210 ILCS 40/ Life Care Facilities Act.

(210 ILCS 40/1) (from Ch. 111 1/2, par. 4160-1)

Sec. 1. This Act shall be known and may be cited as the "Life Care Facilities Act".

(Source: P.A. 82-547.)

(210 ILCS 40/2) (from Ch. 111 1/2, par. 4160-2)

Sec. 2. As used in this Act, unless the context otherwise requires:

(a) "Department" means the Department of Public Health.

(b) "Director" means the Director of the Department.

(c) "Life care contract" means a contract to provide to a person for the duration of such person's life or for a term in excess of one year, nursing services, medical services or personal care services, in addition to maintenance services for such person in a facility, conditioned upon the transfer of an entrance fee to the provider of such services in addition to or in lieu of the payment of regular periodic charges for the care and services involved.

(d) "Provider" means a person who provides services pursuant to a life care contract.

(e) "Resident" means a person who enters into a life care contract with a provider, or who is designated in a life care contract to be a person provided with maintenance and nursing, medical or personal care services.

(f) "Facility" means a place or places in which a provider undertakes to provide a resident with nursing services, medical services or personal care services, in addition to maintenance services for a term in excess of one year or for life pursuant to a life care contract. The term also means a place or places in which a provider undertakes to provide such services to a non-resident.

(g) "Living unit" means an apartment, room or other area within a facility set aside for the exclusive use of one or more identified residents.

(h) "Entrance fee" means an initial or deferred transfer to a provider of a sum of money or property, made or promised to be made by a person entering into a life care contract, which assures a resident of services pursuant to a life care contract.

(i) "Permit" means a written authorization to enter into life care contracts issued by the Department to a provider.

(j) "Medical services" means those services pertaining to medical or dental care that are performed in behalf of patients at the direction of a physician licensed under the Medical Practice Act of 1987 or a dentist licensed under the Illinois Dental Practice Act by such physicians or dentists, or by a registered or licensed practical nurse as defined in the Nurse Practice Act or by other professional and technical personnel.

(k) "Nursing services" means those services pertaining to the curative, restorative and preventive aspects of nursing care that are performed at the direction of a physician licensed under the Medical Practice Act of 1987 by or under the supervision of a registered or licensed practical nurse as defined in the Nurse Practice Act.

(l) "Personal care services" means assistance with meals, dressing, movement, bathing or other personal needs or maintenance, or general supervision and oversight of the physical and mental well-being of an individual, who is incapable of maintaining a private, independent residence or who is incapable of managing his person whether or not a guardian has been appointed for such individual.

(m) "Maintenance services" means food, shelter and laundry services.

(n) "Certificates of Need" means those permits issued pursuant to the Illinois Health Facilities Planning Act as now or hereafter amended.

(o) "Non-resident" means a person admitted to a facility who has not entered into a life care contract.

(Source: P.A. 95-639, eff. 10-5-07.)

(210 ILCS 40/3) (from Ch. 111 1/2, par. 4160-3)

Sec. 3. After July 1, 1982, no person may enter into a life care contract as a provider, or as a provider extend the term of an existing life care contract except pursuant to a permit obtained in accordance with this Act.

(Source: P.A. 82-547.)

(210 ILCS 40/4) (from Ch. 111 1/2, par. 4160-4)

Sec. 4. To qualify for a permit to enter into life care contracts with respect to any facility, a person shall file an application for a permit with the Department on permit application forms provided by the Department and shall attach to the application as an exhibit a copy of the proposed form of life care contract to be entered into with residents at that facility. All applications shall be accompanied by a copy of the Letter of Credit or Escrow Agreement as provided by Section 7 of this Act and by a permit application fee of $100. The application shall be signed under oath by the applicant, and if the applicant is other than an individual the application shall be signed under oath by the chief executive officer of the applicant.

(Source: P.A. 85-1349.)

(210 ILCS 40/5) (from Ch. 111 1/2, par. 4160-5)

Sec. 5. (a) At the time of or prior to the execution of a life care contract and the transfer of any money or other property to a provider or escrow agent, the provider shall deliver to the resident a copy of a financial disclosure statement reflecting the provider's financial condition. This statement shall include, but not be limited to, disclosure of short term assets and liabilities.

(b) The life care contract shall provide that any person entering into the contract shall have a period of 14 days beginning with the first full calendar day following the execution of the contract, or the payment of an initial sum of money as a deposit or application fee, or receipt of the financial disclosure statement, whichever occurs last, within which to rescind the life care contract without penalty or further obligation. In the event of such rescission, all money or property paid or transferred by such person shall be fully refunded. No person shall be required to move into a facility until after the expiration of the 14 day rescission period. No permit shall be issued under this Act if the form of life care contract attached as an exhibit in support of the application for permit as provided in Section 4 does not contain the provisions required by this paragraph (b).

