TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.110 GENERAL REQUIREMENTS
Section 300.110 General
Requirements
a) This Part applies to the operator/licensee of facilities, or
distinct parts of facilities, that are to be licensed and classified to provide
intermediate care or skilled nursing care, pursuant to the terms and conditions
of the Nursing Home Care Act.
b) The license issued to each operator/licensee shall designate
the licensee's name, the facility name and address, the classification by level
of service authorized for that facility, the number of beds authorized for each
level, the date the license was issued and the expiration date. Licenses will
be issued for a period of not less than six months nor more than 18
months for facilities with annual licenses and not less than 18 months nor more
than 30 months for facilities with two-year licenses. The
Department will set the period of the license based on the license expiration
dates of the facilities in the geographical area surrounding the facility in
order to distribute the expiration dates as evenly as possible throughout
the calendar year. (Section 3-110 of the Act)
c) An applicant may request that the license issued by the
Department have distinct parts classified according to levels of services. The
distinct part shall meet the applicable physical plant standards of this Part,
based on the level of service classification sought for that distinct part. To
protect the health, welfare, and safety of residents in a distinct part of the
facility who require higher standards, the facility shall comply with whatever
additional physical plant standards in any distinct part to achieve this
protection as required by the highest level of care being licensed.
Administrative, supervisory, and other personnel may be shared by the entire
facility to meet the health, welfare, and safety needs of the residents of the
facility.
d) A facility shall admit only that number of residents for
which it is licensed. (Section 2-209 of the Act)
e) No person shall:
1) Willfully
file any false, incomplete or intentionally misleading information required to
be filed under the Act, or willfully fail or refuse to file any required
information;
2) Open or operate a
facility without a license. (Section 3-318(a) of the Act)
f) A
violation of subsection (e) is a business offense, punishable by a fine
not to exceed $10,000, except as otherwise provided in subsection (2) of
Section 3-103 of the Act and Section 300.120(e) as to submission of
false or misleading information in a license application. (Section
3-318(b) of the Act)
g) An intermediate care facility shall not use in its title or
description "Hospital", "Sanitarium",
"Sanatorium", "Skilled Nursing Facility", or any other word
or description in its title or advertisements that indicates that a type of
service is provided by the facility for which the facility is not licensed to
provide or does not provide. A skilled nursing facility may use in its title
or advertisement the words or description "Nursing Home",
"Intermediate Care", "Rehabilitation Center", or "Skilled
Nursing Facility".
h) Any person establishing, constructing, or modifying a
health care facility or portion of a health care facility without obtaining a
required permit from the Health Facilities and Services Review Board, or
in violation of the terms of the required permit, shall not be eligible
to apply for any necessary operating licenses or be eligible for payment by any
State agency for services rendered in that facility until the required permit
is obtained. (Section 13.1 of the Illinois Health Facilities Planning Act)
i) The administrator of a facility licensed under the Act
and this Part shall give 60 days' notice prior to voluntarily closing a
facility or prior to closing any part of a facility if closing the part
will require the transfer or discharge of more than 10% of the residents. Notice
shall be given to the Department, to the Office of State Long-Term Care
Ombudsman, to any resident who must be transferred or discharged, to the
resident's representative, and to a member of the resident's family, when
practicable. If the Department suspends, revokes, or denies renewal of the
facility's license, then notice of the facility's closure shall be given
no later than the date specified by the Department. Notice shall state the
proposed date of closing and the reason for closing. The facility shall submit
a closure plan to the Department for approval, which shall address the
process for the safe and orderly transfer of residents. The approved plan
shall be included in the notice. The facility shall offer to assist the
resident in securing an alternative placement and shall advise the resident on
available alternatives. When the resident is unable to choose an alternate
placement and is not under guardianship, the Department shall be notified of
the need for relocation assistance. A facility closing in its entirety shall not
admit any new residents on or after the date the written notice is submitted to
the Department as specified by the Act and this Part. The facility
shall comply with all applicable laws and regulations until the date of
closing, including those related to transfer or discharge of residents. The
Department may place a relocation team in the facility as provided by Section
3-419 of the Act and Section 300.3300 of this Part. (Section 3-423 of
the Act)
j) Licensure for More Than One Level of Care
1) A facility may be licensed for more than one level of care.
Bedrooms of like-licensed levels of care shall be contiguous to each other
within each "nursing unit" as defined in Section 300.330. Each
nursing unit may have up to two levels of care and shall meet the construction
standards for the highest licensed level of care in the nursing unit.
2) If a facility wishes to license a portion of its beds as an
Intermediate Care for the Developmentally Disabled, Medically Complex for the
Developmentally Disabled, or assisted living, licensed under the ID/DD
Community Care Act, the MC/DD Act, and the Assisted Living and Shared Housing
Act, respectively, the beds shall be located in a distinct part (as defined in
Section 300.330) of the facility.
k) Each facility shall notify the Department via e-mail at DPH.StrikePlan@illinois.gov
within 24 hours after receiving a notice of impending strike of staff providing
direct care. The facility shall submit a strike contingency plan to the
Department no later than three calendar days prior to the impending strike.
l) Each facility shall provide the Department with a facility-specific
email address. The facility shall not change the email address without prior
notice to the Department.
m) A facility licensed under the Nursing Home Care Act may not
refer a patient or the family of a patient to a home health agency, home
nursing agency, or home services agency unless the agency is licensed under
the Home Health, Home Services, and Home Nursing Agency Licensing Act. (Section
3.8 of the Home Health, Home Services, and Home Nursing Agency Licensing Act) A
facility shall request a copy of an agency's license prior to making a referral
to that agency.
n) A facility shall comply with the Alzheimer's Disease and
Related Dementias Services Act and the Alzheimer's Disease and Related
Dementias Services Code.
o) A facility shall obtain approval from the Department prior to
providing medical ventilator care for residents. Facilities providing medical
ventilator care shall:
1) Comply with the requirements in Section 300.2940 (Electrical
Systems) or Section 300.3140 (Electrical Requirements), as applicable; and
2) Submit documentation of compliance to the Department via email
at the DPH.LTCQA.Licensure@illinois.gov for review and approval. Submission of
documentation and the response by the Department shall be in accordance with
Section 3-202.5 of the Act and Section 300.2810 of this Part.
(Source: Amended at 49 Ill. Reg. 6468, effective April 22, 2025)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.120 APPLICATION FOR LICENSE
Section 300.120 Application
for License
a) Any person acting individually or jointly with other persons
who proposes to build, own, establish, or operate an intermediate care facility
or skilled nursing facility shall submit application information on forms
provided by the Department. The applicant shall provide a written description
of the proposed program, and other such information as the Department may
require in order to determine the appropriate level of care for which the
facility should be licensed. Application forms and other required information
shall be submitted and approved prior to surveys of the physical plant or
review of building plans and specifications.
b) An application for a new facility shall be accompanied by a
permit as required by the Illinois Health Facilities Planning Act [20 ILCS
3960].
c) Application for a license to establish or operate
an intermediate care facility or skilled nursing facility shall be made
in writing and submitted to the Department, with other such information
as the Department may require, on forms furnished by the Department.
(Section 3-103(1) of the Act)
d) All license applications shall be accompanied with an
application fee of $1,990. The fee for a 2-year license shall be double the
fee for the annual license. (Section 3-103(2) of the Act)
e) The application shall be under oath and the submission of
false or misleading information shall be a Class A misdemeanor. The
application shall contain the following information:
1) The name and address of the applicant if an individual, and
if a firm, partnership, or association, of every member thereof, and in the
case of a corporation, the name and address thereof and of its officers and its
registered agent, and in the case of a unit of local government, the name and
address of its chief executive officer;
2) The name and location of the facility for which a license
is sought;
3) The name of the person or persons under whose management or
supervision the facility will be conducted;
4) The number and type of residents for which maintenance,
personal care, or nursing is to be provided; and
5) Such information relating to the number, experience, and
training of the employees of the facility, any management agreements for the
operation of the facility, and of the moral character of the applicant and
employees as the Department may deem necessary. (Section 3-103(2) of the
Act)
f) Ownership Change or Discontinuation
1) The license is not transferable. It is issued to a specific
licensee and for a specific location. The license and the valid current
renewal certificate immediately become void and shall be returned to the
Department when the facility is sold or leased; when operation is discontinued;
when operation is moved to a new location; when the licensee (if an individual)
dies; when the licensee (if a corporation or partnership) dissolves or
terminates; or when the licensee (whatever the entity) ceases to be.
2) A license issued to a corporation shall become null, void and
of no further effect upon the dissolution of the corporation. The license shall
not be revived if the corporation is subsequently reinstated. A new license shall
be obtained in such cases.
g) Each initial application shall be accompanied by a
financial statement setting forth the financial condition of the applicant and
by a statement from the unit of local government having zoning jurisdiction
over the facility's location stating that the location of the facility is not
in violation of a zoning ordinance. An initial application for a new facility
shall be accompanied by a permit as required by the Illinois Health Facilities
Planning Act. After the application is approved, the applicant shall advise
the Department every six months of any changes in the information originally
provided in the application. (Section 3-103(3) of the Act)
h) The Department may issue licenses or renewals for periods
of not less than six months nor more than 18 months for facilities with
annual licenses and not less than 18 months nor more than 30 months for
facilities with 2-year licenses in order to distribute the
expiration dates of such licenses throughout the calendar year. The fees
for such licenses shall be pro-rated on the basis
of the portion of the year for which they are issued. (Section 3-110 of the
Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.130 LICENSEE
Section 300.130 Licensee
a) The licensee is the corporate body, political subdivision,
individual, or individuals responsible for the operation of the facility and
upon whom rests the responsibility for meeting the licensing requirements. The
licensee does not have to own the building being used.
b) If the licensee does not own the building, a lease or
management agreement between the licensee and the owner of the building is
required. A copy of the lease or management agreement shall be furnished to the
Department. The Department shall also be provided with a copy of all new lease
agreements or any changes to existing agreements within 30 days of the
effective date of such changes.
c) If the licensee is not a corporation or a political
subdivision of the State of Illinois, each person responsible for the operation
of the facility and upon whom rests the responsibility for meeting the
licensing Minimum Standards shall be at least 18 years of age.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.140 ISSUANCE OF AN INITIAL LICENSE FOR A NEW FACILITY
Section 300.140 Issuance of
an Initial License for a New Facility
a) Upon receipt and review of an application for a license made
under the Act and inspection of the applicant facility under the Act,
the Director will issue a probationary license if the
Director finds that:
1) The individual applicant, or the corporation, partnership
or other entity if the applicant is not an individual, is a person responsible
and suitable to operate or to direct or participate in the operation of a facility
by virtue of financial capacity, appropriate business or professional
experience, a record of compliance with lawful orders of the Department and
lack of revocation of a license during the previous five years;
2) The facility is under the supervision of an administrator
who is licensed, if required, under the Nursing Home Administrators Licensing
and Disciplinary Act; and
3) The facility is in substantial compliance with the Act
and this Part. (Section 3-109 of the Act)
b) If the applicant has not been previously licensed or if the
facility is not in operation at the time application is made, the Department will
issue only a probationary license. A probationary license shall be valid for
120 days unless sooner suspended or revoked under Section 3-119 of the
Act. (Section 3-116 of the Act.
c) Within 30 days prior to the termination of a probationary
license, the Department will fully and completely inspect the facility and, if
the facility meets the applicable requirements for licensure, will issue
a license under Section 3-109 of the Act, except that, during a statewide
public health emergency, as defined in the Illinois Emergency Management Agency
Act, the Department will fully and completely inspect the facility
within appropriate time frames to the extent feasible. (Section 3-116 of
the Act) If the facility is not in compliance and satisfactory progress toward
compliance is not being made, the Department will allow the probationary
license to expire.
d) If the Department finds that the facility does not meet the
requirements for licensure but has made substantial progress toward meeting
those requirements, the license may be renewed once for a period not to exceed
120 days from the expiration date of the initial probationary license. (Section
3-116 of the Act) Under no condition will more than two successive
probationary licenses be issued.
e) The licensee shall qualify for issuance of a two-year license
if the licensee has met the criteria contained in Section 3-110(b) of the Act
for the last twenty-four consecutive months.
(Source: Amended at 48 Ill. Reg. 3317,
effective February 16, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.150 ISSUANCE OF AN INITIAL LICENSE DUE TO A CHANGE OF OWNERSHIP
Section 300.150 Issuance of
an Initial License Due to a Change of Ownership
a) Upon receipt and review of an application for a license made
under the Act and inspection of the applicant facility under the Act,
the Director will issue a probationary license if the
Director finds:
1) The individual applicant, or the corporation, partnership
or other entity if the applicant is not an individual, is a person responsible
and suitable to operate or to direct or to participate in the operation of a
facility by virtue of financial capacity, appropriate business or professional
experience, a record of compliance with lawful orders of the Department and
lack of revocation of a license during the previous five years;
2) The facility is under the supervision of an administrator
who is licensed, if required, under the Nursing Home Administrators Licensing
and Disciplinary Act; and
3) The facility is in substantial compliance with the Act
and this Part. (Section 3-109 of the Act)
b) Whenever ownership of a facility is transferred from the
person named in a license to any other person, the transferee shall
obtain a new probationary license. The transferee shall notify the Department
of the transfer and apply for a new license at least 30 days prior to final
transfer. (Section 3-112(a) of the Act)
c) The transferor shall notify the Department at least 30 days
prior to final transfer. The transferor shall remain responsible for the
operation of the facility until a license is issued to the transferee.
(Section 3-112(b) of the Act)
d) The transferee shall submit to the Department a transition
plan, signed by both the transferee and the transferor, that includes, at a
minimum, a detailed explanation of how resident care and appropriate staffing
levels shall be maintained until the license has been obtained and the transfer
of the facility operations occurs. The transition plan shall be submitted at
the same time as notice to the Department of the transfer. The transferor and
transferee shall coordinate as necessary to ensure that there are no gaps in
care, staffing, and safety during the transition period.
e) The Department will accept or reject the transition
plan within 10 days after submission. If the transition plan is rejected, the
Department will work with the facility, the transferee, and the
transferor to bring the transition plan into compliance.
f) If the Department finds that an entity failed to follow an
accepted transition plan and ensure residents are provided adequate care during
the change of ownership process, and finds actual harm to a resident, the
Department will establish a high-risk designation pursuant to paragraph
(9) of Section 3-305 of the Act. The Department will issue a
violation to the entity that failed to carry out their responsibility under the
transition plan that resulted in the violation. As described in this
Section, the change of ownership process shall begin upon submission of the
transition plan to 30 days after the transfer of the facility. (Sections
3-112(c), 3-113(b), and 3-114 of the Act)
g) The license granted to the transferee shall be subject to the
plan of correction submitted by the previous owner and approved by the
Department and any conditions contained in a conditional license issued to the
previous owner. If there are outstanding violations and no approved plan of
correction has been implemented, the Department may issue a conditional license
and plan of correction as provided in Sections 3-311 through 3-317 of the
Act.
h) The license granted to a transferee for a facility that is
in receivership shall be subject to any contractual obligations assumed by a
grantee under the Equity in Long-term Care Quality Act and to the plan
submitted by the receiver for continuing and increasing adherence to best
practices in providing high-quality nursing home care, unless the grant is
repaid under the Equity in Long-Term Care Quality Act. (Section
3-113(a) of the Act)
i) The transferor shall remain liable for all penalties
assessed against the facility that are imposed for violations occurring
prior to transfer of ownership. (Section 3-114 of the Act)
j) If the applicant has not been previously licensed or if
the facility is not in operation at the time application is made, the
Department will issue only a probationary license. A probationary
license shall be valid for 120 days unless sooner suspended or revoked under
Section 3-119 of the Act.
k) Within 30 days prior to the termination of a probationary
license, the Department will fully and completely inspect the facility
and, if the facility meets the applicable requirements for licensure, shall
issue a license under Section 3-109 of the Act, except that, during a statewide
public health emergency, as defined in the Illinois Emergency Management Agency
Act, the Department will fully and completely inspect the establishment
within appropriate time frames to the extent feasible. (Section 3-116 of
the Act) If the facility is not in compliance and satisfactory progress toward
compliance is not being made, the Department will allow the probationary
license to expire.
l) If the Department finds that the facility does not meet
the requirements for licensure but has made substantial progress toward meeting
those requirements, the license may be renewed once for a period not to exceed
120 days from the expiration date of the initial probationary license.
(Section 3-116 of the Act) Under no condition will more than two successive
probationary licenses be issued.
m) The issuance date of the probationary license to the new owner
will be the date the last licensure requirement is met as determined by the
Department.
n) The licensee shall qualify for issuance of a two-year license
if the licensee has met the criteria contained in Section 3-110(b) of the Act
for the last twenty-four consecutive months.
(Source: Amended at 49 Ill. Reg. 4670,
effective March 25, 2025)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.160 ISSUANCE OF A RENEWAL LICENSE
Section 300.160 Issuance of
a Renewal License
At least 120 days but
not more than 150 days prior to license expiration, the licensee shall
submit an application for renewal of the license in such form and containing
such information as the Department requires. If the application is approved,
and the facility is in compliance with all other licensure requirements, the
license shall be renewed in accordance with Section 3-110 of the
Act. The renewal application shall not be approved unless the applicant has
provided to the Department an accurate disclosure document in accordance with
the Alzheimer's Special Care Disclosure Act [220 ILCS 4] and Section
300.163 of this Part, if applicable. (Section 3-115 of the Act)
(Source: Amended at 24 Ill. Reg. 17330, effective November 1, 2000)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.163 ALZHEIMER'S SPECIAL CARE DISCLOSURE
Section 300.163 Alzheimer's
Special Care Disclosure
A facility that offers to
provide care for persons with Alzheimer's disease through an Alzheimer's
special care unit or center shall disclose to the Department or to a
potential or actual client of the facility the following information in writing
on request of the Department or client:
a) The form of care or treatment that distinguishes the
facility as suitable for persons with Alzheimer's disease;
b) The philosophy of the facility concerning the care or
treatment of persons with Alzheimer's disease;
c) The facility's pre-admission, admission, and discharge
procedures;
d) The facility's assessment, care planning, and
implementation guidelines in the care and treatment of persons with Alzheimer's
disease;
e) The facility's minimum and maximum staffing ratios,
specifying the general licensed health care provider to client ratio and the
trainee health care provider to client ratio;
f) The facility's physical environment;
g) Activities available to clients at the facility;
h) The role of family members in the care of clients at the
facility; and
i) The costs of care and treatment under the program or at
the center. (Section 15 of the Alzheimer's Special Care Disclosure Act)
(Source: Added at 23 Ill. Reg. 1103, effective January 15, 1999)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.165 CRITERIA FOR ADVERSE LICENSURE ACTIONS
Section 300.165 Criteria for
Adverse Licensure Actions
a) Adverse licensure actions are determinations to deny the
issuance of an initial license, to deny the issuance of a renewal of a license,
or to revoke the current license of a facility.
b) A determination by the Director or his or her designee to take
adverse licensure action against a facility shall be based on a finding that
one or more of the following criteria are met:
1) A substantial failure to comply with the Act or this
Part. For purposes of this provision, substantial failure is a failure to meet
the requirements of this Part that is other than a variance from strict and
literal performance and that results only in unimportant omissions or defects
given the particular circumstances involved. A substantial failure by a
facility shall include, but not limited to, any of the following:
A) termination
of Medicare or Medicaid certification by the Centers for Medicare and Medicaid
Services; or
B) a
failure by the facility to pay any fine assessed under the Act after the
Department has sent to the facility at least 2 notices of assessment that
include a schedule of payments as determined by the Department, taking into
account extenuating circumstances and financial hardships of the facility.
