HB4563 EngrossedLRB097 17230 PJG 62430 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 3, 13, and 14.1 as follows:
 
6    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 3. Definitions. As used in this Act:
9    "Health care facilities" means and includes the following
10facilities and organizations:
11        1. An ambulatory surgical treatment center required to
12    be licensed pursuant to the Ambulatory Surgical Treatment
13    Center Act;
14        2. An institution, place, building, or agency required
15    to be licensed pursuant to the Hospital Licensing Act;
16        3. Skilled and intermediate long term care facilities
17    licensed under the Nursing Home Care Act;
18        3.5. Skilled and intermediate care facilities licensed
19    under the ID/DD Community Care Act;
20        3.7. Facilities licensed under the Specialized Mental
21    Health Rehabilitation Act;
22        4. Hospitals, nursing homes, ambulatory surgical
23    treatment centers, or kidney disease treatment centers

 

 

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1    maintained by the State or any department or agency
2    thereof;
3        5. Kidney disease treatment centers, including a
4    free-standing hemodialysis unit required to be licensed
5    under the End Stage Renal Disease Facility Act;
6        6. An institution, place, building, or room used for
7    the performance of outpatient surgical procedures that is
8    leased, owned, or operated by or on behalf of an
9    out-of-state facility;
10        7. An institution, place, building, or room used for
11    provision of a health care category of service as defined
12    by the Board, including, but not limited to, cardiac
13    catheterization and open heart surgery; and
14        8. An institution, place, building, or room used for
15    provision of major medical equipment used in the direct
16    clinical diagnosis or treatment of patients, and whose
17    project cost is in excess of the capital expenditure
18    minimum.
19    This Act shall not apply to the construction of any new
20facility or the renovation of any existing facility located on
21any campus facility as defined in Section 5-5.8b of the
22Illinois Public Aid Code, provided that the campus facility
23encompasses 30 or more contiguous acres and that the new or
24renovated facility is intended for use by a licensed
25residential facility.
26    No federally owned facility shall be subject to the

 

 

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1provisions of this Act, nor facilities used solely for healing
2by prayer or spiritual means.
3    No facility licensed under the Supportive Residences
4Licensing Act or the Assisted Living and Shared Housing Act
5shall be subject to the provisions of this Act.
6    No facility established and operating under the
7Alternative Health Care Delivery Act as a children's respite
8care center alternative health care model demonstration
9program or as an Alzheimer's Disease Management Center
10alternative health care model demonstration program shall be
11subject to the provisions of this Act.
12    A facility designated as a supportive living facility that
13is in good standing with the program established under Section
145-5.01a of the Illinois Public Aid Code shall not be subject to
15the provisions of this Act.
16    This Act does not apply to facilities granted waivers under
17Section 3-102.2 of the Nursing Home Care Act. However, if a
18demonstration project under that Act applies for a certificate
19of need to convert to a nursing facility, it shall meet the
20licensure and certificate of need requirements in effect as of
21the date of application.
22    This Act does not apply to a dialysis facility that
23provides only dialysis training, support, and related services
24to individuals with end stage renal disease who have elected to
25receive home dialysis. This Act does not apply to a dialysis
26unit located in a licensed nursing home that offers or provides

 

 

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1dialysis-related services to residents with end stage renal
2disease who have elected to receive home dialysis within the
3nursing home. The Board, however, may require these dialysis
4facilities and licensed nursing homes to report statistical
5information on a quarterly basis to the Board to be used by the
6Board to conduct analyses on the need for proposed kidney
7disease treatment centers.
8    This Act shall not apply to the closure of an entity or a
9portion of an entity licensed under the Nursing Home Care Act,
10the Specialized Mental Health Rehabilitation Act, or the ID/DD
11MR/DD Community Care Act, with the exceptions of facilities
12operated by a county or Illinois Veterans Homes, that elects to
13convert, in whole or in part, to an assisted living or shared
14housing establishment licensed under the Assisted Living and
15Shared Housing Act.
16    This Act does not apply to any change of ownership of a
17healthcare facility that is licensed under the Nursing Home
18Care Act, the Specialized Mental Health Rehabilitation Act, or
19the ID/DD Community Care Act, with the exceptions of facilities
20operated by a county or Illinois Veterans Homes. Changes of
21ownership of facilities licensed under the Nursing Home Care
22Act must meet the requirements set forth in Sections 3-101
23through 3-119 of the Nursing Home Care Act.
24    With the exception of those health care facilities
25specifically included in this Section, nothing in this Act
26shall be intended to include facilities operated as a part of