(Source: P.A. 82-547.)

(210 ILCS 40/5.1)

(This Section may contain text from a Public Act with a delayed effective date)

Sec. 5.1. Pre-sale disclosures.

(a) Prior to the execution of a refundable life care contract and the transfer of any money or other property to a provider or escrow agent, the provider shall deliver to the consumer a pre-sale disclosure printed on paper. The pre-sale disclosure shall be signed by the consumer prior to executing the life care contract. The pre-sale disclosure shall include:

(1) the caption, "ENTRY FEE REFUNDS: CONSUMER NOTICE", in at least 28-point font and the remaining portion in at least 12-point font;

(2) the caption, "The timing of refunds for past residents may not be indicative of your refund experience. Your ability to collect on the full amount of the calculated refund may be modified or nullified pending market conditions, any future sale of this organization, or in the event of bankruptcy. Current residents, former residents awaiting refunds, and the estates of former residents awaiting refunds shall be provided with the most recent entry fee refund data disclosure upon request.";

(3) for refunds returned by the provider in the most recently completed calendar year:

(A) the average number of months passed before the refund of an entry fee by the provider; and

(B) the median number of months passed before the refund of an entry fee by the provider;

(4) the percentage of entry fee contracts awaiting refunds from the provider with wait times exceeding 24 months as of the end of the most recently completed calendar year;

(5) the percentage of entry fee contracts awaiting refunds from the provider with wait times exceeding 36 months as of the end of the most recently completed calendar year;

(6) the percentage of entry fee contracts awaiting refunds from the provider with wait times exceeding 60 months as of the end of the most recently completed calendar year;

(7) the number of entry fee contracts awaiting refunds from the provider as of the last day of the most recently completed calendar year; and

(8) the number of entry fee refunds returned by the provider in the most recently completed calendar year.

(b) For the purpose of determining the time a refund is due, the start time of the refund begins after the unit has been permanently vacated, returned to resalable condition, and the outgoing resident has a zero balance due, excluding outstanding balances to be payable by outside payors, including, but not limited to, Medicare, Medicaid, Managed Medicare, or within 30 days of the unit being permanently vacated and the outgoing resident has a zero balance due, whichever is shorter. Refund delays due to estate factors outside of the community's control, including, but not limited to, probate challenges, estate challenges, or an inability to confirm next of kin, are not included in the outstanding refunds to be disclosed.

(c) Pre-sale disclosures may include additional data by calendar year.

(d) If a payee for an entry fee refund cannot be determined, for purposes of calculating the data in subsection (a), a refund shall be considered complete when a new resident occupies the specified living unit.

(e) The most current pre-sale disclosure data detailed in subsection (a) shall be made available, upon request, to current residents that have refundable entry fee contracts, former residents who have not yet received refunds for their refundable entry fees, and the estates of former residents who have not yet received refunds for their refundable entry fees.

(f) Failure to provide the pre-sale disclosure in accordance with this Section may result in a minimum monetary penalty of $500 at the discretion of the Department. The Department shall adopt rules to enforce this Section and provide for factors to be considered when imposing monetary penalties and for repeat violations of this Section.

(Source: P.A. 103-812, eff. 1-1-25.)

(210 ILCS 40/5.2)

(This Section may contain text from a Public Act with a delayed effective date)

Sec. 5.2. Living unit reappropriation. If an unoccupied living unit is contemplated for use for a purpose other than as a living unit, including, but not limited to, an exam room or a storage room, and if there exist beneficiaries awaiting an entry fee refund, the beneficiaries of the entry fee refund must provide a signed acknowledgment of, and agreement to, the reappropriation that may be in effect up to a specific date. The reappropriation acknowledgment shall include:

(1) the caption, "ENTRY FEE REFUND DELAYS: CONSUMER NOTICE" in at least 28-point font and the remaining portion in at least a 12-point font;

(2) the caption, "Your agreement to this arrangement may result in the delayed sale of the living unit as well as the delayed return of the entry fee."; and

(3) a statement that the rights provided under this Section may not be waived.

(Source: P.A. 103-812, eff. 1-1-25.)

(210 ILCS 40/6) (from Ch. 111 1/2, par. 4160-6)

Sec. 6. Upon receipt of the completed application and exhibits and payment of the fee by the applicant, and proof of compliance by the applicant with the provisions of Section 7, the Director shall issue a permit to the provider, subject to the conditions imposed pursuant to Section 7, allowing the provider to enter into life care contracts with respect to the number of living units and facility described in the application.

