Full Text of HB4674 102nd General Assembly
HB4674ham001 102ND GENERAL ASSEMBLY | Rep. Maurice A. West, II Filed: 2/24/2022
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| 1 | | AMENDMENT TO HOUSE BILL 4674
| 2 | | AMENDMENT NO. ______. Amend House Bill 4674 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Nursing Home Care Act is amended by | 5 | | changing 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
| 9 | | accordance with subsection (b), shall inspect, survey and | 10 | | evaluate every
facility to determine compliance with | 11 | | applicable licensure requirements and
standards. Submission of | 12 | | a facility's current Consumer Choice Information Report | 13 | | required by Section 2-214 shall be verified at time of | 14 | | inspection. An inspection should occur within 120 days prior
| 15 | | to license renewal. The Department may periodically visit a | 16 | | facility for the
purpose of consultation. An inspection, |
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| 1 | | survey, or evaluation, other than
an inspection of financial | 2 | | records, shall be conducted without prior notice
to the | 3 | | facility. A visit for the sole purpose of consultation may be
| 4 | | announced.
The Department shall provide training to surveyors | 5 | | about the appropriate
assessment, care planning, and care of | 6 | | persons with mental illness (other than
Alzheimer's disease or | 7 | | related disorders) to enable its surveyors to
determine | 8 | | whether a facility is complying with State and federal | 9 | | requirements
about the assessment, care planning, and care of | 10 | | those persons.
| 11 | | (a-1) An employee of a State or unit of local government | 12 | | agency
charged with inspecting, surveying, and evaluating | 13 | | facilities who directly
or indirectly gives prior notice of an | 14 | | inspection, survey, or evaluation,
other than an inspection of | 15 | | financial records, to a facility or to an
employee of a | 16 | | facility is guilty of a Class A misdemeanor.
| 17 | | An inspector or an employee of the Department who | 18 | | intentionally prenotifies
a facility,
orally or in writing, of | 19 | | a pending complaint investigation or inspection shall
be | 20 | | guilty of a Class A misdemeanor.
Superiors of persons who have | 21 | | prenotified a facility shall be subject to the
same penalties, | 22 | | if they have knowingly allowed the prenotification. A person
| 23 | | found guilty of prenotifying a facility shall be subject to | 24 | | disciplinary action
by his or her employer.
| 25 | | If the Department has a good faith belief, based upon | 26 | | information that comes
to its attention, that a violation of |
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| 1 | | this subsection has occurred, it must
file a complaint with | 2 | | the Attorney General or the State's Attorney in the
county | 3 | | where the violation
took place within 30 days after discovery | 4 | | of the information.
| 5 | | (a-2) An employee of a State or unit of local government | 6 | | agency charged with
inspecting, surveying, or evaluating | 7 | | facilities who willfully profits from
violating the | 8 | | confidentiality of the inspection, survey, or evaluation
| 9 | | process shall be guilty of a Class 4 felony and that conduct | 10 | | shall be deemed
unprofessional conduct that may subject a | 11 | | person to loss of his or her
professional license. An action to | 12 | | prosecute a person for violating this
subsection (a-2) may be | 13 | | brought by either the Attorney General or the State's
Attorney | 14 | | in the county where the violation took place.
