Illinois General Assembly - Full Text of HB5012
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Full Text of HB5012  103rd General Assembly



State of Illinois
2023 and 2024


Introduced 2/8/2024, by Rep. Lindsey LaPointe


See Index

    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.

LRB103 36301 CES 66399 b





HB5012LRB103 36301 CES 66399 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Assisted Living and Shared Housing Act is
5amended by changing Sections 10, 15, 75, 80, 90, and 95 as
7    (210 ILCS 9/10)
8    Sec. 10. Definitions. For purposes of this Act:
9    "Activities of daily living" means eating, dressing,
10bathing, toileting, transferring, or personal hygiene.
11    "Assisted living establishment" or "establishment" means a
12home, building, residence, or any other place where sleeping
13accommodations are provided for at least 3 unrelated adults,
14at least 80% of whom are 55 years of age or older and where the
15following are provided consistent with the purposes of this
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



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1    the 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
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
10    and contain private bathing, washing, and toilet
11    facilities, or private washing and toilet facilities with
12    a common bathing room readily accessible to each resident.
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
18not 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



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1    parts of the facility to assisted living. If the facility
2    elects to do so, the facility shall retain the Certificate
3    of Need 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
14    and for persons who rely exclusively upon treatment by
15    spiritual means through prayer in accordance with the
16    creed 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
11serious physical harm to a resident of an establishment.
12    "Involuntary termination of residency" means the full
13release of any resident from a facility, without the informed
14consent of the resident, freely given and not coerced.
15"Involuntary termination of residency" includes an assisted
16living or shared housing establishment's failure to readmit a
17resident following hospitalization, other medical leave, or
18other absence from the establishment.
19    "License" means any of the following types of licenses
20issued to an applicant or licensee by the Department:
21        (1) "Probationary license" means a license issued to
22    an applicant or licensee that has not held a license under
23    this Act prior to its application or pursuant to a license
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,
4corporation, partnership, or organization that has been issued
5a license to operate an assisted living or shared housing
7    "Licensed health care professional" means a registered
8professional nurse, an advanced practice registered nurse, a
9physician assistant, and a licensed practical nurse.
10    "Mandatory services" include the following:
11        (1) 3 meals per day available to the residents
12    prepared 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
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
3his or her representative, may formally negotiate with
4providers what risks each are willing and unwilling to assume
5in service provision and the resident's living environment.
6The provider assures that the resident and the resident's
7representative, if any, are informed of the risks of these
8decisions and of the potential consequences of assuming these
10    "Owner" means the individual, partnership, corporation,
11association, or other person who owns an assisted living or
12shared housing establishment. In the event an assisted living
13or shared housing establishment is operated by a person who
14leases or manages the physical plant, which is owned by
15another person, "owner" means the person who operates the
16assisted living or shared housing establishment, except that
17if the person who owns the physical plant is an affiliate of
18the person who operates the assisted living or shared housing
19establishment and has significant control over the day to day
20operations of the assisted living or shared housing
21establishment, the person who owns the physical plant shall
22incur jointly and severally with the owner all liabilities
23imposed on an owner under this Act.
24    "Physician" means a person licensed under the Medical
25Practice Act of 1987 to practice medicine in all of its



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1    "Resident" means a person residing in an assisted living
2or shared housing establishment.
3    "Resident's representative" means a person, other than the
4owner, agent, or employee of an establishment or of the health
5care provider unless related to the resident, designated in
6writing by a resident or a court to be his or her
7representative. This designation may be accomplished through
8the Illinois Power of Attorney Act, pursuant to the
9guardianship process under the Probate Act of 1975, or
10pursuant to an executed designation of representative form
11specified by the Department.
12    "Self" means the individual or the individual's designated
14    "Shared housing establishment" or "establishment" means a
15publicly or privately operated free-standing residence for 16
16or fewer persons, at least 80% of whom are 55 years of age or
17older and who are unrelated to the owners and one manager of
18the 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
7mean 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
2    and for persons who rely exclusively upon treatment by
3    spiritual means through prayer in accordance with the
4    creed or tenants of a well-recognized church or religious
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
22performs the entire activity of daily living without
23participation by the resident.
24(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
25    (210 ILCS 9/15)



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1    Sec. 15. Assessment and service plan requirements. Prior
2to admission to any establishment covered by this Act, a
3comprehensive assessment that includes an evaluation of the
4prospective resident's physical, cognitive, and psychosocial
5condition shall be completed. At least annually, a
6comprehensive assessment shall be completed, and upon
7identification of a significant change in the resident's
8condition, including, but not limited to, a diagnosis of
9Alzheimer's disease or a related dementia, the resident shall
10be reassessed. The Department may by rule specify
11circumstances under which more frequent assessments of skin
12integrity and nutritional status shall be required. The
13comprehensive assessment shall be completed by a physician.
14Based on the assessment, the resident's interests and
15preferences, dislikes, and any known triggers for behavior
16that endangers the resident or others, a written service plan
17shall be developed and mutually agreed upon by the provider,
18and the resident, and the resident's representative, if any.
19The service plan, which shall be reviewed annually, or more
20often as the resident's condition, preferences, or service
21needs change, shall serve as a basis for the service delivery
22contract between the provider and the resident. The resident
23and the resident's representative, if any, shall be given a
24copy of the most recent assessment; a supplemental assessment,
25if any, done by the establishment; and a service plan. Based on
26the assessment, the service plan may provide for the



