Full Text of HB4674 102nd General Assembly
HB4674sam001 102ND GENERAL ASSEMBLY | Sen. Mattie Hunter Filed: 3/21/2022
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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, or evaluate a facility. The Department shall | 18 | | offer continuing education opportunities at least quarterly. | 19 | | Employees of a State agency charged with inspecting, | 20 | | surveying, or evaluating a facility are required to complete | 21 | | at least 10 hours of continuing education annually on topics | 22 | | that support the survey process, including, but not limited | 23 | | to, trauma-informed care, infection control, abuse and | 24 | | neglect, and civil monetary penalties. Qualifying hours of | 25 | | continuing education intended to fulfill the requirements of | 26 | | this subsection shall only be offered by the Department. |
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| 1 | | Content presented during the continuing education shall be | 2 | | consistent throughout the State, regardless of survey region. | 3 | | The continuing education required under this subsection is | 4 | | separate from any continuing education required for any | 5 | | license that the employee holds. | 6 | | (b) In determining whether to make more than the required | 7 | | number of
unannounced inspections, surveys and evaluations of | 8 | | a facility the
Department shall consider one or more of the | 9 | | following: previous inspection
reports; the facility's history | 10 | | of compliance with standards, rules and
regulations | 11 | | promulgated under this Act and correction of violations,
| 12 | | penalties or other enforcement actions; the number and | 13 | | severity of
complaints received about the facility; any | 14 | | allegations of resident abuse
or neglect; weather conditions; | 15 | | health emergencies; other reasonable belief
that deficiencies | 16 | | exist.
| 17 | | (b-1) The Department shall not be required to determine | 18 | | whether a
facility certified to participate in the Medicare | 19 | | program under Title XVIII of
the Social Security Act, or the | 20 | | Medicaid program under Title XIX of the Social
Security Act, | 21 | | and which the Department determines by inspection under this
| 22 | | Section or under Section 3-702 of this Act to be in compliance | 23 | | with the
certification requirements of Title XVIII or XIX, is | 24 | | in compliance with any
requirement of this Act that is less | 25 | | stringent than or duplicates a federal
certification | 26 | | requirement. In accordance with subsection (a) of this Section
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| 1 | | or subsection (d) of Section 3-702, the Department shall | 2 | | determine whether a
certified facility is in
compliance with | 3 | | requirements of this Act that exceed federal certification
| 4 | | requirements. If a certified facility is found to be out of | 5 | | compliance with
federal certification requirements, the | 6 | | results of an inspection conducted
pursuant to Title XVIII or | 7 | | XIX of the Social Security Act may be used as the
basis for | 8 | | enforcement remedies authorized and commenced, with the | 9 | | Department's discretion to evaluate whether penalties are | 10 | | warranted, under this Act.
Enforcement of this Act against a | 11 | | certified facility shall be commenced
pursuant to the | 12 | | requirements of this Act, unless enforcement remedies sought
| 13 | | pursuant to Title XVIII or XIX of the Social Security Act | 14 | | exceed those
authorized by this Act. As used in this | 15 | | subsection, "enforcement remedy"
means a sanction for | 16 | | violating a federal certification requirement or this
Act.
| 17 | | (c) Upon completion of each inspection, survey and | 18 | | evaluation, the
appropriate Department personnel who conducted | 19 | | the inspection, survey or
evaluation shall submit a physical | 20 | | or electronic copy of their report to the licensee upon | 21 | | exiting
the facility, and shall submit the actual report to | 22 | | the appropriate
regional office of the Department. Such report | 23 | | and any recommendations for
action by the Department under | 24 | | this Act shall be transmitted to the
appropriate offices of | 25 | | the associate director of the Department, together
with | 26 | | related comments or documentation provided by the licensee |
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| 1 | | which may
refute findings in the report, which explain | 2 | | extenuating circumstances that
the facility could not | 3 | | reasonably have prevented, or which indicate methods
and | 4 | | timetables for correction of deficiencies described in the | 5 | | report.