| 15 | | (a-3) The Department shall by rule establish guidelines | 16 | | for required continuing education of all employees who | 17 | | inspect, survey, review, or evaluate a facility. The | 18 | | Department shall offer continuing education opportunities at | 19 | | least quarterly. Employees of a State or unit of local | 20 | | government agency charged with inspecting, surveying, | 21 | | reviewing, or evaluating a facility are required to complete | 22 | | at least 10 hours of continuing education annually on topics | 23 | | including, but not limited to, trauma-informed care, infection | 24 | | control, abuse and neglect, and civil monetary penalties. | 25 | | Qualifying hours of continuing education shall only be offered | 26 | | by the Department. Content presented during the continuing |
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| 1 | | education shall be consistent throughout the State, regardless | 2 | | of survey region. The continuing education required by this | 3 | | subsection is separate from any continuing education required | 4 | | for any license that the employee holds. | 5 | | (b) In determining whether to make more than the required | 6 | | number of
unannounced inspections, surveys and evaluations of | 7 | | a facility the
Department shall consider one or more of the | 8 | | following: previous inspection
reports; the facility's history | 9 | | of compliance with standards, rules and
regulations | 10 | | promulgated under this Act and correction of violations,
| 11 | | penalties or other enforcement actions; the number and | 12 | | severity of
complaints received about the facility; any | 13 | | allegations of resident abuse
or neglect; weather conditions; | 14 | | health emergencies; other reasonable belief
that deficiencies | 15 | | exist.
| 16 | | (b-1) The Department shall not be required to determine | 17 | | whether a
facility certified to participate in the Medicare | 18 | | program under Title XVIII of
the Social Security Act, or the | 19 | | Medicaid program under Title XIX of the Social
Security Act, | 20 | | and which the Department determines by inspection under this
| 21 | | Section or under Section 3-702 of this Act to be in compliance | 22 | | with the
certification requirements of Title XVIII or XIX, is | 23 | | in compliance with any
requirement of this Act that is less | 24 | | stringent than or duplicates a federal
certification | 25 | | requirement. In accordance with subsection (a) of this Section
| 26 | | or subsection (d) of Section 3-702, the Department shall |
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| 1 | | determine whether a
certified facility is in
compliance with | 2 | | requirements of this Act that exceed federal certification
| 3 | | requirements. If a certified facility is found to be out of | 4 | | compliance with
federal certification requirements, the | 5 | | results of an inspection conducted
pursuant to Title XVIII or | 6 | | XIX of the Social Security Act may be used as the
basis for | 7 | | enforcement remedies authorized and commenced, with the | 8 | | Department's discretion to evaluate whether penalties are | 9 | | warranted, under this Act.
Enforcement of this Act against a | 10 | | certified facility shall be commenced
pursuant to the | 11 | | requirements of this Act, unless enforcement remedies sought
| 12 | | pursuant to Title XVIII or XIX of the Social Security Act | 13 | | exceed those
authorized by this Act. As used in this | 14 | | subsection, "enforcement remedy"
means a sanction for | 15 | | violating a federal certification requirement or this
Act.
| 16 | | (c) Upon completion of each inspection, survey and | 17 | | evaluation, the
appropriate Department personnel who conducted | 18 | | the inspection, survey or
evaluation shall submit a physical | 19 | | or electronic copy of their report to the licensee upon | 20 | | exiting
the facility, and shall submit the actual report to | 21 | | the appropriate
regional office of the Department. Such report | 22 | | and any recommendations for
action by the Department under | 23 | | this Act shall be transmitted to the
appropriate offices of | 24 | | the associate director of the Department, together
with | 25 | | related comments or documentation provided by the licensee | 26 | | which may
refute findings in the report, which explain |
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| 1 | | extenuating circumstances that
the facility could not | 2 | | reasonably have prevented, or which indicate methods
and | 3 | | timetables for correction of deficiencies described in the | 4 | | report.
Without affecting the application of subsection (a) of | 5 | | Section 3-303, any
documentation or comments of the licensee | 6 | | shall be provided within 10
days of receipt of the copy of the | 7 | | report. Such report shall recommend to
the Director | 8 | | appropriate action under this Act with respect to findings
| 9 | | against a facility. The Director shall then determine whether | 10 | | the report's
findings constitute a violation or violations of | 11 | | which the facility must be
given notice. Such determination | 12 | | shall be based upon the severity of the
finding, the danger | 13 | | posed to resident health and safety, the comments and
| 14 | | documentation provided by the facility, the diligence and | 15 | | efforts to
correct deficiencies, correction of the reported | 16 | | deficiencies, the
frequency and duration of similar findings | 17 | | in previous reports and the
facility's general inspection | 18 | | history. Violations shall be determined
under this subsection | 19 | | no later than 75 calendar days after completion of each
| 20 | | inspection, survey and evaluation.