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1disconnection or removal of any appliance.
2(Source: P.A. 91-656, eff. 1-1-01.)
3    (210 ILCS 9/75)
4    Sec. 75. Residency requirements.
5    (a) No individual shall be accepted for residency or
6remain in residence if the establishment cannot provide or
7secure appropriate services, if the individual requires a
8level of service or type of service for which the
9establishment is not licensed or which the establishment does
10not provide, or if the establishment does not have the staff
11appropriate in numbers and with appropriate skill to provide
12such services.
13    (b) Only adults may be accepted for residency.
14    (c) A person shall not be accepted for residency if:
15        (1) the person poses a serious threat to himself or
16    herself or to others;
17        (2) the person is not able to communicate his or her
18    needs and no resident representative residing in the
19    establishment, and with a prior relationship to the
20    person, has been appointed to direct the provision of
21    services;
22        (3) the person requires total assistance with 2 or
23    more activities of daily living;
24        (4) the person requires the assistance of more than
25    one paid caregiver at any given time with an activity of



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1    daily living;
2        (5) the person requires more than minimal assistance
3    in moving to a safe area in an emergency;
4        (6) the person has a severe mental illness, which for
5    the purposes of this Section means a condition that is
6    characterized by the presence of a major mental disorder
7    as classified in the Diagnostic and Statistical Manual of
8    Mental Disorders, Fourth Edition (DSM-IV) (American
9    Psychiatric Association, 1994), where the individual is a
10    person with a substantial disability due to mental illness
11    in the areas of self-maintenance, social functioning,
12    activities of community living and work skills, and the
13    disability specified is expected to be present for a
14    period of not less than one year, but does not mean
15    Alzheimer's disease and other forms of dementia based on
16    organic or physical disorders;
17        (7) the person requires intravenous therapy or
18    intravenous feedings unless self-administered or
19    administered by a qualified, licensed health care
20    professional;
21        (8) the person requires gastrostomy feedings unless
22    self-administered or administered by a licensed health
23    care professional;
24        (9) the person requires insertion, sterile irrigation,
25    and replacement of catheter, except for routine
26    maintenance of urinary catheters, unless the catheter care



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1    is self-administered or administered by a licensed health
2    care professional;
3        (10) the person requires sterile wound care unless
4    care is self-administered or administered by a licensed
5    health care professional;
6        (11) (blank);
7        (12) the person is a diabetic requiring routine
8    insulin injections unless the injections are
9    self-administered or administered by a licensed health
10    care professional;
11        (13) the person requires treatment of stage 3 or stage
12    4 decubitus ulcers or exfoliative dermatitis;
13        (14) the person requires 5 or more skilled nursing
14    visits per week for conditions other than those listed in
15    items (13) and (15) of this subsection for a period of 3
16    consecutive weeks or more except when the course of
17    treatment is expected to extend beyond a 3 week period for
18    rehabilitative purposes and is certified as temporary by a
19    physician; or
20        (15) other reasons prescribed by the Department by
21    rule.
22    (d) A resident with a condition listed in items (1)
23through (15) of subsection (c) shall have his or her residency
25    (e) Residency shall be terminated when services available
26to the resident in the establishment are no longer adequate to



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1meet the needs of the resident. The establishment shall notify
2the resident and the resident's representative, if any, when
3there is a significant change in the resident's condition that
4affects the establishment's ability to meet the resident's
5needs. The requirements of subsection (c) of Section 80 shall
6then apply. This provision shall not be interpreted as
7limiting the authority of the Department to require the
8residency termination of individuals.
9    (f) Subsection (d) of this Section shall not apply to
10terminally ill residents who receive or would qualify for
11hospice care and such care is coordinated by a hospice program
12licensed under the Hospice Program Licensing Act or other
13licensed health care professional employed by a licensed home
14health agency and the establishment and all parties agree to
15the continued residency.
16    (g) Items (3), (4), (5), and (9) of subsection (c) shall
17not apply to a quadriplegic, paraplegic, or individual with
18neuro-muscular diseases, such as muscular dystrophy and
19multiple sclerosis, or other chronic diseases and conditions
20as defined by rule if the individual is able to communicate his
21or her needs and does not require assistance with complex
22medical problems, and the establishment is able to accommodate
23the individual's needs. The Department shall prescribe rules
24pursuant to this Section that address special safety and
25service needs of these individuals.
26    (h) For the purposes of items (7) through (10) of



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1subsection (c), a licensed health care professional may not be
2employed by the owner or operator of the establishment, its
3parent entity, or any other entity with ownership common to
4either the owner or operator of the establishment or parent
5entity, including but not limited to an affiliate of the owner
6or operator of the establishment. Nothing in this Section is
7meant to limit a resident's right to choose his or her health
8care provider.
9    (i) Subsection (h) is not applicable to residents admitted
10to an assisted living establishment under a life care contract
11as defined in the Life Care Facilities Act if the life care
12facility has both an assisted living establishment and a
13skilled nursing facility. A licensed health care professional
14providing health-related or supportive services at a life care
15assisted living or shared housing establishment must be
16employed by an entity licensed by the Department under the
17Nursing Home Care Act or the Home Health, Home Services, and
18Home Nursing Agency Licensing Act.
19(Source: P.A. 103-444, eff. 1-1-24.)
20    (210 ILCS 9/80)
21    Sec. 80. Involuntary termination of residency.
22    (a) Residency shall be involuntarily terminated only for
23the following reasons:
24        (1) as provided in Section 75 of this Act;
25        (2) nonpayment of contracted charges after the



