Section 250.240  Admission and Discharge

a)         Principle

            The hospital shall have written policies for the admission, discharge, and referral of all patients who present themselves for care.  Procedures shall assure appropriate utilization of hospital resources, such as preadmission testing, ambulatory care programs, and short-term procedure units.

b)         Access

1)         All persons shall be admitted to the hospital, whether as inpatients or outpatients, by a member of the medical staff with admitting privileges, and shall be under the professional care of a member of the medical staff.

2)         Insofar as possible, the hospital shall assign patients to accommodations with regard to gender, age, and medical requirement.

3)         The hospital shall provide basic and effective care to each patient.  No person seeking necessary medical care from the hospital shall be denied such care for reasons not based on sound medical practice or the hospital's charter, and, particularly, no such person shall be denied such care on account of race, creed, color, religion, gender, or sexual preference.

4)         When the hospital does not provide the services required by a patient or a person seeking necessary medical care, an appropriate referral shall be made.

c)         Required Testing for All Admissions

1)         The laboratory examinations required on all admissions shall be determined by the medical staff and shall be consistent with the scope and nature of the hospital.  The required list or lists of tests shall be in written form and shall be available to all members of the medical staff.  The required examinations shall be consistent with the requirements of this subsection (c).

2)         Uterine Cytologic Examination for Cancer

A)        Every hospital shall offer a uterine cytologic examination for cancer to every female inpatient 20 years of age or over, unless one of the following conditions exists:

i)          The examination is considered contra-indicated by the attending physician; or

ii)         The patient has had a uterine cytologic examination for cancer performed within the previous year prior to the admission to the hospital.

B)        Every woman for whom the test is applicable shall have the right to refuse such test on the counsel of the attending physician or on her own judgment.

C)        Patient records for all female inpatients 20 years of age or older shall indicate one of the following:

i)          The results of the test;

ii)         The reasons that the test offer requirement was not applicable as provided under subsection (c)(2)(A); or

iii)         A statement that it was refused by the patient. (Section 2310-540 of the Civil Administrative Code [20 ILCS 2310/2310-540]).

3)         Testing for Infection with Human Immunodeficiency Virus (HIV)

A)        The hospital shall offer testing for infection with human immunodeficiency virus (HIV) to patients upon request.

B)        The hospital shall ensure that pre-test and post-test counseling is provided to the patient in accordance with the provisions of the AIDS Confidentiality Act [210 ILCS 115/20]  and the AIDS Confidentiality and Testing Code (77 Ill. Adm. Code 697).

C)        Testing that is performed under the Act and this Part shall be subject to the provisions of the AIDS Confidentiality Act and the AIDS Confidentiality and Testing Code. (Section 6.10 of the Act)

d)         Discharge Notification

1)         The hospital shall develop a discharge plan of care for all patients who present themselves to the hospital for care.

2)         The discharge plan shall be based on an assessment of the patient's needs by various disciplines responsible for the patient's care.

3)         When a patient is discharged to another level of care, the hospital shall ensure that the patient is being transferred to a facility that is capable of meeting the patient's assessed needs.

4)         Whenever a patient who qualifies for the federal Medicare program is hospitalized, the patient shall be notified of discharge at least 24 hours prior to discharge from the hospital.  The notification shall be provided by, or at the direction of, a physician with medical staff privileges at the hospital or any appropriate medical staff member.  The notification shall include:

A)        The anticipated date and time of discharge.

B)        Written information concerning the patient's right to appeal the discharge pursuant to the federal Medicare program, including the steps to follow to appeal the discharge and the appropriate telephone number to call if the patient intends to appeal the discharge.  This written information does not need to be included in the notification, if it has already been provided to the patient. (Section 6.09 of the Act)

5)         Every hospital shall develop and implement policies and procedures to provide the discharge notice required in subsection (d)(4).  The policies and procedures may also include a waiver of the notification requirement in either or both of the following cases:

A)        When a discharge notice is not feasible due to a short length of stay in the hospital by the patient.  The hospital policy shall specify the length of stay when discharge notification will not be considered feasible.

B)        When the patient voluntarily desires to leave the hospital before the expiration of the 24 hour period. (Section 6.09 of the Act)

e)         Background Checks for Patients Transferring to a Long-Term Care Facility

1)         Before transfer of a patient to a long term care facility licensed under the Nursing Home Care Act [210 ILCS 45] where elderly persons reside, a hospital shall as soon as practicable initiate a name-based criminal history background check by electronic submission to the Department of State Police for all persons between the ages of 18 and 70 years; provided, however, that a hospital shall be required to initiate such a background check only with respect to patients who:

A)        are transferring to a long term care facility for the first time;

B)        have been in the hospital more than 5 days;

C)        are reasonably expected to remain at the long term care facility for more than 30 days;

D)        have a known history of serious mental illness or substance abuse; and

E)         are independently ambulatory or mobile for more than a temporary period of time.

2)         A hospital may also request a criminal history background check for a patient who does not meet any of the criteria set forth in subsections (e)(1)(A) through (E).

3)         A hospital shall notify a long term care facility if the hospital has initiated a criminal history background check on a patient being discharged to that facility.  In all circumstances in which the hospital is required by this subsection (e) to initiate the criminal history background check, the transfer to the long term care facility may proceed regardless of the availability of criminal history results.

4)         Upon receipt of the results, the hospital shall promptly forward the results to the appropriate long term care facility.  If the results of the background check are inconclusive, the hospital shall have no additional duty or obligation to seek additional information from, or about, the patient. (Section 6.09(d) of the Act)

(Source:  Amended at 35 Ill. Reg. 13875, effective August 1, 2011)