| 21 | | (d) The Department shall maintain all inspection, survey | 22 | | and evaluation
reports for at least 5 years in a manner | 23 | | accessible to and understandable
by the public.
| 24 | | (e) Revisit surveys. The Department shall conduct a | 25 | | revisit to its licensure and certification surveys, consistent | 26 | | with federal regulations and guidelines. |
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| 1 | | (f) Notwithstanding any other provision of this Act, the | 2 | | Department shall, no later than 180 days after the effective | 3 | | date of this amendatory Act of the 98th General Assembly, | 4 | | implement a single survey process that encompasses federal | 5 | | certification and State licensure requirements, health and | 6 | | life safety requirements, and an enhanced complaint | 7 | | investigation initiative. | 8 | | (1) To meet the requirement of a single survey | 9 | | process, the portions of the health and life safety survey | 10 | | associated with federal certification and State licensure | 11 | | surveys must be started within 7 working days of each | 12 | | other. Nothing in this paragraph (1) of subsection (f) of | 13 | | this Section applies to a complaint investigation. | 14 | | (2) The enhanced complaint and incident report | 15 | | investigation initiative shall permit the facility to | 16 | | challenge the amount of the fine due to the excessive | 17 | | length of the investigation which results in one or more | 18 | | of the following conditions: | 19 | | (A) prohibits the timely development and | 20 | | implementation of a plan of correction; | 21 | | (B) creates undue financial hardship impacting the | 22 | | quality of care delivered to the resident; | 23 | | (C) delays initiation of corrective training; and | 24 | | (D) negatively impacts quality assurance and | 25 | | patient improvement standards. | 26 | | This paragraph (2) does not apply to complaint |
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| 1 | | investigations exited within 14 working days or a | 2 | | situation that triggers an extended survey. | 3 | | (Source: P.A. 98-104, eff. 7-22-13.)
| 4 | | (210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
| 5 | | Sec. 3-702.
(a) A person who believes that this Act or a | 6 | | rule promulgated
under this Act may have been violated may | 7 | | request an investigation. The
request may be submitted to the | 8 | | Department in writing, by telephone, by electronic means, or | 9 | | by
personal visit. An oral complaint shall be reduced to | 10 | | writing by the
Department. The Department shall make | 11 | | available, through its website and upon request, information | 12 | | regarding the oral and phone intake processes and the list of | 13 | | questions that will be asked of the complainant. The | 14 | | Department shall request information identifying the
| 15 | | complainant, including the name, address and telephone number, | 16 | | to help
enable appropriate follow-up. The Department shall act | 17 | | on such complaints
via on-site visits or other methods deemed | 18 | | appropriate to handle the
complaints with or without such | 19 | | identifying information, as otherwise
provided under this | 20 | | Section. The complainant shall be informed that
compliance | 21 | | with such request is not required to satisfy the procedures | 22 | | for
filing a complaint under this Act. The Department must | 23 | | notify complainants that complaints with less information | 24 | | provided are far more difficult to respond to and investigate.
| 25 | | (b) The substance of the complaint shall be provided in |
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| 1 | | writing to the
licensee, owner, or administrator upon no | 2 | | earlier than at the commencement of an
on-site inspection of | 3 | | the facility which takes place pursuant to the complaint.
| 4 | | (c) The Department shall not disclose the name of the | 5 | | complainant unless
the complainant consents in writing to the | 6 | | disclosure or the investigation
results in a judicial | 7 | | proceeding, or unless disclosure is essential to the
| 8 | | investigation. The complainant shall be given the opportunity | 9 | | to withdraw
the complaint before disclosure. Upon the request | 10 | | of the complainant, the
Department may permit the complainant | 11 | | or a representative of the complainant
to accompany the person | 12 | | making the on-site inspection of the facility.