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1    resident and the resident's representative have received a
2    minimum of 30 days' 30-days written notice of the
3    delinquency and the resident or the resident's
4    representative has had at least 15 days to cure the
5    delinquency; or
6        (3) failure to execute a service delivery contract or
7    to substantially comply with its terms and conditions,
8    failure to comply with the assessment requirements
9    contained in Section 15, or failure to substantially
10    comply with the terms and conditions of the lease
11    agreement.
12    (b) A 30-day 30 day written notice of residency
13termination shall be provided to the resident, the resident's
14representative, or both, the Department, and the long term
15care ombudsman, which shall include the reason for the pending
16action, the date of the proposed move, and a notice, the
17content and form to be set forth by rule, of the resident's
18right to appeal, the steps that the resident or the resident's
19representative must take to initiate an appeal, and a
20statement of the resident's right to continue to reside in the
21establishment until a decision is rendered. The notice shall
22include a toll free telephone number to initiate an appeal and
23a written hearing request form, together with a postage paid,
24pre-addressed envelope to the Department. If the resident or
25the resident's representative, if any, cannot read English,
26the notice must be provided in a language the individual



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1receiving the notice can read or the establishment must
2provide a translator who has been trained to assist the
3resident or the resident's representative in the appeal
4process. In emergency situations as defined in Section 10 of
5this Act, the 30-day provision of the written notice may be
7    (c) The establishment shall attempt to resolve with the
8resident or the resident's representative, if any,
9circumstances that if not remedied have the potential of
10resulting in an involuntary termination of residency and shall
11document those efforts in the resident's file. This action may
12occur prior to or during the 30 day notice period, but must
13occur prior to the termination of the residency. In emergency
14situations as defined in Section 10 of this Act, the
15requirements of this subsection may be waived.
16    (d) A request for a hearing shall stay an involuntary
17termination of residency until a decision has been rendered by
18the Department, according to a process adopted by rule. During
19this time period, the establishment may not terminate or
20reduce any service without the consent of the resident or the
21resident's representative, if any, for the purpose of making
22it more difficult or impossible for the resident to remain in
23the establishment.
24    (e) The establishment shall offer the resident and the
25resident's representative, if any, resident and the resident's
26representative, if any, residency termination and relocation



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1assistance including information on available alternative
2placement. Residents shall be involved in planning the move
3and shall choose among the available alternative placements
4except when an emergency situation makes prior resident
5involvement impossible. Emergency placements are deemed
6temporary until the resident's input can be sought in the
7final placement decision. No resident shall be forced to
8remain in a temporary or permanent placement.
9    (f) The Department may offer assistance to the
10establishment and the resident in the preparation of residency
11termination and relocation plans to assure safe and orderly
12transition and to protect the resident's health, safety,
13welfare, and rights. In nonemergencies, and where possible in
14emergencies, the transition plan shall be designed and
15implemented in advance of transfer or residency termination.
16    (g) An establishment may not initiate a termination of
17residency due to an emergency situation if the establishment
18is able to safely care for the resident and (1) a resident has
19been hospitalized and the resident's physician states that
20returning to the establishment would not create an imminent
21danger of death or serious physical harm to a resident; or (2)
22the emergency can be negated by changes in staffing,
23activities, health care, personal care, or rooming
24accommodations, consistent with the license of the
25establishment. The Department may not find an establishment to
26be in violation of Section 75 of this Act for failing to



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1initiate an emergency discharge in these circumstances.
2    (h) If the Department determines that an involuntary
3termination of residency does not meet the requirements of
4this Act, the Department shall issue a written decision
5stating that the involuntary termination of residency is
6denied. If the action of the establishment giving rise to the
7request for hearings is the establishment's failure to readmit
8the resident following hospitalization, other medical leave of
9absence, or other absence, the Department shall order the
10immediate readmission of the resident to the establishment.
11    (i) If an order to readmit is entered pursuant to
12subsection (h), the establishment shall immediately comply. As
13used in this subsection, "comply" means the establishment and
14the resident have agreed on a schedule for readmission or the
15resident is living in the establishment. If the resident,
16resident's representative, a long-term care ombudsman, or any
17other individual notifies the Department that the
18establishment is not complying with an agreed-upon schedule,
19or that the establishment is not complying with the
20representation described in subsection (k), a surveyor shall
21make an on-site inspection to determine compliance.
22    (j) An establishment that does not readmit a resident
23after the Department has ordered readmission shall be assessed
24a fine in accordance with a Type 1 violation. Additionally, a
25daily fine of $1,250 beginning on the third day after the
26readmission order was issued by the Department shall be



HB5012- 20 -LRB103 36301 CES 66399 b

1assessed. This fine shall be imposed for every day thereafter,
2until the establishment notifies the Department that it is in
3compliance with the order and a surveyor makes an on-site
4inspection to determine if there is compliance or the resident
5confirms to the Department that there is compliance, as
6defined in subsection (i) of this Section. The establishment
7shall be required to submit an acceptable plan of correction
8to the Department within 30 days after the violation is
10    (k) Once a notice of appeal is filed, the Department shall
11hold a hearing unless the notice of appeal is withdrawn. If the
12notice of appeal is withdrawn based upon a representation made
13by the establishment to the resident and the Department,
14including the hearing officer, that a resident who has been
15previously denied readmission will be readmitted, failure to
16comply with the representation shall be considered a failure
17to comply with a Department order pursuant to subsection (h)
18and shall result in the imposition of a fine as provided in
19subsection (j) of this Section.
20    (l) A long term care ombudsman may request a hearing on
21behalf of a resident and secure representation of a resident
22if, in the judgment of the long term care ombudsman, doing so
23is in the best interests of the resident and the resident does
24not object.
25(Source: P.A. 91-656, eff. 1-1-01.)