 

 

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1the practice of a physician or other licensed health care
2professional, whether practicing in his individual capacity or
3within the legal structure of any partnership, medical or
4professional corporation, or unincorporated medical or
5professional group. Further, this Act shall not apply to
6physicians or other licensed health care professional's
7practices where such practices are carried out in a portion of
8a health care facility under contract with such health care
9facility by a physician or by other licensed health care
10professionals, whether practicing in his individual capacity
11or within the legal structure of any partnership, medical or
12professional corporation, or unincorporated medical or
13professional groups. This Act shall apply to construction or
14modification and to establishment by such health care facility
15of such contracted portion which is subject to facility
16licensing requirements, irrespective of the party responsible
17for such action or attendant financial obligation.
18    No permit or exemption is required for a facility licensed
19under the ID/DD Community Care Act prior to the reduction of
20the number of beds at a facility. If there is a total reduction
21of beds at a facility licensed under the ID/DD Community Care
22Act, this is a discontinuation or closure of the facility.
23However, if a facility licensed under the ID/DD Community Care
24Act reduces the number of beds or discontinues the facility,
25that facility must notify the Board as provided in Section 14.1
26of this Act.

 

 

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1    "Person" means any one or more natural persons, legal
2entities, governmental bodies other than federal, or any
3combination thereof.
4    "Consumer" means any person other than a person (a) whose
5major occupation currently involves or whose official capacity
6within the last 12 months has involved the providing,
7administering or financing of any type of health care facility,
8(b) who is engaged in health research or the teaching of
9health, (c) who has a material financial interest in any
10activity which involves the providing, administering or
11financing of any type of health care facility, or (d) who is or
12ever has been a member of the immediate family of the person
13defined by (a), (b), or (c).
14    "State Board" or "Board" means the Health Facilities and
15Services Review Board.
16    "Construction or modification" means the establishment,
17erection, building, alteration, reconstruction, modernization,
18improvement, extension, discontinuation, change of ownership,
19of or by a health care facility, or the purchase or acquisition
20by or through a health care facility of equipment or service
21for diagnostic or therapeutic purposes or for facility
22administration or operation, or any capital expenditure made by
23or on behalf of a health care facility which exceeds the
24capital expenditure minimum; however, any capital expenditure
25made by or on behalf of a health care facility for (i) the
26construction or modification of a facility licensed under the

 

 

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1Assisted Living and Shared Housing Act or (ii) a conversion
2project undertaken in accordance with Section 30 of the Older
3Adult Services Act shall be excluded from any obligations under
4this Act.
5    "Establish" means the construction of a health care
6facility or the replacement of an existing facility on another
7site or the initiation of a category of service as defined by
8the Board.
9    "Major medical equipment" means medical equipment which is
10used for the provision of medical and other health services and
11which costs in excess of the capital expenditure minimum,
12except that such term does not include medical equipment
13acquired by or on behalf of a clinical laboratory to provide
14clinical laboratory services if the clinical laboratory is
15independent of a physician's office and a hospital and it has
16been determined under Title XVIII of the Social Security Act to
17meet the requirements of paragraphs (10) and (11) of Section
181861(s) of such Act. In determining whether medical equipment
19has a value in excess of the capital expenditure minimum, the
20value of studies, surveys, designs, plans, working drawings,
21specifications, and other activities essential to the
22acquisition of such equipment shall be included.
23    "Capital Expenditure" means an expenditure: (A) made by or
24on behalf of a health care facility (as such a facility is
25defined in this Act); and (B) which under generally accepted
26accounting principles is not properly chargeable as an expense

 

 

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1of operation and maintenance, or is made to obtain by lease or
2comparable arrangement any facility or part thereof or any
3equipment for a facility or part; and which exceeds the capital
4expenditure minimum.
5    For the purpose of this paragraph, the cost of any studies,
6surveys, designs, plans, working drawings, specifications, and
7other activities essential to the acquisition, improvement,
8expansion, or replacement of any plant or equipment with
9respect to which an expenditure is made shall be included in
10determining if such expenditure exceeds the capital
11expenditures minimum. Unless otherwise interdependent, or
12submitted as one project by the applicant, components of
13construction or modification undertaken by means of a single
14construction contract or financed through the issuance of a
15single debt instrument shall not be grouped together as one
16project. Donations of equipment or facilities to a health care
17facility which if acquired directly by such facility would be
18subject to review under this Act shall be considered capital
19expenditures, and a transfer of equipment or facilities for
20less than fair market value shall be considered a capital
21expenditure for purposes of this Act if a transfer of the
22equipment or facilities at fair market value would be subject
23to review.
24    "Capital expenditure minimum" means $11,500,000 for
25projects by hospital applicants, $6,500,000 for applicants for
26projects related to skilled and intermediate care long-term

