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90_HB3692 New Act 30 ILCS 105/5.480 new 210 ILCS 45/2-209.5 new 210 ILCS 45/3-202 from Ch. 111 1/2, par. 4153-202 210 ILCS 45/3-202.52 new 210 ILCS 45/3-202.55 new 210 ILCS 45/3-202.6 new 210 ILCS 45/3-202.65 new 210 ILCS 45/3-202.7 new Creates the Nursing Home Reform Act to increase public and nursing facility employee participation in correcting substandard care at nursing facilities. Amends the Nursing Home Care Act to set forth a minimum number of nursing personnel that must be available to nursing home residents. Amends the State Finance Act to add the Nursing Home Reform Fund. Effective immediately. LRB9010928LDmbA LRB9010928LDmbA 1 AN ACT to create the Nursing Home Reform Act, amending 2 named Acts. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 ARTICLE 5. GENERAL PROVISIONS 6 Section 5-1. Short title. This Act may be cited as the 7 Nursing Home Reform Act. 8 Section 5-5. Legislative findings. The General Assembly 9 finds and declares: 10 (1) That the State of Illinois has a large and 11 growing population of senior and disabled persons who 12 require nursing home care and that the level of patient 13 acuity has risen dramatically, requiring more complex 14 services. 15 (2) That despite the efforts of federal and State 16 officials to protect the health and safety of nursing 17 home residents, significant quality problems remain in 18 many nursing homes. 19 (3) That, according to the National Citizens' 20 Coalition for Nursing Home Reform, the nursing home 21 industry in the United States has annually spent $1.2 22 billion to treat preventable decubitis ulcers (bedsores), 23 caused by lack of nutritional hydration, mobility, and 24 cleanliness, and $4.3 billion on incontinent care because 25 residents are not toileted frequently enough. 26 (4) That the nursing home industry ranks among the 27 most dangerous for employees in the United States, with 28 nursing home workers injured at a rate that is twice the 29 national average. 30 (5) That long-term care nursing facilities that -2- LRB9010928LDmbA 1 receive public money should be required to provide at all 2 times staffing resources to meet the minimum levels 3 necessary to provide quality care to each resident. 4 (6) That nursing facilities that receive public 5 money have a responsibility to report to residents, their 6 families, and to the taxpayers of this State information 7 that pertains to staffing levels, billing charges, and 8 other matters relating to sources and uses of funds 9 affecting the care of senior and disabled nursing home 10 residents. 11 (7) That effective enforcement of laws regulating 12 the nursing home industry is impossible without the 13 active support of nursing home workers, who are on the 14 front lines of resident care every day. 15 (8) That many nursing home workers who witness 16 actions and situations that may violate the laws of this 17 State may fail to report these matters to licensing 18 bodies or other authorities because they fear losing 19 their jobs. 20 (9) That family members and other visitors can also 21 be observers and reporters providing valuable 22 supplementary oversight of compliance with the laws for 23 protection of residents' safety and well being, although 24 fear of retaliation may deter them from speaking out. 25 Section 5-10. Definitions. As used in this Act: 26 "Department" means the Department of Public Health. 27 "Nursing facility" means all or any part of a nursing 28 home that is qualified and certified for participation in the 29 Medicaid program in Illinois or is licensed as a private 30 nursing home in Illinois. 31 "Plan of correction" means a plan that is prepared by the 32 Department of Public Health to correct deficiencies found as 33 a result of its inspection of a nursing facility or skilled -3- LRB9010928LDmbA 1 nursing facility. 2 "Skilled nursing facility" means all or any part of a 3 nursing home that is qualified and certified for 4 participation in the Medicare program or is licensed as a 5 skilled nursing facility in Illinois. 