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1    (210 ILCS 9/90)
2    Sec. 90. Contents of service delivery contract. A contract
3between an establishment and a resident must be entitled
4"assisted living establishment contract" or "shared housing
5establishment contract" as applicable, shall be printed in no
6less than 12 point type, and shall include at least the
7following elements in the body or through supporting documents
8or attachments:
9        (1) the name, street address, and mailing address of
10    the establishment;
11        (2) the name and mailing address of the owner or
12    owners of the establishment and, if the owner or owners
13    are not natural persons, the type of business entity of
14    the owner or owners;
15        (3) the name and mailing address of the managing agent
16    of the establishment, whether hired under a management
17    agreement or lease agreement, if the managing agent is
18    different from the owner or owners;
19        (4) the name and address of at least one natural
20    person who is authorized to accept service on behalf of
21    the owners and managing agent;
22        (5) a statement describing the license status of the
23    establishment and the license status of all providers of
24    health-related or supportive services to a resident under
25    arrangement with the establishment;
26        (6) the duration of the contract;



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1        (7) the base rate to be paid by the resident and a
2    description of the services to be provided as part of this
3    rate;
4        (8) a description of any additional services to be
5    provided for an additional fee by the establishment
6    directly or by a third party provider under arrangement
7    with the establishment;
8        (9) the fee schedules outlining the cost of any
9    additional services;
10        (10) a description of the process through which the
11    contract may be modified, amended, or terminated;
12        (11) a description of the establishment's complaint
13    resolution process available to residents and notice of
14    the availability of the Department on Aging's Senior
15    Helpline for complaints;
16        (12) the name of the resident's designated
17    representative, if any;
18        (13) the resident's obligations in order to maintain
19    residency and receive services including compliance with
20    all assessments required under Section 15;
21        (14) the billing and payment procedures and
22    requirements;
23        (15) a statement affirming the resident's freedom to
24    receive services from service providers with whom the
25    establishment does not have a contractual arrangement,
26    which may also disclaim liability on the part of the



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1    establishment for those services;
2        (16) a statement that medical assistance under Article
3    V or Article VI of the Illinois Public Aid Code is not
4    available for payment for services provided in an
5    establishment, excluding contracts executed with residents
6    residing in licensed establishments participating in the
7    Department on Aging's Comprehensive Care in Residential
8    Settings Demonstration Project;
9        (17) a statement detailing the admission, risk
10    management, and residency termination criteria and
11    procedures;
12        (18) a written explanation, prepared by the Office of
13    State Long Term Care Ombudsman, statement listing the
14    rights specified in Sections 80 and Section 95, including
15    an acknowledgment by the establishment and acknowledging
16    that, by contracting with the assisted living or shared
17    housing establishment, the resident does not forfeit those
18    rights;
19        (19) a statement detailing the Department's annual
20    on-site review process including what documents contained
21    in a resident's personal file shall be reviewed by the
22    on-site reviewer as defined by rule; and
23        (20) a statement outlining whether the establishment
24    charges a community fee and, if so, the amount of the fee
25    and whether it is refundable; if the fee is refundable,
26    the contract must describe the conditions under which it



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1    is refundable and how the amount of the refund is
2    determined.
3(Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)
4    (210 ILCS 9/95)
5    Sec. 95. Resident rights. No resident shall be deprived of
6any rights, benefits, or privileges guaranteed by law, the
7Constitution of the State of Illinois, or the Constitution of
8the United States solely on account of his or her status as a
9resident of an establishment, nor shall a resident forfeit any
10of the following rights:
11        (1) the right to retain and use personal property and
12    a place to store personal items that is locked and secure;
13        (2) the right to refuse services and to be advised of
14    the consequences of that refusal;
15        (3) the right to respect for bodily privacy and
16    dignity at all times, especially during care and
17    treatment;
18        (4) the right to the free exercise of religion;
19        (5) the right to privacy with regard to mail, phone
20    calls, and visitors;
21        (6) the right to uncensored access to the State
22    Ombudsman or his or her designee;
23        (7) the right to be free of retaliation for
24    criticizing the establishment or making complaints to
25    appropriate agencies;



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1        (8) the right to be free of chemical and physical
2    restraints;
3        (9) the right to be free of abuse or neglect or to
4    refuse to perform labor;
5        (10) the right to confidentiality of the resident's
6    medical records;
7        (11) the right of access and the right to copy the
8    resident's personal files maintained by the establishment;
9        (12) the right to 24 hours access to the
10    establishment;
11        (13) the right to a minimum of 90 days' 90-days notice
12    of a planned establishment closure;
13        (14) the right to a minimum of 30 days' 30-days notice
14    of an involuntary residency termination, except where the
15    resident poses a threat to himself or others, or in other
16    emergency situations, and the right to appeal such
17    termination; if an establishment withdraws a notice of
18    involuntary termination of residency, then the resident
19    has the right to maintain residency at the establishment;
20    and
21        (15) the right to a 30-day notice of delinquency and
22    at least 15 days right to cure delinquency; .
23        (16) the right to not be unlawfully transferred or
24    discharged;
25        (17) the right to retain residency during any hospital
26    stay totaling 10 days or less following a hospital