| 13 | | (d) Upon receipt of a complaint, the Department shall | 14 | | determine whether this
Act or a rule promulgated under this | 15 | | Act has been or is being violated. The
Department shall | 16 | | investigate all complaints alleging abuse or neglect within
7 | 17 | | days after the receipt of the complaint except that complaints | 18 | | of abuse
or neglect which indicate that a resident's life or | 19 | | safety is in imminent
danger shall be investigated within 24 | 20 | | hours after receipt of the
complaint. All other complaints | 21 | | shall be investigated within 30 days after
the receipt of the | 22 | | complaint. The Department employees investigating a
complaint | 23 | | shall conduct a brief, informal exit conference with the | 24 | | facility
to alert its administration of any suspected serious | 25 | | deficiency that poses
a direct threat to the health, safety or | 26 | | welfare of a resident to enable an
immediate correction for |
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| 1 | | the alleviation or elimination of such threat.
Such | 2 | | information and findings discussed in the brief exit | 3 | | conference shall
become a part of the investigating record but | 4 | | shall not in any way
constitute an official or final notice of | 5 | | violation as provided under
Section 3-301. All complaints | 6 | | shall be classified as
"an invalid report", "a valid report", | 7 | | or "an undetermined
report". For any complaint classified as | 8 | | "a valid report", the
Department must determine within 30 | 9 | | working days after any Department employee enters a facility | 10 | | to begin an on-site inspection
if any rule or provision of this | 11 | | Act has been or is being violated.
| 12 | | (d-1) The Department shall, whenever possible, combine an | 13 | | on-site
investigation of a complaint in a facility with other | 14 | | inspections in order
to avoid duplication of inspections.
| 15 | | (e) In all cases, the Department shall inform the | 16 | | complainant of its
findings within 10 days of its | 17 | | determination unless otherwise indicated
by the complainant, | 18 | | and the complainant may direct the Department to
send a copy of | 19 | | such findings to another person. The Department's findings
may | 20 | | include comments or documentation provided by either the | 21 | | complainant
or the licensee pertaining to the complaint. The | 22 | | Department shall also
notify the facility of such findings | 23 | | within 10 days of the determination,
but the name of the | 24 | | complainant or residents shall not be disclosed in this
notice | 25 | | to the facility. The notice of such
findings shall include a | 26 | | copy of the written determination; the
correction order, if |
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| 1 | | any; the warning notice, if any; the inspection
report; or the | 2 | | State licensure form on which the violation is listed.
| 3 | | (f) A written determination, correction order, or warning | 4 | | notice
concerning a complaint, together with the facility's | 5 | | response, shall be
available for public inspection, but the | 6 | | name of the complainant or
resident shall not be disclosed | 7 | | without his consent.
| 8 | | (g) A complainant who is dissatisfied with the | 9 | | determination or
investigation by the Department may request a | 10 | | hearing under Section
3-703. The facility shall be given | 11 | | notice of any such
hearing and may participate in the hearing | 12 | | as a party. If a facility
requests a hearing under Section | 13 | | 3-703 which
concerns a matter covered by a complaint, the | 14 | | complainant shall be given
notice and may participate in the | 15 | | hearing as a party. A request
for a hearing by either a | 16 | | complainant or a facility shall be
submitted in writing to the | 17 | | Department within 30 days after the mailing
of the | 18 | | Department's findings as described in subsection (e) of this
| 19 | | Section. Upon receipt of the request the Department shall | 20 | | conduct a hearing
as provided under Section 3-703.
