Illinois General Assembly - Full Text of HB4674
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Full Text of HB4674  102nd General Assembly




State of Illinois
2021 and 2022


Introduced 1/21/2022, by Rep. Maurice A. West, II


210 ILCS 45/3-212  from Ch. 111 1/2, par. 4153-212
210 ILCS 45/3-702  from Ch. 111 1/2, par. 4153-702

    Amends the Nursing Home Care Act. Requires the Department of Public Health to establish by rule guidelines for required continuing education of all employees who inspect, survey, or evaluate a facility and to offer continuing education opportunities at least quarterly. Provides that the Department shall notify a facility and complainant of its findings regarding a complainant's complaint within 5 calendar days (rather than 10 days) of the determination. Provides that employees of a State or unit of local government agency charged with inspecting, surveying, or evaluating facilities are required to complete at least 10 hours of continuing education annually. Provides that if a facility is found to have violated any provision of the Act or rule adopted under the Act, the facility shall develop a plan of correction to address deficiencies indicated in a statement of deficiency. Requires the Department to approve or deny the plan of correction within 72 hours after receiving the plan of correction. Provides that the Department shall conduct an annual review of all survey activity from the preceding calendar year (rather than conduct an annual review) and make a report including specified information concerning the complaint and survey process. Contains other provisions.

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HB4674LRB102 23801 CPF 32992 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 Nursing Home Care Act is amended by
5changing Sections 3-212 and 3-702 as follows:
6    (210 ILCS 45/3-212)  (from Ch. 111 1/2, par. 4153-212)
7    Sec. 3-212. Inspection.
8    (a) The Department, whenever it deems necessary in
9accordance with subsection (b), shall inspect, survey and
10evaluate every facility to determine compliance with
11applicable licensure requirements and standards. Submission of
12a facility's current Consumer Choice Information Report
13required by Section 2-214 shall be verified at time of
14inspection. An inspection should occur within 120 days prior
15to license renewal. The Department may periodically visit a
16facility for the purpose of consultation. An inspection,
17survey, or evaluation, other than an inspection of financial
18records, shall be conducted without prior notice to the
19facility. A visit for the sole purpose of consultation may be
20announced. The Department shall provide training to surveyors
21about the appropriate assessment, care planning, and care of
22persons with mental illness (other than Alzheimer's disease or
23related disorders) to enable its surveyors to determine



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1whether a facility is complying with State and federal
2requirements about the assessment, care planning, and care of
3those persons.
4    (a-1) An employee of a State or unit of local government
5agency charged with inspecting, surveying, and evaluating
6facilities who directly or indirectly gives prior notice of an
7inspection, survey, or evaluation, other than an inspection of
8financial records, to a facility or to an employee of a
9facility is guilty of a Class A misdemeanor.
10    An inspector or an employee of the Department who
11intentionally prenotifies a facility, orally or in writing, of
12a pending complaint investigation or inspection shall be
13guilty of a Class A misdemeanor. Superiors of persons who have
14prenotified a facility shall be subject to the same penalties,
15if they have knowingly allowed the prenotification. A person
16found guilty of prenotifying a facility shall be subject to
17disciplinary action by his or her employer.
18    If the Department has a good faith belief, based upon
19information that comes to its attention, that a violation of
20this subsection has occurred, it must file a complaint with
21the Attorney General or the State's Attorney in the county
22where the violation took place within 30 days after discovery
23of the information.
24    (a-2) An employee of a State or unit of local government
25agency charged with inspecting, surveying, or evaluating
26facilities who willfully profits from violating the



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1confidentiality of the inspection, survey, or evaluation
2process shall be guilty of a Class 4 felony and that conduct
3shall be deemed unprofessional conduct that may subject a
4person to loss of his or her professional license. An action to
5prosecute a person for violating this subsection (a-2) may be
6brought by either the Attorney General or the State's Attorney
7in the county where the violation took place.
8    (a-3) The Department shall by rule establish guidelines
9for required continuing education of all employees who
10inspect, survey, or evaluate a facility. The Department shall
11offer continuing education opportunities at least quarterly.
12Employees of a State or unit of local government agency
13charged with inspecting, surveying, or evaluating a facility
14are required to complete at least 10 hours of continuing
15education annually. Qualifying hours of continuing education
16shall only be offered by the Department. Content presented
17during the continuing education shall be consistent throughout
18the State, regardless of survey region. The continuing
19education required by this subsection is separate from any
20continuing education required for any license that the
21employee holds.
22    (b) In determining whether to make more than the required
23number of unannounced inspections, surveys and evaluations of
24a facility the Department shall consider one or more of the
25following: previous inspection reports; the facility's history
26of compliance with standards, rules and regulations