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1    admission; and
2        (18) the right not to be charged for any period during
3    which the resident was unlawfully denied residency.
4(Source: P.A. 91-656, eff. 1-1-01.)
5    Section 10. The Nursing Home Care Act is amended by
6changing Sections 1-111, 1-114.005, 1-128, 2-104, 2-111,
73-401, 3-401.1, 3-402, 3-404, 3-405, 3-410, 3-411, and 3-413
8and by adding Sections 3-305.6 and 3-413.1 as follows:
9    (210 ILCS 45/1-111)  (from Ch. 111 1/2, par. 4151-111)
10    Sec. 1-111. "Discharge" means the full release of any
11resident from a facility. "Discharge" includes a nursing
12facility's failure to readmit following hospitalization, other
13medical leave, or other absence.
14(Source: P.A. 81-223.)
15    (210 ILCS 45/1-114.005)
16    Sec. 1-114.005. High risk designation. "High risk
17designation" means a violation of a provision of the Illinois
18Administrative Code or statute that has been identified by the
19Department through rulemaking or designated in statute to be
20inherently necessary to protect the health, safety, and
21welfare of a resident. "High risk designation" includes an
22unlawful discharge of a resident.
23(Source: P.A. 96-1372, eff. 7-29-10.)



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1    (210 ILCS 45/1-128)  (from Ch. 111 1/2, par. 4151-128)
2    Sec. 1-128. "Transfer" means a change in status of a
3resident's living arrangements from one facility to another
4facility. "Transfer" includes a nursing facility's failure to
5readmit a resident following hospitalization, other medical
6leave, or other absence, resulting in the resident being moved
7to another institutional setting.
8(Source: P.A. 81-223.)
9    (210 ILCS 45/2-104)  (from Ch. 111 1/2, par. 4152-104)
10    Sec. 2-104. (a) A resident shall be permitted to retain
11the services of his own personal physician at his own expense
12or under an individual or group plan of health insurance, or
13under any public or private assistance program providing such
14coverage. However, the facility is not liable for the
15negligence of any such personal physician. Every resident
16shall be permitted to obtain from his own physician or the
17physician attached to the facility complete and current
18information concerning his medical diagnosis, treatment and
19prognosis in terms and language the resident can reasonably be
20expected to understand. Every resident shall be permitted to
21participate in the planning of his total care and medical
22treatment to the extent that his condition permits. No
23resident shall be subjected to experimental research or
24treatment without first obtaining his informed, written



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1consent. The conduct of any experimental research or treatment
2shall be authorized and monitored by an institutional review
3board appointed by the Director. The membership, operating
4procedures and review criteria for the institutional review
5board shall be prescribed under rules and regulations of the
6Department and shall comply with the requirements for
7institutional review boards established by the federal Food
8and Drug Administration. No person who has received
9compensation in the prior 3 years from an entity that
10manufactures, distributes, or sells pharmaceuticals,
11biologics, or medical devices may serve on the institutional
12review board.
13    The institutional review board may approve only research
14or treatment that meets the standards of the federal Food and
15Drug Administration with respect to (i) the protection of
16human subjects and (ii) financial disclosure by clinical
17investigators. The Office of State Long Term Care Ombudsman
18and the State Protection and Advocacy organization shall be
19given an opportunity to comment on any request for approval
20before the board makes a decision. Those entities shall not be
21provided information that would allow a potential human
22subject to be individually identified, unless the board asks
23the Ombudsman for help in securing information from or about
24the resident. The board shall require frequent reporting of
25the progress of the approved research or treatment and its
26impact on residents, including immediate reporting of any



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1adverse impact to the resident, the resident's representative,
2the Office of the State Long Term Care Ombudsman, and the State
3Protection and Advocacy organization. The board may not
4approve any retrospective study of the records of any resident
5about the safety or efficacy of any care or treatment if the
6resident was under the care of the proposed researcher or a
7business associate when the care or treatment was given,
8unless the study is under the control of a researcher without
9any business relationship to any person or entity who could
10benefit from the findings of the study.
11    No facility shall permit experimental research or
12treatment to be conducted on a resident, or give access to any
13person or person's records for a retrospective study about the
14safety or efficacy of any care or treatment, without the prior
15written approval of the institutional review board. No nursing
16home administrator, or person licensed by the State to provide
17medical care or treatment to any person, may assist or
18participate in any experimental research on or treatment of a
19resident, including a retrospective study, that does not have
20the prior written approval of the board. Such conduct shall be
21grounds for professional discipline by the Department of
22Financial and Professional Regulation.
23    The institutional review board may exempt from ongoing
24review research or treatment initiated on a resident before
25the individual's admission to a facility and for which the
26board determines there is adequate ongoing oversight by