Without affecting the application of subsection (a) of | 6 | | Section 3-303, any
documentation or comments of the licensee | 7 | | shall be provided within 10
days of receipt of the copy of the | 8 | | report. Such report shall recommend to
the Director | 9 | | appropriate action under this Act with respect to findings
| 10 | | against a facility. The Director shall then determine whether | 11 | | the report's
findings constitute a violation or violations of | 12 | | which the facility must be
given notice. Such determination | 13 | | shall be based upon the severity of the
finding, the danger | 14 | | posed to resident health and safety, the comments and
| 15 | | documentation provided by the facility, the diligence and | 16 | | efforts to
correct deficiencies, correction of the reported | 17 | | deficiencies, the
frequency and duration of similar findings | 18 | | in previous reports and the
facility's general inspection | 19 | | history. Violations shall be determined
under this subsection | 20 | | no later than 75 days after completion of each
inspection, | 21 | | survey and evaluation.
| 22 | | (d) The Department shall maintain all inspection, survey | 23 | | and evaluation
reports for at least 5 years in a manner | 24 | | accessible to and understandable
by the public.
| 25 | | (e) Revisit surveys. The Department shall conduct a | 26 | | revisit to its licensure and certification surveys, consistent |
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| 1 | | with federal regulations and guidelines. | 2 | | (f) Notwithstanding any other provision of this Act, the | 3 | | Department shall, no later than 180 days after the effective | 4 | | date of this amendatory Act of the 98th General Assembly, | 5 | | implement a single survey process that encompasses federal | 6 | | certification and State licensure requirements, health and | 7 | | life safety requirements, and an enhanced complaint | 8 | | investigation initiative. | 9 | | (1) To meet the requirement of a single survey | 10 | | process, the portions of the health and life safety survey | 11 | | associated with federal certification and State licensure | 12 | | surveys must be started within 7 working days of each | 13 | | other. Nothing in this paragraph (1) of subsection (f) of | 14 | | this Section applies to a complaint investigation. | 15 | | (2) The enhanced complaint and incident report | 16 | | investigation initiative shall permit the facility to | 17 | | challenge the amount of the fine due to the excessive | 18 | | length of the investigation which results in one or more | 19 | | of the following conditions: | 20 | | (A) prohibits the timely development and | 21 | | implementation of a plan of correction; | 22 | | (B) creates undue financial hardship impacting the | 23 | | quality of care delivered to the resident; | 24 | | (C) delays initiation of corrective training; and | 25 | | (D) negatively impacts quality assurance and | 26 | | patient improvement standards. |
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| 1 | | This paragraph (2) does not apply to complaint | 2 | | investigations exited within 14 working days or a | 3 | | situation that triggers an extended survey. | 4 | | (Source: P.A. 98-104, eff. 7-22-13.)
| 5 | | (210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
| 6 | | Sec. 3-702.
(a) A person who believes that this Act or a | 7 | | rule promulgated
under this Act may have been violated may | 8 | | request an investigation. The
request may be submitted to the | 9 | | Department in writing, by telephone, by electronic means, or | 10 | | by
personal visit. An oral complaint shall be reduced to | 11 | | writing by the
Department. The Department shall make | 12 | | available, through its website and upon request, information | 13 | | regarding the oral and phone intake processes and the list of | 14 | | questions that will be asked of the complainant. The | 15 | | Department shall request information identifying the
| 16 | | complainant, including the name, address and telephone number, | 17 | | to help
enable appropriate follow-up. The Department shall act | 18 | | on such complaints
via on-site visits or other methods deemed | 19 | | appropriate to handle the
complaints with or without such | 20 | | identifying information, as otherwise
provided under this | 21 | | Section. The complainant shall be informed that
compliance | 22 | | with such request is not required to satisfy the procedures | 23 | | for
filing a complaint under this Act. The Department must | 24 | | notify complainants that complaints with less information | 25 | | provided are far more difficult to respond to and investigate.