(Section 3-119(a)(1) of the Act)
2) Conviction of the licensee, or of the person designated to
manage or supervise the facility, of
any of the following crimes during the previous five
years. Such convictions shall be verified by a certified copy of the
record of the court of conviction.
A) A felony; or
B) Two or more misdemeanors involving moral turpitude. (Section
3-119(a)(2) of the Act)
3) The moral character of the licensee, administrator, manager,
or supervisor of the facility is not reputable. Evidence to be considered will
include verifiable statements by residents of a facility, law enforcement
officials, or other persons with knowledge of the individual's character. In
addition, the definition afforded to the terms "reputable,"
"unreputable," and "irreputable" by the circuit courts of
the State of Illinois shall apply when appropriate to the given situation. For
purposes of this Section, a manager or supervisor of the facility is an
individual with responsibility for the overall management, direction,
coordination, or supervision of the facility or the facility staff.
4) The facility is operating (or, for an initial applicant,
intends to operate) with personnel who are insufficient in number or
unqualified by training or experience to properly care for the number and type
of residents in the facility. Standards in this Part concerning personnel,
including Sections 300.810, 300.820, 300.830, 300.1220, 300.1230 and 300.1240,
will be considered in making this determination. (Section 3-119(a)(3) of the
Act)
5) Financial or other resources are insufficient to
operate the facility in accordance with the Act and this Part.
Financial information and changes in financial information provided by the
facility under Section 300.120(f) and under Section 3-208 of the Act will be
considered in making this determination (Section 3-119(a)(4) of the Act)
6) The facility is not under the direct supervision of a
full-time administrator as required by Section 300.510. (Section
3-119(a)(5) of the Act)
7) The
facility has committed two Type "AA" violations within a two-year
period. (Section 3-119(a)(6) of the Act)
8) The facility has violated the rights of residents of the
facility by any of the following actions:
A) A pervasive pattern of cruelty or indifference to residents has
occurred in the facility.
B) The facility has appropriated the property of a resident or
has converted a resident's property for the facility's use without the
resident's written consent or the consent of his or her legal guardian.
C) The facility has secured property, or a bequest of property,
from a resident by undue influence.
9) The facility knowingly submitted false information either on
the licensure or renewal application forms or during the course of an
inspection or survey of the facility.
10) The facility has refused to allow an inspection or survey of
the facility by agents of the Department.
c) The Director or his or her designee shall consider all
available evidence at the time of the determination, including the history of
the facility and the applicant in complying with the Act and this Part, notices
of violations that have been issued to the facility and the applicant, findings
of surveys and inspections, and any other evidence provided by the facility,
residents, law enforcement officials and other interested individuals.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.170 DENIAL OF INITIAL LICENSE
Section 300.170 Denial of
Initial License
a) A determination by the Director or his or her designee to deny
the issuance of an initial license shall be based on a finding that one or more
of the criteria outlined in Section 300.165 or the following criteria are met:
1) Conviction of the applicant, or if the applicant is a firm,
partnership or association, or any of its members or if a corporation, the
conviction of the corporation or any of its officers and stockholders, or of
the person designated to manage or supervise the facility of any of the
following crimes during the previous 5 years. Such convictions shall be
verified by a certified copy of the record of the court of conviction.
A) A felony; or
B) Two or more misdemeanors involving moral turpitude.
(Section 3-117(2) of the Act)
2) Prior license revocation. Both of the following conditions shall
be met:
A) Revocation of a facility license during the previous 5
years, if such prior license was issued to the individual applicant, a
controlling owner or controlling combination of owners of the applicant; or any
affiliate of the individual applicant or controlling owner of the applicant
or affiliate of the applicant was a controlling owner of the prior license.
Operation for the purposes of this provision shall include individuals with
responsibility for the overall management, direction, or supervision of the
facility.
B) The denial of an application for a license pursuant to this
subsection (a)(2) must be supported by evidence that such prior
revocation renders the applicant unqualified or incapable of meeting or
maintaining a facility in accordance with the Act and this Part. This
determination will be based on the applicant's qualifications and ability to
meet the criteria outlined in Section 300.165(b) as evidenced by the
application and the applicant's prior history. (Section 3-117(5) of the Act)
3) Personnel
insufficient in number or unqualified by training or experience to properly
care for the proposed number and type of residents. (Section 3-117(3) of
the Act)
4) Insufficient
financial or other resources to operate and conduct the facility in accordance
with this Part and with contractual obligations assumed by a recipient
of a grant under the Equity in Long-term Care Quality Act and the plan (if
applicable) submitted by a grantee for continuing and increasing adherence to
best practices in providing high-quality nursing home care. (Section
3-117(4) of the Act)
5) That
the facility is not under the direct supervision of a full-time administrator,
as defined by this Part, who is licensed, if required, under the Nursing
Home Administrators Licensing and Disciplinary Act. (Section 3-117(6) of
the Act)
6) That
the facility is in receivership and the proposed licensee has not submitted a
specific detailed plan to bring the facility into compliance with the
requirements of the Act and this Part, and with federal
certification requirements, if the facility is certified, and to keep the
facility in such compliance. (Section 3-117(7) of the Act)
b) The Department shall notify an applicant immediately upon
denial of any application. Such notice shall be in writing and
shall include:
1) A clear and concise statement of the basis of the
denial. The statement shall include a citation to the provisions of Section
3-117 of the Act and the provisions of this Part under which the application is
being denied.
2) A notice of the opportunity for a hearing under Section 3-103
of the Act. If the applicant desires to contest the denial of a license,
it shall provide written notice to the Department of a request for a hearing
within 10 days after receipt of the notice of denial. (Section 3-118 of
the Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.175 DENIAL OF RENEWAL OF LICENSE
Section 300.175 Denial of
Renewal of License
a) Application for renewal of a license of a facility shall be
denied and the license of the facility shall be allowed to expire when the
Director or his or her designee finds that a condition, occurrence, or
situation in the facility meets any of the criteria specified in Section
300.165(b) and in Section 3-119(a) of the Act. Pursuant to Section 10-65 of
the Illinois Administrative Procedure Act [5 ILCS 100/10-65], licensees who
are individuals are subject to denial of renewal of licensure if the individual
is more than 30 days delinquent in complying with a child support order.
b) When the Director or his or her designee determines that an
application for renewal of a license of a facility is to be denied, the
Department shall notify the facility. The notice to the facility shall be in
writing and shall include:
1) A clear and concise statement of the basis of the
denial. The statement shall include a citation to the provisions of the Act
and this Part on which the application for renewal is being denied.
2) A statement of the date on which the current license of the
facility will expire as provided in subsection (c) of this Section and Section
3-119(d) of the Act.
3) A description of the right of the applicant to appeal the
denial of the application for renewal and the right to a hearing. (Section
3-119(b) of the Act)
c) The effective date of the nonrenewal of a license shall be as
provided in Section 3-119(d) of the Act.
d) The current license of the facility shall be extended by
the Department when it finds that such extension is necessary to permit
orderly removal and relocation of residents. (Section 3-119(d)(3) of the
Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.180 REVOCATION OF LICENSE
Section 300.180 Revocation
of License
a) The license of a facility shall be revoked when the Director
or his or her designee finds that a condition, occurrence or situation in the
facility meets any of the criteria specified in Section 300.165(b) and in
Section 3-119(a) of the Act. In addition, the license of a facility will be
revoked when the facility fails to abate or eliminate a level A violation as
provided in Section 300.282(b) or when the facility has committed 2 Type "AA"
violations within a 2-year period. (Section 3-119(a)(6) of the Act) Pursuant
to Section 10-65 of the Illinois Administrative Procedure Act, licensees who
are individuals are subject to revocation of licensure if the individual is
more than 30 days delinquent in complying with a child support order.
b) When the Director or his or her designee determines that the
license of a facility is to be revoked, the Department shall notify the facility.
The notice to the facility shall be in writing and shall include:
1) A clear and concise statement of the basis of the
revocation. The statement shall include a citation to the provisions of the
Act and this Part on which the license is being revoked.
2) A statement of the date on which the revocation will take
effect as provided in subsection (c) of this Section and Section 3-119(d) of
the Act.
3) Notice of the opportunity for a hearing under Section 3-703
of the Act. (Section 3-119(b) of the Act)
c) The effective date of the revocation of a license shall be as
provided in Section 3-119(d) of the Act.
d) The Department may extend the effective date of license
revocation when it finds that such extension is necessary to permit
orderly removal and relocation of residents. (Section 3-119(d)(3) of the
Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.190 EXPERIMENTAL PROGRAM CONFLICTING WITH REQUIREMENTS
Section 300.190 Experimental
Program Conflicting With Requirements
a) Any facility desiring to conduct an experimental program or do
research which is in conflict with this Part shall submit a written request to
the Department and secure prior approval. The Department will not approve
experimental programs which would violate residents rights under the Act. Such
approval will be granted only if the request will not create an unnecessary and
unusual threat to the health, welfare, or safety of the residents or staff.
(A, B)
b) The Department may grant to a facility special permission to
provide day care when it has adequate facilities and staff to satisfactorily
provide such services based on the requirements in Section 300.3710.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.200 INSPECTIONS, SURVEYS, EVALUATIONS AND CONSULTATION
Section 300.200 Inspections,
Surveys, Evaluations and Consultation
The terms survey, inspection and
evaluation are synonymous. These terms refer to the overall examination of
compliance with the Act and this Part.
a) All facilities to which this Part applies shall be subject to
and shall be deemed to have given consent to annual inspections, surveys or
evaluations by properly identified personnel of the Department, or by other
properly identified persons, including local health department staff, as the
Department may designate. An inspection, survey or evaluation, other than
an inspection of financial records, shall be conducted without prior
notice to the facility. A visit for the sole purpose of consultation
may be announced. (Section 3-212(a) of the Act) The licensee, or
person representing the licensee in the facility, shall provide to the
representative of the Department access and entry to the premises or facility
for obtaining information required to carry out the Act and this Part. In
addition, representatives of the Department shall have access to and may reproduce
or photocopy at its cost any books, records, and other documents
maintained by the facility, the licensee or their representatives to the
extent necessary to carry out the Act and this Part. (Section 3-213 of the
Act) A facility may charge the Department for photocopying at a rate
determined by the facility not to exceed the rate in the Freedom of Information
Act.
b) No person shall:
1) Intentionally
prevent, interfere with, or attempt to impede in any way any duly authorized
investigation and enforcement of the Act or this Part;
2) Intentionally
prevent or attempt to prevent any examination of any relevant books or records
pertinent to investigations and enforcement of the Act or this Part;
3) Intentionally
prevent or interfere with the preservation of evidence pertaining to any
violation of the Act or this Part;
4) Intentionally
retaliate or discriminate against any resident or employee for contacting or
providing information to any state official, or for initiating, participating
in, or testifying in an action for any remedy authorized under the Act or
this Part (Section 3-318(a) of the Act);
c) A
violation of subsection (b) is a business offense, punishable by a fine
not to exceed $10,000, except as otherwise provided in subsection (2) of
Section 3-103 of the Act and Section 300.120(e) as to submission of
false or misleading information in a license application. (Section
3-318(b) of the Act)
d) In determining whether to make more than the
required number of unannounced inspections, surveys and
evaluations of a facility, the Department will consider one or more of
the following:
1) previous inspection reports;
2) the facility's history of compliance with the Act and
this Part:
A) correction of violations;
B) penalties or other enforcement actions;
3) the number and severity of complaints received
about the facility;
4) any allegations of resident abuse or neglect;
5) weather conditions;
6) health emergencies;
7) other reasonable belief that deficiencies exist (Section
3-212(b) of the Act); or
8) requirements pursuant to the "1864 Agreement" (42
U.S.C.A. 1395aa) between the Department and U.S. Health and Human Services
(HHS) (e.g., annual and follow-up certification inspections, life safety code
inspections and any inspections requested by the secretary of HHS).
e) The Department shall not be required to determine whether a
facility certified to participate in the Medicare program under Title XVIII of
the Social Security Act, or the Medicaid Program under Title XIX of the Social
Security Act, and which the Department determines by inspection to be in
compliance with the certification requirements of Title XVIII or XIX, is in
compliance with any requirement of the Act that is less stringent than
or duplicates a federal certification requirement. (Section 3-212(b-1) of
the Act)
f) The Department shall, in accordance with Section
3-212(a) of the Act, determine whether a certified facility is in compliance
with requirements of the Act that exceed federal certification
requirements. (Section 3-212(b-1) of the Act)
g) If a certified facility is found to be out of compliance
with federal certification requirements, the results of the inspection
conducted pursuant to Title XVIII or XIX of the Social Security Act
(Section 3-212(b-1) of the Act) shall be reviewed to determined which, if any,
of the results shall be considered licensure findings, as follows:
1) The result identifies potential violations of the Act and this
Part; and
2) The result, based on available information, would likely
represent a Type “AA”, a Type “A", or Type "B" violation if
tested against the factors described in Sections 300.272 and 300.274.
h) All results of an inspection conducted pursuant to Title XVIII
or XIX of the Social Security Act that the Department considers licensure
findings shall be provided to the facility at the time of exit or by mail in
accordance with subsection (i) of this Section.
i) Upon the completion of each inspection, survey and
evaluation, the appropriate Department personnel who
conducted the inspection, survey or evaluation shall submit a copy of their
report to the licensee or their representative upon exiting the facility
or upon considering results of an inspection conducted pursuant to Title XVIII
or XIX of the Social Security Act as licensure findings. A copy of the
information gathered during a complaint investigation will not be provided upon
exiting the facility. Comments or documentation provided by the licensee
which may refute findings in the report, which explain extenuating
circumstances that the facility could not reasonably have
prevented, or which indicate methods and timetables for correction of
deficiencies described in the report shall be provided to the Department
within ten days after receipt of the copy of the report. (Section
3-212(c) of the Act)
j) Consultation consists of providing advice or suggestions to
the staff of a facility at their request relative to specific matters of the
scope of regulation, methods of compliance with the Act or this Part, or
general matters of resident care.
(Source: Amended at 46 Ill. Reg. 14237, effective July 27, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.210 FILING AN ANNUAL ATTESTED FINANCIAL STATEMENT
Section 300.210 Filing an
Annual Attested Financial Statement
a) Each licensee shall submit an annual attested financial
statement to the Department. This financial statement shall be filed in a
prescribed format on forms supplied by the Department. The forms will be
developed in conjunction with the Illinois Department of Public Aid. The
time period covered in the financial statement shall be a period determined by
the Department for the initial filing, and shall thereafter coincide with the
facility's fiscal year or the calendar year. (Section 3-208 of the Act)
b) The Department may require any facility to file an audited
financial statement, if the Department determines that such a statement is
needed. (Section 3-208 of the Act)
c) The Department may require any or all facilities to submit
attested or audited financial statements more frequently than annually, if the
Department determines that more frequent financial statements are needed. The
frequency and time period of such filings shall be as determined by the
Department for each individual facility. (Section 3-208 of the Act)
d) The financial statement shall be filed with the Department
within 90 days following the end of the designated reporting period. The
financial statement will not be considered as having been filed unless all
sections of the prescribed forms have been properly completed. Those sections
which do not apply to a particular facility shall be noted "not
applicable" on the forms.
e) The information required to be submitted in the financial
statement will include at a minimum the following:
1) Facility information, including: facility name and address,
licensure information, type of ownership, licensed bed capacity, date and cost
of building construction and additions, date and cost of acquisition of
buildings, building sizes, equipment costs and dates of acquisition.
2) Resident information, including: number and level of care of
residents by source of payment, income from residents by level of care.
3) Cost information by level of care, including:
A) General service costs; such as dietary, food, housekeeping,
laundry, utilities, and plant operation and maintenance.
B) Health care costs; such as medical director, nursing,
medications, oxygen, activities, medical records, other medical services,
social services, and utilization reviews.
C) General Administration; such as administrative salaries,
professional services, fees, subscriptions, promotional, insurance, travel,
clerical, employee benefits, license fees, and inservice training and
education.
D) Ownership; such as depreciation, interest, taxes, rent, and
leasing.
E) Special Service cost centers; such as habilitative and
rehabilitative services, therapies, transportation, education, barber and
beauty care, and gift and coffee shop.
4) Income information, including operating and nonoperating
income.
5) Ownership information, including balance sheet and payment to
owners.
6) Personnel information, including the number and type of people
employed and salaries paid.
7) Related organization information, including related
organizations from which services are purchased.
f) The new owner or a new lessee of a previously licensed
facility may file a projection of capital costs at the time of closing or
signing of the lease.
1) A facility which is licensed for the first time (a newly
constructed facility) must file a projection of capital costs.
2) Each of the above must file a full cost report within nine
months after acquisition (covering the first six months of operation). Each
must also file a cost report within 90 days of the close of its first complete
fiscal year.
g) No public funds shall be expended for the maintenance of
any resident in any facility which has failed to file this financial statement,
and no public funds shall be paid to, or on behalf of, a facility which has
failed to file the statement. (Section 3-208(b) of the Act)
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.220 INFORMATION TO BE MADE AVAILABLE TO THE PUBLIC BY THE DEPARTMENT
Section 300.220 Information
to Be Made Available to the Public By the Department
a) The Department shall respect the confidentiality of a
resident's record and shall not divulge or disclose the contents of a record in
a manner which identifies a resident, except upon a resident's death to a
relative or guardian, or under judicial proceedings. Section 2-206 of the
Act shall not be construed to limit the right of a resident or a resident's
representative to inspect or copy the resident's records. (Section
2-206(a) of the Act)
b) Confidential medical, social, personal or financial information
identifying a resident shall not be available for public inspection in a manner
which identifies a resident. (Section 2-206(b) of the Act)
c) The following information is subject to disclosure to the
public from the Department or the Department of Healthcare and Family Services:
1) Information submitted under Sections 3-103 and 3-207 of
the Act, except information concerning the remuneration of personnel
licensed, registered, or certified by the Department of Financial and Professional
Regulation and monthly charges for an individual private resident;
2) Records of license and certification inspections, surveys,
and evaluations of facilities, other reports of inspections, surveys, and
evaluations of resident care, whether a facility has been designated a
distressed facility, and the basis for the designation, and reports concerning
a facility prepared pursuant to Titles XVIII and XIX of the Social Security Act,
subject to the provisions of the Social Security Act;
3) Cost and reimbursement reports submitted by a facility
under Section 3-208 of the Act, reports of audits of facilities, and
other public records concerning the cost incurred by, revenues received by, and
reimbursement of facilities; and
4) Complaints filed against a facility and complaint
investigation reports, except that a complaint or complaint investigation
report shall not be disclosed to a person other than the complainant or
complainant's representative before it is disclosed to a facility under Section
3-702 of the Act, and, further, except that a complainant or resident's
name shall not be disclosed except under Section 3-702 of the Act.