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1another institutional review board. Nothing in this Section
2shall prevent a facility, any facility employee, or any other
3person from assisting or participating in any experimental
4research on or treatment of a resident, if the research or
5treatment began before the person's admission to a facility,
6until the board has reviewed the research or treatment and
7decided to grant or deny approval or to exempt the research or
8treatment from ongoing review.
9    The institutional review board requirements of this
10subsection (a) do not apply to investigational drugs,
11biological products, or devices used by a resident with a
12terminal illness as set forth in the Right to Try Act.
13    (b) All medical treatment and procedures shall be
14administered as ordered by a physician. All new physician
15orders shall be reviewed by the facility's director of nursing
16or charge nurse designee within 24 hours after such orders
17have been issued to assure facility compliance with such
19    All physician's orders and plans of treatment shall have
20the authentication of the physician. For the purposes of this
21subsection (b), "authentication" means an original written
22signature or an electronic signature system that allows for
23the verification of a signer's credentials. A stamp signature,
24with or without initials, is not sufficient.
25    According to rules adopted by the Department, every woman
26resident of child-bearing age shall receive routine



HB5012- 31 -LRB103 36301 CES 66399 b

1obstetrical and gynecological evaluations as well as necessary
2prenatal care.
3    (c) Every resident shall be permitted to refuse medical
4treatment and to know the consequences of such action, unless
5such refusal would be harmful to the health and safety of
6others and such harm is documented by a physician in the
7resident's clinical record. The resident's refusal shall free
8the facility from the obligation to provide the treatment. If
9a resident's refusal of treatment does not endanger other
10residents or staff, then the refusal of treatment is not
11grounds for discharge.
12    (d) Every resident, resident's guardian, or parent if the
13resident is a minor shall be permitted to inspect and copy all
14his clinical and other records concerning his care and
15maintenance kept by the facility or by his physician. The
16facility may charge a reasonable fee for duplication of a
18(Source: P.A. 99-270, eff. 1-1-16.)
19    (210 ILCS 45/2-111)  (from Ch. 111 1/2, par. 4152-111)
20    Sec. 2-111. A resident shall not be transferred or
21discharged in violation of this Act. A resident may not be
22charged for any period during which the resident was
23unlawfully denied the right to reside in a facility. A
24resident may be discharged from a facility after he gives the
25administrator, a physician, or a nurse of the facility written



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1notice of his desire to be discharged. If a guardian has been
2appointed for a resident or if the resident is a minor, the
3resident shall be discharged upon written consent of his
4guardian or if the resident is a minor, his parent unless there
5is a court order to the contrary. In such cases, upon the
6resident's discharge, the facility is relieved from any
7responsibility for the resident's care, safety or well-being.
8A resident has the right to not be unlawfully transferred or
9discharged. An unlawful transfer or discharge is, at minimum,
10a Type A violation.
11(Source: P.A. 81-223.)
12    (210 ILCS 45/3-305.6 new)
13    Sec. 3-305.6. Failure to readmit a resident. A facility
14that fails to comply with an order of the Department to readmit
15a resident who wishes to return to the facility and is
16appropriate for that level of care, shall be assessed a fine in
17accordance with a Type A violation. Additionally, a daily fine
18of $1,250 beginning on the third day after the readmission
19order was issued by the Department shall be assessed. This
20fine shall be imposed for every day thereafter, until the
21facility notifies the Department that it is in compliance with
22the order and a surveyor conducts an on-site inspection that
23confirms compliance or the resident or resident's
24representative confirms to the Department in writing that
25there is compliance.



HB5012- 33 -LRB103 36301 CES 66399 b

1    As used in this Section, "compliance with the order" means
2a resident is living in a facility, or a facility and a
3resident have agreed on a schedule for readmission. If a
4resident subsequently notifies the Department that a facility
5is not complying with an agreed-upon schedule, a surveyor
6shall make an on-site inspection to determine compliance.
7    (210 ILCS 45/3-401)  (from Ch. 111 1/2, par. 4153-401)
8    Sec. 3-401. A facility may involuntarily transfer or
9discharge a resident only for one or more of the following
11        (a) the facility is unable to meet the medical needs
12    of the resident, as documented in the resident's clinical
13    record by the resident's physician for medical reasons for
14    medical reasons;
15        (b) for the resident's physical safety;
16        (c) for the physical safety of other residents, the
17    facility staff or facility visitors; or
18        (d) for either late payment or nonpayment for the
19    resident's stay, except as prohibited by Titles XVIII and
20    XIX of the federal Social Security Act. For purposes of
21    this Section, "late payment" means non-receipt of payment
22    after submission of a bill. If payment is not received
23    within 45 days after submission of a bill, a facility may
24    send a notice to the resident and responsible party
25    requesting payment within 30 days. If payment is not



HB5012- 34 -LRB103 36301 CES 66399 b

1    received within such 30 days, the facility may thereupon
2    institute transfer or discharge proceedings by sending a
3    notice of transfer or discharge to the resident and
4    responsible party by registered or certified mail. The
5    notice shall state, in addition to the requirements of
6    Section 3-403 of this Act, that the responsible party has
7    the right to pay the amount of the bill in full up to the
8    date the transfer or discharge is to be made and then the
9    resident shall have the right to remain in the facility.
10    Such payment shall terminate the transfer or discharge
11    proceedings. This subsection does not apply to those
12    residents whose care is provided for under the Illinois
13    Public Aid Code. The Department shall adopt rules setting
14    forth the criteria and procedures to be applied in cases
15    of involuntary transfer or discharge permitted under this
16    Section.
17    In nonemergency situations, prior to issuing the notice of
18transfer or discharge of a resident under subsection (a), (b),
19or (c) of this Section, an attending physician shall conduct
20an in-person assessment and provide an explanation that in the
21physician's medical opinion, the safety threshold under the
22Act and the federal regulations has or has not been breached
23with the findings documented in the resident's clinical
24record. When the resident has the resident's own physician,
25that physician and not a physician working for the facility
26should be the physician that conducts the in-person assessment