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| 1 | | (b) The substance of the complaint shall be provided in | 2 | | writing to the
licensee, owner, or administrator no earlier | 3 | | than at the commencement of an
on-site inspection of the | 4 | | facility which takes place pursuant to the complaint.
| 5 | | (c) The Department shall not disclose the name of the | 6 | | complainant unless
the complainant consents in writing to the | 7 | | disclosure or the investigation
results in a judicial | 8 | | proceeding, or unless disclosure is essential to the
| 9 | | investigation. The complainant shall be given the opportunity | 10 | | to withdraw
the complaint before disclosure. Upon the request | 11 | | of the complainant, the
Department may permit the complainant | 12 | | or a representative of the complainant
to accompany the person | 13 | | making the on-site inspection of the facility.
| 14 | | (d) Upon receipt of a complaint, the Department shall | 15 | | determine whether this
Act or a rule promulgated under this | 16 | | Act has been or is being violated. The
Department shall | 17 | | investigate all complaints alleging abuse or neglect within
7 | 18 | | calendar days after the receipt of the complaint except that | 19 | | complaints of abuse
or neglect which indicate that a | 20 | | resident's life or safety is in imminent
danger shall be | 21 | | investigated within 24 hours after receipt of the
complaint. | 22 | | All other complaints shall be investigated within 30 calendar | 23 | | days after
the receipt of the complaint. The Department | 24 | | employees investigating a
complaint shall conduct a brief, | 25 | | informal exit conference with the facility
to alert its | 26 | | administration of any suspected serious deficiency that poses
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| 1 | | a direct threat to the health, safety or welfare of a resident | 2 | | to enable an
immediate correction for the alleviation or | 3 | | elimination of such threat.
Such information and findings | 4 | | discussed in the brief exit conference shall
become a part of | 5 | | the investigating record but shall not in any way
constitute | 6 | | an official or final notice of violation as provided under
| 7 | | Section 3-301. All complaints shall be classified as
"an | 8 | | invalid report", "a valid report", or "an undetermined
| 9 | | report". For any complaint classified as "a valid report", the
| 10 | | Department must determine within 7 calendar 30 working days | 11 | | after any Department employee enters a facility to begin an | 12 | | on-site inspection
if any rule or provision of this Act has | 13 | | been or is being violated.
| 14 | | (d-1) The Department shall, whenever possible, combine an | 15 | | on-site
investigation of a complaint in a facility with other | 16 | | inspections in order
to avoid duplication of inspections.
| 17 | | (e) In all cases, the Department shall inform the | 18 | | complainant of its
findings within 5 calendar 10 days of its | 19 | | determination unless otherwise indicated
by the complainant, | 20 | | and the complainant may direct the Department to
send a copy of | 21 | | such findings to another person. The Department's findings
may | 22 | | include comments or documentation provided by either the | 23 | | complainant
or the licensee pertaining to the complaint. The | 24 | | Department shall also
notify the facility of such findings | 25 | | within 5 calendar 10 days of the determination,
but the name of | 26 | | the complainant or residents shall not be disclosed in this
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| 1 | | notice to the facility. The notice or statement of deficiency | 2 | | of such
findings shall include a copy of the written | 3 | | determination; the
correction order, if any; the warning | 4 | | notice, if any; the inspection
report; or the State licensure | 5 | | form on which the violation is listed. If a facility is found | 6 | | to have violated any provision of this Act or rule adopted | 7 | | under this Act, the facility shall develop a plan of | 8 | | correction to address deficiencies indicated in a statement of | 9 | | deficiency. The facility shall submit the plan of correction | 10 | | to the Department for approval. The Department must approve or | 11 | | deny the plan of correction within 72 hours after receiving | 12 | | the plan of correction. If the facility's plan of correction | 13 | | is denied, the Department must notify the facility within 48 | 14 | | hours after the denial determination and provide specific | 15 | | reasons for the denial, a process to remedy the denial, and | 16 | | requests for additional information, as needed, and complete | 17 | | the plan of correction determination process within 48 hours | 18 | | after receiving requested information from the facility. The | 19 | | Department shall complete an on-site revisit or desk revisit | 20 | | within 7 calendar days after approval of the facility's plan | 21 | | of correction. During the on-site or desk revisit, the | 22 | | Department must address the approved plan of correction and | 23 | | clear any outstanding violation for which a plan of correction | 24 | | has been approved before beginning a new complaint | 25 | | investigation or annual review. If the Department receives an | 26 | | abuse or neglect complaint that indicates a resident is in |
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| 1 | | immediate danger within the same time frame during which an | 2 | | on-site revisit must be completed, the Department must conduct | 3 | | the on-site revisit simultaneously with the new complaint | 4 | | investigation. Under no circumstance may a violation remain | 5 | | open if the Department has approved the facility's plan of | 6 | | correction. If a facility fails to remedy the violation for | 7 | | which an on-site revisit is being conducted, the facility must | 8 | | correct any outstanding violation. Once the facility has | 9 | | notified the Department that the facility is in compliance | 10 | | with the plan of correction, the Department must complete an | 11 | | on-site revisit within 7 calendar days. If the Department | 12 | | fails to complete a revisit within 7 calendar days after | 13 | | approving a facility's plan of correction, the facility shall | 14 | | be considered to be in substantial compliance.