 

 

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1care facilities licensed under the Nursing Home Care Act, and
2$3,000,000 for projects by all other applicants, which shall be
3annually adjusted to reflect the increase in construction costs
4due to inflation, for major medical equipment and for all other
5capital expenditures.
6    "Non-clinical service area" means an area (i) for the
7benefit of the patients, visitors, staff, or employees of a
8health care facility and (ii) not directly related to the
9diagnosis, treatment, or rehabilitation of persons receiving
10services from the health care facility. "Non-clinical service
11areas" include, but are not limited to, chapels; gift shops;
12news stands; computer systems; tunnels, walkways, and
13elevators; telephone systems; projects to comply with life
14safety codes; educational facilities; student housing;
15patient, employee, staff, and visitor dining areas;
16administration and volunteer offices; modernization of
17structural components (such as roof replacement and masonry
18work); boiler repair or replacement; vehicle maintenance and
19storage facilities; parking facilities; mechanical systems for
20heating, ventilation, and air conditioning; loading docks; and
21repair or replacement of carpeting, tile, wall coverings,
22window coverings or treatments, or furniture. Solely for the
23purpose of this definition, "non-clinical service area" does
24not include health and fitness centers.
25    "Areawide" means a major area of the State delineated on a
26geographic, demographic, and functional basis for health

 

 

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1planning and for health service and having within it one or
2more local areas for health planning and health service. The
3term "region", as contrasted with the term "subregion", and the
4word "area" may be used synonymously with the term "areawide".
5    "Local" means a subarea of a delineated major area that on
6a geographic, demographic, and functional basis may be
7considered to be part of such major area. The term "subregion"
8may be used synonymously with the term "local".
9    "Physician" means a person licensed to practice in
10accordance with the Medical Practice Act of 1987, as amended.
11    "Licensed health care professional" means a person
12licensed to practice a health profession under pertinent
13licensing statutes of the State of Illinois.
14    "Director" means the Director of the Illinois Department of
15Public Health.
16    "Agency" means the Illinois Department of Public Health.
17    "Alternative health care model" means a facility or program
18authorized under the Alternative Health Care Delivery Act.
19    "Out-of-state facility" means a person that is both (i)
20licensed as a hospital or as an ambulatory surgery center under
21the laws of another state or that qualifies as a hospital or an
22ambulatory surgery center under regulations adopted pursuant
23to the Social Security Act and (ii) not licensed under the
24Ambulatory Surgical Treatment Center Act, the Hospital
25Licensing Act, or the Nursing Home Care Act. Affiliates of
26out-of-state facilities shall be considered out-of-state

 

 

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1facilities. Affiliates of Illinois licensed health care
2facilities 100% owned by an Illinois licensed health care
3facility, its parent, or Illinois physicians licensed to
4practice medicine in all its branches shall not be considered
5out-of-state facilities. Nothing in this definition shall be
6construed to include an office or any part of an office of a
7physician licensed to practice medicine in all its branches in
8Illinois that is not required to be licensed under the
9Ambulatory Surgical Treatment Center Act.
10    "Change of ownership of a health care facility" means a
11change in the person who has ownership or control of a health
12care facility's physical plant and capital assets. A change in
13ownership is indicated by the following transactions: sale,
14transfer, acquisition, lease, change of sponsorship, or other
15means of transferring control.
16    "Related person" means any person that: (i) is at least 50%
17owned, directly or indirectly, by either the health care
18facility or a person owning, directly or indirectly, at least
1950% of the health care facility; or (ii) owns, directly or
20indirectly, at least 50% of the health care facility.
21    "Charity care" means care provided by a health care
22facility for which the provider does not expect to receive
23payment from the patient or a third-party payer.
24    "Freestanding emergency center" means a facility subject
25to licensure under Section 32.5 of the Emergency Medical
26Services (EMS) Systems Act.

 

 

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1(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
296-1000, eff. 7-2-10; 97-38, eff. 6-28-11; 97-277, eff. 1-1-12;
3revised 9-7-11.)
 