| 21 | | (g-5) The Department shall conduct an annual review of all | 22 | | survey activity from the preceding calendar year and make a | 23 | | report concerning the complaint and survey process . The report | 24 | | shall include, but not be limited to: that includes the total | 25 | | number of complaints received ; the total number of 24-hour, | 26 | | 7-day, and 30-day complaints; , the breakdown of anonymous and |
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| 1 | | non-anonymous complaints ; and whether the number of complaints | 2 | | that were substantiated versus unsubstantiated; or not, the | 3 | | total number of substantiated complaints that were completed | 4 | | in the time frame determined under subsection (d) ; the total | 5 | | number of informal dispute resolutions requested; the total | 6 | | number of informal dispute resolution requests approved; the | 7 | | total number of informal dispute resolutions that were | 8 | | overturned or reduced in severity; the total number of | 9 | | independent informal dispute resolutions requested; the total | 10 | | number of independent informal dispute resolution requests | 11 | | approved; the total number of independent informal dispute | 12 | | resolutions that were overturned or reduced in severity; the | 13 | | total number of revisits not completed within the statutorily | 14 | | mandated time frames; the total number of nurse surveyors | 15 | | hired during the calendar year; the total number of nurse | 16 | | surveyors who left Department employment; the total number of | 17 | | times the Department recommended a discretionary denial of | 18 | | payment for new Medicare or Medicaid admissions with an | 19 | | effective date that is (i) less than 15 days after the date of | 20 | | the Department's notice to the facility, (ii) at least 15 days | 21 | | and less than 31 days after the date of the Department's notice | 22 | | to the facility, (iii) at least 31 days and less than 60 days | 23 | | after the date of the Department's notice to the facility, and | 24 | | (iv) at least 60 days after the date of the Department's notice | 25 | | to the facility; the total number of Department employees who | 26 | | entered long-term care facilities for any reason who were |
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| 1 | | fully vaccinated for influenza and COVID-19; the total number | 2 | | of Department employees who entered long-term care facilities | 3 | | for any reason who were not fully vaccinated for influenza and | 4 | | COVID-19 and the number of instances in which Department | 5 | | employees not fully vaccinated against influenza and COVID-19 | 6 | | entered a long-term care facility; the total number of | 7 | | Department employees who entered long-term care facilities and | 8 | | who tested positive for COVID-19 within 7 calendar days after | 9 | | entering a long-term care facility and the number of instances | 10 | | in which a Department employee entered a long-term care | 11 | | facility within 7 calendar days after testing positive for | 12 | | COVID-19; , and any other complaint information requested by | 13 | | the Long-Term Care Facility Advisory Board created under | 14 | | Section 2-204 of this Act or the Illinois Long-Term Care | 15 | | Council created under Section 4.04a of the Illinois Act on the | 16 | | Aging. All of the listed reporting criteria in this subsection | 17 | | and additional complaint information requested by the | 18 | | Long-Term Care Facility Advisory Board, the Illinois Long-Term | 19 | | Care Council, or the General Assembly shall be provided in | 20 | | aggregate and broken down by Office of Health Care Regulation | 21 | | region. In addition, the Department shall provide health | 22 | | vaccine and health equity report findings, information about | 23 | | continued progress toward correcting identified deficiencies, | 24 | | and annual Centers for Medicare and Medicaid Services' State | 25 | | Performance Standards System results for the State of | 26 | | Illinois. This report shall be provided to the Long-Term Care |
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| 1 | | Facility Advisory Board, the Illinois Long-Term Care Council, | 2 | | and the General Assembly. The Long-Term Care Facility Advisory | 3 | | Board and the Illinois Long-Term Care Council shall review the | 4 | | report and suggest any changes deemed necessary to the | 5 | | Department for review and action, including how to investigate | 6 | | and substantiate anonymous complaints. | 7 | | (h) Any person who knowingly transmits a false report to | 8 | | the
Department commits the offense of disorderly conduct under | 9 | | subsection
(a)(8) of Section 26-1 of the Criminal Code of | 10 | | 2012.
| 11 | | (Source: P.A. 102-432, eff. 8-20-21.)".
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