6 ARTICLE 10. RESIDENT CARE ENFORCEMENT 7 Section 10-5. Definitions. As used in this Article: 8 (a) "Deficiency" means the failure of a facility subject 9 to Section 2-209.5 of the Nursing Home Care Act to meet any 10 of the requirements for participation by the facility in the 11 Medicaid program, as specified in Part 483, Subpart B of the 12 Code of Federal Regulations or as otherwise provided by law. 13 (b) "Substandard quality of care" means one or more 14 deficiencies related to standards for responding to resident 15 behavior and facility practices, quality of life, or quality 16 of care, as set forth in federal conditions for 17 Medicaid/Medicare participation, or related to conditions of 18 licensure as a nursing facility in Illinois, that constitute 19 either immediate jeopardy to resident health or safety, a 20 pattern of or widespread actual harm that is not immediate 21 jeopardy, or a widespread potential for harm but less than 22 immediate jeopardy with no actual harm. 23 Section 10-10. Mandatory civil penalties. 24 (a) The Department of Public Health shall impose a civil 25 penalty upon a facility that has been found by the Department 26 to have provided substandard quality of care. 27 (b) The amount of the penalty shall be determined as 28 follows: 29 (i) Upper range - $3,050-$10,000. Penalties in the 30 range of $3,050 to $10,000 per day shall be imposed for 31 deficiencies that constitute immediate jeopardy to -4- LRB9010928LDmbA 1 resident health or safety. 2 (ii) Lower range - $250-$3,000. Penalties in the 3 range of $250 to $3,000 per day shall be imposed for 4 deficiencies that constitute substandard quality of care 5 and do not constitute immediate jeopardy to resident 6 health and safety. 7 The Department shall annually adjust the upper and lower 8 range amounts set forth in items (i) and (ii) to reflect the 9 increase, if any, in the Consumer Price Index For All Urban 10 Consumers for the previous calendar year, as determined by 11 the United States Department of Labor. However, if the 12 Consumer Price Index decreases during a calendar year, there 13 shall be no adjustment for that calendar year. The adjusted 14 amounts shall be published in the Department rules. 15 (c) Civil penalties shall begin to accrue on the date 16 that the facility is first determined by the Department to 17 have provided substandard quality of care and shall continue 18 to accrue until the Department determines that the 19 deficiencies constituting substandard quality of care have 20 been corrected. 21 (d) The penalties described in subsections (a) and (b) 22 shall be in addition to other enforcement penalties available 23 to the Department. 24 ARTICLE 15. NURSING FACILITY WHISTLE BLOWERS PROVISIONS 25 Section 15-5. Right to participate. 26 (a) A person who files a complaint with the Department 27 of Public Health with regard to the care of a resident in a 28 nursing facility subject to Section 2-209.5 of the Nursing 29 Home Care Act shall, upon request, be afforded the 30 opportunity to participate in any inspection arising from the 31 complaint. An opportunity to participate shall include, at a 32 minimum, the right to be present, either personally or -5- LRB9010928LDmbA 1 through a designated representative, at any initial, 2 entrance, and exit conferences held between the operator of 3 the facility, or the operator's designated agent, and the 4 authorized agent of the Department. 5 (b) During any inspection by the Department of a nursing 6 facility, including but not limited to complaint 7 investigations, annual inspections, and post-survey visits, 8 State and Local Long-Term Care Ombudsmen, residents, members 9 of the families of residents, employees of the facility, and 10 their designated representatives shall be afforded an 11 opportunity to (1) meet privately with the agents of the 12 Department to present concerns related to compliance with 13 resident care standards and (2) accompany those responsible 14 for the inspection, in a manner consistent with the privacy 15 of residents, to the areas of the facility where those 16 concerns are evidenced. 17 The Department shall not disclose to a nursing facility 18 the identity of a person who meets with an agent of the 19 Department or attends an inspection as provided under this 20 subsection. 21 (c) As soon as a nursing facility receives notification 22 from the Department that an inspection is to occur, the 23 facility shall notify its employees of the inspection and 24 their right to participate. Nothing in this subsection shall 25 be construed to authorize facility notification of an 26 inspection prior to the actual occurrence of the inspection 27 by the Department. 