(Section 2-205 of the Act)
d) The Department shall disclose information under this
Section in accordance with provisions for inspection and copying of public
records required by the Freedom of Information Act. (Section 2-205 of the
Act)
e) However, the disclosure of information described in
subsection (c)(1) shall not be restricted by any provision of the
Freedom of Information Act. (Section 2-205 of the Act)
f) Copies of reports available to the public may be obtained by
making a written request to the Department in accordance with the Department's rules
titled Access to Records of the Department of Public Health (2 Ill. Adm. Code
1127). The Department may, at its discretion, waive reproduction fees if the
party requesting the material is involved in legal action with the Department.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.230 INFORMATION TO BE MADE AVAILABLE TO THE PUBLIC BY THE LICENSEE
Section 300.230 Information to Be Made Available to the
Public by the Licensee
a) Every
facility shall conspicuously post for display in an area of its offices
accessible to residents, employees, and visitors the following:
1) Its
current license;
2) A
description, provided by the Department of complaint procedures established
under the Act and the name, address, and telephone number of a person
authorized by the Department to receive complaints;
3) A
copy of any order pertaining to the facility issued by the Department or a
court;
4) A
list of the material available for public inspection under subsection (b) and
Section 3-210 of the Act;
5) Phone
numbers and websites for rights protection services must be posted in common
areas and at the main entrance and provided upon entry and at the request of
resident's representatives; and
6) The
statement "The Illinois Long-Term Care Ombudsman Program is a free
resident advocacy service available to the public."
b) The
administrator shall post for all residents and at the main entrance the name,
address, and telephone number of the appropriate State governmental office where
complaints may be lodged in language the resident can understand, which must
include notice of the grievance procedure of the facility or program as well as
addresses and phone numbers for the Office of Health Care Regulation and the
Long-Term Care Ombudsman Program and website showing the information of a
facility's ownership. The facility shall include a link to the Long-Term Care
Ombudsman Program's website on the home page of the facility's website. (Section
3-209(a) of the Act) If a facility does not have a facility-specific website,
the link to the Long-Term Care Ombudsman Program's website shall be included on
the facility's parent company website.
c) A facility shall
retain the following for public inspection:
1) A
complete copy of every inspection report of the facility received from the
Department during the past five years;
2) A
copy of every order pertaining to the facility issued by the Department or a
court during the past five years;
3) A
description of the services provided by the facility and the rates charged for
those services and items for which a resident may be separately charged;
4) A
copy of the statement of ownership required by Section 3-207 of the Act;
5) A
record of personnel employed or retained by the facility who are licensed,
certified or registered by the Department of Financial and Professional
Regulation;
6) A
complete copy of the most recent inspection report of the facility received
from the Department; and
7) A
copy of the current Consumer Choice Information Report required by Section
2-214 of the Act. (Section 3-210 of the Act)
d) A
facility that has received a notice of violation for a violation of the minimum
staffing requirements under Section 3-202.05 of the Act and Section
300.1230 of this Part shall display, during the period of time the facility is
out of compliance, a notice stating in Calibri (body) font and 26-point type in
black letters on an 8.5 by 11 inch white paper the following:
"Notice Dated:
...................
This facility does not
currently meet the minimum staffing ratios required by law. Posted at the
direction of the Illinois Department of Public Health."
1) The
notice shall be posted, at a minimum, at all publicly used exterior entryways
into the facility, inside the main entrance lobby, and next to any registration
desk for easily accessible viewing. The notice shall also be posted on the main
page of the facility's website.
2) Pursuant
to Section 300.1234(a)(5), the Department shall have the discretion to
determine the gravity of any violation and, taking into account mitigating and
aggravating circumstances and facts, may reduce the requirement of, and amount
of time for, posting the notice. (Section 3-209 of the Act)
e) All
Cook County facilities with Colbert Class Members shall conspicuously display,
in a public and accessible location, a Department-provided poster informing
residents of their right to explore or decline community transition, and their
right to be free from retaliation, regardless of their decision on transition.
This poster shall include a telephone number for reporting retaliation to the
Department and shall include the steps a resident should take if retaliation
does occur. The display of the poster will be included as a compliance measure
in the Department's survey process.
(Source: Amended at 49 Ill. Reg. 760,
effective December 31, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.240 MUNICIPAL LICENSING
Section 300.240 Municipal
Licensing
a) Municipalities which have adopted a licensing ordinance as
provided under Section 3-104 of the Act and this Part shall adopt this Part by
complying with Article I, Division 3, of the Illinois Municipal Code (Ill. Rev.
Stat. 1987, ch. 24, pars. 1-3-1 et seq.).
b) Municipalities shall issue licenses so that the expiration
dates are distributed throughout the calendar year. The month the license
expires shall coincide with the date of original licensure of the licensee.
During the 24 month period following the effective date of the Act, the
municipality may issue renewal licenses for a period of less than one year in
order to distribute the expiration date of such licenses throughout the
calendar year.
c) The municipality shall notify the Department within ten days
from the date of issuance or denial of a license that the municipal license has
been issued or denied. If the license is issued, the notice will include the
facility name, address, the date of issuance, and the number of beds by level
of care for which the license was issued. If the license is denied, the notice
will indicate reason for denial and the current status of licensee's
(applicant's) application for municipal license.
d) The municipality shall use the same licensing
classifications as the Department; and a facility may not be licensed for a
different classification by the Department than by the municipality.
e) The Department and the municipality shall have the right at
any time to visit and inspect the premises and personnel of any facility for
the purpose of determining whether the applicant or licensee is in compliance
with the Act, this Part or with the local ordinances which govern the
regulation of the facility. The Department may survey any former facility
which once held a license to insure that the facility is not again operating
without a license. Municipalities may charge a reasonable license or renewal
fee for the regulation of facilities, which fees shall be in addition to the
fees paid to the Department.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.250 OWNERSHIP DISCLOSURE
Section 300.250 Ownership
Disclosure
a) As a condition of the issuance or renewal of the license of
any facility, the applicant shall file a statement of ownership. The applicant
shall update the information required in the statement of
ownership within 10 days after any change. (Section 3-207(a) of the
Act)
b) The statement of ownership shall include the following:
1) The name, address, telephone number, occupation or business
activity, business address and business telephone number of the person who is
the owner of the facility, and every person who owns the building in which the
facility is located, if other than the owner of the facility, that is
the subject of the application or license;
2) If the owner is a partnership or corporation, the name of
every partner and stockholder of the owner (Section 3-207(b) of the Act);
3) The percent of direct or indirect financial interest of those
persons who have a direct or indirect financial interest of five percent or
more in the legal entity designated as the operator/licensee of the facility that
is the subject of the application or license;
4) The name, address, telephone number, occupation or business
activity, business address, business telephone number, and the percent of
direct or indirect financial interest of those persons who have a direct or
indirect financial interest of five percent or more in the legal entity that
owns the building in which the operator/licensee is operating the facility that
is the subject of the application or license; and
5) The name and address of any facility, wherever located, any
financial interest that is owned by the applicant, if the facility were
required to be licensed if it were located in this State. (Section
3-207(b) of the Act)
(Source: Amended at 41 Ill. Reg. 14811, effective November 15, 2017)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.260 ISSUANCE OF CONDITIONAL LICENSES
Section 300.260 Issuance of
Conditional Licenses
a) The Director may issue a conditional license under
Section 3-305 of the Act to any facility if the Director finds that
either a Type "A" or Type "B" violation exists in such
facility. The issuance of a conditional license shall revoke any license held
by the facility. (Section 3-311 of the Act)
b) Prior to the issuance of a conditional license, the
Department shall review and approve a written plan of correction. The
Department shall specify the violations which prevent full licensure and shall
establish a time schedule for correction of the deficiencies. Retention of the
license shall be conditional on the timely correction
of the deficiencies in accordance with the plan of correction. (Section
3-312 of the Act)
c) Written notice of the decision to issue a conditional
license shall be sent to the applicant or licensee together with the
specification of all violations of the Act and this Part which prevent
full licensure and which form the basis for the Department's decision to issue
a conditional license and the required plan of correction. The notice shall
inform the applicant or licensee of its right to a full hearing under Section
3-315 of the Act to contest the issuance of the conditional license.
(Section 3-313 of the Act)
d) If the applicant or licensee desires to contest the
basis for issuance of a conditional license, or the terms of the plan of
correction, the applicant or licensee shall send a written request for hearing to
the Department within ten (10) days after receipt by the applicant or
licensee of the Department's notice and decision to issue a conditional
license. The Department shall hold the hearing as provided under Section
3-703 of the Act. The terms of the conditional license shall be stayed
pending the issuance of the Final Order at the conclusion of the hearing, and
the facility may operate in the same manner as with an unrestricted license.
(Section 3-315 of the Act)
e) A conditional license shall be issued for a period
specified by the Department, but in no event for more than one year. The
effective date of the conditional license shall not begin until such time as
the applicant or licensee has had the opportunity to request a hearing pursuant
to subsection (d) of this Section, and if a hearing is requested in a timely
manner, then the terms of the conditional license shall be stayed as provided
for in subsection (d) of this Section. The Department shall periodically
inspect any facility operating under a conditional license. If the Department
finds substantial failure by the facility to timely correct the
violations which prevented full licensure and formed the basis for the
Department's decision to issue a conditional license in accordance with the required
plan of correction, the conditional license may be revoked as provided under
Section 3-119 of the Act. (Section 3-316 of the Act)
(Source: Amended at 17 Ill. Reg. 15106, effective September 3, 1993)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.270 MONITOR AND RECEIVERSHIP
Section 300.270 Monitor and
Receivership
a) The Department may place an employee or agent to serve as a
monitor in a facility when any of the following conditions exist:
1) The facility is operating without a license;
2) The Department has suspended, revoked or refused to renew
the existing license of the facility;
3) The facility is closing or has informed the Department that
it intends to close and adequate arrangements for relocation of residents have
not been made at least 30 days prior to closure;
4) The Department determines that an emergency exists, whether
or not it has initiated revocation or nonrenewal procedures, if because of the
unwillingness or inability of the licensee to remedy the emergency the
Department believes a monitor is necessary; as used in this subsection, "emergency"
means a threat to the health, safety or welfare of a resident that the facility
is unwilling or unable to correct; or
5) The Department receives notification that the facility is
terminated or will not be renewed for participation in the federal
reimbursement program under either Title XVIII (Medicare) or Title XIX
(Medicaid) of the Social Security Act. (Section 3-501 of the Act)
b) The monitor shall meet the following minimum requirements:
1) be in good physical health as evidenced by a physical
examination by a physician within the last year;
2) have an understanding of the needs of long-term care facility
residents as evidenced by one year of experience in working, as appropriate,
with elderly or developmentally disabled individuals in programs such as
patient care, social work, or advocacy;
3) have an understanding of the Act and this Part which are the
subject of the monitors' duties as evidenced in a personal interview of the
candidate;
4) not be related to the owners of the involved facility either
through blood, marriage or common ownership of real or personal property except
ownership of stock that is traded on a stock exchange;
5) have successfully completed a baccalaureate degree or possess
a nursing license or a nursing home administrator's license; and
6) have two years full-time work experience in the long-term care
industry of the State of Illinois.
c) The monitor shall be under the supervision of the Department;
shall perform the duties of a monitor delineated in Section 3-502 of the Act;
and shall accomplish the following actions:
1) visit the facility as directed by the Department;
2) review all records pertinent to the condition for such
monitor's placement under subsection (a) of this Section;
3) provide to the Department written and oral reports detailing
the observed conditions of the facility; and
4) be available as a witness for hearings involving the condition
for placement as monitor.
d) All communications, including but not limited to data,
memoranda, correspondence, records and reports shall be transmitted to and
become the property of the Department. In addition, findings and results of
the monitor's work done under this Part shall be strictly confidential and not
subject to disclosure without written authorization from the Department or by
court order subject to disclosure only in accordance with the provisions of the
Freedom of Information Act, subject to the confidentiality requirements of the
Act.
e) The assignment as monitor may be terminated at any time by the
Department.
f) Through consultation with the long-term care industry
associations, professional organizations, consumer groups and health-care
management corporations, the Department shall maintain a list of receivers.
Preference on the list shall be given to individuals possessing a valid Illinois
Nursing Home Administrator's License, experience in financial and operations
management of a long-term care facility and individuals with access to
consultative experts with the aforementioned experience. To be placed on the
list, individuals must meet the following minimum requirements:
1) be in good physical health as evidenced by a physical
examination by a physician within the last year;
2) have an understanding of the needs of long-term care facility
residents and the delivery of the highest possible quality of care as evidenced
by one year of experience in working with elderly or developmentally disabled
individuals in programs such as patient care, social work, or advocacy;
3) have an understanding and working knowledge of the Act and
this Part, as evidenced in a personal interview of the candidate;
4) have successfully completed a baccalaureate degree or possess
a nursing license or a nursing home administrator's license; and
5) have two years full-time working experience in the Illinois
long-term care industry.
g) Upon appointment of a receiver for a facility by a court, the
Department shall inform the individual of all legal proceedings to date which
concern the facility.
h) The receiver may request that the Director of the Department
authorize expenditures from monies appropriated, pursuant to Section 3-511 of
the Act, if incoming payments from the operation of the facility are less than
the costs incurred by the receiver.
i) In the case of Department ordered patient transfers, the
receiver may:
1) assist in providing for the orderly transfer of all residents
in the facility to other suitable facilities or make other provisions for their
continued health;
2) assist in providing for transportation of the resident, his
medical records and his belongings if he is transferred or discharged; assist
in locating alternative placement; assist in preparing the resident for
transfer; and permit the resident's legal guardian to participate in the
selection of the resident's new location;
3) unless emergency transfer is necessary, explain alternative
placements to the resident and provide orientation to the place chosen by the
resident or resident's guardian.
j) In any action or special proceeding brought against a
receiver in the receiver's official capacity for acts committed while carrying
out the aforesaid powers and duties, the receiver shall be considered a
public employee under the Local Governmental and Governmental Employees Tort
Immunity Act [745 ILCS 10]. A receiver may be held liable in a personal
capacity only for the receiver's own gross negligence, intentional acts or
breach of fiduciary duty. (Section 3-513 of the Act)
(Source: Amended at 19 Ill. Reg. 11600, effective July 29, 1995)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.271 PRESENTATION OF FINDINGS
Section 300.271 Presentation
of Findings
a) If it is probable that findings will be presented that could
be issued as violations of regulations which represent a direct threat to the
health, safety or welfare of residents, surveyors shall notify the
administrator or designee during the course of the survey of such possible
findings.
b) The Department shall conduct an exit conference with the
administrator or other facility designee at the conclusion of each on-site
inspection at the facility, whether or not the investigation has been
completed. If the investigation has been completed, findings shall be
presented during the exit conference. If the investigation has not been
completed at the time of the facility exit, the Department shall inform the
facility administrator or designee that the investigation is not complete and
that findings may be presented to the facility at a later date. Presentation
of any additional findings may be conducted at the facility, at the
Department's regional office, or by telephone.
c) With the assistance of the administrator, surveyors shall
schedule a time and place for the exit conference to be held at the conclusion
of the survey.
d) At the exit conference, surveyors shall present their findings
and resident identity key and identify regulations related to the findings.
The facility administrator or designee shall have an opportunity at the exit
conference to discuss and provide additional documentation related to the
findings. The Department's surveyors conducting the exit conference may, in
their discretion, modify or eliminate any or all preliminary findings in
accordance with any facts presented by the facility to the Department during
the exit conference.
e) Additional comments or documentation may be submitted by the
facility to the Department during a 10-day comment period as allowed by the
Act.
f) If the Department determines, after review of the comments
submitted pursuant to subsection (d) of this Section, that the facility may
have committed violations of the Act or this Part different than or in addition
to those presented at the exit conference and the violations may be cited as
either Type A or repeat Type B violations, the Department shall so inform the
facility in writing. The facility shall then have an opportunity to submit
additional comments addressing the different or additional Sections of the Act
or this Part. The surveyors will be advised of any code changes made after
their recommendations are submitted.
g) The facility shall have 5 (five) working days from receipt of
the notice required by subsection (f) of this Section to submit its additional
comments to the Department. The Department shall consider such additional
comments in determining the existence and level of violation of the Act and/or
this Part in the same manner as the Department considers the facility's
original comments.
h) If desired by the facility, an audio-taped recording may be
made of the exit conference provided that a copy of such recording is provided,
at facility expense, to the surveyors at the conclusion of the exit conference.
No video-taped recording shall be allowed.
i) Surveyors shall not conduct an exit conference for the
following reason:
1) The facility administrator or designee requests that an exit
conference not be held;
2) During a scheduled exit conference, facility staff and/or
their guests create an environment that is not conducive to a meaningful
exchange of information.
(Source: Added at 17 Ill. Reg. 15106, effective September 3, 1993)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.272 DETERMINATION TO ISSUE A NOTICE OF VIOLATION OR ADMINISTRATIVE WARNING
Section 300.272
Determination to Issue a Notice of Violation or Administrative Warning
a) Upon receipt of a report of an inspection, survey or
evaluation of a facility, the Director or his or her designee will review the
findings contained in the report to determine whether the report's
findings constitute a violation or violations of which the facility must be
given notice. All information, evidence, and observations made during an
inspection, survey, or evaluation will be considered findings or deficiencies.
(Section 3-212(c) of the Act)
b) In making this determination, the Director or his or her designee
will consider any comments and documentation provided by the licensee within
10 days after receipt of the copy of the report in accordance
with Section 300.200(c). (Section 3-212(c) of the Act)
c) In determining whether the findings warrant the issuance of a
notice of violation, the Director or his or her designee will base his or her determination
on the following factors:
1) The severity of the finding. The Director or his or
her designee will consider whether the finding constitutes a technical
non-substantial error or whether the finding is serious enough to constitute an
actual violation of the intent and purpose of the Act or this Part.
2) The danger posed to resident health and safety. The
Director or his or her designee will consider whether the finding could pose
any direct harm to the residents.
3) The diligence and efforts to correct deficiencies and
correction of reported deficiencies by the facility. The Director or his
or her designee will consider comments and documentation provided by the
facility evidencing that steps have been taken to correct reported findings
and to insure a reduction of deficiencies.
4) The frequency and duration of similar findings in previous
reports and the facility's general inspection history. The Director or his
or her designee will consider whether the same finding or a similar finding
relating to the same condition or occurrence has been included in previous
reports and the facility has allowed the condition or occurrence to continue or
to recur. (Section 3-212(c) of the Act)
d) If the Director or his or her designee determines that the
report's findings constitute a violation or violations that do not directly
threaten the health, safety, or welfare of a resident or residents, the Department
shall issue an administrative warning as provided in Section 300.277
(Section 3-303.2(a) of the Act)
e) Violations shall be determined under this Section no
later than 75 days after completion of each inspection, survey, and evaluation.
(Section 3-212(c) of the Act)
(Source: Amended at 43 Ill. Reg. 3536, effective February 28, 2019)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.274 DETERMINATION OF THE LEVEL OF A VIOLATION
Section 300.274
Determination of the Level of a Violation
a) After determining that issuance of a notice of violation is
warranted and prior to issuance of the notice, the Director or his or her designee
will review the findings that are the basis of the violation, and any comments
and documentation provided by the facility, to determine the level of the
violation. Each violation shall be determined to be either a level AA, a level
A, a level B, or a level C violation based on the criteria in this Section.
b) The following definitions of levels of violations shall be
used in determining the level of each violation:
1) A "level
AA violation" or a "Type AA violation" is a violation of
the Act or this Part which creates a condition or occurrence relating
to the operation and maintenance of a facility that proximately caused a
resident's death. (Section 1-128.5 of the Act)
2) A "level A violation" or "Type A
violation" is a violation of the Act or this Part which
creates a condition or occurrence relating to the operation and maintenance of
a facility that creates a substantial probability that the risk of death or
serious mental or physical harm will result therefrom or has resulted in actual
physical or mental harm to a resident. (Section 1-129 of the Act)
3) A "level B violation" or "Type B
violation" is a violation of the Act or this Part which
creates a condition or occurrence relating to the operation and maintenance of
a facility that is more likely than not to cause more than minimal physical or
mental harm to a resident. (Section 1-130 of the Act)
4) A "level
C violation" or "Type C violation" is a violation of the Act
or this Part which creates a condition or occurrence relating to the
operation and maintenance of a facility that creates a substantial probability
that less than minimal physical or mental harm to a resident will result
therefrom. (Section 1-132 of the Act)
c) In determining the level of a violation, the Director or his or
her designee shall consider the following criteria:
1) The degree of danger to the resident or residents that is
posed by the condition or occurrence in the facility. The following factors
will be considered in assessing the degree of danger:
A) Whether the resident or residents of the facility are able to
recognize conditions or occurrences that may be harmful and are able to take
measures for self-preservation and self-protection. The extent of nursing care
required by the residents as indicated by review of patient needs will be
considered in relation to this determination.