HB5012- 35 -LRB103 36301 CES 66399 b

1of the resident. In the absence of other bases for transfer or
2discharge in this Section, unless it has complied with the
3prior notice and other procedural requirements of this Act, a
4facility may not refuse
to readmit a resident following a
5medical leave of absence if the resident's need for care does
6not exceed the provisions of the facility's license.
7(Source: P.A. 91-357, eff. 7-29-99.)
8    (210 ILCS 45/3-401.1)  (from Ch. 111 1/2, par. 4153-401.1)
9    Sec. 3-401.1. (a) A facility participating in the Medical
10Assistance Program is prohibited from failing or refusing to
11retain as a resident any person because he or she is a
12recipient of or an applicant for the Medical Assistance
13Program. A resident who is in the process of appealing the
14denial of his or her application for the Medical Assistance
15Program is considered to be a Medicaid applicant under this
17    (a-5) After the effective date of this amendatory Act of
181997, a facility of which only a distinct part is certified to
19participate in the Medical Assistance Program may refuse to
20retain as a resident any person who resides in a part of the
21facility that does not participate in the Medical Assistance
22Program and who is unable to pay for his or her care in the
23facility without Medical Assistance only if:
24        (1) the facility, no later than at the time of
25    admission and at the time of the resident's contract



HB5012- 36 -LRB103 36301 CES 66399 b

1    renewal, explains to the resident (unless he or she is
2    incompetent), and to the resident's representative, and to
3    the person making payment on behalf of the resident for
4    the resident's stay, in writing, that the facility may
5    discharge the resident if the resident is no longer able
6    to pay for his or her care in the facility without Medical
7    Assistance;
8        (2) the resident (unless he or she is incompetent),
9    the resident's representative, and the person making
10    payment on behalf of the resident for the resident's stay,
11    acknowledge in writing that they have received the written
12    explanation.
13    (a-10) For the purposes of this Section, a recipient or
14applicant shall be considered a resident in the facility
15during any hospital stay totaling 10 days or less following a
16hospital admission. The Department of Healthcare and Family
17Services shall recoup funds from a facility when, as a result
18of the facility's refusal to readmit a recipient after
19hospitalization for 10 days or less, the recipient incurs
20hospital bills in an amount greater than the amount that would
21have been paid by that Department (formerly the Illinois
22Department of Public Aid) for care of the recipient in the
23facility. The amount of the recoupment shall be the difference
24between the Department of Healthcare and Family Services'
25(formerly the Illinois Department of Public Aid's) payment for
26hospital care and the amount that Department would have paid



HB5012- 37 -LRB103 36301 CES 66399 b

1for care in the facility.
2    (b) A facility which violates this Section shall be guilty
3of a business offense and fined not less than $500 nor more
4than $1,000 for the first offense and not less than $1,000 nor
5more than $5,000 for each subsequent offense.
6(Source: P.A. 95-331, eff. 8-21-07.)
7    (210 ILCS 45/3-402)  (from Ch. 111 1/2, par. 4153-402)
8    Sec. 3-402. Involuntary transfer or discharge of a
9resident from a facility shall be preceded by the discussion
10required under Section 3-408 and by a minimum written notice
11of 30 21 days, except in one of the following instances:
12    (a) When the resident's attending physician has completed
13an assessment and determines the resident should be discharged
14because of the resident's health care needs, an emergency
15discharge may be ordered. When an emergency transfer or
16discharge is ordered by the resident's attending physician
17because of the resident's health care needs. The State Long
18Term Care Ombudsman shall be notified at the time of the
19emergency transfer or discharge.
20    (b) When the transfer or discharge is mandated by the
21physical safety of other residents, the facility staff, or
22facility visitors, as documented in the clinical record. The
23Department, the Office of State Long Term Care Ombudsman, and
24the resident's managed care organization, if applicable, and
25the State Long Term Care Ombudsman shall be notified prior to



HB5012- 38 -LRB103 36301 CES 66399 b

1any such involuntary transfer or discharge. The Department
2shall immediately offer transfer, or discharge and relocation
3assistance to residents transferred or discharged under this
4subparagraph (b), and the Department may place relocation
5teams as provided in Section 3-419 of this Act.
6    (c) When an identified offender is within the provisional
7admission period defined in Section 1-120.3. If the Identified
8Offender Report and Recommendation prepared under Section
92-201.6 shows that the identified offender poses a serious
10threat or danger to the physical safety of other residents,
11the facility staff, or facility visitors in the admitting
12facility and the facility determines that it is unable to
13provide a safe environment for the other residents, the
14facility staff, or facility visitors, the facility shall
15transfer or discharge the identified offender within 3 days
16after its receipt of the Identified Offender Report and
18(Source: P.A. 103-320, eff. 1-1-24.)
19    (210 ILCS 45/3-404)  (from Ch. 111 1/2, par. 4153-404)
20    Sec. 3-404. A request for a hearing made under Section
213-403 shall stay a transfer or discharge pending a hearing or
22appeal of the decision, unless a condition which would have
23allowed transfer or discharge in less than 30 21 days as
24described under paragraphs (a) and (b) of Section 3-402
25develops in the interim.