28 (d) If a deficiency is found as a result of an 29 inspection, a plan of correction shall be filed with the 30 Department stating where and how the deficiency will be 31 corrected and the facility shall post the plan in a 32 conspicuous place at or near the facility entrance and 33 accessible and visible to the public concurrently with the 34 submission of the plan to the Department. The Department -6- LRB9010928LDmbA 1 shall afford the opportunity to any interested person to file 2 comments on a plan of corrections and its implementation and 3 shall review the comments prior to renewing the facility's 4 license or its certification to participate in a medical 5 assistance program. 6 Section 15-10. Ban on retaliation. 7 (a) No nursing facility or officer, agent, or employee 8 of the facility shall threaten, intimidate, coerce, or 9 retaliate in any way against an individual because the 10 individual has notified the Department or another State, 11 local, or federal authority of a deficiency in resident care 12 or participated in an investigation conducted by the 13 Department. 14 (b) An employee whose rights under this Section have 15 been violated may bring an action in the appropriate circuit 16 court against the nursing facility and the responsible agent 17 of the facility for reinstatement, back pay, and compensation 18 for any other damages sustained. 19 Section 15-15. Restrictions on the use of public health 20 care funds. The costs of an attorney, consultant, or other 21 person to advise, consult, or provide any other service 22 relative to persuading nursing facility employees to support 23 or oppose an organization of the employees or any other 24 employee self-organization or concerted activity for mutual 25 aid or protection shall not be considered to be reasonable 26 costs under a health care program for purposes of 27 reimbursement from the State of Illinois or any agency, 28 authority, or political subdivision of this State. This 29 Section shall not apply to the costs of attorneys or 30 consultants to assist in collective bargaining with a union 31 or other employee organization recognized as the employees' 32 bargaining agent or to administer a collective bargaining -7- LRB9010928LDmbA 1 agreement. 2 Section 15-20. Employer responsibility for certain costs 3 of illegal discharges. A health care employer shall pay to 4 the federal Unemployment Insurance Corporation Fund an amount 5 equal to the unemployment benefits paid to a person who 6 receives an award or settlement of back pay resulting from an 7 action or grievance brought against that employer for 8 wrongful discharge, if the amount of any back pay award or 9 settlement was reduced by the amount of unemployment benefits 10 received. In addition, the employer shall pay to the Fund 11 any administrative or other costs related to the payment of 12 the unemployment benefits. 13 Section 15-25. Maintenance of records. In order to 14 assure compliance with Section 15-15, all health care 15 employers shall maintain for a period of 10 years records 16 adequate to demonstrate the source of payment for all covered 17 costs. 18 ARTICLE 20. NURSING FACILITY BILLING DISCLOSURE 19 Section 20-5. Right to itemized bills. 20 (a) Upon receipt of a written request from a resident or 21 his or her responsible guardian or family member, a nursing 22 facility operating within this State shall provide a 23 statement itemizing all charges incurred for care of the 24 resident since his or her initial entry into the facility. 25 (b) A nursing facility shall notify every resident and 26 his or her responsible guardian or family member of the right 27 to receive an itemized statement, upon the resident's initial 28 entry into the facility. 29 Section 20-10. Disclosure of full information. -8- LRB9010928LDmbA 1 (a) The statement of charges provided in Section 20-5 2 shall include a list of each type of service provided, 3 including pharmaceuticals, equipment use, and other ancillary 4 services and the amount charged the resident directly or to 5 any public or private health care program, plan, or insurance 6 on his or her behalf for each type of service received. For 7 any per diem rate listed, the nursing facility shall state 8 the services provided at that rate. 9 (b) The statement shall also include the agency to which 10 the service was billed and the resident's case-mix 11 designation as to the level of care to be provided. 12 Section 20-15. Non-discrimination. The right to receive 13 the information described in Sections 20-5 and 20-10 shall 14 extend to all residents irrespective of whether the 15 resident's care is reimbursed by public programs. 16 Section 20-20. Process for questioning charges. 