HB4674 EngrossedLRB102 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, review, or evaluate a facility. The
11Department shall offer continuing education opportunities at
12least quarterly. Employees of a State or unit of local
13government agency charged with inspecting, surveying,
14reviewing, or evaluating a facility are required to complete
15at least 10 hours of continuing education annually on topics
16including, but not limited to, trauma-informed care, infection
17control, abuse and neglect, and civil monetary penalties.
18Qualifying hours of continuing education shall only be offered
19by the Department. Content presented during the continuing
20education shall be consistent throughout the State, regardless
21of survey region. The continuing education required by this
22subsection is separate from any continuing education required
23for any license that the employee holds.
24    (b) In determining whether to make more than the required
25number of unannounced inspections, surveys and evaluations of
26a facility the Department shall consider one or more of the



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1following: previous inspection reports; the facility's history
2of compliance with standards, rules and regulations
3promulgated under this Act and correction of violations,
4penalties or other enforcement actions; the number and
5severity of complaints received about the facility; any
6allegations of resident abuse or neglect; weather conditions;
7health emergencies; other reasonable belief that deficiencies
9    (b-1) The Department shall not be required to determine
10whether a facility certified to participate in the Medicare
11program under Title XVIII of the Social Security Act, or the
12Medicaid program under Title XIX of the Social Security Act,
13and which the Department determines by inspection under this
14Section or under Section 3-702 of this Act to be in compliance
15with the certification requirements of Title XVIII or XIX, is
16in compliance with any requirement of this Act that is less
17stringent than or duplicates a federal certification
18requirement. In accordance with subsection (a) of this Section
19or subsection (d) of Section 3-702, the Department shall
20determine whether a certified facility is in compliance with
21requirements of this Act that exceed federal certification
22requirements. If a certified facility is found to be out of
23compliance with federal certification requirements, the
24results of an inspection conducted pursuant to Title XVIII or
25XIX of the Social Security Act may be used as the basis for
26enforcement remedies authorized and commenced, with the



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



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1appropriate action under this Act with respect to findings
2against a facility. The Director shall then determine whether
3the report's findings constitute a violation or violations of
4which the facility must be given notice. Such determination
5shall be based upon the severity of the finding, the danger
6posed to resident health and safety, the comments and
7documentation provided by the facility, the diligence and
8efforts to correct deficiencies, correction of the reported
9deficiencies, the frequency and duration of similar findings
10in previous reports and the facility's general inspection
11history. Violations shall be determined under this subsection
12no later than 75 calendar days after completion of each
13inspection, survey and evaluation.
14    (d) The Department shall maintain all inspection, survey
15and evaluation reports for at least 5 years in a manner
16accessible to and understandable by the public.
17    (e) Revisit surveys. The Department shall conduct a
18revisit to its licensure and certification surveys, consistent
19with federal regulations and guidelines.
20    (f) Notwithstanding any other provision of this Act, the
21Department shall, no later than 180 days after the effective
22date of this amendatory Act of the 98th General Assembly,
23implement a single survey process that encompasses federal
24certification and State licensure requirements, health and
25life safety requirements, and an enhanced complaint
26investigation initiative.



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



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



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



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1"a valid report", the Department must determine within 30
2working days after any Department employee enters a facility
3to begin an on-site inspection if any rule or provision of this
4Act has been or is being violated.
5    (d-1) The Department shall, whenever possible, combine an
6on-site investigation of a complaint in a facility with other
7inspections in order to avoid duplication of inspections.
8    (e) In all cases, the Department shall inform the
9complainant of its findings within 10 days of its
10determination unless otherwise indicated by the complainant,
11and the complainant may direct the Department to send a copy of
12such findings to another person. The Department's findings may
13include comments or documentation provided by either the
14complainant or the licensee pertaining to the complaint. The
15Department shall also notify the facility of such findings
16within 10 days of the determination, but the name of the
17complainant or residents shall not be disclosed in this notice
18to the facility. The notice of such findings shall include a
19copy of the written determination; the correction order, if
20any; the warning notice, if any; the inspection report; or the
21State licensure form on which the violation is listed.
22    (f) A written determination, correction order, or warning
23notice concerning a complaint, together with the facility's
24response, shall be available for public inspection, but the
25name of the complainant or resident shall not be disclosed
26without his consent.



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1    (g) A complainant who is dissatisfied with the
2determination or investigation by the Department may request a
3hearing under Section 3-703. The facility shall be given
4notice of any such hearing and may participate in the hearing
5as a party. If a facility requests a hearing under Section
63-703 which concerns a matter covered by a complaint, the
7complainant shall be given notice and may participate in the
8hearing as a party. A request for a hearing by either a
9complainant or a facility shall be submitted in writing to the
10Department within 30 days after the mailing of the
11Department's findings as described in subsection (e) of this
12Section. Upon receipt of the request the Department shall
13conduct a hearing as provided under Section 3-703.
14    (g-5) The Department shall conduct an annual review of all
15survey activity from the preceding calendar year and make a
16report concerning the complaint and survey process. The report
17shall include, but not be limited to: that includes the total
18number of complaints received; the total number of 24-hour,
197-day, and 30-day complaints; , the breakdown of anonymous and
20non-anonymous complaints; and whether the number of complaints
21that were substantiated versus unsubstantiated; or not, the
22total number of substantiated complaints that were completed
23in the time frame determined under subsection (d); the total
24number of informal dispute resolutions requested; the total
25number of informal dispute resolution requests approved; the
26total number of informal dispute resolutions that were



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1overturned or reduced in severity; the total number of
2independent informal dispute resolutions requested; the total
3number of independent informal dispute resolution requests
4approved; the total number of independent informal dispute
5resolutions that were overturned or reduced in severity; the
6total number of revisits not completed within the statutorily
7mandated time frames; the total number of nurse surveyors
8hired during the calendar year; the total number of nurse
9surveyors who left Department employment; the total number of
10times the Department recommended a discretionary denial of
11payment for new Medicare or Medicaid admissions with an
12effective date that is (i) less than 15 days after the date of
13the Department's notice to the facility, (ii) at least 15 days
14and less than 31 days after the date of the Department's notice
15to the facility, (iii) at least 31 days and less than 60 days
16after the date of the Department's notice to the facility, and
17(iv) at least 60 days after the date of the Department's notice
18to the facility; the total number of Department employees who
19entered long-term care facilities for any reason who were
20fully vaccinated for influenza and COVID-19; the total number
21of Department employees who entered long-term care facilities
22for any reason who were not fully vaccinated for influenza and
23COVID-19 and the number of instances in which Department
24employees not fully vaccinated against influenza and COVID-19
25entered a long-term care facility; the total number of
26Department employees who entered long-term care facilities and



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



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1the Department commits the offense of disorderly conduct under
2subsection (a)(8) of Section 26-1 of the Criminal Code of
4(Source: P.A. 102-432, eff. 8-20-21.)