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1promulgated under this Act and correction of violations,
2penalties or other enforcement actions; the number and
3severity of complaints received about the facility; any
4allegations of resident abuse or neglect; weather conditions;
5health emergencies; other reasonable belief that deficiencies
7    (b-1) The Department shall not be required to determine
8whether a facility certified to participate in the Medicare
9program under Title XVIII of the Social Security Act, or the
10Medicaid program under Title XIX of the Social Security Act,
11and which the Department determines by inspection under this
12Section or under Section 3-702 of this Act to be in compliance
13with the certification requirements of Title XVIII or XIX, is
14in compliance with any requirement of this Act that is less
15stringent than or duplicates a federal certification
16requirement. In accordance with subsection (a) of this Section
17or subsection (d) of Section 3-702, the Department shall
18determine whether a certified facility is in compliance with
19requirements of this Act that exceed federal certification
20requirements. If a certified facility is found to be out of
21compliance with federal certification requirements, the
22results of an inspection conducted pursuant to Title XVIII or
23XIX of the Social Security Act may be used as the basis for
24enforcement remedies authorized and commenced, with the
25Department's discretion to evaluate whether penalties are
26warranted, under this Act. Enforcement of this Act against a



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1certified facility shall be commenced pursuant to the
2requirements of this Act, unless enforcement remedies sought
3pursuant to Title XVIII or XIX of the Social Security Act
4exceed those authorized by this Act. As used in this
5subsection, "enforcement remedy" means a sanction for
6violating a federal certification requirement or this Act.
7    (c) Upon completion of each inspection, survey and
8evaluation, the appropriate Department personnel who conducted
9the inspection, survey or evaluation shall submit a copy of
10their report to the licensee upon exiting the facility, and
11shall submit the actual report to the appropriate regional
12office of the Department. Such report and any recommendations
13for action by the Department under this Act shall be
14transmitted to the appropriate offices of the associate
15director of the Department, together with related comments or
16documentation provided by the licensee which may refute
17findings in the report, which explain extenuating
18circumstances that the facility could not reasonably have
19prevented, or which indicate methods and timetables for
20correction of deficiencies described in the report. Without
21affecting the application of subsection (a) of Section 3-303,
22any documentation or comments of the licensee shall be
23provided within 10 days of receipt of the copy of the report.
24Such report shall recommend to the Director appropriate action
25under this Act with respect to findings against a facility.
26The Director shall then determine whether the report's



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1findings constitute a violation or violations of which the
2facility must be given notice. Such determination shall be
3based upon the severity of the finding, the danger posed to
4resident health and safety, the comments and documentation
5provided by the facility, the diligence and efforts to correct
6deficiencies, correction of the reported deficiencies, the
7frequency and duration of similar findings in previous reports
8and the facility's general inspection history. Violations
9shall be determined under this subsection no later than 75
10days after completion of each inspection, survey and
12    (d) The Department shall maintain all inspection, survey
13and evaluation reports for at least 5 years in a manner
14accessible to and understandable by the public.
15    (e) Revisit surveys. The Department shall conduct a
16revisit to its licensure and certification surveys, consistent
17with federal regulations and guidelines.
18    (f) Notwithstanding any other provision of this Act, the
19Department shall, no later than 180 days after the effective
20date of this amendatory Act of the 98th General Assembly,
21implement a single survey process that encompasses federal
22certification and State licensure requirements, health and
23life safety requirements, and an enhanced complaint
24investigation initiative.
25        (1) To meet the requirement of a single survey
26    process, the portions of the health and life safety survey



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1    associated with federal certification and State licensure
2    surveys must be started within 7 working days of each
3    other. Nothing in this paragraph (1) of subsection (f) of
4    this Section applies to a complaint investigation.
5        (2) The enhanced complaint and incident report
6    investigation initiative shall permit the facility to
7    challenge the amount of the fine due to the excessive
8    length of the investigation which results in one or more
9    of the following conditions:
10            (A) prohibits the timely development and
11        implementation of a plan of correction;
12            (B) creates undue financial hardship impacting the
13        quality of care delivered to the resident;
14            (C) delays initiation of corrective training; and
15            (D) negatively impacts quality assurance and
16        patient improvement standards.
17    This paragraph (2) does not apply to complaint
18    investigations exited within 14 working days or a
19    situation that triggers an extended survey.
20(Source: P.A. 98-104, eff. 7-22-13.)
21    (210 ILCS 45/3-702)  (from Ch. 111 1/2, par. 4153-702)
22    Sec. 3-702. (a) A person who believes that this Act or a
23rule promulgated under this Act may have been violated may
24request an investigation. The request may be submitted to the
25Department in writing, by telephone, by electronic means, or