17 (a) The Governor shall establish an office within the 18 Department of Public Health to respond to and investigate 19 inquiries relating to statements under Sections 20-5 and 20 20-10. The office shall also act as an advocate for a 21 taxpayer in cases where public dollars are being used to 22 reimburse the nursing facility. 23 (b) If a person receiving an itemized statement under 24 Section 20-5 believes charges or services to be 25 inappropriate, he or she must first notify the nursing 26 facility administrator in writing of his or her concerns 27 before seeking an investigation by the office described in 28 subsection (a). 29 Section 20-25. Enforcement. 30 (a) If, after conducting an investigation, the office 31 described in subsection (a) of Section 20-20 finds improper -9- LRB9010928LDmbA 1 charges associated with the resident's care, the nursing 2 facility shall reimburse the person or entity who has paid 3 the charges no later than 60 days after receiving 4 notification from the office. 5 (b) No facility shall take any adverse action against a 6 person who exercises the rights provided under this law. A 7 person against whom such adverse action is taken shall be 8 entitled to recover in a civil suit treble the amount of 9 damages incurred. 10 ARTICLE 25. PUBLIC RIGHT TO INFORMATION 11 Section 25-5. Maintenance of records. A nursing 12 facility operating within this State shall maintain the 13 following records for a 10-year period: 14 (1) reports of all safety and health inspections and 15 surveys; 16 (2) Occupational Safety and Health Act complaints under 17 the federal Occupational Safety and Health Act of 1970; 18 (3) payroll records and wage and hour complaints to 19 public agencies on behalf of employees of the facility; 20 (4) complaints relating to the facility filed by the 21 National Labor Relations Board; 22 (5) reports of deficiencies prepared by the Department; 23 (6) reports of incidents involving injury or harm to a 24 resident, employee, or visitor or breach of safety 25 precautions; and 26 (7) daily records of both scheduled and actual staffing 27 of each department for each shift. 28 Section 25-10. Public right to information. A nursing 29 facility shall notify the public of the right to the 30 information set forth in Section 25-5. This notice shall be 31 posted in a conspicuous manner accessible and visible to the -10- LRB9010928LDmbA 1 public at or near the entrance to the facility. The 2 information shall be made available for the current year and 3 the 2 years immediately prior to the current year. 4 Section 25-15. Notification of hazard. A nursing 5 facility shall immediately notify the family of each resident 6 of each occasion on which the resident and workers are 7 evacuated from the facility and of each occasion when an 8 imminent hazard to residents or workers arises. 9 Section 25-20. Notification of incidents involving a 10 resident. A nursing facility or skilled nursing facility 11 shall promptly notify the physician and a resident's 12 designated family member or representative of any incident in 13 which there is harm or potential harm to the resident and of 14 any significant change in the resident's status. 15 ARTICLE 30. NURSING FACILITY WATCHDOG PROTECTION 16 Section 30-5. Prohibition of adverse action. 17 (a) A nursing facility operating within this State shall 18 not take any of the following actions against an employee on 19 the basis of a protected communication: 20 (1) permanently or temporarily terminate the 21 employee's employment; 22 (2) demote or involuntarily transfer the employee; 23 (3) reduce the employee's pay or benefits; 24 (4) impose a fine or other penalty; or 25 (5) take other adverse actions as defined by the 26 Department in rules implementing this Section. 27 Section 30-10. Definition of protected communication. 28 (a) For purposes of this Article, "protected 29 communication" means a communication, other than a knowing -11- LRB9010928LDmbA 1 and willful misrepresentation, made by an employee of a 2 nursing facility to an employee, officer, or representative 3 of an agency of this State or the United States that has 4 responsibility for the licensing, regulation, or 5 reimbursement of nursing facilities operating within this 6 State. 7 A "protected communication" includes, but is not limited 8 to, a communication concerning: 9 (A) violations of laws regulating the health, 10 safety, and well-being of nursing facility residents; 11 (B) violations of workplace safety and health laws; 12 (C) violations of labor and employment law; 13 (D) alleged fraud or misrepresentation, including 14 misrepresentation of billing information to federal or 15 State agencies or to private health insurers or health 16 plans; and 17 (E) other communications as defined by the 18 Department in rules implementing this Section. 