| 15 | | (f) A written determination, correction order, or warning | 16 | | notice
concerning a complaint, together with the facility's | 17 | | response, shall be
available for public inspection, but the | 18 | | name of the complainant or
resident shall not be disclosed | 19 | | without his consent.
| 20 | | (g) A complainant who is dissatisfied with the | 21 | | determination or
investigation by the Department may request a | 22 | | hearing under Section
3-703. The facility shall be given | 23 | | notice of any such
hearing and may participate in the hearing | 24 | | as a party. If a facility
requests a hearing under Section | 25 | | 3-703 which
concerns a matter covered by a complaint, the | 26 | | complainant shall be given
notice and may participate in the |
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| 1 | | hearing as a party. A request
for a hearing by either a | 2 | | complainant or a facility shall be
submitted in writing to the | 3 | | Department within 30 days after the mailing
of the | 4 | | Department's findings as described in subsection (e) of this
| 5 | | Section. Upon receipt of the request the Department shall | 6 | | conduct a hearing
as provided under Section 3-703.
| 7 | | (g-5) The Department shall conduct an annual review of all | 8 | | survey activity from the preceding fiscal year and make a | 9 | | report concerning the complaint and survey process . The report | 10 | | shall include, but not be limited to: that includes the total | 11 | | number of complaints received ; the breakdown of 24-hour, | 12 | | 7-day, and 30-day complaints; , the breakdown of anonymous and | 13 | | non-anonymous complaints ; and whether the number of complaints | 14 | | that were substantiated versus unsubstantiated; or not, the | 15 | | total number of substantiated complaints that were completed | 16 | | in the time frame determined under subsection (d) ; the total | 17 | | number of informal dispute resolutions requested; the total | 18 | | number of informal dispute resolution requests approved; the | 19 | | total number of informal dispute resolutions that were | 20 | | overturned or reduced in severity; the total number of nurse | 21 | | surveyors
hired during the calendar year; the total number of | 22 | | nurse
surveyors who left Department employment; the average | 23 | | length of tenure for nurse surveyors employed by the | 24 | | Department at the time the report is created; the total number | 25 | | of
times the Department recommended a discretionary denial of
| 26 | | payment for new Medicare or Medicaid admissions and how much |
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| 1 | | time existed between the start of that denial and when the | 2 | | facility was notified, with a
start date for the denial of | 3 | | payment that is (i) less than 15 days after the date of
the | 4 | | Department's notice to the facility, (ii) at least 15 days
and | 5 | | less than 31 days after the date of the Department's notice
to | 6 | | the facility, (iii) at least 31 days and less than 60 days
| 7 | | after the date of the Department's notice to the facility, and
| 8 | | (iv) at least 60 days after the date of the Department's notice
| 9 | | to the facility; , and any other complaint information | 10 | | requested by the Long-Term Care Facility Advisory Board | 11 | | created under Section 2-204 of this Act or the Illinois | 12 | | Long-Term Care Council created under Section 4.04a of the | 13 | | Illinois Act on the Aging. This report shall be provided to the | 14 | | Long-Term Care Facility Advisory Board, the Illinois Long-Term | 15 | | Care Council, and the General Assembly. The Long-Term Care | 16 | | Facility Advisory Board and the Illinois Long-Term Care | 17 | | Council shall review the report and suggest any changes deemed | 18 | | necessary to the Department for review and action, including | 19 | | how to investigate and substantiate anonymous complaints. | 20 | | (h) Any person who knowingly transmits a false report to | 21 | | the
Department commits the offense of disorderly conduct under | 22 | | subsection
(a)(8) of Section 26-1 of the Criminal Code of | 23 | | 2012.
| 24 | | (Source: P.A. 102-432, eff. 8-20-21.)".
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