B) Whether the resident or residents have access to the area of
the facility in which the condition or occurrence exists and the extent of such
access. A facility's use of barriers, warning notices, instructions to staff
and other means of restricting resident access to hazardous areas will be
considered.
C) Whether the condition or occurrence was the result of
inherently hazardous activities or negligence by the facility.
D) Whether the resident or residents of the facility were notified
of the condition or occurrence and the promptness of such notice. Failure of
the facility to notify residents of potentially harmful conditions or
occurrences will be considered. The adequacy of the method of such
notification and the extent to which such notification reduced the potential
danger to the residents will also be considered.
2) The directness and imminence of the danger to the resident or
residents by the condition or occurrence in the facility. In assessing the
directness and imminence of the danger, the following factors will be
considered:
A) Whether actual harm, including death, physical injury or
illness, mental injury or illness, distress, or pain, to a resident or
residents resulted from the condition or occurrence and the extent of such
harm.
B) Whether available statistics and records from similar
facilities indicate that direct and imminent danger to the resident or
residents has resulted from similar conditions or occurrences and the frequency
of such danger.
C) Whether professional opinions and findings indicate that direct
and imminent danger to the resident or residents will result from the condition
or occurrence.
D) Whether the condition or occurrence was limited to a specific
area of the facility or was widespread throughout the facility. Efforts taken
by the facility to limit or reduce the scope of the area affected by the
condition or occurrence will be considered.
E) Whether the physical, mental, or emotional state of the
resident or residents, who are subject to the danger, would facilitate or
hinder harm actually resulting from the condition or occurrence.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.276 NOTICE OF VIOLATION
Section 300.276 Notice of
Violation
a) Each notice of violation shall be in writing and shall
contain the following information:
1) A description of the nature of the violation.
2) A citation of the specific statutory provision or rule alleged
by the Department to have been violated. (Section 3-301 of the Act)
3) A statement of the level of the violation as determined
pursuant to Section 300.274.
4) One of the following requirements for corrective action:
A) The situation, condition or practice constituting a Type
"AA" violation or a Type "A" violation shall be abated or
eliminated immediately unless a fixed period of time, not exceeding 15 days, as
determined by the Department and specified in the notice of violation, is
required for correction. In setting this period, the Department will
consider whether harm to residents of the facility is imminent, whether
necessary precautions can be taken to protect residents before the corrective
action is completed, and whether delay would pose additional risks to the
residents.
B) At the time of issuance of a notice of a Type "B"
violation, the Department shall request a plan of correction which is subject
to the Department's approval. The facility shall have 10 days after receipt of
notice of violation in which to prepare and submit a plan of correction. (Section
3-303 of the Act)
5) A statement that the Department may take additional action
under the Act, including assessment of penalties or licensure action.
6) A description of the licensee's right to appeal the notice and
its right to a hearing.
b) For each notice of violation, the Director or his designee
shall serve a notice of violation upon the licensee within 10 days after
the Director determines that issuance of a notice of violation is warranted
under Section 300.272. (Section 3-301 of the Act)
(Source: Amended at 46 Ill. Reg. 14237, effective July 27, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.277 ADMINISTRATIVE WARNING
Section 300.277
Administrative Warning
a) If
the Department finds a situation, condition, or practice which violates the
Act or this Part that does not constitute a Type "AA", Type "A",
Type "B", or Type "C" violation, the Department shall issue
an administrative warning. (Section 3-303.2(a) of the Act)
b) Each administrative warning shall be in writing and shall
include the following information:
1) A description of the nature of the violation.
2) A citation of the specific statutory provision or rule that
the Department alleges has been violated.
3) A statement that the facility shall be responsible for
correcting the situation, condition, or practice. (Section 3-303.2(a) of
the Act)
c) Each administrative warning shall be sent to the facility and
the licensee or served personally at the facility within 10 days after the
Director or his or her designee determines that issuance of an administrative
warning is warranted under Section 300.272.
d) The facility is not required to submit a plan of correction in
response to an administrative warning.
e) If the Department finds, during the next on-site inspection
which occurs no earlier than 90 days from the issuance of the administrative
warning, that the facility has not corrected the situation, condition,
or practice which resulted in the issuance of the administrative warning,
the Department shall notify the facility of the finding. The facility shall
then submit a written plan of correction as provided in Section
300.278. The Department will consider the plan of correction and take any
necessary action in accordance with Section 302.278. (Section 3-303.2(b) of
the Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.278 PLANS OF CORRECTION
Section 300.278 Plans of
Correction
a) The
situation, condition, or practice constituting a Type "AA" violation
or a Type "A" violation shall be abated or eliminated immediately
unless a fixed period of time, not exceeding 15 days, as determined by the
Department and specified in the notice of violation, is required for
correction. (Section 3-303(a) of the Act)
b) The facility shall have 10 days after receipt of notice
of violation for a Type B violation, or after receipt of a notice under
Section 300.277(d) of failure to correct a situation, condition, or practice that
resulted in the issuance of an administrative warning, to prepare and submit
a plan of correction to the Department. (Section 3-303(b) of the Act)
c) Within the 10-day period, a facility may request additional
time for submission of the plan of correction. The Department will extend the
period for submission of the plan of correction for an additional 30 days, when
it finds that corrective action by a facility to abate or eliminate the
violation will require substantial capital improvement. The Department
will consider the extent and complexity of necessary physical plant repairs and
improvements and any impact on the health, safety, or welfare of the residents
of the facility in determining whether to grant a requested extension.
(Section 3-303(b) of the Act)
d) No
person shall intentionally fail to correct or interfere with the correction of
a Type "AA", Type "A", or Type "B" violation
within the time specified on the notice or approved plan of correction under the
Act as the maximum period given for correction, unless an extension is granted
pursuant to subsection (c) and the corrections are made before expiration of
extension. A violation of this subsection is a business offense,
punishable by a fine not to exceed $10,000, except as otherwise provided in
subsection (2) of Section 3-103 of the Act and Section 300.120(e)
as to submission of false or misleading information in a license application.
(Section 3-318 (a)(1) and (b) of the Act)
e) Each plan of correction shall be based on an assessment by the
facility of the conditions or occurrences that are the basis of the violation
and an evaluation of the practices, policies, and procedures that have caused
or contributed to the conditions or occurrences. Evidence of the assessment and
evaluation shall be maintained by the facility. Each plan of correction shall
include:
1) A description of the specific corrective action the facility
is taking, or plans to take, to abate, eliminate, or correct the violation
cited in the notice.
2) A description of the steps that will be taken to avoid future
occurrences of the same and similar violations.
3) A specific date by which the corrective action will be
completed.
f) Submission of a plan of correction will not be considered an
admission by the facility that the violation has occurred.
g) The Department will review each plan of correction to ensure
that it provides for the abatement, elimination, or correction of the
violation. The Department will reject a submitted plan only if it finds any of
the following deficiencies:
1) The plan does not appear to address the conditions or
occurrences that are the basis of the violation and an evaluation of the
practices, policies, and procedures that have caused or contributed to the
conditions or occurrences.
2) The plan is not specific enough to indicate the actual actions
the facility will be taking to abate, eliminate, or correct the violation.
3) The plan does not provide for measures that will abate,
eliminate, or correct the violation.
4) The plan does not provide steps that will avoid future
occurrences of the same and similar violations.
5) The plan does not provide for timely completion of the
corrective action, considering the seriousness of the violation, any possible
harm to the residents, and the extent and complexity of the corrective action.
h) When the Department rejects a submitted plan of correction, it
will notify the facility. The notice of rejection shall be in writing and
shall specify the reason for the rejection. The facility shall have 10 days
after receipt of the notice of rejection in which to submit a
modified plan. (Section 3-303(b) of the Act)
i) If a facility fails to submit a plan or modified plan meeting
the criteria in subsection (e) within the prescribed time periods in subsection
(b) or (c), or anytime the Department issues a Type "AA," a Type "A"
or repeat Type "B" violation, the Department will impose an approved
plan of correction.
j) The Department will verify the completion of the corrective
action required by the plan of correction within the specified time period
during subsequent investigations, surveys and evaluations of the facility.
(Source: Amended at 46 Ill.
Reg. 14237, effective July 27, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.280 REPORTS OF CORRECTION
Section 300.280 Reports of
Correction
a) In lieu of submission of a plan of correction, a facility may
submit a report of correction if the corrective action has been completed. The
report of correction must be submitted within the time periods required in
Section 300.278 for submission of a plan of correction.
b) Each report of correction shall be based on an assessment by
the facility of the conditions or occurrences which are the basis of the
violation and an evaluation of the practices, policies, and procedures which
have caused or contributed to the conditions or occurrences. Evidence of such
assessment and evaluation shall be maintained by the facility. Each report of
correction shall include:
1) A description of the specific corrective action the facility
has taken to abate, eliminate, or correct the violation cited in the notice.
2) A description of the steps which have been taken to avoid
future occurrences of the same and similar violations.
3) The specific date on which the corrective action was
completed.
4) A signed statement by the administrator of the facility that
the report of correction is true and accurate, which shall be considered an
oath for the purposes of any legal proceedings.
c) Submission of a report of correction shall not be considered
an admission by the facility that the violation has occurred.
d) The Department shall review and approve or disapprove the
report of correction based on the criteria outlined in Section 300.278(d) for
review of plans of correction. If a report of correction is disapproved, the
facility shall be subject to a plan of correction imposed by the Department as
provided in Section 300.278.
e) The Department shall verify the completion of the corrective
action outlined in the report of correction during subsequent investigations, surveys
and evaluations of the facility.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.282 CONDITIONS FOR ASSESSMENT OF PENALTIES
Section 300.282 Conditions
for Assessment of Penalties
The Department will consider the
assessment of a monetary penalty against a facility under the following
conditions:
a) A
licensee who commits a Type "AA" violation as defined in Section
1-128.5 of the Act is automatically issued a conditional license for a
period of 6 months to coincide with an acceptable plan of correction and
assessed a fine up to $25,000 per violation. (Section 3-305(1) of the Act)
b) A
licensee who commits a Type "A" violation as defined in Section 1-129
of the Act is automatically issued a conditional license for a period of 6
months to coincide with an acceptable plan of correction and assessed a fine of
up to $12,500 per violation. (Section 3-305(1.5) of the Act)
c) A
licensee who commits a Type "AA" or Type "A" violation as
defined in Section 1-128.5 or 1-129 of the Act which continues beyond
the time specified in Section 3-303(a) of the Act, which is cited as a
repeat violation, shall have its license revoked and shall be assessed a fine
of 3 times the fine computed per resident per day under subsection (a) or
(b) of this Section. (Section 3-305(3) of the Act)
d) A
licensee who commits a Type "B" violation as defined in Section 1-130
of the Act shall be assessed a fine of up to $1,100 per violation.
(Section 3-305(2) of the Act)
e) A
licensee who fails to satisfactorily comply with an accepted plan of correction
for a Type "B" violation or an administrative warning issued
pursuant to Sections 3-401 through 3-413 of the Act or pursuant to this
Part shall be automatically issued a conditional license for a period of not
less than 6 months. A second or subsequent acceptable plan of correction shall
be filed. A fine shall be assessed in accordance with subsection (d) of
this Section when cited for the repeat violation. This fine shall be
computed for all days of the violation, including the duration of the first
plan of correction compliance time. (Section 3-305(4) of the Act
f) A
licensee who commits 10 or more Type "C" violations, as defined in
Section 1-132 of the Act, in a single survey shall be assessed a fine of
up to $250 per violation. A licensee who commits one or more Type "C"
violations with a high risk designation shall be assessed a fine of up to $500
per violation. (Section 3-305(2.5) of the Act)
g) If
an occurrence results in more than one type of violation as defined in the Act
(that is, a Type "AA", Type "A", Type "B", or
Type "C" violation), the maximum fine that may be assessed for that
occurrence is the maximum fine that may be assessed for the most serious type
of violation charged. For purposes of the preceding sentence, a Type "AA"
violation is the most serious type of violation that may be charged, followed
by a Type "A", Type "B", or Type "C" violation,
in that order. (Section 3-305(7.5) of the Act)
h) The
minimum and maximum fines that may be assessed pursuant to Section 3-305 of
the Act and this Section 300.282 shall be twice those otherwise
specified for any facility that willfully makes a misstatement of fact to the
Department, or willfully fails to make a required notification to the
Department, if that misstatement or failure delays the start of a surveyor or
impedes a survey. (Section 3-305(8) of the Act)
i) High
risk designation. If the Department finds that a facility has violated a
provision of this Part that has a high risk designation, or that a
facility has violated the same provision of this Part 3 or more times in
the previous 12 months, the Department may assess a fine of up to 2 times the
maximum fine otherwise allowed. (Section 3-305(9) of the Act)
j) For
the purposes of calculating certain penalties pursuant to this Section,
violations of the following requirements shall have the status of "high
risk designation".
1) Section
300.615(b)
2) Section
300.615(e)
3) Section
300.615(f)
4) Section
300.615(g)
5) Section
300.625(a)
6) Section
300.625(b)
7) Section
300.625(c)
8) Section
300.625(f)
9) Section
300.625(j)
10) Section
300.625(k)
11) Section
300.625(l)
12) Section
300.625(n)
13) Section
300.625(o)
14) Section
300.627(c)
15) Section
300.627(d)
16) Section
300.627(e)
17) Section
300.661
18) Section
300.680
19) Section
300.686
20) Section
300.690
21) Section
300.695(b)
22) Section
300.696
23) Section
300.1210(b)
24) Section
300.1210(d)(5)
25) Section
300.1210(d)(6)
26) Section
300.1230
27) Section
300.1240
28) Section
300.2900(d)(2)
29) Section
300.3100(d)(2)
30) Section
300.3240(a)
31) Section
300.3240(d)
32) Section
300.3240(e)
k) If
a licensee has paid a civil monetary penalty imposed pursuant to the Medicare
and Medicaid Certification Program for the equivalent federal violation giving
rise to a fine under Section 3-305 of the Act and this Section 300.282,
or provides the Department with a copy of a letter to the Centers for
Medicare and Medicaid Services (CMMS) of its binding intent to waive its right
to a federal hearing to contest a civil monetary penalty for the equivalent
federal violation, the Department shall offset the fine by the amount of the
civil monetary penalty. The offset may not reduce the fine by more than 75% of
the original fine, however. (Section 3-305(10) of the Act) The
meaning of "equivalent federal violation" shall be determined by the
Department. Upon request by the Department, the facility shall provide proof to
the Department of the federal civil monetary penalty when the payment is due.
l) When
the Department finds that a provision of Article II has been violated with
regard to a particular resident, the Department shall issue an order requiring
the facility to reimburse the resident for injuries incurred, or $100,
whichever is greater. In the case of a violation involving any action other
than theft of money belonging to a resident, reimbursement shall be ordered
only if a provision of Article II has been violated with regard to that or any
other resident of the facility within the 2 years immediately preceding the
violation in question. (Section 3-305(6) of the Act)
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.284 CALCULATION OF PENALTIES (REPEALED)
Section 300.284 Calculation
of Penalties (Repealed)
(Source: Repealed at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.286 NOTICE OF PENALTY ASSESSMENT; RESPONSE BY FACILITY
Section 300.286 Notice
of Penalty Assessment; Response by Facility
a) If the Director or his or her designee determines that a
penalty is to be assessed, a written notice of penalty assessment shall be sent
to the facility. Each notice of penalty assessment shall include:
1) The amount of the penalty assessed as provided in
Section 300.282.
2) The amount of any reduction or whether the penalty has been
waived pursuant to Section 300.288.
3) A description of the violation, including a reference
to the notices of violation and plans of correction that are the basis of the
assessment.
4) A citation to the provision of the statute or rule that
the facility has violated.
5) A description of the right of the facility to appeal the
assessment and of the right to a hearing under Section 3-703
of the Act. (Section 3-307 of the Act)
b) A
facility may contest an assessment of a penalty by sending a written request to
the Department for hearing under Section 3-703 of the Act. Upon receipt
of the request the Department shall hold a hearing as provided under
Section 3-703 of the Act. Instead of requesting a hearing pursuant to
Section 3-703 of the Act, a facility may, within 10 business days after
receipt of the notice of violation and fine assessment, transmit to the
Department 65% of the amount assessed for each violation specified in
the penalty assessment. (Section 3-309 of the Act)
c) The facility shall pay penalties to the Department within the
time periods provided in Section 3-310 of the Act.
d) The submission of 65% of the amount assessed for each
violation specified in the penalty assessment pursuant to subsection (b) shall
constitute a waiver by the facility of a right to hearing pursuant to Section
3-703 of the Act.
(Source: Amended at 46 Ill.
Reg. 14237, effective July 27, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.287 CONSIDERATION OF FACTORS FOR ASSESSING PENALTIES
Section 300.287
Consideration of Factors for Assessing Penalties
At
any hearing requested by a facility that challenges the appropriateness of any
penalty imposed by the Department, the facility may present evidence as to any
or all of the following factors. The Director or his or her designee will then
consider any such evidence presented by the facility, or any evidence otherwise
available to the Department, regarding the following factors in determining
whether a penalty is to be imposed and in determining the amount of the penalty
to be imposed, if any, for a violation.
a) The
gravity of the violation, including the probability that death or serious
physical or mental harm to a resident will result or has resulted; the severity
of the actual or potential harm, and the extent to which the provisions of the
Act or this Part were violated. A penalty will be assessed when the
Director or his or her designee finds that death or serious physical or mental
harm to a resident has occurred or that the facility has knowingly subjected
residents to potential serious harm.
b) The
reasonable diligence exercised by the licensee and efforts to correct violations.
The Director or his or her designee will assess a monetary penalty if he or she
finds that the violation recurred or continued, is widespread throughout the
facility or evidences flagrant violation of the Act or this Part.
c) Any
previous violations committed by the licensee. The Director or his or her
designee will assess a penalty when he or she finds that the facility has been
cited for similar violations and has failed to correct those violations as
promptly as practicable or has failed to exercise diligence in taking necessary
corrective action. The Director or his or her designee will also consider any
evidence that the violations constitute a pattern of deliberate action by the
facility. The extent of any change in the ownership and management of the
facility will be considered in relation to the seriousness of previous
violations.
d) The
financial benefit to the facility of committing or continuing the violation.
These benefits include, but are not limited to, diversion of costs associated
with physical plant repairs, staff salaries, consultant fees or direct patient
care services. (Section 3-306 of the Act)
(Source: Added at 35 Ill. Reg. 11419,
effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.288 REDUCTION OR WAIVER OF PENALTIES
Section 300.288 Reduction or
Waiver of Penalties
a) Reductions for all types of violations subject to penalties.
1) The Director or his designee shall consider the factors
contained in Section 300.286(a) in determining whether to reduce the amount of
the penalty to be assessed from the amount calculated pursuant to Section
300.284 and in determining the amount of such reduction.