19 Section 30-15. Civil penalties. 20 (a) An entity that violates Section 30-5 of this Article 21 shall be subject to a civil penalty of (1) up to $25,000 for 22 each violation or (2) up to $100,000 for each violation if 23 the Department determines that the entity has engaged, within 24 5 years immediately preceding the violation, in a pattern of 25 such violations. For purposes of this subsection, a pattern 26 of violations means 3 or more violations in a 2-year period. 27 (b) Enforcement under this Section shall not foreclose a 28 civil action under Section 30-20 or any other remedy 29 available at law. 30 Section 30-20. Employee's private right of action. An 31 employee who suffers harm or monetary loss as a result of an 32 employer's violation of Section 30-5 may, in civil action -12- LRB9010928LDmbA 1 against the employer, recover back pay and damages in the 2 same manner as provided under subsection (b) of Section 3 15-10. 4 ARTICLE 40. NURSING FACILITY WORKER WAGE ADJUSTMENT 5 Section 40-5. Wage and benefit pass-through. It is the 6 intent of the General Assembly that at least 50% of inflation 7 increases in rates shall be used for a wage and benefit 8 pass-through to nursing home workers. The rate increases for 9 enhanced wages and benefits shall be provided to those 10 facilities that apply re-assessment of rate increases under 11 the Medicaid program share of wage and benefits increases up 12 to 50 cents per employee hour. The pass-through shall only 13 be used to increase wages and benefits. Nursing facilities 14 shall be required to document that these wage and benefit 15 increases were actually provided. 16 In the event that a federal budget reconciliation act is 17 adopted that increases Medicaid appropriations for Illinois, 18 it is the intent of the General Assembly that funds shall be 19 appropriated to increase the Medicaid program share of the 20 nursing facility wage pass-through up to $1.00 per employee 21 hour. 22 Section 40-15. Services for the elderly and disabled. 23 Medical services shall be provided to elderly and disabled 24 persons with incomes less than or equal to 100% of the 25 official poverty line, pursuant to the State's option to 26 elect such coverage under section 1902(a)(10)(A)(ii) and (m) 27 of title XIX of the Social Security Act, chapter 531, 49 28 Stat. 620, 42 U.S.C. 1396a. 29 Section 40-20. Department enforcement actions. The 30 Department shall implement enforcement actions as specified -13- LRB9010928LDmbA 1 in the nursing facility enforcement provisions of 42 U.S.C. 2 1396c. 3 Section 40-25. The Department is authorized to receive 4 and spend penalty money received as the result of 5 noncompliance with this Act. Penalty money, characterized as 6 private funds, received by the Department shall be deposited 7 into the Nursing Home Reform Fund, a special fund created in 8 the State Treasury, and shall be used to increase 9 authorizations and allotments in the long-term care accounts. 10 Any unexpended penalty money in the Fund at the end of the 11 fiscal year shall carry forward to the following year. 12 ARTICLE 45. IMPLEMENTATION PROVISIONS 13 Section 45-5. Rulemaking. The Department shall adopt 14 rules in accordance with Illinois Administrative Procedure 15 Act to implement this Act. 16 ARTICLE 50. AMENDATORY PROVISIONS 17 Section 50-5. The State Finance Act is amended by adding 18 Section 5.480 as follows: 19 (30 ILCS 105/5.480 new) 20 Sec. 5.480. The Nursing Home Reform Fund. 21 Section 50-10. The Nursing Home Care Act is amended by 22 changing Section 3-202 and adding Sections 2-209.5, 3-202.52, 23 3-202.55, 3-202.6, 3-202.65, and 3-202.7 as follows: 24 (210 ILCS 45/2-209.5 new) 25 Sec. 2-209.5. Minimum standards for nurse staffing. 