A permit issued pursuant to this Act shall remain in full force, subject to the provisions of this Act, and shall contain in a prominent location a statement that the issuance of such permit neither constitutes approval, recommendation or endorsement by the Department or Director nor evidences the accuracy or completeness of the information furnished to the Department. A permit may be revoked by the Department if the facility fails to provide to the Department an accurate disclosure document in accordance with the Alzheimer's Disease and Related Dementias Special Care Disclosure Act.

All permits shall be nontransferable.

(Source: P.A. 96-990, eff. 7-2-10.)

(210 ILCS 40/6.1) (from Ch. 111 1/2, par. 4160-6.1)

Sec. 6.1. In the case of a newly constructed facility, the permit standards prescribed by the Department shall provide that the licensed skilled nursing beds in the facility may be made available to non-residents of the facility, provided that the applicant demonstrates on the permit application form, to the satisfaction of the Department, that the facility can accommodate all residents requiring skilled nursing beds, as well as all non-residents admitted to the facility requiring such beds. Such accommodation shall be accomplished without transferring or discharging any resident or non-resident.

(Source: P.A. 85-1244.)

(210 ILCS 40/7) (from Ch. 111 1/2, par. 4160-7)

Sec. 7. As a condition for the issuance of a permit pursuant to this Act, the provider shall establish and maintain on a current basis, a letter of credit or an escrow account with a bank, trust company, or other financial institution located in the State of Illinois. The letter of credit shall be in an amount and form acceptable to the Department, but in no event shall the amount exceed that applicable to the corresponding escrow agreement alternative, as described below. The terms of the escrow agreement shall meet the following provisions:

(a) Requirements for new facilities.

(1) If the entrance fee applies to a living unit which has not previously been occupied by any resident, all entrance fee payments representing either all or any smaller portion of the total entrance fee shall be paid to the escrow agent by the resident.

(2) When the provider has sold at least 1/2 of its living units, obtained a mortgage commitment, if needed, and obtained all necessary zoning permits and Certificates of Need, if required, the escrow agent may release a sum representing 1/5 of the resident's total entrance fee to the provider. Upon completion of the foundation of the living unit an additional 1/5 of the resident's total entrance fee may be released to the provider. When the living unit is under roof a further and additional 1/5 of the resident's total entrance fee may be released to the provider. All remaining monies, if any, shall remain in escrow until the resident's living unit is substantially completed and ready for occupancy by the resident. When the living unit is ready for occupancy the escrow agent may release the remaining escrow amount to the provider and further entrance fee payments, if any, may be paid by the resident to the provider directly. All monies released from escrow shall be used for the facility and for no other purpose.

(b) General requirements for all facilities, including new and existing facilities.

(1) At the time of resident occupancy and at all times thereafter, the escrow amount shall be in an amount which equals or exceeds the aggregate principal and interest payments due during the next 6 months on account of any first mortgage or other long-term financing of the facility. Existing facilities shall have 2 years from the date of this Act becoming law to comply with this subsection. Upon application from a facility showing good cause, the Director may extend compliance with this subsection one additional year.

(2) Notwithstanding paragraph (1) of this subsection, the escrow monies required under paragraph (1) of this subsection may be released to the provider upon approval by the Director. The Director may attach such conditions on the release of monies as he deems fit including, but not limited to, the performance of an audit which satisfies the Director that the facility is solvent, a plan from the facility to bring the facility back in compliance with paragraph (1) of this subsection, and a repayment schedule.

(3) The principal of the escrow account may be invested with the earnings thereon payable to the provider as it accrues.

(4) If the facility ceases to operate all monies in the escrow account except the amount representing principal and interest shall be repaid by the escrow agent to the resident.

(5) Balloon payments due at conclusion of the mortgage shall not be subject to the escrow requirements of paragraph (1) this subsection.

(Source: P.A. 85-1349.)

(210 ILCS 40/8) (from Ch. 111 1/2, par. 4160-8)

Sec. 8. No State or federal funds which are appropriated by the General Assembly or which pass through the General Revenue Fund or any special fund in the State Treasury shall be paid to a provider not having a permit issued under this Act.

(Source: P.A. 82-547.)

(210 ILCS 40/9) (from Ch. 111 1/2, par. 4160-9)

Sec. 9. At any time the Director receives notice from the escrow agent that the provisions of Section 7 have not been complied with, or at any other time when the Director has reason to believe that the provider is insolvent, is in imminent danger of becoming insolvent or that its condition is such that it may be financially unable to fully perform its obligations pursuant to life care contracts, the Director shall, through the Attorney General, file an appropriate action on behalf of the State of Illinois and any or all residents in any court of competent jurisdiction, including the federal bankruptcy court or any other federal court.