4    (20 ILCS 3960/13)  (from Ch. 111 1/2, par. 1163)
5    (Section scheduled to be repealed on December 31, 2019)
6    Sec. 13. Investigation of applications for permits and
7certificates of recognition. The Agency or the State Board
8shall make or cause to be made such investigations as it or the
9State Board deems necessary in connection with an application
10for a permit or an application for a certificate of
11recognition, or in connection with a determination of whether
12or not construction or modification which has been commenced is
13in accord with the permit issued by the State Board or whether
14construction or modification has been commenced without a
15permit having been obtained. The State Board may issue
16subpoenas duces tecum requiring the production of records and
17may administer oaths to such witnesses.
18    Any circuit court of this State, upon the application of
19the State Board or upon the application of any party to such
20proceedings, may, in its discretion, compel the attendance of
21witnesses, the production of books, papers, records, or
22memoranda and the giving of testimony before the State Board,
23by a proceeding as for contempt, or otherwise, in the same
24manner as production of evidence may be compelled before the
25court.

 

 

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1    The State Board shall require all health facilities
2operating in this State to provide such reasonable reports at
3such times and containing such information as is needed by it
4to carry out the purposes and provisions of this Act. Prior to
5collecting information from health facilities, the State Board
6shall make reasonable efforts through a public process to
7consult with health facilities and associations that represent
8them to determine whether data and information requests will
9result in useful information for health planning, whether
10sufficient information is available from other sources, and
11whether data requested is routinely collected by health
12facilities and is available without retrospective record
13review. Data and information requests shall not impose undue
14paperwork burdens on health care facilities and personnel.
15Health facilities not complying with this requirement shall be
16reported to licensing, accrediting, certifying, or payment
17agencies as being in violation of State law. Health care
18facilities and other parties at interest shall have reasonable
19access, under rules established by the State Board, to all
20planning information submitted in accord with this Act
21pertaining to their area.
22    Among the reports to be required by the State Board are
23facility questionnaires for health care facilities licensed
24under the Ambulatory Surgical Treatment Center Act, the
25Hospital Licensing Act, the Nursing Home Care Act, the ID/DD
26Community Care Act, the Specialized Mental Health

 

 

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1Rehabilitation Act, or the End Stage Renal Disease Facility
2Act. These questionnaires shall be conducted on an annual basis
3and compiled by the Agency. For health care facilities licensed
4under the Nursing Home Care Act or , the Specialized Mental
5Health Rehabilitation Act, or the ID/DD Community Care Act,
6these reports shall include, but not be limited to, the
7identification of specialty services provided by the facility
8to patients, residents, and the community at large. Annual
9reports for facilities licensed under the ID/DD Community Care
10Act shall be different from the annual reports required of
11other health care facilities and shall be specific to those
12facilities licensed under the ID/DD Community Care Act. The
13Health Facilities and Services Review Board shall consult with
14associations representing facilities licensed under the ID/DD
15Community Care Act when developing the information requested in
16these annual reports. For health care facilities that contain
17long term care beds, the reports shall also include the number
18of staffed long term care beds, physical capacity for long term
19care beds at the facility, and long term care beds available
20for immediate occupancy. For purposes of this paragraph, "long
21term care beds" means beds (i) licensed under the Nursing Home
22Care Act, (ii) licensed under the ID/DD Community Care Act,
23(iii) licensed under the Hospital Licensing Act, or (iv)
24licensed under the Specialized Mental Health Rehabilitation
25Act and certified as skilled nursing or nursing facility beds
26under Medicaid or Medicare.

 

 

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1(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-227,
2eff. 1-1-12; revised 9-7-11.)
 
3    (20 ILCS 3960/14.1)
4    Sec. 14.1. Denial of permit; other sanctions.
5    (a) The State Board may deny an application for a permit or
6may revoke or take other action as permitted by this Act with
7regard to a permit as the State Board deems appropriate,
8including the imposition of fines as set forth in this Section,
9for any one or a combination of the following:
10        (1) The acquisition of major medical equipment without
11    a permit or in violation of the terms of a permit.
12        (2) The establishment, construction, or modification
13    of a health care facility without a permit or in violation
14    of the terms of a permit.
15        (3) The violation of any provision of this Act or any
16    rule adopted under this Act.
17        (4) The failure, by any person subject to this Act, to
18    provide information requested by the State Board or Agency
19    within 30 days after a formal written request for the
20    information.
21        (5) The failure to pay any fine imposed under this
22    Section within 30 days of its imposition.
23    (a-5) For facilities licensed under the ID/DD Community
24Care Act, no permit shall be denied on the basis of prior
25operator history, other than for actions specified under item

 

 