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1by personal visit. An oral complaint shall be reduced to
2writing by the Department. The Department shall make
3available, through its website and upon request, information
4regarding the oral and phone intake processes and the list of
5questions that will be asked of the complainant. The
6Department shall request information identifying the
7complainant, including the name, address and telephone number,
8to help enable appropriate follow-up. The Department shall act
9on such complaints via on-site visits or other methods deemed
10appropriate to handle the complaints with or without such
11identifying information, as otherwise provided under this
12Section. The complainant shall be informed that compliance
13with such request is not required to satisfy the procedures
14for filing a complaint under this Act. The Department must
15notify complainants that complaints with less information
16provided are far more difficult to respond to and investigate.
17    (b) The substance of the complaint shall be provided in
18writing to the licensee, owner, or administrator upon no
19earlier than at the commencement of an on-site inspection of
20the facility which takes place pursuant to the complaint.
21    (c) The Department shall not disclose the name of the
22complainant unless the complainant consents in writing to the
23disclosure or the investigation results in a judicial
24proceeding, or unless disclosure is essential to the
25investigation. The complainant shall be given the opportunity
26to withdraw the complaint before disclosure. Upon the request



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1of the complainant, the Department may permit the complainant
2or a representative of the complainant to accompany the person
3making the on-site inspection of the facility.
4    (d) Upon receipt of a complaint, the Department shall
5determine whether this Act or a rule promulgated under this
6Act has been or is being violated. The Department shall
7investigate all complaints alleging abuse or neglect within 7
8calendar days after the receipt of the complaint except that
9complaints of abuse or neglect which indicate that a
10resident's life or safety is in imminent danger shall be
11investigated within 24 hours after receipt of the complaint.
12All other complaints shall be investigated within 30 calendar
13days after the receipt of the complaint. The Department
14employees investigating a complaint shall conduct a brief,
15informal exit conference with the facility to alert its
16administration of any suspected serious deficiency that poses
17a direct threat to the health, safety or welfare of a resident
18to enable an immediate correction for the alleviation or
19elimination of such threat. Such information and findings
20discussed in the brief exit conference shall become a part of
21the investigating record but shall not in any way constitute
22an official or final notice of violation as provided under
23Section 3-301. All complaints shall be classified as "an
24invalid report", "a valid report", or "an undetermined
25report". For any complaint classified as "a valid report", the
26Department must determine within 7 calendar 30 working days



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1after any Department employee enters a facility to begin an
2on-site inspection if any rule or provision of this Act has
3been or is being violated.
4    (d-1) The Department shall, whenever possible, combine an
5on-site investigation of a complaint in a facility with other
6inspections in order to avoid duplication of inspections.
7    (e) In all cases, the Department shall inform the
8complainant of its findings within 5 calendar 10 days of its
9determination unless otherwise indicated by the complainant,
10and the complainant may direct the Department to send a copy of
11such findings to another person. The Department's findings may
12include comments or documentation provided by either the
13complainant or the licensee pertaining to the complaint. The
14Department shall also notify the facility of such findings
15within 5 calendar 10 days of the determination, but the name of
16the complainant or residents shall not be disclosed in this
17notice to the facility. The notice or statement of deficiency
18of such findings shall include a copy of the written
19determination; the correction order, if any; the warning
20notice, if any; the inspection report; or the State licensure
21form on which the violation is listed. If a facility is found
22to have violated any provision of this Act or rule adopted
23under this Act, the facility shall develop a plan of
24correction to address deficiencies indicated in a statement of
25deficiency. The facility shall submit the plan of correction
26to the Department for approval. The Department must approve or