(Source: P.A. 82-547.)

(210 ILCS 40/10) (from Ch. 111 1/2, par. 4160-10)

Sec. 10. The Director or his authorized designee may conduct an audit or other examination of the financial affairs of any provider as often as he deems it necessary for the protection of the interests of the residents and the people of this State, and for this purpose shall have access to the books, records, financial data and other documents maintained by the facility.

(Source: P.A. 82-547.)

(210 ILCS 40/10.1)

Sec. 10.1. Vaccinations.

(a) A facility shall annually administer a vaccination against influenza to each resident, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that are most recent to the time of vaccination, unless the vaccination is medically contraindicated or the resident has refused the vaccine. Influenza vaccinations for all residents age 65 and over shall be completed by November 30 of each year or as soon as practicable if vaccine supplies are not available before November 1. Residents admitted after November 30, during the flu season, and until February 1 shall, as medically appropriate, receive an influenza vaccination prior to or upon admission or as soon as practicable if vaccine supplies are not available at the time of the admission, unless the vaccine is medically contraindicated or the resident has refused the vaccine. In the event that the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention determines that dates of administration other than those stated in this Act are optimal to protect the health of residents, the Department is authorized to develop rules to mandate vaccinations at those times rather than the times stated in this Act. A facility shall document in the resident's medical record that an annual vaccination against influenza was administered, refused or medically contraindicated.

(b) A facility shall provide or arrange for administration of a pneumococcal vaccination to each resident who is age 65 and over, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, who has not received this immunization prior to or upon admission to the facility, unless the resident refuses the offer for vaccination or the vaccination is medically contraindicated. A facility shall document in each resident's medical record that a vaccination against pneumococcal pneumonia was offered and administered, refused, or medically contraindicated.

(Source: P.A. 93-384, eff. 7-25-03.)

(210 ILCS 40/10.2)

Sec. 10.2. Facility employee assistance programs. A facility shall ensure that nurses employed by the facility are aware of employee assistance programs or other like programs available for the physical and mental well-being of the employee. The facility shall provide information on these programs, no less than at the time of employment and during any benefit open enrollment period, by an information form about the respective programs that the nurse must sign during onboarding at the facility. The signed information form shall be added to the nurse's personnel file. The facility may provide this information to nurses electronically.

(Source: P.A. 102-1007, eff. 1-1-23.)

(210 ILCS 40/10.3)

Sec. 10.3. Posting of Long Term Care Ombudsman Program information.

(a) Except as provided under subsection (b), all licensed facilities shall post on the home page of the facility's website the following:

(1) The Long Term Care Ombudsman Program's statewide toll-free telephone number.

(2) A link to the Long Term Care Ombudsman Program's website.

(b) A facility:

(1) may comply with this Section by posting the required information on the website of the facility's parent company if the facility does not maintain a unique website;

(2) is not required to comply with this Section if the facility and any parent company do not maintain a website; and

(3) is not required to comply with this Section in instances where the parent company operates in multiple states and the facility does not maintain a unique website.

(Source: P.A. 103-119, eff. 1-1-24; 103-605, eff. 7-1-24.)

(210 ILCS 40/10.4)

Sec. 10.4. Provision of at-home continuing care.

(a) The Department shall adopt rules that:

(1) establish standards for providers of at-home continuing care;

(2) provide for the certification and registration of providers of at-home continuing care and the annual renewal of certificates of registration;

(3) provide for and encourage the establishment of at-home continuing care programs;

(4) set minimum requirements for any individual who is employed by or under contract with a provider of at-home continuing care and who will enter a provider of at-home continuing care's subscriber's home to provide at-home continuing care services, including requirements for criminal background checks of such an individual who will have routine, direct access to a subscriber;

(5) establish standards for the renewal of certificates of registration for providers of at-home continuing care;

(6) establish standards for the number of executed agreements necessary to begin operation as a provider of at-home continuing care;

(7) establish standards for when and how a provider of at-home continuing care or a subscriber may rescind an at-home continuing care agreement before at-home continuing care services are provided to the subscriber;

(8) allow a subscriber to rescind an agreement for at-home continuing care services at any time if the terms of the agreement violate this Section;

(9) establish that a provider may terminate an agreement to provide at-home continuing care services or discharge a subscriber only for just cause; and

(10) establish procedures to carry out a termination or discharge under paragraph (9).