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1(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
2Act. For facilities licensed under the Specialized Mental
3Health Rehabilitation Act, no permit shall be denied on the
4basis of prior operator history, other than for actions
5specified under item (2), (4), or (5) of Section 3-117 of the
6Specialized Mental Health Rehabilitation Act. For facilities
7licensed under the Nursing Home Care Act, no permit shall be
8denied on the basis of prior operator history, other than for:
9(i) actions specified under item (2), (3), (4), (5), or (6) of
10Section 3-117 of the Nursing Home Care Act; (ii) actions
11specified under item (a)(6) of Section 3-119 of the Nursing
12Home Care Act; or (iii) actions within the preceding 5 years
13constituting a substantial and repeated failure to comply with
14the Nursing Home Care Act or the rules and regulations adopted
15by the Department under that Act. The State Board shall not
16deny a permit on account of any action described in this
17subsection (a-5) without also considering all such actions in
18the light of all relevant information available to the State
19Board, including whether the permit is sought to substantially
20comply with a mandatory or voluntary plan of correction
21associated with any action described in this subsection (a-5).
22    (b) Persons shall be subject to fines as follows:
23        (1) A permit holder who fails to comply with the
24    requirements of maintaining a valid permit shall be fined
25    an amount not to exceed 1% of the approved permit amount
26    plus an additional 1% of the approved permit amount for

 

 

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1    each 30-day period, or fraction thereof, that the violation
2    continues.
3        (2) A permit holder who alters the scope of an approved
4    project or whose project costs exceed the allowable permit
5    amount without first obtaining approval from the State
6    Board shall be fined an amount not to exceed the sum of (i)
7    the lesser of $25,000 or 2% of the approved permit amount
8    and (ii) in those cases where the approved permit amount is
9    exceeded by more than $1,000,000, an additional $20,000 for
10    each $1,000,000, or fraction thereof, in excess of the
11    approved permit amount.
12        (3) A person who acquires major medical equipment or
13    who establishes a category of service without first
14    obtaining a permit or exemption, as the case may be, shall
15    be fined an amount not to exceed $10,000 for each such
16    acquisition or category of service established plus an
17    additional $10,000 for each 30-day period, or fraction
18    thereof, that the violation continues.
19        (4) A person who constructs, modifies, or establishes a
20    health care facility without first obtaining a permit shall
21    be fined an amount not to exceed $25,000 plus an additional
22    $25,000 for each 30-day period, or fraction thereof, that
23    the violation continues.
24        (5) A person who discontinues a health care facility or
25    a category of service without first obtaining a permit
26    shall be fined an amount not to exceed $10,000 plus an

 

 

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1    additional $10,000 for each 30-day period, or fraction
2    thereof, that the violation continues. For purposes of this
3    subparagraph (5), facilities licensed under the Nursing
4    Home Care Act or the ID/DD Community Care Act, with the
5    exceptions of facilities operated by a county or Illinois
6    Veterans Homes, are exempt from this permit requirement.
7    However, facilities licensed under the Nursing Home Care
8    Act or the ID/DD Community Care Act must comply with
9    Section 3-423 of the Nursing Home Care Act or Section 3-423
10    of the ID/DD Community Care Act and must provide the Board
11    and the Department of Human Services with 30 days' 30-days'
12    written notice of its intent to close. Facilities licensed
13    under the ID/DD Community Care Act also must provide the
14    Board and the Department of Human Services with 30 days'
15    written notice of its intent to reduce the number of beds
16    for a facility.
17        (6) A person subject to this Act who fails to provide
18    information requested by the State Board or Agency within
19    30 days of a formal written request shall be fined an
20    amount not to exceed $1,000 plus an additional $1,000 for
21    each 30-day period, or fraction thereof, that the
22    information is not received by the State Board or Agency.
23    (c) Before imposing any fine authorized under this Section,
24the State Board shall afford the person or permit holder, as
25the case may be, an appearance before the State Board and an
26opportunity for a hearing before a hearing officer appointed by

 

 

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1the State Board. The hearing shall be conducted in accordance
2with Section 10.
3    (d) All fines collected under this Act shall be transmitted
4to the State Treasurer, who shall deposit them into the
5Illinois Health Facilities Planning Fund.
6(Source: P.A. 96-339, eff. 7-1-10; 96-1372, eff. 7-29-10;
797-38, eff. 6-28-11; 97-227, eff. 1-1-12; revised 9-7-11.)
 
8    Section 99. Effective date. This Act takes effect upon
9becoming law.