the amount that would |
17 | | have been paid by that
Department (formerly the Illinois |
18 | | Department of Public Aid) for care of the recipient in the |
19 | | facility. The amount of the
recoupment shall be the difference |
20 | | between the Department of Healthcare and Family Services' |
21 | | (formerly the Illinois Department of
Public Aid's) payment for |
22 | | hospital care and the amount that Department
would have paid |
23 | | for care in the facility.
|
24 | | (b) A facility which violates this Section shall be guilty |
25 | | of a business
offense and fined not less than $500 nor more |
26 | | than $1,000 for the first
offense and not less than $1,000 nor |
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1 | | more than $5,000 for each subsequent
offense.
|
2 | | (Source: P.A. 95-331, eff. 8-21-07.)
|
3 | | (210 ILCS 45/3-402) (from Ch. 111 1/2, par. 4153-402) |
4 | | Sec. 3-402. Involuntary transfer or discharge of a resident |
5 | | from a facility
shall be preceded by the discussion required |
6 | | under Section 3-408 and by
a minimum written notice
of 30 21 |
7 | | days, except in one of the following instances: |
8 | | (a) When an emergency transfer or discharge is ordered
by |
9 | | the resident's attending physician because of the resident's |
10 | | health
care needs upon an attending physician completing an |
11 | | in-person assessment . |
12 | | (b) When the transfer or discharge is mandated by the |
13 | | physical safety of
other residents, the facility staff, or |
14 | | facility visitors, as
documented in the clinical record.
The |
15 | | Department , the Office of State Long Term Care Ombudsman, and |
16 | | the resident's managed care organization, if applicable, shall |
17 | | be notified prior to any such involuntary transfer
or |
18 | | discharge. The Department shall immediately offer transfer, or |
19 | | discharge
and relocation assistance to residents transferred |
20 | | or discharged under this
subparagraph (b), and the Department |
21 | | may place relocation teams as
provided in Section 3-419 of this |
22 | | Act. |
23 | | (c) When an identified offender is within the provisional |
24 | | admission period defined in Section 1-120.3. If the Identified |
25 | | Offender Report and Recommendation prepared under Section |
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1 | | 2-201.6 shows that the identified offender poses a serious |
2 | | threat or danger to the physical safety of other residents, the |
3 | | facility staff, or facility visitors in the admitting facility |
4 | | and the facility determines that it is unable to provide a safe |
5 | | environment for the other residents, the facility staff, or |
6 | | facility visitors, the facility shall transfer or discharge the |
7 | | identified offender within 3 days after its receipt of the |
8 | | Identified Offender Report and Recommendation. |
9 | | (Source: P.A. 96-1372, eff. 7-29-10.)
|
10 | | (210 ILCS 45/3-404) (from Ch. 111 1/2, par. 4153-404)
|
11 | | Sec. 3-404.
A request for a hearing made under Section |
12 | | 3-403 shall stay
a transfer or discharge pending a hearing or |
13 | | appeal of the decision, unless a condition
which would have |
14 | | allowed transfer or discharge in less than 30 21 days as |
15 | | described
under paragraphs (a) and (b) of Section 3-402 |
16 | | develops in the interim.
|
17 | | (Source: P.A. 81-223.)
|
18 | | (210 ILCS 45/3-405) (from Ch. 111 1/2, par. 4153-405)
|
19 | | Sec. 3-405. A copy of the notice required by Section 3-402 |
20 | | shall be placed
in the resident's clinical record and a copy |
21 | | shall be transmitted to the
Department, the resident, and the |
22 | | resident's representative , if any, the resident's managed care |
23 | | organization, if applicable, and the Office of State Long Term |
24 | | Care Ombudsman .
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1 | | (Source: P.A. 97-820, eff. 7-17-12.)
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2 | | (210 ILCS 45/3-410) (from Ch. 111 1/2, par. 4153-410)
|
3 | | Sec. 3-410.
A resident subject to involuntary transfer or |
4 | | discharge from
a facility, the resident's guardian or if the |
5 | | resident is a minor, his parent
shall have the opportunity to |
6 | | file a request for a hearing with the Department
within 10 days |
7 | | following receipt of the written notice
of the involuntary |
8 | | transfer or discharge by the facility. A long term care |
9 | | ombudsman may request a hearing on behalf of the resident, and |
10 | | secure representation for the resident, if, in the judgment of |
11 | | the long term care ombudsman, doing so is in the best interests |
12 | | of the resident, and the resident does not object.
|
13 | | (Source: P.A. 81-223.)
|
14 | | (210 ILCS 45/3-411) (from Ch. 111 1/2, par. 4153-411)
|
15 | | Sec. 3-411. The Department of Public Health, when the basis |
16 | | for
involuntary transfer or discharge is other than action by |
17 | | the Department of Healthcare and Family Services (formerly
|
18 | | Department
of Public Aid) with respect to the Title XIX |
19 | | Medicaid recipient, shall
hold a hearing at the resident's |
20 | | facility not later than 10 days after a
hearing request is |
21 | | filed, and render a decision within 14 days after the
filing of |
22 | | the hearing request. The Department has continuing |
23 | | jurisdiction over the transfer or discharge irrespective of the |
24 | | timing of the hearing and decision. Once a request for a |
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1 | | hearing is filed, the Department shall hold a hearing unless |
2 | | the request is withdrawn by the resident. If the request for a |
3 | | hearing is withdrawn based upon a representation made by the |
4 | | facility to the resident and the Department, including the |
5 | | hearing officer, that a resident who has been denied |
6 | | readmission will be readmitted, and the resident or resident |
7 | | representative notifies the Department that the facility is |
8 | | still denying readmission, failure to readmit is considered |
9 | | failure to comply with a Department order to readmit pursuant |
10 | | to Section 3-305.6, including the imposition of a daily fine |
11 | | under Section 3-305.6.
|
12 | | (Source: P.A. 95-331, eff. 8-21-07.)
|
13 | | (210 ILCS 45/3-413) (from Ch. 111 1/2, par. 4153-413)
|
14 | | Sec. 3-413.