2) When the Director or his designee finds that correction of a
violation required capital improvements or repairs in the physical plant of the
facility and the facility has a history of compliance with physical plant
requirements, the penalty will be reduced by the amount of the cost of the
improvements or repairs. This reduction, however, shall not reduce the penalty
for a level A violation to an amount less than $1000.
b) Reductions and waivers for level B violations.
1) Penalties resulting from level B violations may be reduced or
waived only under one of the following conditions:
A) The facility submits a report of correction within ten days
after the notice of violation is received, and the report is subsequently
verified by the Department.
B) The facility submits a plan of correction within ten days
after the notice of violation is received, the plan is approved by the
Department, the facility submits a report of correction within 15 days
after submission of the plan or correction, and the report is subsequently
verified by the Department.
C) The facility submits a plan of correction within ten days
after the notice of violation is received, the plan provides for correction
within not more than 30 days after submission of the plan of correction,
and the plan is approved by the Department.
D) Correction of the violation requires substantial capital
improvements or repairs in the physical plant of the facility, the facility
submits a plan or correction involving substantial capital costs, the plan of
correction provides completion of the corrective action within 90 days
after submission of the plan, and the plan is approved by the Department.
(Section 3-308 of the Act)
2) Under these conditions, the Director or his designee shall
consider the factors outlined in Section 300.286(a) in determining whether to
reduce or waive the penalty and in setting the amount of any reduction.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.290 QUARTERLY LIST OF VIOLATORS (REPEALED)
Section 300.290 Quarterly
List of Violators (Repealed)
(Source: Repealed at 24 Ill. Reg. 17330, effective November 1, 2000)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.300 ALCOHOLISM TREATMENT PROGRAMS IN LONG-TERM CARE FACILITIES
Section 300.300 Alcoholism
Treatment Programs In Long-Term Care Facilities
a) A long-term care facility that desires to provide an
alcoholism treatment program must first receive written approval from the
Department. Such approval will be granted only if it can be shown that such
program will not interfere in any way with the residents in the other parts of
the facility.
b) Any alcoholism treatment program in a long-term care facility
must meet the program standards of the rules for Alcoholism and Substance Abuse
Treatment, Intervention and Research Programs (77 Ill. Adm. Code 2058), as
promulgated by the Illinois Department of Alcoholism and Substance Abuse under
the Illinois Alcoholism and Other Drug Dependency Act (Ill. Rev. Stat. 1987,
ch. 111½, par. 6351-1 et seq.).
c) The alcoholism treatment program must be in a completely separate
distinct part of the long-term care facility, and must include all beds in that
distinct part. It must be completely separated from the rest of the facility,
and have separate entrances.
d) Beds designated for alcoholism treatment cannot be used for
long-term care residents, nor can beds designated for long-term care residents
be used for residents undergoing treatment for alcoholism.
e) The alcoholism treatment program staff will not be utilized in
performing services in the long-term care area of the facility, nor will
long-term care program staff be utilized to provide any services in the
alcoholism treatment designated area.
f) There may be joint use of laundry, food service, housekeeping
and administrative services, provided written approval is obtained from the
Department. Such approval will be granted only if it can be shown that such
joint usage will not interfere in any way with the residents in other parts of
the facility.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.310 DEPARTMENT MAY SURVEY FACILITIES FORMERLY LICENSED
Section 300.310 Department
may Survey Facilities Formerly Licensed
The Department may survey any
former facility which once held a license to insure that the facility is not
operating without a license. (Section 3-107 of the Act)
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.315 SUPPORTED CONGREGATE LIVING ARRANGEMENT DEMONSTRATION (REPEALED)
Section 300.315 Supported
Congregate Living Arrangement Demonstration (Repealed)
(Source: Repealed at 48 Ill. Reg. 3317,
effective February 16, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.320 WAIVERS
Section 300.320 Waivers
a) Upon application by a facility, the Director may grant or
renew the waiver of the facility's compliance with a rule or standard for a
period not to exceed the duration of the current license or, in the case of an application
for license renewal, the duration of the renewal period. (Section 3-303.1
of the Act)
b) The waiver may be conditioned upon the facility taking
action prescribed by the Director as a measure equivalent to compliance.
(Section 3-303.1 of the Act)
c) In determining whether to grant or renew a waiver, the
Director shall consider:
1) the duration and basis for any current waiver with respect
to the same rule or standard;
2) the continued validity of extending the waiver on the same
basis;
3) the effect upon the health and safety of residents;
4) the quality of resident care (whether the waiver would
reduce the overall quality of the resident care below that required by the Act
or this Part);
5) the facility's history of compliance with the Act and this
Part (the existence of a consistent pattern of violation of the Act or this
Part); and
6) the facility's attempts to comply with the particular rule
or standard in question. (Section 3-303.1 of the Act)
d) The Department shall renew waivers relating to physical
plant standards issued pursuant to this Section at the time of the indicated
reviews, unless it can show why such waivers should not be extended for the
following reasons:
1) the condition of the physical plant has deteriorated or its
use substantially changed so that the basis upon which the waiver was issued is
materially different; or
2) the facility is renovated or substantially remodeled in
such a way as to permit compliance with the applicable rules and standards
without substantial increase in cost. (Section 3-303.1 of the Act)
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.330 DEFINITIONS
Section 300.330 Definitions
Abuse
− any physical or mental injury or sexual assault inflicted on a resident
other than by accidental means in a facility. (Section 1-103 of the Act)
Abuse means:
Physical abuse
refers to the infliction of injury on a resident that occurs other than by
accidental means and that requires (whether or not actually given) medical
attention.
Mental injury
arises from the following types of conduct:
Verbal abuse
refers to the use by a licensee, employee or agent of oral, written or gestured
language that includes disparaging and derogatory terms to residents or within
their hearing or seeing distance, regardless of their age, ability to
comprehend or disability.
Mental abuse
includes, but is not limited to, humiliation, harassment, threats of punishment
or deprivation, or offensive physical contact by a licensee, employee or agent.
Sexual
harassment or sexual coercion perpetrated by a licensee, employee or agent.
Sexual
assault.
Access
− the right to:
Enter any
facility;
Communicate
privately and without restriction with any resident who consents to the
communication;
Seek
consent to communicate privately and without restriction with any resident;
Inspect the
clinical and other records of a resident with the express written consent of
the resident;
Observe all
areas of the facility except the living area of any resident who protests the
observation. (Section 1-104 of the Act)
Act − as
used in this Part, the Nursing Home Care Act.
Activity
Program − a specific planned program of varied group and individual
activities geared to the individual resident's needs and available for a
reasonable number of hours each day.
Adaptive
Behavior − the effectiveness or degree with which the individual meets
the standards of personal independence and social responsibility expected of
the individual's age and cultural group.
Adaptive
Equipment − a physical or mechanical device, material or equipment
attached or adjacent to the resident's body that may restrict freedom of
movement or normal access to one's body, the purpose of which is to permit or
encourage movement, or to provide opportunities for increased functioning, or
to prevent contractures or deformities. Adaptive equipment is not a physical
restraint. No matter the purpose, adaptive equipment does not include any
device, material or method described in Section 300.680 of this Part as a
physical restraint.
Addition
− any construction attached to the original building that increases the
area or cubic content of the building.
Adequate or
Satisfactory or Sufficient − enough in either quantity or quality, as
determined by a reasonable person familiar with the professional standards of
the subject under review, to meet the needs of the residents of a facility
under the particular set of circumstances in existence at the time of review.
Administrative
Warning − a notice to a facility issued by the Department under Section
300.277 of this Part and Section 3-303.2 of the Act that indicates that a
situation, condition, or practice in the facility violates the Act or the
Department's rules, but is not a Type AA, Type A, Type B, or Type C violation.
Administrator
− a person who is charged with the general administration and
supervision of a facility and licensed, if required, under the Nursing Home
Administrators Licensing and Disciplinary Act. (Section 1-105 of the Act)
Advocate
− a person who represents the rights and interests of an individual as
though they were the person's own, in order to realize the rights to which the
individual is entitled, obtain needed services, and remove barriers to meeting
the individual's needs.
Affiliate
− means:
With
respect to a partnership, each partner thereof.
With
respect to a corporation, each officer, director and stockholder thereof.
With
respect to a natural person: any person related in the first degree of kinship
to that person; each partnership and each partner thereof of which that person
or any affiliate of that person is a partner; and each corporation in which
that person or any affiliate of that person is an officer, director or
stockholder. (Section 1-106 of the Act)
Aide or
Orderly − any person providing direct personal care, training or
habilitation services to residents.
Alteration
− any construction change or modification of an existing building that
does not increase the area or cubic content of the building.
Ambulatory
Resident − a person who is physically and mentally capable of walking
without assistance, or is physically able with guidance to do so, including the
ascent and descent of stairs.
Applicant
− any person making application for a license. (Section 1-107 of the
Act)
Appropriate
− term used to indicate that a requirement is to be applied according to
the needs of a particular individual or situation.
Assessment
− the use of an objective system with which to evaluate the physical,
social, developmental, behavioral, and psychosocial aspects of an individual.
Audiologist
− a person who is licensed as an audiologist under the Illinois
Speech-Language Pathology and Audiology Practice Act.
Autism −
a syndrome described as consisting of withdrawal, very inadequate social
relationships, exceptional object relationships, language disturbances and
monotonously repetitive motor behavior.
Autoclave
− an apparatus for sterilizing by superheated steam under pressure.
Basement
− when used in this Part, any story or floor level below the main or
street floor. Where, due to grade difference, there are two levels that
qualify as a street floor, a basement is any floor below the level of the two
street floors. Basements shall not be counted in determining the height of a
building in stories.
Behavior
Modification − treatment to be used to establish or change behavior
patterns.
Cerebral Palsy
− a disorder dating from birth or early infancy, nonprogressive,
characterized by examples of aberrations of motor function (paralysis,
weakness, incoordination) and often other manifestations of organic brain
damage such as sensory disorders, seizures, learning difficulty and behavior
disorders.
Certification
for Title XVIII and XIX − the issuance of a document by the Department to
the U.S. Department of Health and Human Services or the Department of
Healthcare and Family Services verifying compliance with applicable statutory
or regulatory requirements for the purposes of participation as a provider of
care and service in a specific federal or State health program.
Certified Nursing
Assistant – any person who meets the requirements of 77 Ill. Adm. Code 395 and
who provides nursing care or personal care to residents of facilities,
regardless of title, and who is not otherwise licensed, certified or registered
by the Department of Financial and Professional Regulation to render medical
care. Certified nursing assistants shall function under the supervision of a
licensed nurse.
Charge Nurse
− a registered professional nurse or a licensed practical nurse in charge
of the nursing activities for a specific unit or floor during a shift.
Chemical
Restraint − any drug that is used for discipline or convenience
and is not required to treat medical symptoms or behavior
manifestations of mental illness. (Section 2-106 of the Act)
Colbert
Consent Decree – Colbert et al. v. Pritzker et al., Case No. 07 C 4737, United
States District Court, N.D. Illinois, Eastern Division.
Colbert
Consent Decree Class Members or Colbert Class Members – all Medicaid-eligible
adults with disabilities in Cook County, Illinois, who are being, or may in the
future be, unnecessarily confined to nursing facilities and who, with
appropriate supports and services, may be able to live in a community setting.
Colbert
Consent Decree Defendant Agencies – the Illinois Department of Human Services,
the Illinois Department of Public Health, the Illinois Department on Aging, and
the Illinois Department of Healthcare and Family Services, including any
successor to these departments.
Community
Alternatives − service programs in the community provided as an
alternative to institutionalization.
Continuing
Care Contract − a contract through which a facility agrees to supplement
all forms of financial support for a resident throughout the remainder of the
resident's life.
Contract
− a binding agreement between a resident or the resident's guardian (or,
if the resident is a minor, the resident's parent) and the facility or its
agent.
Dentist
− any person licensed to practice dentistry, including persons holding a
Temporary Certificate of Registration, as provided in the Illinois Dental
Practice Act.
Department
− the Department of Public Health. (Section 1-109 of the Act)
Developmental
Disability − means a severe, chronic disability of a person which:
is
attributable to a mental or physical impairment or combination of mental and
physical impairments, such as intellectual disability, cerebral palsy,
epilepsy, autism;
is
manifested before the person attains age 22;
is likely
to continue indefinitely;
results in
substantial functional limitations in 3 or more of the following areas of major
life activity:
self-care,
receptive
and expressive language,
learning,
mobility,
self-direction,
capacity
for independent living, and
economic
self-sufficiency; and
reflects
the person's need for combination and sequence of special, interdisciplinary or
generic care, treatment or other services which are of lifelong or extended
duration and are individually planned and coordinated. (Section 3-801.1 of
the Act)
Dietetic
Service Supervisor − a person who:
is a
dietitian;
is a graduate
of a dietetic and nutrition school or program authorized by the Accreditation
Council for Education in Nutrition and Dietetics, the Academy of Nutrition and
Dietetics, or the American Clinical Board of Nutrition;
is a graduate,
prior to July 1, 1990, of a Department-approved course that provided 90 or more
hours of classroom instruction in food service supervision and has had
experience as a supervisor in a health care institution which included
consultation from a dietitian;
has
successfully completed an Association of Nutrition & Foodservice
Professionals approved Certified Dietary Manager or Certified Food Protection
Professional course;
is certified
as a Certified Dietary Manager or Certified Food Protection Professional by the
Association of Nutrition & Foodservice Professionals; or
has training
and experience in food service supervision and management in a military service
equivalent in content to the programs in the second, third or fourth paragraph
of this definition.
Dietitian
− a person who is a licensed dietitian nutritionist as defined in the Dietitian
Nutritionist Practice Act.
Direct
Supervision − under the guidance and direction of a supervisor who is
responsible for the work, who plans work and methods, who is available on short
notice to answer questions and deal with problems that are not strictly
routine, who regularly reviews the work performed, and who is accountable for
the results.
Director
− the Director of Public Health or the Director's designee.
(Section 1-110 of the Act)
Director of
Nursing Service − the full-time registered professional nurse who is
directly responsible for the immediate supervision of the nursing services.
Discharge
− the full release of any resident from a facility. (Section 1-111
of the Act)
Discipline
− any action taken by the facility for the purpose of punishing or
penalizing residents.
Distinct Part
− an entire, physically identifiable unit consisting of all of the beds
within that unit and having facilities meeting the standards applicable to the
levels of service to be provided. Staff and services for a distinct part are
established as set forth in the respective regulations governing the levels of
services approved for the distinct part.
Emergency
− a situation, physical condition or one or more practices, methods or
operations which present imminent danger of death or serious physical or mental
harm to residents of a facility. (Section 1-112 of the Act)
Epilepsy
− a chronic symptom of cerebral dysfunction, characterized by recurrent
attacks, involving changes in the state of consciousness, sudden in onset, and
of brief duration. Many attacks are accompanied by a seizure in which the
person falls involuntarily.
Existing
Facility − any facility initially licensed as a health care facility or
approved for construction by the Department, or any facility initially licensed
or operated by any other agency of the State of Illinois, prior to March 1,
1980. Existing facilities shall meet the design and construction standards for
existing facilities for the level of long-term care for which the license (new
or renewal) is to be granted.
Exploitation
− taking advantage of a resident for personal gain through the use of
manipulation, intimidation, threats or coercion.
Facility,
Intermediate Care − a facility that provides basic nursing care and other
restorative services under periodic medical direction. Many of these services
may require skill in administration. These facilities are for residents who
have long-term illnesses or disabilities that may have reached a relatively
stable plateau.
Facility or
Long-Term Care Facility − a private home, institution, building,
residence, or any other place, whether operated for profit or not, or a county
home for the infirm and chronically ill operated pursuant to Division
5-21 or 5-22 of the Counties Code, or any similar institution operated
by a political subdivision of the State of Illinois, which provides, through
its ownership or management, personal care, sheltered care or nursing for three
or more persons, not related to the applicant or owner by blood or marriage.
It includes skilled nursing facilities and intermediate care facilities as
those terms are defined in Title XVIII and Title XIX of the Federal Social
Security Act (42 U.S.C. 1395 et seq. and 1936 et seq.). It also
includes homes, institutions, or other places operated by or under the
authority of the Illinois Department of Veterans' Affairs. A
"facility" may consist of more than one building as long as the buildings
are on the same tract, or adjacent tracts of land. However, there shall be no
more than one "facility" in any one building. "Facility"
does not include the following:
A home,
institution, or other place operated by the federal government or agency
thereof, or by the State of Illinois other than homes, institutions, or
other places operated by or under the authority of the Illinois Department of
Veterans' Affairs;
A hospital,
sanitarium, or other institution whose principal activity or business is the
diagnosis, care, and treatment of human illness through the maintenance and
operation as organized facilities therefor, which is required to be licensed
under the Hospital Licensing Act;
Any
"facility for child care" as defined in the Child Care Act of 1969;
Any
"community living facility" as defined in the Community Living
Facilities Licensing Act;
Any nursing
home or sanatorium operated solely by and for persons who rely exclusively upon
treatment by spiritual means through prayer, in accordance with the creed or
tenets of any well-recognized church or religious denomination. However, the
nursing home or sanatorium shall comply with all local laws and rules relating
to sanitation and safety;
Any
facility licensed by the Department of Human Services as a
community-integrated living arrangement as defined in the Community-Integrated
Living Arrangements Licensure and Certification Act;
Any
supportive residence licensed under the Supportive Residences Licensing Act;
Any
supportive living facility in good standing with the program established under
Section 5-5.01a of the Illinois Public Aid Code, except only for
purposes of the employment of persons in accordance with Section 3-206.01
of the Act;
Any
assisted living or shared housing establishment licensed under the Assisted
Living and Shared Housing Act, except only for purposes of the
employment of persons in accordance with Section 3-206.01 of the Act;
An
Alzheimer's disease management center alternative health care model licensed under
the Alternative Health Care Delivery Act;
A facility
licensed under the ID/DD Community Care Act;
A facility
licensed under the Specialized Mental Health Rehabilitation Act of 2013;
A facility
licensed under the MC/DD Act; or
A medical
foster home, as defined in 38 CFR 17.73, that is under the oversight of the U.S.
Department of Veterans Affairs. (Section 1-113 of the Act)
Facility,
Skilled Nursing − when used in this Part is synonymous with a skilled
nursing facility. A skilled nursing facility provides skilled nursing care,
continuous skilled nursing observations, restorative nursing, and other
services under professional direction with frequent medical supervision. These
facilities are provided for patients who need the type of care and treatment
required during the post-acute phase of illness or during recurrences of
symptoms in long-term illness.
Financial
Responsibility − having sufficient assets to provide adequate services
such as: staff, heat, laundry, foods, supplies, and utilities for at least a
two-month period of time.
Full-time
− means on duty a minimum of 36 hours, four days per week.
Goal −
an expected result or condition that involves a relatively long period of time
to achieve, that is specified in behavioral terms in a statement of relatively
broad scope, and that provides guidance in establishing specific, short-term
objectives directed toward its attainment.
Governing Body
− the policy-making authority, whether an individual or a group, that
exercises general direction over the affairs of a facility and establishes
policies concerning its operation and the welfare of the individuals it serves.
Guardian
− a person appointed as a guardian of the person or guardian of the
estate, or both, of a resident under the Probate Act of 1975. (Section
1-114 of the Act)
Habilitation
− an effort directed toward the alleviation of a disability or toward
increasing a person's level of physical, mental, social or economic
functioning. Habilitation may include, but is not limited to, diagnosis,
evaluation, medical services, residential care, day care, special living
arrangements, training, education, sheltered employment, protective services,
counseling and other services.