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1deny the plan of correction within 72 hours after receiving
2the plan of correction. If the facility's plan of correction
3is denied, the Department must notify the facility within 48
4hours after the denial determination and provide specific
5reasons for the denial, a process to remedy the denial, and
6requests for additional information, as needed, and complete
7the plan of correction determination process within 48 hours
8after receiving requested information from the facility. The
9Department shall complete an on-site revisit or desk revisit
10within 7 calendar days after approval of the facility's plan
11of correction. During the on-site or desk revisit, the
12Department must address the approved plan of correction and
13clear any outstanding violation for which a plan of correction
14has been approved before beginning a new complaint
15investigation or annual review. If the Department receives an
16abuse or neglect complaint that indicates a resident is in
17immediate danger within the same time frame during which an
18on-site revisit must be completed, the Department must conduct
19the on-site revisit simultaneously with the new complaint
20investigation. Under no circumstance may a violation remain
21open if the Department has approved the facility's plan of
22correction. If a facility fails to remedy the violation for
23which an on-site revisit is being conducted, the facility must
24correct any outstanding violation. Once the facility has
25notified the Department that the facility is in compliance
26with the plan of correction, the Department must complete an



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1on-site revisit within 7 calendar days. If the Department
2fails to complete a revisit within 7 calendar days after
3approving a facility's plan of correction, the facility shall
4be considered to be in substantial compliance.
5    (f) A written determination, correction order, or warning
6notice concerning a complaint, together with the facility's
7response, shall be available for public inspection, but the
8name of the complainant or resident shall not be disclosed
9without his consent.
10    (g) A complainant who is dissatisfied with the
11determination or investigation by the Department may request a
12hearing under Section 3-703. The facility shall be given
13notice of any such hearing and may participate in the hearing
14as a party. If a facility requests a hearing under Section
153-703 which concerns a matter covered by a complaint, the
16complainant shall be given notice and may participate in the
17hearing as a party. A request for a hearing by either a
18complainant or a facility shall be submitted in writing to the
19Department within 30 days after the mailing of the
20Department's findings as described in subsection (e) of this
21Section. Upon receipt of the request the Department shall
22conduct a hearing as provided under Section 3-703.
23    (g-5) The Department shall conduct an annual review of all
24survey activity from the preceding calendar year and make a
25report concerning the complaint and survey process. The report
26shall include, but not be limited to: that includes the total



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1number of complaints received; the total number of 24-hour,
27-day, and 30-day complaints; , the breakdown of anonymous and
3non-anonymous complaints; and whether the number of complaints
4that were substantiated versus unsubstantiated; or not, the
5total number of substantiated complaints that were completed
6in the time frame determined under subsection (d); the total
7number of informal dispute resolutions requested; the total
8number of informal dispute resolution requests approved; the
9total number of informal dispute resolutions that were
10overturned or reduced in severity; the total number of
11independent informal dispute resolutions requested; the total
12number of independent informal dispute resolution requests
13approved; the total number of independent informal dispute
14resolutions that were overturned or reduced in severity; the
15total number of revisits not completed within the statutorily
16mandated time frames; the total number of nurse surveyors
17hired during the calendar year; the total number of nurse
18surveyors who left Department employment; the total number of
19nurse surveyors who transferred to other positions within the
20Department or transferred to another State agency; the total
21number of Department employees entering long-term care
22facilities for any reason who are fully vaccinated for
23influenza and COVID-19; the total number of Department
24employees entering long-term care facilities for any reason
25who are not fully vaccinated for influenza and COVID-19; the
26total number of Department employees who enter long-term care



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1facilities and who have tested positive for COVID-19; , and any
2other complaint information requested by the Long-Term Care
3Facility Advisory Board created under Section 2-204 of this
4Act or the Illinois Long-Term Care Council created under
5Section 4.04a of the Illinois Act on the Aging. All of the
6listed reporting criteria in this subsection and additional
7complaint information requested by the Long-Term Care Facility
8Advisory Board, the Illinois Long-Term Care Council, or the
9General Assembly shall be provided in aggregate and broken
10down by Office of Health Care Regulation region. In addition,
11the Department shall provide Manatt health vaccine and health
12equity report findings, information about continued progress
13toward correcting identified deficiencies, and annual Centers
14for Medicare and Medicaid Services' State Performance
15Standards System results for the State of Illinois. This
16report shall be provided to the Long-Term Care Facility
17Advisory Board, the Illinois Long-Term Care Council, and the
18General Assembly. The Long-Term Care Facility Advisory Board
19and the Illinois Long-Term Care Council shall review the
20report and suggest any changes deemed necessary to the
21Department for review and action, including how to investigate
22and substantiate anonymous complaints.
23    (h) Any person who knowingly transmits a false report to
24the Department commits the offense of disorderly conduct under
25subsection (a)(8) of Section 26-1 of the Criminal Code of



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1(Source: P.A. 102-432, eff. 8-20-21.)