If the Department determines that a transfer or |
15 | | discharge
is authorized under Section 3-401, the resident shall |
16 | | not be required to
leave the facility before the 34th day |
17 | | following receipt of the notice required
under Section 3-402, |
18 | | or the 10th day following receipt of the Department's
decision, |
19 | | whichever is later, unless a condition which would have allowed
|
20 | | transfer or discharge in less than 30 21 days as described |
21 | | under paragraphs
(a) and (b) of Section 3-402 develops in the |
22 | | interim. The Department maintains jurisdiction over the |
23 | | transfer or discharge irrespective of the timing of the notice |
24 | | and discharge.
|
25 | | (Source: P.A. 81-223.)
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1 | | (210 ILCS 45/3-413.1 new) |
2 | | Sec. 3-413.1. Denial of transfer or discharge. If the |
3 | | Department determines that a transfer or discharge is not |
4 | | authorized under Section 3-401, then the Department shall issue |
5 | | a written decision stating that the transfer or discharge is |
6 | | denied. If the action of the facility giving rise to the |
7 | | request for hearings is the facility's failure to readmit the |
8 | | resident following hospitalization, other medical leave of |
9 | | absence, or other absence, then the Department shall order the |
10 | | immediate readmission of the resident to the facility. The |
11 | | facility shall comply with the order immediately. A surveyor |
12 | | shall make an on-site inspection of the facility's compliance |
13 | | with the order within 3 days of the order's entry unless the |
14 | | resident notifies the Department in writing that there is |
15 | | compliance. |
16 | | (210 ILCS 45/3-424 new) |
17 | | Sec. 3-424. Conflict of interest. The Department shall |
18 | | adopt rules providing for a prohibition on conflicts of |
19 | | interest for surveyors and all persons who conduct involuntary |
20 | | transfer or discharge hearings. As used in this Section, |
21 | | "conflict of interest" includes, but is not limited to, the |
22 | | existence of any professional relationship within 2 years prior |
23 | | to conducting the survey or the hearing, or a financial |
24 | | relationship between (1) a surveyor or person conducting an |
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1 | | involuntary transfer or discharge hearing or their immediate |
2 | | family, and (2) a facility regulated by the Department. As used |
3 | | in this Section, "immediate family" means husband or wife, |
4 | | natural or adoptive parents, children, siblings, stepparents, |
5 | | stepchildren, stepbrothers, stepsisters, father-in-law, |
6 | | mother-in-law, brothers-in-law, sisters-in-law, grandparents, |
7 | | and grandchildren.
|
8 | | Section 99. Effective date. This Act takes effect upon |
9 | | becoming law.
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| 1 | |
INDEX
| 2 | |
Statutes amended in order of appearance
| | 3 | | 210 ILCS 9/10 | | | 4 | | 210 ILCS 9/15 | | | 5 | | 210 ILCS 9/75 | | | 6 | | 210 ILCS 9/80 | | | 7 | | 210 ILCS 9/90 | | | 8 | | 210 ILCS 9/95 | | | 9 | | 210 ILCS 9/110 | | | 10 | | 210 ILCS 45/1-111 | from Ch. 111 1/2, par. 4151-111 | | 11 | | 210 ILCS 45/1-114.005 | | | 12 | | 210 ILCS 45/1-128 | from Ch. 111 1/2, par. 4151-128 | | 13 | | 210 ILCS 45/2-104 | from Ch. 111 1/2, par. 4152-104 | | 14 | | 210 ILCS 45/2-111 | from Ch. 111 1/2, par. 4152-111 | | 15 | | 210 ILCS 45/3-305.6 new | | | 16 | | 210 ILCS 45/3-401 | from Ch. 111 1/2, par. 4153-401 | | 17 | | 210 ILCS 45/3-401.1 | from Ch. 111 1/2, par. 4153-401.1 | | 18 | | 210 ILCS 45/3-402 | from Ch. 111 1/2, par. 4153-402 | | 19 | | 210 ILCS 45/3-404 | from Ch. 111 1/2, par. 4153-404 | | 20 | | 210 ILCS 45/3-405 | from Ch. 111 1/2, par. 4153-405 | | 21 | | 210 ILCS 45/3-410 | from Ch. 111 1/2, par. 4153-410 | | 22 | | 210 ILCS 45/3-411 | from Ch. 111 1/2, par. 4153-411 | | 23 | | 210 ILCS 45/3-413 | from Ch. 111 1/2, par. 4153-413 | | 24 | | 210 ILCS 45/3-413.1 new | | | 25 | | 210 ILCS 45/3-424 new | |
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