Health
Information Management Consultant − a person who is certified as a
Registered Health Information Administrator (RHIA) or a Registered Health
Information Technician (RHIT) by the American Health Information Management
Association; or is a graduate of a school of health information management that
is accredited jointly by the American Medical Association and the American
Health Information Management Association.
Health
Services Supervisor (Director of Nursing Service) − the full-time
Registered Nurse who is directly responsible for the immediate supervision of
the health services in an Intermediate Care Facility.
High Risk
Designation – a violation, as described in Section 300.282(i), of
a provision that has been identified by the Department in Section
300.282(j) to be inherently necessary to protect the health, safety, and
welfare of a resident. (Section 1-114.005 of the Act)
Hospitalization
− the care and treatment of a person in a hospital as an inpatient.
Identified Offender – a
person who:
Has been convicted of, found
guilty of, adjudicated delinquent for, found not guilty by reason of insanity
for, or found unfit to stand trial for, any felony offense listed in Section 25
of the Health Care Worker Background Check Act, except for the following: a
felony offense described in Section 10-5 of the Nurse Practice Act; a felony
offense described in Section 4, 5, 6, 8, or 17.02 of the Illinois Credit
Card and Debit Card Act; a felony offense described in Section 5, 5.1, 5.2, 7,
or 9 of the Cannabis Control Act; a felony offense described in Section 401,
401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois Controlled Substances
Act; and a felony offense described in the Methamphetamine Control and
Community Protection Act; or
Has been convicted of,
adjudicated delinquent for, found not guilty by reason of insanity for, or
found unfit to stand trial for, any sex offense as defined in subsection (c) of
Section 10 of the Sex Offender Management Board Act; or
Any other resident as
determined by the Department of State Police. (Section 1-114.01 of the Act)
Intellectual
Disability – subaverage general intellectual functioning originating during the
developmental period and associated with maladaptive behavior.
Interdisciplinary
Team − a group of persons that represents those professions, disciplines,
or service areas that are relevant to identifying an individual's strengths and
needs, and designs a program to meet those needs. This team shall include at
least a physician, a social worker and other professionals. The
Interdisciplinary Team includes the resident, the resident's guardian, the
resident's primary service providers, including staff most familiar with the
resident; and other appropriate professionals and caregivers as determined by
the resident's needs. The resident or his or her guardian may also invite
other individuals to meet with the Interdisciplinary Team and participate in
the process of identifying the resident's strengths and needs.
Lead Defendant
Agency – State of Illinois Agency named in each fiscal year's Implementation Plan
as the lead agency for the Williams and Colbert Consent Decrees on behalf of
the Defendants. For the purposes of this definition,
"Implementation Plan" refers to the plan set forth in the Consent
Decree, created and implemented by the Defendants, with the input of the
Monitor and Plaintiffs, to accomplish the obligations and objectives set forth
in the Decree.
Licensed
Nursing Home Administrator − see "Administrator".
Licensed
Practical Nurse − a person with a valid Illinois license to practice as a
practical nurse.
Licensee
− the individual or entity licensed by the Department to operate the
facility. (Section 1-115 of the Act)
Life Care
Contract − a contract through which a facility agrees to provide
maintenance and care for a resident throughout the remainder of the resident's
life.
Maintenance
− food, shelter, and laundry services. (Section 1-116 of the Act)
Maladaptive
Behavior − impairment in adaptive behavior as determined by a clinical
psychologist or by a physician. Impaired adaptive behavior may be reflected in
delayed maturation, reduced learning ability or inadequate social adjustment.
Medical
Ventilator (or assisted ventilation) – a mechanized device that enables the
delivery or movement of air and oxygen into the lungs of a patient whose
breathing has ceased, is failing, or is inadequate.
Misappropriation
of a Resident's Property − the deliberate misplacement, exploitation,
or wrongful temporary or permanent use of a resident's belongings or money
without the resident's consent. (Section 1-116.5 of the Act) Misappropriation
of a resident's property includes failure to return valuables after a
resident's discharge; or failure to refund money after death or discharge when
there is an unused balance in the resident's personal account.
Monitor
− a qualified person placed in a facility by the Department to observe
operations of the facility, assist the facility by advising it on how to comply
with the State regulations, and who reports periodically to the Department on
the operations of the facility.
Neglect
− a facility's failure to provide, or willful withholding of, adequate
medical care, mental health treatment, psychiatric rehabilitation, personal
care, or assistance with activities of daily living that is necessary to avoid
physical harm, mental anguish, or mental illness of a resident. (Section
1-117 of the Act) This shall include any allegation in which:
the alleged
failure causing injury or deterioration is ongoing or repetitious; or
a resident
required medical treatment as a result of the alleged failure; or
the failure is
alleged to have caused a noticeable negative impact on a resident's health,
behavior or activities for more than 24 hours.
New Facility
− any facility initially licensed as a health care facility by the
Department, or any facility initially licensed or operated by any other agency
of the State of Illinois, on or after March 1, 1980. New facilities shall meet
the design and construction standards for new facilities for the level of
long-term care for which the license (new or renewal) is to be granted.
Nurse
− a registered professional nurse or a licensed practical nurse as
defined in the Nurse Practice Act. (Section 1-118 of the Act)
Nursing Care
− a complex of activities that carries out the diagnostic, therapeutic,
and rehabilitative plan as prescribed by the physician; care for the resident's
environment; observing symptoms and reactions and taking necessary measures to
carry out nursing procedures involving understanding of cause and effect to
safeguard life and health.
Nursing Unit
− a physically identifiable designated area of a facility consisting of
all the beds within the designated area, but having no more than 75 beds, none
of which are more than 120 feet from the nurse's station.
Objective
− an expected result or condition that involves a relatively short period
of time to achieve, that is specified in behavioral terms, and that is related
to the achievement of a goal.
Occupational
Therapist, Registered or OTR − a person who is registered as an
occupational therapist under the Illinois Occupational Therapy Practice Act.
Occupational
Therapy Assistant − a person who is registered as a certified
occupational therapy assistant under the Illinois Occupational Therapy Practice
Act.
Operator
− the person responsible for the control, maintenance and governance of
the facility, its personnel and physical plant.
Oversight
− general watchfulness and appropriate reaction to meet the total needs
of the residents, exclusive of nursing or personal care. Oversight shall
include, but is not limited to, social, recreational and employment
opportunities for residents who, by reason of mental disability, or in the
opinion of a licensed physician, are in need of residential care.
Owner
− the individual, partnership, corporation, association or other person
who owns a facility. In the event a facility is operated by a person who
leases the physical plant, which is owned by another person, "owner"
means the person who operates the facility, except that if the person who owns
the physical plant is an affiliate of the person who operates the facility and
has significant control over the day-to-day operations of the facility, the
person who owns the physical plant shall incur jointly and severally with the
owner all liabilities imposed on an owner under the Act. (Section 1-119 of
the Act)
Person −
any individual, partnership, corporation, association, municipality, political
subdivision, trust, estate or other legal entity whatsoever.
Personal
Care − 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 this individual. (Section 1-120 of the Act)
Pharmacist,
Licensed − a person who holds a license as a pharmacist under the
Pharmacy Practice Act.
Physical
Restraint − any manual method or physical or mechanical device, material,
or equipment attached or adjacent to a resident's body that the resident cannot
remove easily and which restricts freedom of movement or normal access to one's
body. (Section 2-106 of the Act)
Physical
Therapist − a person who is registered as a physical therapist under the
Illinois Physical Therapy Act.
Physical
Therapist Assistant − a person who has graduated from a two-year college
level program approved by the American Physical Therapy Association.
Physician
− any person licensed to practice medicine in all its branches as
provided in the Medical Practice Act of 1987.
Probationary
License − an initial license issued for a period of 120 days during which
time the Department will determine the qualifications of the applicant.
Provisional Admission Period –
the time between the admission of an identified offender as defined in Section
1-114.01 of the Act and this Section, and 3 days following the admitting
facility's receipt of an Identified Offender Report and Recommendation in
accordance with Section 2-201.6 of the Act. (Section 1-120.3 of the
Act)
Psychiatric
Services Rehabilitation Aide – an individual employed by a long-term care
facility to provide, for mentally ill residents, at a minimum, crisis intervention,
rehabilitation, and assistance with activities of daily living. (Section
1-120.7 of the Act)
Psychiatrist
− a physician who has had at least three years of formal training or
primary experience in the diagnosis and treatment of mental illness.
Psychologist
− a person who is licensed to practice clinical psychology under the
Clinical Psychologist Licensing Act.
Qualified
Professional − a person who meets the educational, technical and ethical
criteria of a health care profession, as evidenced by eligibility for
membership in an organization established by the profession for the purpose of
recognizing those persons who meet this criteria; and who is licensed,
registered, or certified by the State of Illinois, if required.
Reasonable
Hour or Visiting Hours − any time between the hours of
10 a.m. and 8 p.m. daily. (Section 1-121 of the Act)
Registered
Professional Nurse − a person with a valid license to practice as a
registered professional nurse under the Nurse Practice Act.
Repeat
Violation − for purposes of assessing fines under Section 3-305 of
the Act, a violation that has been cited during one inspection of the
facility for which a subsequent inspection indicates that an accepted
plan of correction was not complied with, within a period of not more than
12 months from the issuance of the initial violation. A repeat violation
shall not be a new citation of the same rule, unless the licensee is not
substantially addressing the issue routinely throughout the facility.
(Section 3-305(7) of the Act)
Reputable
Moral Character − having no history of a conviction of the applicant, or
if the applicant is a firm, partnership, or association, of any of its members,
or of a corporation, of any of its officers, or directors, or of the person
designated to manage or supervise the facility, of a felony, or of two or more
misdemeanors involving moral turpitude, as shown by a certified copy of the
record of the court of conviction, or in the case of the conviction of a
misdemeanor by a court not of record, as shown by other evidence; or other
satisfactory evidence that the moral character of the applicant, or manager, or
supervisor of the facility is not reputable.
Resident
− person receiving personal or medical care, including but not limited to
mental health treatment, psychiatric rehabilitation, physical rehabilitation,
and assistance with activities of daily living, from a facility. (Section
1-122 of the Act)
Resident
Services Director − the full-time administrator, or an individual on the
professional staff in the facility, who is directly responsible for the
coordination and monitoring of the residents' overall plans of care in an
intermediate care facility.
Resident's
Representative − a person other than the owner, or an agent or employee
of a facility not related to the resident, designated in writing by a resident
to be his or her representative, or the resident's guardian, or the
parent of a minor resident for whom no guardian has been appointed.
(Section 1-123 of the Act)
Restorative
Services or Restorative Measures − services or measures designed to
assist residents to attain and maintain the highest degree of function of which
they are capable (physical, mental, and social).
Room − a
part of the inside of a facility that is partitioned continuously from floor to
ceiling with openings closed with glass or hinged doors.
Sanitization −
the reduction of pathogenic organisms on a utensil surface to a safe level,
which is accomplished through the use of steam, hot water, or chemicals.
Seclusion
− the retention of a resident alone in a room with a door that the
resident cannot open.
Self
Preservation − the ability to follow directions and recognize impending
danger or emergency situations and react by avoiding or leaving the unsafe
area.
Social Worker
− a person who is a licensed social worker or a licensed clinical social
worker under the Clinical Social Work and Social Work Practice Act.
State
Authorized Personnel – individuals who have a legal duty to provide specified
services to residents of long-term care facilities, including, but not limited
to, representatives of the Office of the State Long-Term Care Ombudsman
Program, the Office of State Guardian, and community-service providers or third
parties serving as agents of the State for purposes of providing telemedicine,
transitional services to community-based living, in-person assessments and
evaluations, legal services, and other supports related to existing consent
decrees court-mandated actions.
State Fire
Marshal − the Fire Marshal of the Office of the State Fire Marshal,
Division of Fire Prevention.
Sterilization
− the act or process of destroying completely all forms of microbial
life, including viruses.
Stockholder
of a Corporation − any person who, directly or indirectly,
beneficially owns, holds or has the power to vote, at least 5% of any
class of securities issued by the corporation. (Section 1-125 of the Act)
Story −
when used in this Part, means that portion of a building between the upper
surface of any floor and the upper surface of the floor above except that the
topmost story shall be the portion of a building between the upper surface of
the topmost floor and the upper surface of the roof above.
Student
Intern − any person whose total term of employment in any facility during
any 12-month period is equal to or less than 90 continuous days, and whose term
of employment:
is an
academic credit requirement in a high school or undergraduate or graduate
institution; or
immediately
succeeds a full quarter, semester or trimester of academic enrollment in either
a high school or undergraduate or graduate institution, provided that this
person is registered for another full quarter, semester or trimester of
academic enrollment in either a high school or undergraduate institution which
quarter, semester or trimester will commence immediately following the term of
employment; or
immediately
succeeds graduation from the high school or undergraduate or graduate
institution. (Section 1-125.1 of the Act)
Substantial
Compliance − meeting requirements except for variance from the strict and
literal performance that results in unimportant omissions or defects given the
particular circumstances involved. This definition is limited to the term as
used in Sections 300.140(a)(3) and 300.150(a)(3).
Substantial
Failure − the failure to meet requirements other than a variance from the
strict and literal performance that results in unimportant omissions or defects
given the particular circumstances involved. This definition is limited to the
term as used in Section 300.165(b)(1).
Supervision
− authoritative guidance by a qualified person for the accomplishment of
a function or activity within his or her sphere of competence.
Therapeutic
Recreation Specialist − a person who is certified by the National Council
for Therapeutic Recreation Certification and who meets the minimum standards it
has established for classification as a Therapeutic Recreation Specialist.
Time Out
− removing an individual from a situation that results in undesirable
behavior. It is a behavior modification procedure that is developed and
implemented under the supervision of a qualified professional.
Title XVIII
− Title XVIII of the federal Social Security Act as now or hereafter
amended. (Section 1-126 of the Act)
Title XIX
− Title XIX of the federal Social Security Act as now or hereafter
amended. (Section 1-127 of the Act)
Transfer
− a change in status of a resident's living arrangements from one
facility to another facility. (Section 1-128 of the Act)
Type AA Violation – a violation
of the Act or this Part which creates a condition or occurrence
relating to the operation and maintenance of a facility that proximately caused
a resident's death. (Section 1-128.5 of the Act)
Type A
Violation − a violation of the Act or this Part that
creates a condition or occurrence relating to the operation and maintenance of
a facility that creates a substantial probability that the risk of death or
serious mental or physical harm to a resident will result therefrom or has
resulted in actual physical or mental harm to a resident. (Section 1-129
of the Act)
Type B
Violation − a violation of the Act or this Part that
creates a condition or occurrence relating to the operation and maintenance of
a facility that is more likely than not to cause more than minimal physical or
mental harm to a resident. (Section 1-130 of the Act)
Type C Violation – a violation
of the Act or this Part that creates a condition or occurrence
relating to the operation and maintenance of a facility that creates a
substantial probability that less than minimal physical or mental harm to a
resident will result therefrom. (Section 1-132 of the Act)
Unit −
an entire physically identifiable residence area having facilities meeting the
standards applicable to the levels of service to be provided. Staff and
services for each distinct resident area are established as set forth in the
respective rules governing the approved levels of service.
Universal
Progress Notes − a common record with periodic narrative documentation by
all persons involved in resident care.
Valid License
− a license that is unsuspended, unrevoked and unexpired.
(Source: Amended at 49 Ill. Reg. 6468,
effective April 22, 2025)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.340 INCORPORATED AND REFERENCED MATERIALS
Section 300.340 Incorporated
and Referenced Materials
a) The following regulations and standards are incorporated in
this Part:
1) Private and professional association standards:
A) ANSI/ASME Standard No. A17.1-2007, Safety Code for Elevators
and Escalators, which may be obtained from the American Society of Mechanical
Engineers (ASME) International, 22 Law Drive, Box 2900, Fairfield, NJ
07007-2900.
B) American Society of Heating, Refrigerating, and Air
Conditioning Engineers (ASHRAE), Handbook of Fundamentals (2001), Handbook of
Applications (2007), and ASHRAE Guideline 12-2020, "Managing the Risk of
Legionellosis Associated with Building Water Systems" (March 30, 2021),
which may be obtained from the American Society of Heating, Refrigerating, and
Air Conditioning Engineers, Inc., 1791 Tullie Circle, N.E., Atlanta, GA 30329.
C) American Society for Testing and Materials (ASTM) International
Standard No. E90-09 (2009): Standard Test Method for Laboratory Measurement of
Airborne Sound Transmission Loss of Building Partitions and Elements, and
Standard No. E84-08a, Standard Test Method for Surface Burning Characteristics
of Building Materials (2010), which may be obtained from ASTM International,
100 Barr Harbor Drive, P.O. Box C700, West Conshohocken, PA 19428-2959.
D) International Building Code (IBC) (2012), which may be obtained
from the International Code Council (ICC), 4051 W. Flossmoor Road, Country Club
Hills, IL 60478-5795.
E) For existing facilities, National Fire Protection Association
(NFPA) 101: Life Safety Code, (2012) Chapter 19 and all appropriate references
under Chapter 2, and the following additional standards, which may be obtained
from the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA
02169:
i) NFPA 20 (2010): Installation of Stationary Pumps for Fire
Protection
ii) NFPA 22 (2008): Water Tanks for Private Fire Protection
iii) NFPA 101A (2013): Guide on Alternative Approaches to Life
Safety
F) For new facilities, the standards of the NFPA 101, Life Safety
Code (2012), Chapter 18 and all appropriate references under Chapter 2, and the
following additional standards, which may be obtained from the National Fire
Protection Association, 1 Batterymarch Park, Quincy, MA 02169:
i) NFPA
20 (2010): Standard for the Installation of Stationary Pumps for Fire
Protection
ii) NFPA
22 (2008), Standard for Water Tanks for Private Fire Protection
G) For
new and existing facilities, NFPA 99: Health Care Facilities Code – 2012
Edition.
H) The following standards, which may be obtained from
Underwriters Laboratories (UL), Inc., 333 Pfingsten Rd., Northbrook, IL 60062:
i) Fire Resistance Directory (2015 Edition)
ii) Building Material Directory (2015 Edition)
I) American Psychiatric Association, Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition DSM-5 (2022), available at: https://appi.org/Products/dsm
or from the American Psychiatric Association, 800 Maine
Avenue, SW, Suite 900, Washington, DC 20024.
J) American
College of Obstetricians and Gynecologists, Guidelines for Women's Health Care,
Fourth Edition (2014), which may be obtained from the American College of
Obstetricians and Gynecologists Distribution Center, P.O. Box 933104, Atlanta, GA
31193-3104 (800-762-2264). (See Section 300.3220.)
K) The
Prescribers' Digital Reference (PDR) database, which may be accessed at www.pdr.net.
L) The
Lexicomp-online database, which may be accessed at www.wolterskluwercdi.com/lexicomp-online.
M) The
American Society of Health-System Pharmacists (ASHP) database, which may be
accessed at www.ashp.org.