26 (a) At a minimum, a Medicare or Medicaid certified -14- LRB9010928LDmbA 1 facility that is a skilled nursing facility or a nursing 2 facility licensed in Illinois and any part of a licensed 3 nursing home that has public and private pay beds shall 4 provide: 5 (1) the following administrative nursing personnel: 6 (A) one full-time Registered Nurse acting as 7 Director of Nursing; 8 (B) in a facility with 100 or more beds, one 9 full-time Registered Nurse acting as Assistant 10 Director of Nursing; 11 (C) in a facility with fewer than 100 beds, 12 one half-time Registered Nurse Director of 13 In-service Education; 14 (D) in a facility with 100 or more beds, one 15 full-time Registered Nurse Director of In-service 16 Education; and 17 (2) the following direct care nursing personnel: 18 (A) one Registered Nurse on duty at all times 19 at the facility acting as Nursing Supervisor who may 20 not be the Director of Nursing, except in facilities 21 with 60 or fewer residents; 22 (B) one direct caregiver, including and 23 limited to a Registered Nurse, Licensed Practical 24 Nurse licensed in the State of Illinois, or Nurse 25 Aide certified in this State, for every 5 residents 26 during a day shift, for every 10 residents during an 27 evening shift, and for every 15 residents during a 28 night shift; and 29 (C) one licensed caregiver, including and 30 limited to a Registered Nurse or Licensed Practical 31 Nurse licensed in the State of Illinois, for every 32 15 residents during a day shift, for every 25 33 residents during an evening shift, and for every 35 34 residents during a night shift. -15- LRB9010928LDmbA 1 (b) In addition, staff must be increased above these 2 minimum requirements to meet the care needs of any resident 3 population, based on each resident's assessed care needs to 4 attain or maintain the highest practical mental, physical, 5 and psychosocial well-being. 6 (c) The Department shall prescribe methodology for 7 adjusting nursing service staffing above the required minimum 8 to meet the care needs of residents. 9 (210 ILCS 45/3-202) (from Ch. 111 1/2, par. 4153-202) 10 Sec. 3-202. The Department shall prescribe minimum 11 standards for facilities. These standards shall regulate: 12 (1) Location and construction of the facility, including 13 plumbing, heating, lighting, ventilation, and other physical 14 conditions which shall ensure the health, safety, and comfort 15 of residents and their protection from fire hazard; 16 (2) Number and qualifications of all personnel, 17 including management and nursing personnel, having 18 responsibility for any part of the services providedcare19givento residents, with the exception of a nursing facility 20 that is subject to Section 2-209.5 of this Act and that 21 establishes the required nursing staff ratios for the 22 facility.;specifically,The Department shall establish 23 staffing ratios for facilities which shall specify the number 24 of staff hours per resident of care that are needed for 25 professional nursing care for various types of facilities or 26 areas within facilities other than nursing facilities subject 27 to Section 2-209.5 of this Act; 28 (3) All sanitary conditions within the facility and its 29 surroundings, including water supply, sewage disposal, food 30 handling, and general hygiene, which shall ensure the health 31 and comfort of residents; 32 (4) Diet related to the needs of each resident based on 33 good nutritional practice and on recommendations which may be -16- LRB9010928LDmbA 1 made by the physicians attending the resident; 2 (5) Equipment essential to the health, safety, and 3 welfare of the residents; 4 (6) A program of habilitation and rehabilitation for 5 those residents who would benefit from such programs; 6 (7) A program for adequate maintenance of physical plant 7 and equipment; 8 (8) Adequate accommodations, staff and services for the 9 number and types of residents for whom the facility is 10 licensed to care, including standards for temperature and 11 relative humidity within comfort zones determined by the 12 Department based upon a combination of air temperature, 13 relative humidity and air movement. Such standards shall 14 also require facility plans that provide for health and 15 comfort of residents at medical risk as determined by the 16 attending physician whenever the temperature and relative 17 humidity are outside such comfort zones established by the 18 Department. 19 (9) Development of evacuation and other appropriate 20 safety plans for use during weather, health, fire, physical 21 plant, environmental and national defense emergencies; and 22 (10) Maintenance of minimum financial or other resources 23 necessary to meet the standards established under this 24 Section, and to operate and conduct the facility in 25 accordance with this Act. 26 (Source: P.A. 83-1530.) 27 (210 ILCS 45/3-202.52 new) 28 Sec. 3-202.52. Sanctions for noncompliance with minimum 29 nurse staffing standards. 30 (a) The Department of Public Health shall not issue or 31 renew a license of a Medicare or Medicaid licensed facility 32 that is a skilled nursing facility or a nursing facility 33 subject to Section 2-209.5 of this Act unless that facility -17- LRB9010928LDmbA 1 employs nursing personnel sufficient to meet the standards 2 set forth in Section 2-209.5. 