(b) The Department shall certify and register a person as a provider of at-home continuing care services under this Section if the Department determines that:

(1) a reasonable financial plan has been developed to provide at-home continuing care services, including a plan for the number of agreements to be executed before beginning operation;

(2) a market for the at-home continuing care program exists;

(3) the provider has submitted all proposed advertisements, advertising campaigns, and other promotional materials for the program;

(4) the form and substance of all advertisements, advertising campaigns, and other promotional materials submitted are not deceptive, misleading, or likely to mislead; and

(5) an actuarial forecast supports the market for the program.

(c) A provider may not enter into an agreement to provide at-home continuing care services until the Department issues a preliminary certificate of registration to the provider. An application for a preliminary certificate of registration shall:

(1) be filed in a form determined by the Department by rule; and

(2) include:

(A) a copy of the proposed at-home continuing care agreement; and

(B) the form and substance of any proposed advertisements, advertising campaigns, or other promotional materials for the program that are available at the time of filing the application and that have not been filed previously with the Department.

(d) The Department shall issue a preliminary certificate of registration to a provider under subsection (c) if the Department determines that:

(1) the proposed at-home continuing care agreement is satisfactory;

(2) the provider has submitted all proposed advertisements, advertising campaigns, and other promotional materials for the program; and

(3) the form and substance of all advertisements, advertising campaigns, and other promotional materials submitted are not deceptive, misleading, or likely to mislead.

(e) A person may not provide at-home continuing care services until the Department issues a certificate of registration to the person. An application for a certificate of registration shall:

(1) be filed in a form determined by the Department by rule; and

(2) include:

(A) verification that the required number of agreements has been executed;

(B) the form and substance of any proposed advertisements, advertising campaigns, or other promotional materials for the program that are available at the time of filing and that have not been filed previously with the Department; and

(C) verification that any other license or certificate required by other appropriate State units has been issued to the provider.

(f) The Department shall issue a certificate of registration to a provider under subsection (e) if the Department determines that:

(1) the information and documents submitted and application for a preliminary certificate of registration are current and accurate or have been updated to make them accurate;

(2) the required agreements have been executed;

(3) any other license or certificate required by other appropriate State units has been issued to the provider;

(4) the provider has submitted all proposed advertisements, advertising campaigns, and other promotional materials for the program; and

(5) the material submitted is not an advertisement, advertising campaign, or other promotional material that is deceptive, misleading, or likely to mislead.

If a provider intends to advertise before the Department issues a certificate of registration, the provider shall submit to the Department any advertisement, advertising campaign, or other promotional material before using it.

(g) Every 2 years, within 120 days after the end of a provider's fiscal year, a provider shall file an application for a renewal certificate of registration with the Department. The application shall:

(A) be filed in a form determined by the Department by rule; and

(B) contain any reasonable and pertinent information that the Department requires.

(h) The Department shall issue a renewal certificate of registration under subsection (g) if the Department determines that:

(1) all required documents have been filed and are satisfactory;

(2) any revised agreements for at-home continuing care services meet the Department's requirements;

(3) the provider has submitted all proposed advertisements, advertising campaigns, and other promotional materials for the program; and

(4) the form and substance of all advertisements, advertising campaigns, and other promotional materials submitted are not deceptive, misleading, or likely to mislead.

(i) The Department may deny, suspend, or revoke a preliminary, initial, or renewal certificate of registration under this Section for cause. The Department shall set forth in writing its reasons for a denial, suspension, or revocation. A provider may appeal a denial in writing. Grounds for a denial, suspension, or revocation include, but are not limited to:

(1) violation of this Section;

(2) violation of a rule adopted by the Department under this Section;

(3) misrepresentation; or

(4) submission of false information.

(Source: P.A. 103-332, eff. 1-1-24; 103-605, eff. 7-1-24.)

(210 ILCS 40/11) (from Ch. 111 1/2, par. 4160-11)

Sec. 11. The Department may deny the application for permit or revoke or suspend an existing permit for violation of any provision of this Act. The provisions of The Illinois Administrative Procedure Act and the Administrative Review Law as now or hereafter amended shall apply to all proceedings under this Act.

(Source: P.A. 82-783.)

(210 ILCS 40/12) (from Ch. 111 1/2, par. 4160-12)

Sec. 12. After July 1, 1982, any person acting in the capacity of a provider who enters into a life care contract, or extends the term of an existing life care contract, without first having been issued a permit by the Department or without otherwise acting in compliance with the provisions of this Act, shall be guilty of a Class A misdemeanor.

(Source: P.A. 82-547.)