2) Federal guidelines:
The following
guidelines and toolkits of the Centers for Disease Control and Prevention,
United States Public Health Service, Department of Health and Human Services, Agency
for Healthcare Research and Quality, and Occupational Safety and Health
Administration:
A) Guideline for Prevention of Catheter-Associated Urinary Tract
Infections, available at: https://www.cdc.gov/infection-control/media/pdfs/guideline-cauti-h.pdf?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/pdf/guidelines/cauti-guidelines-H.pdf
(June 6, 2019)
B) Guideline for Hand Hygiene in Health-Care Settings, available
at: https://www.cdc.gov/infection-control/media/pdfs/Guideline-Hand-Hygiene-P.pdf
(October 25, 2002)
C) Guidelines for Prevention of Intravascular Catheter-Related
Infections, 2011, available at: https://www.cdc.gov/infection-control/media/pdfs/guideline-bsi-h.pdf?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/pdf/guidelines/bsi-guidelines-H.pdf
(October 2017)
D) Guideline for Prevention of Surgical
Site Infection, 2017, available at: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725
(August 2017)
E) Guideline for Preventing Healthcare-Associated Pneumonia, 2003,
available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm (March
26, 2004)
F) 2007 Guideline for Isolation Precautions: Preventing
Transmission of Infectious Agents in Healthcare Settings, available at: https://www.cdc.gov/infection-control/media/pdfs/Guideline-Isolation-H.pdf
(September 2024)
G) Infection
Control in Healthcare Personnel, available in two parts: Infrastructure and
Routine Practices for Occupational Infection Prevention and Control Services,
available at: https://www.cdc.gov/infection-control/media/pdfs/Guideline-Infection-Control-HCP-H.pdf
(October 25, 2019) and Epidemiology and Control of Selected Infections
Transmitted Among Healthcare Personnel and Patients, available at: https://www.cdc.gov/infection-control/media/pdfs/Guideline-IC-HCP-H.pdf
(March 28, 2024)
H) The
Core Elements of Antibiotic Stewardship for Nursing Homes, available at: https://www.cdc.gov/antibiotic-use/media/pdfs/core-elements-antibiotic-stewardship-508.pdf
(March 18, 2024)
I) The
Core Elements of Antibiotic Stewardship for Nursing Homes, Appendix A: Policy
and Practice Actions to Improve Antibiotic Use, available at: https://www.cdc.gov/antibiotic-use/core-elements/pdfs/core-elements-antibiotic-stewardship-appendix-a-508.pdf
J) Nursing
Home Antimicrobial Stewardship Guide, available at:
https://www.ahrq.gov/nhguide/index.html (March 2023)
K) Toolkit
3. Minimum Criteria for Common Infections Toolkit, available at:
https://www.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit3-minimum-criteria.html
(September 2017)
L) TB Prevention
in Health Care Settings (December 15, 2023) available at:
https://www.cdc.gov/tb-healthcare-settings/hcp/infection-control/index.html
M) Infection
Control Guidance: SARS-CoV-2 (June 24, 2024) available at: https://www.cdc.gov/covid/hcp/infection-control/?CDC_AAref_Val=https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
N) Implementation
of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread
of Novel or Targeted Multidrug-resistant Organisms (MDROs) (April 2, 2024)
available at: https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/ppe.html?CDC_AAref_Val=https://www.cdc.gov/hai/containment/PPE-Nursing-Homes.html
O) Hospital
Respiratory Protection Program Toolkit: Resources for Respirator Program
Administrators (April 2022) available at: https://www.cdc.gov/niosh/docs/2015-117/default.html
P) Respiratory
Protection Guidance for the Employers of Those Working in Nursing Homes,
Assisted Living, and Other Long-Term Care Facilities During the COVID-19
Pandemic available at:
https://www.osha.gov/sites/default/files/respiratory-protection-covid19-long-term-care.pdf
Q) Guidelines
for Environmental Infection Control in Health-Care Facilities (July 2019)
available at: https://www.cdc.gov/infection-control/media/pdfs/Guideline-Environmental-H.pdf
R) Toolkit
for Controlling Legionella in Common Sources of Exposure (January 13, 2021),
available at: https://stacks.cdc.gov/view/cdc/104362
3) Federal regulations:
A) 21
CFR 1306, Prescriptions (April 1, 2024)
B) 42 CFR 483, Requirements for States and Long-Term Care
Facilities (October 1, 2023)
C) 38 CFR 17.73, Medical Foster Homes – General (July 1, 2023)
D) 42
CFR 483.80, Infection Control (October 1, 2023)
b) All incorporations by reference of federal regulations and the
standards of nationally recognized organizations refer to the regulations and
standards on the date specified and do not include any amendments or editions
subsequent to the date specified.
c) The following statutes and State regulations are referenced in
this Part:
1) Federal statutes:
A) Civil Rights Act of 1964 (42 U.S.C. 2000e et seq.)
B) Social Security Act (42 U.S.C. 301 et seq., 1935 et seq. and
1936 et seq.)
C) Controlled Substances Act (21 U.S.C. 802)
2) State of Illinois statutes:
A) Substance Use Disorder Act [20 ILCS 301]
B) Child Care Act of 1969 [225 ILCS 10]
C) Court of Claims Act [705 ILCS 505]
D) Illinois Dental Practice Act [225 ILCS 25]
E) Election Code [10 ILCS 5]
F) Freedom of Information Act [5 ILCS 140]
G) General Not For Profit Corporation Act of 1986 [805 ILCS 105]
H) Hospital Licensing Act [210 ILCS 85]
I) Illinois Controlled Substances Act [720 ILCS 570]
J) Illinois Health Facilities Planning Act [20 ILCS 3960]
K) Illinois Municipal Code [65 ILCS 5]
L) Nurse Practice Act [225 ILCS 65]
M) Illinois Occupational Therapy Practice Act [225 ILCS 75]
N) Illinois Physical Therapy Act [225 ILCS 90]
O) Life Care Facilities Act [210 ILCS 40]
P) Local Governmental and Governmental Employees Tort Immunity
Act [745 ILCS 10]
Q) Medical Practice Act of 1987 [225 ILCS 60]
R) Mental Health and Developmental Disabilities Code [405 ILCS 5]
S) Nursing Home Administrators Licensing and Disciplinary Act
[225 ILCS 70]
T) Nursing Home Care Act [210 ILCS 45]
U) Pharmacy Practice Act [225 ILCS 85]
V) Probate Act of 1975 [775 ILCS 5]
W) Illinois Public Aid Code [305 ILCS 5]
X) Illinois Administrative Procedure Act [5 ILCS 100]
Y) Clinical Psychologist Licensing Act [225 ILCS 15]
Z) Dietitian Nutritionist Practice Act [225 ILCS 30]
AA) Health Care Worker Background Check Act [225 ILCS 46]
BB) Clinical Social Work and Social Work Practice Act [225 ILCS 20]
CC) Illinois Living Will Act [755 ILCS 35]
DD) Illinois Power of Attorney Act [755 ILCS 45/Art. IV]
EE) Health Care Surrogate Act [755 ILCS 45]
FF) Health Care Right of Conscience Act [745 ILCS 70]
GG) Abused and Neglected Long-Term Care Facility Residents Reporting
Act [210 ILCS 30]
HH) Supportive Residences Licensing Act [210 ILCS 65]
II) Community Living Facilities Licensing Act [210 ILCS 35]
JJ) Community-Integrated Living Arrangements Licensure and
Certification Act [210 ILCS 135]
KK) Counties Code [55 ILCS 5]
LL) Professional Counselor and Clinical Professional Counselor
Licensing Act [225 ILCS 107]
MM) Podiatric Medical Practice Act of 1987 [225 ILCS 100]
NN) Illinois Optometric Practice Act of 1987 [225 ILCS 80]
OO) Physician Assistant Practice Act of 1987 [225 ILCS 95]
PP) Alzheimer's Disease and Related Dementias Special Care
Disclosure Act [210 ILCS 4]
QQ) Illinois Act on the Aging [20 ILCS 105]
RR) Alternative Health Care Delivery Act [210 ILCS 3]
SS) Assisted Living and Shared Housing Act [210 ILCS 9]
TT) Language Assistance Services Act [210 ILCS 87]
UU) Alzheimer's
Disease and Related Dementias Services Act [410 ILCS 406]
VV) Illinois
Uniform Conviction Information Act [20 ILCS 2635]
WW) Specialized Mental Health Rehabilitation Act of 2013 [210 ILCS 49]
XX) ID/DD
Community Care Act [210 ILCS 47]
YY) MC/DD
Act [210 ILCS 46]
ZZ) Home
Health, Home Services, and Home Nursing Agency Licensing Act [210 ILCS 55]
AAA) Methamphetamine
Control and Community Protection Act [720 ILCS 646]
BBB) Sex Offender Management Board Act [20 ILCS 4026]
CCC) Illinois
Emergency Management Agency Act [20 ILCS 3305]
DDD) Authorized Electronic Monitoring in Long-Term Care Facilities Act
[210 ILCS 32]
EEE) Latex Glove Ban Act [410 ILCS 180]
3) State of Illinois rules:
A) Office of the State Fire Marshal, Boiler and Pressure Vessel
Safety (41 Ill. Adm. Code 2120)
B) Capital Development Board, Illinois Accessibility Code (71 Ill.
Adm. Code 400)
C) Department of Public Health:
i) Control of Notifiable Diseases and Conditions Code (77 Ill.
Adm. Code 690)
ii) Control of Sexually Transmissible Infections Code (77 Ill.
Adm. Code 693)
iii) Food Code (77 Ill. Adm. Code 750)
iv) Illinois Plumbing Code (77 Ill. Adm. Code 890)
v) Private Sewage Disposal Code (77 Ill. Adm. Code 905)
vi) Drinking Water Systems Code (77 Ill. Adm. Code 900)
vii) Water Well Construction Code (77 Ill. Adm. Code 920)
viii) Illinois Water Well Pump Installation Code (77 Ill. Adm. Code
925)
ix) Access to Public Records of the Department of Public Health (2
Ill. Adm. Code 1127)
x) Intermediate Care for the Developmentally Disabled Facilities
Code (77 Ill. Adm. Code 350)
xi) Medically Complex for the Developmentally Disabled Facilities
Code (77 Ill. Adm. Code 390)
xii) Long-Term Care Assistants and Aides Training Programs Code (77
Ill. Adm. Code 395)
xiii) Control of Tuberculosis Code (77 Ill. Adm. Code 696)
xiv) Health Care Worker Background Check Code (77 Ill. Adm. Code
955)
xv) Language Assistance Services Code (77 Ill. Adm. Code 940)
xvi) Alzheimer's
Disease And Related Dementias Services Code (77 Ill. Adm. Code 973)
xvii) Specialized
Mental Health Rehabilitation Facilities Code (77 Ill. Adm. Code 380)
xviii) Supportive
Residences Licensing Code (77 Ill. Adm. Code 385)
xix) Authorized Electronic Monitoring in Long-Term Care Facilities
Code (77 Ill. Adm. Code 389)
D) Department of Financial and Professional Regulation:
i) Illinois Controlled Substances Act (77 Ill. Adm. Code 3100)
ii) Pharmacy Practice Act (68 Ill. Adm. Code 1330)
E) Department of Human Services, Alcoholism and Substance Abuse
Treatment and Intervention Licenses (77 Ill. Adm. Code 2060)
F) Department of Natural Resources, Regulation of Construction
within Flood Plains (17 Ill. Adm. Code 3706)
G) Department of Healthcare and Family Services, Medical Payment
(89 Ill. Adm. Code 140)
H) Department on Aging, Community Care Program (89 Ill. Adm. Code
240)
(Source: Amended at 49 Ill.
Reg. 760, effective December 31, 2024)
SUBPART B: ADMINISTRATION
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.510 ADMINISTRATOR
Section 300.510
Administrator
a) There shall be an administrator licensed under the Nursing
Home Administrators Licensing and Disciplinary Act (Ill. Rev. Stat. 1987, ch.
111, par. 3651 et seq.) full-time for each licensed facility. The licensee
will report any change in administrator to the Department, within five days.
b) The administrator shall delegate in writing adequate authority
to a person at least 18 years of age who is capable of acting in an emergency
during his or her absence. Such administrative assignment shall not interfere
with resident care and supervision. The administrator or the person designated
by the administrator to be in charge of the facility in the administrator's
absence, shall be deemed by the Department to be the agent of the license for
the purpose of Section 3-212 of the Act, which requires Department staff to
provide the licensee with a copy of their report before leaving the facility.
(B)
c) The administrator shall arrange for facility supervisory
personnel to annually attend appropriate educational programs on supervision,
nutrition, and other pertinent subjects.
d) The administrator shall appoint in writing a member of the
facility staff to coordinate the establishment of, and render assistance to,
the residents' advisory council.
e) The licensee and the administrator shall be familiar with this
Part. They shall be responsible for seeing that the applicable regulations are
met in the facility and that employees are familiar with those regulations
according to the level of their responsibilities. (A, B)
f) If the facility has an assistant administrator, the Department
shall be informed of the name and dates of employment and termination of this
person. This will provide documentation of service to qualify for a license
under the Nursing Home Administrators Licensing and Disciplinary Act (Ill. Rev.
Stat. 1987, ch. 111, par. 3651 et seq.).
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
SUBPART C: POLICIES
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.610 RESIDENT CARE POLICIES
Section 300.610 Resident
Care Policies
a) The facility shall have written policies and procedures
governing all services provided by the facility. The written policies and
procedures shall be formulated by a Resident Care Policy Committee consisting
of at least the administrator, the advisory physician or the medical advisory
committee, and representatives of nursing and other services in the facility. The
policies shall comply with the Act and this Part. The written policies shall
be followed in operating the facility and shall be reviewed at least annually
by this committee, documented by written, signed and dated minutes of the
meeting.
b) All of the information contained in the policies shall be
available to the public, staff and residents, and for review by the Department.
c) The written policies shall include, at a minimum the following
provisions:
1) Admission, transfer and discharge of residents, including
categories of residents accepted and not accepted, residents that will be
transferred or discharged, transfers within the facility from one room to
another, and other types of transfers;
2) Resident care services, including physician services,
emergency services, personal care and nursing services, restorative services,
activity services, pharmaceutical services, dietary services, social services,
clinical records, dental services, and diagnostic services (including
laboratory and x-ray);
3) A policy prohibiting blood transfusions, unless the facility
is hospital based and appropriate services are available in case of an adverse
reaction to the transfusions; and
4) A policy to identify, assess, and develop strategies to
control risk of injury to residents and nurses and other health care workers
associated with the lifting, transferring, repositioning, or movement of a
resident. The policy shall establish a process that, at a minimum, includes all
of the following:
A) Analysis of the risk of injury to residents and nurses and
other health care workers taking into account the resident handling needs of
the resident populations served by the facility and the physical environment in
which the resident handling and movement occurs;
B) Education of nurses in the identification, assessment, and
control of risks of injury to residents and nurses and other health care
workers during resident handling;
C) Evaluation of alternative ways to reduce risks associated
with resident handling, including evaluation of equipment and the environment;
D) Restriction, to the extent feasible with existing equipment
and aids, of manual resident handling or movement of all or most of a
resident's weight, except for emergency, life-threatening, or otherwise
exceptional circumstances;
E) Procedures for a nurse to refuse to perform or be involved
in resident handling or movement that the nurse, in good faith, believes will
expose a resident or nurse or other health care worker to an unacceptable risk
of injury;
F) Development of strategies to control risk of injury to
residents and nurses and other health care workers associated with the lifting,
transferring, repositioning, or movement of a resident; and
G) Consideration of the feasibility of incorporating resident
handling equipment or the physical space and construction design needed to
incorporate that equipment when developing architectural plans for construction
or remodeling of a facility or unit of a facility in which resident handling
and movement occurs. (Section 3-206.05 of the Act)
d) For the purposes of subsection (c)(4):
1) "Health care worker" means an individual
providing direct resident care services who may be required to lift, transfer,
reposition, or move a resident.
2) "Nurse" means an advanced practice nurse, a
registered nurse, or a licensed practical nurse licensed under the Nurse
Practice Act. (Section 3-206.05 of the Act)
e) The facility shall have a written agreement with one or more
hospitals to provide diagnostic, emergency and acute care hospital services. The
Department will waive this requirement if the facility can document that it is
unable to meet the requirement because of its remote location or refusal of
local hospitals to enter an agreement. The services shall include:
1) Emergency admissions;
2) Admission of facility residents who are in need of hospital
care;
3) Diagnostic services; and
4) Any other hospital-based services needed by the resident.
(Source: Amended at 37 Ill.
Reg. 4954, effective March 29, 2013)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.615 DETERMINATION OF NEED SCREENING AND REQUEST FOR RESIDENT CRIMINAL HISTORY RECORD INFORMATION
Section 300.615
Determination of Need Screening and Request for Resident Criminal History
Record Information
a) For the purpose of this Section only, a nursing facility is
any bed licensed as a skilled nursing or intermediate care facility bed, or a
location certified to participate in the Medicare program under Title XVIII of
the Social Security Act or Medicaid program under Title XIX of the Social
Security Act.
b) All persons seeking admission to a nursing facility must be
screened to determine the need for nursing facility services prior to being
admitted, regardless of income, assets, or funding source. (Section 2-201.5(a)
of the Act) A screening assessment is not required provided one of the
conditions in Section 140.642(c) of the rules of the Department of Healthcare
and Family Services titled Medical Payment (89 Ill. Adm. Code 140.642(c)) is
met.
c) Any person who seeks to become eligible for medical
assistance from the Medical Assistance program under the Illinois Public Aid
Code to pay for long-term care services while residing in a facility shall be
screened in accordance with 89 Ill. Adm. Code 140.642(b)(4). (Section
2-201.5(a) of the Act)
d) Screening shall be administered through procedures
established by administrative rule by the agency responsible for screening.
(Section 2-201.5(a) of the Act) The Illinois Department on Aging is
responsible for the screening required in subsection (b) of this Section for
individuals 60 years of age or older who are not developmentally disabled or do
not have a severe mental illness. The Illinois Department of Human Services is
responsible for the screening required in subsection (b) of this Section for
all individuals 18 through 59 years of age and for individuals 60 years of age
or older who are developmentally disabled or have a severe mental illness.
The Illinois Department of Healthcare and Family Services or its designee is
responsible for the screening required in subsection (c) of this Section.
e) In
addition to the screening required by Section 2-201.5(a) of the Act and
this Section, a facility shall, within 24 hours after admission of a
resident, request a criminal history background check pursuant to the
Uniform Conviction Information Act for all persons 18 or older seeking
admission to the facility, unless a background check was initiated by a
hospital pursuant to the Hospital Licensing Act. Background checks shall be
based on the resident's name, date of birth, and other identifiers as required
by the Department of State Police. (Section 2-201.5(b) of the Act)
f) The
facility shall check for the individual's name on the Illinois Sex Offender
Registration website at www.isp.state.il.us and the Illinois Department of
Corrections sex registrant search page at www.idoc.state.il.us to determine if
the individual is listed as a registered sex offender.
g) If
the results of the background check are inconclusive, the facility shall
initiate a fingerprint-based check, unless the fingerprint check is waived by
the Director of Public Health based on verification by the facility that the
resident is completely immobile or that the resident meets other criteria
related to the resident's health or lack of potential risk, such as the
existence of a severe, debilitating physical, medical, or mental condition that
nullifies any potential risk presented by the resident. (Section 2-201.5(b) of
the Act) The facility shall arrange for a fingerprint-based background check
or request a waiver from the Department within 5 days after receiving
inconclusive results of a name-based background check. The fingerprint-based
background check shall be conducted within 25 days after receiving the
inconclusive results of the name-based check.
h) A
waiver issued pursuant to Section 2-201.5(b) of the Act shall be
valid only while the resident is immobile or while the criteria
supporting the waiver exist. (Section 2-201.5(b) of the Act)
i) The facility shall provide for or arrange
for any required fingerprint-based checks to be taken on the premises of the
facility. If a fingerprint-based check is required, the facility shall arrange
for it to be conducted in a manner that is respectful of the resident's dignity
and that minimizes any emotional or physical hardship to the resident.