3 (b) An employee designated as a member of the nursing 4 staff shall not be required to provide services such as food 5 preparation, housekeeping, laundry, or maintenance services. 6 A person employed to provide such services shall not provide 7 nursing care to residents and shall not be counted in 8 determining the ratios set forth in Section 2-209.5. 9 (210 ILCS 45/3-202.55 new) 10 Sec. 3-202.55. Public right to staffing information. A 11 nursing facility subject to Section 2-209.5 shall post for 12 each wing and floor of the facility and for each shift the 13 current number of licensed and unlicensed nursing staff 14 directly responsible for resident care and the current ratios 15 of residents to staff, which show separately the number of 16 residents to licensed nursing staff and the number of 17 residents to unlicensed nursing staff. In addition, that 18 information shall be posted for the most recently concluded 19 cost reporting period in the form of average daily direct 20 care nursing personnel staffing ratios per shift for that 21 period. The information shall be posted in a manner that is 22 visible and accessible to all residents, their families, 23 caregivers, and potential consumers in each facility. 24 (210 ILCS 45/3-202.6 new) 25 Sec. 3-202.6. Enforcement. 26 (a) The Department of Public Health shall impose a civil 27 penalty upon a facility that fails to meet the staffing 28 requirements set forth in Section 2-209.5. The penalty shall 29 be imposed for each day on which the failure occurs. 30 (b) The amount of the penalty in subsection (a) shall be 31 determined as follows: 32 (i) Upper range - $3,050-$10,000. Penalties in the -18- LRB9010928LDmbA 1 range of $3,050 to $10,000 per day shall be imposed for 2 deficiencies in staffing that constitute immediate 3 jeopardy to resident health or safety and for repeat 4 deficiencies when a penalty has been previously imposed. 5 (ii) Lower range - $250-$3,000. Penalties in the 6 range of $250 to $3,000 per day shall be imposed for 7 deficiencies in staffing that do not constitute immediate 8 jeopardy to resident health or safety. In each case, the 9 penalty shall not be less than the cost of providing 10 required staff members. 11 The Department shall annually adjust the upper and lower 12 range amounts set forth in items (i) and (ii) to reflect the 13 increase, if any, in the Consumer Price Index For All Urban 14 Consumers for the previous calendar year, as determined by 15 the United States Department of Labor. However, if the 16 Consumer Price Index decreases during a calendar year, there 17 shall be no adjustment for that calendar year. The adjusted 18 amounts shall be published in the Department rules. 19 (c) In addition to the penalty described in subsections 20 (a) and (b), in any action brought forth by or on behalf of a 21 resident of the facility or his or her heirs or assigns for 22 intentional or negligent infliction of harm or lack of 23 adequate care, it shall be established that a failure to meet 24 the staffing requirements of Section 2-209.5 was a 25 contributory cause of an injury sustained by a resident. 26 (d) The Department of Public Health shall impose a civil 27 penalty upon a facility that fails to meet the posting 28 requirements set forth in Section 3-202.55. The penalty 29 shall be in the amount of $100 and shall be imposed for each 30 day on which the facility fails to meet fully the posting 31 requirements. 32 (210 ILCS 45/3-202.65 new) 33 Sec. 3-202.65. Resident private right of action. A -19- LRB9010928LDmbA 1 resident who suffers harm or monetary loss as a result of a 2 nursing facility's violation of this Act or the Department's 3 knowing or willful failure to enforce the provisions of this 4 Act may, in a civil action against the nursing facility or 5 the Department, recover compensation for damages sustained. 6 (210 ILCS 45/3-202.7 new) 7 Sec. 3-202.7. Independent Ombudsman Program. To ensure 8 the independent operation of the Illinois Department on Aging 9 Ombudsman Program established to protect the interests of 10 nursing facility residents, the Illinois Department on Aging 11 shall contract with an appropriate independent, 12 not-for-profit advocacy organization to administer the 13 Ombudsmen Program. 14 ARTICLE 90. EFFECTIVE DATE 15 Section 90-5. Effective date. This Act takes effect 16 upon becoming law.