HB5012- 39 -LRB103 36301 CES 66399 b

1(Source: P.A. 81-223.)
2    (210 ILCS 45/3-405)  (from Ch. 111 1/2, par. 4153-405)
3    Sec. 3-405. A copy of the notice required by Section 3-402
4shall be placed in the resident's clinical record and a copy
5shall be transmitted to the Department, the State Long Term
6Care Ombudsman, the resident, and the resident's
7representative, if any, the resident's managed care
8organization, if applicable, and the Office of State Long Term
9Care Ombudsman.
10(Source: P.A. 103-320, eff. 1-1-24.)
11    (210 ILCS 45/3-410)  (from Ch. 111 1/2, par. 4153-410)
12    Sec. 3-410. A resident subject to involuntary transfer or
13discharge from a facility, the resident's guardian or if the
14resident is a minor, his parent shall have the opportunity to
15file a request for a hearing with the Department within 10 days
16following receipt of the written notice of the involuntary
17transfer or discharge by the facility. A long term care
18ombudsman may request a hearing on behalf of the resident, and
19secure representation for the resident, if, in the judgment of
20the long term care ombudsman, doing so is in the best interests
21of the resident, and the resident does not object.
22(Source: P.A. 81-223.)
23    (210 ILCS 45/3-411)  (from Ch. 111 1/2, par. 4153-411)



HB5012- 40 -LRB103 36301 CES 66399 b

1    Sec. 3-411. The Department of Public Health, when the
2basis for involuntary transfer or discharge is other than
3action by the Department of Healthcare and Family Services
4(formerly Department of Public Aid) with respect to the Title
5XIX Medicaid recipient, shall hold a hearing at the resident's
6facility not later than 10 days after a hearing request is
7filed, and render a decision within 14 days after the filing of
8the hearing request. The Department has continuing
9jurisdiction over the transfer or discharge irrespective of
10the timing of the hearing and decision. Once a request for a
11hearing is filed, the Department shall hold a hearing unless
12the request is withdrawn by the resident. If the request for a
13hearing is withdrawn based upon a representation made by the
14facility to the resident and the Department, including the
15hearing officer, that a resident who has been denied
16readmission will be readmitted, and the resident or resident
17representative notifies the Department that the facility is
18still denying readmission, failure to readmit is considered
19failure to comply with a Department order to readmit pursuant
20to Section 3-305.6, including the imposition of a daily fine
21under Section 3-305.6.
22(Source: P.A. 95-331, eff. 8-21-07.)
23    (210 ILCS 45/3-413)  (from Ch. 111 1/2, par. 4153-413)
24    Sec. 3-413. If the Department determines that a transfer
25or discharge is authorized under Section 3-401, the resident



HB5012- 41 -LRB103 36301 CES 66399 b

1shall not be required to leave the facility before the 34th day
2following receipt of the notice required under Section 3-402,
3or the 10th day following receipt of the Department's
4decision, whichever is later, unless a condition which would
5have allowed transfer or discharge in less than 30 21 days as
6described under paragraphs (a) and (b) of Section 3-402
7develops in the interim. The Department maintains jurisdiction
8over the transfer or discharge irrespective of the timing of
9the notice and discharge.
10(Source: P.A. 81-223.)
11    (210 ILCS 45/3-413.1 new)
12    Sec. 3-413.1. Denial of transfer or discharge. If the
13Department determines that a transfer or discharge is not
14authorized under Section 3-401, then the Department shall
15issue a written decision stating that the transfer or
16discharge is denied. If the action of the facility giving rise
17to the request for hearings is the facility's failure to
18readmit the resident following hospitalization, other medical
19leave of absence, or other absence, then the Department shall
20order the immediate readmission of the resident to the
21facility. The facility shall comply with the order
22immediately. A surveyor shall make an on-site inspection of
23the facility's compliance with the order unless the resident
24or resident representative notifies the Department in writing
25that there is compliance.



HB5012- 42 -LRB103 36301 CES 66399 b

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 45/1-111from Ch. 111 1/2, par. 4151-111
10    210 ILCS 45/1-114.005
11    210 ILCS 45/1-128from Ch. 111 1/2, par. 4151-128
12    210 ILCS 45/2-104from Ch. 111 1/2, par. 4152-104
13    210 ILCS 45/2-111from Ch. 111 1/2, par. 4152-111
14    210 ILCS 45/3-305.6 new
15    210 ILCS 45/3-401from Ch. 111 1/2, par. 4153-401
16    210 ILCS 45/3-401.1from Ch. 111 1/2, par. 4153-401.1
17    210 ILCS 45/3-402from Ch. 111 1/2, par. 4153-402
18    210 ILCS 45/3-404from Ch. 111 1/2, par. 4153-404
19    210 ILCS 45/3-405from Ch. 111 1/2, par. 4153-405
20    210 ILCS 45/3-410from Ch. 111 1/2, par. 4153-410
21    210 ILCS 45/3-411from Ch. 111 1/2, par. 4153-411
22    210 ILCS 45/3-413from Ch. 111 1/2, par. 4153-413
23    210 ILCS 45/3-413.1 new