(Section 2-201.5(b) of the Act) If a facility is unable to conduct a
fingerprint-based background check in compliance with this Section, then it
shall provide conclusive evidence of the resident's immobility or risk
nullification of the waiver issued pursuant to Section 2-201.5(b) of the Act.
j) The facility shall be responsible for taking
all steps necessary to ensure the safety of residents while the results of a
name-based background check or a fingerprint-based background check are
pending; while the results of a request for waiver of a fingerprint-based check
are pending; and/or while the Identified Offender Report and Recommendation is
pending.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.620 ADMISSION, RETENTION AND DISCHARGE POLICIES
Section 300.620 Admission,
Retention and Discharge Policies
a) All involuntary discharges and transfers shall be in
accordance with Sections 3-401 through 3-423 of the Act.
b) An individual who needs services that are not readily
available in a particular facility, or through arrangement with a qualified
outside resource, shall not be admitted to or kept in that facility. The
Department defines a "qualified outside source" as one recognized as
meeting professional standards for services provided.
c) Each facility shall have a policy concerning the admission of
persons needing prenatal and/or maternity care, and a policy concerning the
keeping of such persons who become pregnant while they are residents of the
facility. If these policies permit such persons to be admitted to or kept in
the facility, then the facility shall have a policy concerning the provision of
adequate and appropriate prenatal and maternity care to such individuals from
in-house and/or outside resources. (See Section 300.3220.)
d) No person shall be admitted to or kept in the facility:
1) Who is at risk because the person is reasonably expected to
self-inflict serious physical harm or to inflict serious physical harm on
another person in the near future, as determined by professional evaluation;
2) Who is destructive of property, if the destruction jeopardizes
the safety of him/herself or others; or
3) Who
is an identified offender, unless the requirements of Section 300.615 for new
admissions and the requirements of Section 300.625 are met.
e) No resident shall be admitted to the facility who is
developmentally disabled and who needs programming for such conditions, as
described in the rules governing intermediate care facilities for the
developmentally disabled (77 Ill. Adm. Code 350). Such persons shall be
admitted only to facilities licensed as intermediate care facilities for the
developmentally disabled under 77 Ill. Adm. Code 350 or, if the person is under
18, to a long-term care facility for persons under 22 years of age that is
licensed under 77 Ill. Adm. Code 390. Persons from 18 to 21 years of age in
need of such care may be kept in either facility.
f) Persons under 18 years of age may not be cared for in a
facility for adults without prior written approval from the Department.
g) A facility shall not refuse to discharge or transfer a
resident when requested to do so by the resident or, if the resident is
incompetent, by the resident's guardian.
h) If a resident insists on being discharged and is discharged
against medical advice, the facts involved in the situation shall be fully
documented in the resident's clinical record.
i) Persons with communicable, contagious, or infectious diseases
may be admitted under the conditions and in accordance with the procedures
specified in Section 300.1020.
j) A facility shall not admit more residents than the number
authorized by the license issued to it.
(Source: Amended at 31 Ill.
Reg. 6044, effective April 3, 2007)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.624 CRIMINAL HISTORY BACKGROUND CHECKS FOR PERSONS WHO WERE RESIDENTS ON MAY 10, 2006 (REPEALED)
Section 300.624 Criminal History Background Checks for
Persons Who Were Residents on May
10, 2006 (Repealed)
(Source: Repealed at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.625 IDENTIFIED OFFENDERS
Section 300.625
Identified Offenders
a) The
facility shall review the results of the criminal history background checks
immediately upon receipt of these checks.
b) The facility shall be responsible for
taking all steps necessary to ensure the safety of residents while the results
of a name-based background check or a fingerprint-based check are pending;
while the results of a request for a waiver of a fingerprint-based check are
pending; and/or while the Identified Offender Report and Recommendation is
pending.
c) If the results of a resident's criminal
history background check reveal that the resident is an identified
offender as defined in Section 1-114.01 of the Act, the facility
shall do the following:
1) Immediately notify the Department of
State Police, in the form and manner required by the Department of State
Police, that the resident is an identified offender.
2) Within 72 hours, arrange for a
fingerprint-based criminal history record inquiry to be requested on the
identified offender resident. The inquiry shall be based on the subject's
name, sex, race, date of birth, fingerprint images, and other identifiers
required by the Department of State Police. The inquiry shall be processed
through the files of the Department of State Police and the Federal Bureau of
Investigation to locate any criminal history record information that may exist
regarding the subject. The Federal Bureau of Investigation shall furnish to
the Department of State Police, pursuant to an inquiry under this subsection
(c)(2), any criminal history record information contained in its files.
d) The facility shall comply with all
applicable provisions contained in the Uniform Conviction Information Act.
e) All name-based and fingerprint-based
criminal history record inquiries shall be submitted to the Department of State
Police electronically in the form and manner prescribed by the Department of
State Police. The Department of State Police may charge the facility a fee for
processing name-based and fingerprint-based criminal history record inquiries.
The fee shall be deposited into the State Police Services Fund. The fee shall
not exceed the actual cost of processing the inquiry. (Section 2-201.5(c)
of the Act)
f) If identified offenders are residents of a
facility, the facility shall comply with all of the following requirements:
1) The facility shall inform the appropriate
county and local law enforcement offices of the identity of identified
offenders who are registered sex offenders or are serving a term of parole,
mandatory supervised release or probation for a felony offense who are
residents of the facility. If a resident of a licensed facility is an
identified offender, any federal, State, or local law enforcement officer or
county probation officer shall be permitted reasonable access to the individual
resident to verify compliance with the requirements of the Sex Offender
Registration Act, to verify compliance with the requirements of Public Act
94-163 and Public Act 94-752, or to verify compliance with
applicable terms of probation, parole, or mandatory supervised release. (Section
2-110(a-5) of the Act) Reasonable access under this provision shall not
interfere with the identified offender's medical or psychiatric care.
2) The facility staff shall meet
with local law enforcement officials to discuss the need for and to develop, if
needed, policies and procedures to address the presence of facility residents
who are registered sex offenders or are serving a term of parole, mandatory
supervised release or probation for a felony offense, including compliance with
Section 300.695 of this Part.
3) Every licensed facility shall provide to
every prospective and current resident and resident's guardian, and to every
facility employee, a written notice, prescribed by the Department,
advising the resident, guardian, or employee of his or her right to ask whether
any residents of the facility are identified offenders. The facility shall
confirm whether identified offenders are residing in the facility.
A) The notice shall also be prominently
posted within every licensed facility.
B) The notice shall include a statement that
information regarding registered sex offenders may be obtained from the Illinois
State Police website, www.isp.state.il.us, and that information
regarding persons serving terms of parole or mandatory supervised release may
be obtained from the Illinois Department of Corrections website, www.idoc.state.il.us.
(Section 2-216 of the Act)
4) If the identified offender is on probation,
parole, or mandatory supervised release, the facility shall contact the
resident's probation or parole officer, acknowledge the terms of release,
update contact information with the probation or parole office, and maintain
updated contact information in the resident's record. The record must also
include the resident's criminal history record.
g) Facilities shall maintain written
documentation of compliance with Section 300.615 of this Part.
h) Facilities shall annually complete all of
the steps required in subsection (f) of this Section for identified offenders.
This requirement does not apply to residents who have not been discharged from
the facility during the previous 12 months.
i) For current residents who are identified
offenders, the facility shall review the security measures listed in the Identified
Offender Report and Recommendation provided by the Department of the State
Police.
j) Upon admission of
an identified offender to a facility or a decision to retain an identified offender in a facility, the
facility, in consultation with the medical director and law enforcement, shall
specifically address the resident's needs in an individualized plan of care.
k) The facility shall incorporate the Identified
Offender Report and Recommendation into the identified offender's care
plan. (Section 2-201.6(f) of the Act)
l) If the identified offender is a
convicted (see 730 ILCS 150/2) or registered (see 730 ILCS 150/3)
sex offender or if the Identified Offender Report and
Recommendation prepared pursuant to Section 2-201.6(a) of the Act reveals
that the identified offender poses a significant risk of harm to others
within the facility, the offender shall be required to have his or her
own room within the facility subject to the rights of married residents
under Section 2-108(e) of the Act. (Section 2-201.6(d) of the Act)
m) The facility's reliance on the Identified
Offender Report and Recommendation prepared pursuant to Section 2-201.6(a) of
the Act shall not relieve or indemnify in any manner the facility's liability
or responsibility with regard to the identified offender or other facility
residents.
n) The facility shall evaluate care plans at
least quarterly for identified offenders for appropriateness and effectiveness
of the portions specific to the identified offense and shall document such
review. The facility shall modify the care plan if necessary in response to
this evaluation. The facility remains responsible for continuously evaluating
the identified offender and for making any changes in the care plan that are
necessary to ensure the safety of residents.
o) Incident reports shall be submitted to the
Division of Long-Term Care Field Operations in the Department's Office of
Health Care Regulation in compliance with Section 300.690 of this Part. The
facility shall review its placement determination of identified offenders based
on incident reports involving the identified offender. In incident reports
involving identified offenders, the facility shall identify whether the
incident involves substance abuse, aggressive behavior, or inappropriate sexual
behavior, as well as any other behavior or activity that would be reasonably
likely to cause harm to the identified offender or others. If the facility
cannot protect the other residents from misconduct by the identified offender,
then the facility shall transfer or discharge the identified offender in
accordance with Section 300.3300 of this Part.
p) The facility shall notify the appropriate
local law enforcement agency, the Illinois Prisoner Review Board, or the
Department of Corrections of the incident and whether it involved substance
abuse, aggressive behavior, or inappropriate sexual behavior that would
necessitate relocation of that resident.
q) The facility shall develop procedures for
implementing changes in resident care and facility policies when the resident
no longer meets the definition of identified offender.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.626 DISCHARGE PLANNING FOR IDENTIFIED OFFENDERS
Section 300.626 Discharge Planning for Identified
Offenders
a) If,
based on the security measures listed in the Identified Offender
Report and Recommendation, a facility determines that it cannot manage the
identified offender resident safely within the facility, it shall commence
involuntary transfer or discharge proceedings pursuant to Section 3-402 of
the Act and Section 300.3300 of this Part. (Section 2-201.6(g) of the
Act)
b) All discharges and transfers shall be pursuant
to Section 300.3300 of this Part.
c) When a resident who is an identified offender is
discharged, the discharging facility shall notify the Department.
d) A
facility that admits or retains an identified offender shall have in place
policies and procedures for the discharge of an identified offender for reasons
related to the individual's status as an identified offender, including, but
not limited to:
1) The facility's inability to meet the needs of
the resident, based on Section 300.625 of this Part and subsection (a) of this
Section;
2) The
facility's inability to provide the security measures necessary to protect
facility residents, staff and visitors; or
3) The
physical safety of the resident, other residents, the facility staff, or
facility visitors.
e) Discharge planning shall be included as part of
the plan of care developed pursuant to Section 300.625(j).
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.627 TRANSFER OF AN IDENTIFIED OFFENDER
Section 300.627 Transfer of an Identified
Offender
a) If,
based on the security measures listed in the Identified Offender Report
and Recommendation, a facility determines that it cannot manage the identified
offender resident safely within the facility, it shall commence involuntary
transfer or discharge proceedings pursuant to Section 3-402 of the Act and
Section 300.3300 of this Part. (Section 2-201.6(g) of the Act)
b) All
discharges and transfers shall be pursuant to Section 300.3300
of this Part.
c) When
a resident who is an identified offender is transferred to another facility
regulated by the Department, the Department of Healthcare and Family Services,
or the Department of Human Services, the transferring facility shall notify the
Department and the receiving facility that the individual is an identified
offender before making the transfer.
d) This
notification shall include all of the documentation required under Section
300.625 of this Part and subsection (a) of this Section, and the transferring
facility shall provide this information to the receiving facility to complete
the discharge planning.
e) If
the following information has been provided to the transferring facility from
the Department of Corrections, the transferring facility shall provide copies
to the receiving facility before making the transfer:
1) The
mittimus and any pre-sentence investigation reports;
2) The
social evaluation prepared pursuant to Section 3-8-2 of the Unified Code of
Corrections;
3) Any
pre-release evaluation conducted pursuant to subsection (j) of Section 3-6-2 of
the Unified Code of Corrections;
4) Reports of
disciplinary infractions and dispositions;
5) Any
parole plan, including orders issued by the Illinois Prisoner Review Board and
any violation reports and dispositions; and
6) The
name and contact information for the assigned parole agent and parole
supervisor. (Section 3-14-1 of the Unified Code of Corrections)
f) The
information required by this Section shall be provided upon transfer. Information
compiled concerning an identified offender shall not be further disseminated
except to the resident; the resident's legal representative; law enforcement
agencies; the resident's parole or probation officer; the Division of Long Term
Care Field Operations in the Department's Office of Health Care Regulation;
other facilities licensed by the Department, the Illinois Department of
Healthcare and Family Services, or the Illinois Department of Human Services
that are or will be providing care to the resident, or are considering whether
to do so; health care and social service providers licensed by the Illinois
Department of Financial and Professional Regulation who are or will be
providing care to the resident, or are considering whether to do so; health
care facilities and providers in other states that are licensed and/or
regulated in their home state and would be authorized to receive this information
if they were in Illinois.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.630 CONTRACT BETWEEN RESIDENT AND FACILITY
Section 300.630 Contract
Between Resident and Facility
a) Contract Execution
1) Before a person is admitted to a facility, or at the
expiration of the period of previous contract, or when the source of payment
for the resident's care changes from private to public funds or from public to
private funds, a written contract shall be executed between a licensee and the
following in order of priority:
A) The person, or if the person is a minor, his parent or
guardian; or
B) The person's guardian, if any, or agent, if any, as defined
in Section 2-3 of the Illinois Power of Attorney Act; or
C) A member of the person's immediate family. (Section
2-202(a) of the Act)
2) An adult person shall be presumed to have the capacity to
contract for admission to a long-term care facility unless he has been
adjudicated a "disabled person" within the meaning of Section 11a-2
of the Probate Act of 1975, or unless a petition for such an
adjudication is pending in a circuit court of Illinois. (Section 2-202(a) of
the Act)
3) If there is no guardian, agent or member of the person's
immediate family available, able or willing to execute the contract required by
Section 2-202 of the Act and a physician determines that a person is so
disabled as to be unable to consent to placement in a facility, or if a person
has already been found to be a "disabled person," but no order has
been entered allowing residential placement of the person, that person may be
admitted to a facility before the execution of a contract required by that
Section; provided that a petition for guardianship or for modification of
guardianship is filed within 15 days of the person's admission to a facility,
and provided further that such a contract is executed within ten days of the
disposition of the petition. (Section 2-202(a) of the Act)
4) No adult shall be admitted to a facility if he objects,
orally or in writing, to such admission, except as otherwise provided in
Chapters III and IV of the Mental Health and Developmental Disabilities Code,
or Section 11a-14.1 of the Probate Act of 1975. (Section 2-202(a) of the
Act)
5) If on the effective date of this Part, a person has not
executed a contract as required by Section 2-202 of the Act, then such a
contract shall be executed by, or on behalf of, the person, within ten days of
the effective date of this Part, unless a petition has been filed for
guardianship or modification of guardianship. If a petition for guardianship
or modification of guardianship has been filed, and there is no guardian, agent
or a member of the person's immediate family available, able, or willing to execute
the contract at that time, then a contract shall be executed within ten days of
the disposition of such petition.
b) The contract shall be clearly and unambiguously entitled,
"Contract Between Resident and (name of facility)."
c) Before a licensee (any facility licensed under the Act)
enters a contract under Section 2-202 of the Act, it shall provide the
prospective resident and his guardian, if any, with written notice of the
licensee's policy regarding discharge of a resident whose private funds for
payment of care are exhausted. (Section 2-202(a) of the Act)
d) A resident shall not be discharged or transferred at the
expiration of the term of a contract, except as provided in Sections 3-401
through 3-423 of the Act. (Section 2-202(b) of the Act)
e) At the time of the resident's admission to the facility, a
copy of the contract shall be given to the resident, his guardian, if any, and
any other person who executed the contract. (Section 2-220(c) of the Act)
f) The contract shall be signed by the licensee or his agent.
The title of each person signing the contract for the facility shall be clearly
indicated next to each such signature. The nursing home administrator may sign
as the agent of the licensee.
g) The contract shall be signed by, or for, the resident, as
described in subsection (a) of this Section. If any person other than the
principal signatory is to be held individually responsible for payments due
under the contract, that person shall also sign the contract on a separate signature
line labelled "signature of responsible party" or "signature of
guarantor."
h) The contract shall include a definition of "responsible
party" or "guarantor," which describes in full the liability
incurred by any such person.
i) A copy of the contract for a resident who is supported by
nonpublic funds other than the resident's own funds shall be made available to
the person providing the funds for the resident's support. (Section
2-202(d) of the Act)
j) The original or a copy of the contract shall be maintained
in the facility and be made available upon request to representatives of the
Department and the Department of Public Aid. (Section 2-202(e) of the Act)
k) The contract shall be written in clear and unambiguous
language and shall be printed in not less than 12 point type. (Section
2-202(f) of the Act)
l) The contract shall specify the term of the contract.
(Section 2-202(g)(1) of the Act) The term can be until a certain date or
event. If a certain date is specified in the contract, an addendum can extend
the term of the contract to another date certain or on a month-to-month basis.
m) The contract shall specify the services to be provided under
the contract and the charges for the services. (Section 2-202(g)(2) of the
Act) A paragraph shall itemize the services and products to be provided by the
facility and express the costs of the itemized services and products to be
provided either in terms of a daily, weekly, monthly or yearly rate, or in
terms of a single fee. The contract may provide that the charges for services
may be changed with thirty (30) days advance written notice to the resident or
the person executing the contract on behalf of the resident. The resident or
the person executing the contract on behalf of the resident may either assent
to the change or choose to terminate the contract at any time within 30 days of
the receipt of the written notice of the change. The written notice shall
become an addendum to the contract.
n) The contract shall specify the services that may be
provided to supplement the contract and the charges for the services.
(Section 2-202(g)(3) of the Act)
1) A paragraph shall itemize all services and products offered by
the facility or related institutions which are not covered by the rate or fee
established in subsection (m) of this Section. If a separate rate or fee for
any such supplemental service or product can be calculated with definiteness at
the time the contract is executed, then such additional cost shall be specified
in the contract.
2) If the cost of any itemized service or product to be provided
to the resident by the facility or related institutions cannot be established
or predicted with definiteness at the time of the resident's admission to the
facility or at the time of the execution of the contract, then no cost for that
service or product need be stated in the contract. But the contract shall
include a statement explaining the resident's liability for such itemized
service or product and explaining that the resident will be receiving a bill
for such itemized service or product beyond and in addition to any rate or fee
set forth in the contract.
3) The contract may provide that the charges for services and
products not covered by the rate or fee established in subsection (m) may be
changed with thirty (30) days advance written notice to the resident or the
person executing the contract on behalf of the resident. The resident or the
person executing the contract on behalf of the resident may either assent to
the change or choose to terminate the contract at any time within 30 days of
the receipt of the written notice of the change. The written notice shall
become an addendum to the contract.
o) The contract shall specify the sources liable for payment
due under the contract. (Section 2-202(g)(4) of the Act)
p) The contract shall specify the amount of deposit paid.
(Section 2-202(g)(5) of the Act) Such amount shall be expressed in terms of a
precise number of dollars and be clearly designated as a deposit. The contract
shall specify when such deposit shall be paid by the resident, and the contract
shall specify when such deposit shall be returned by the facility. The
contract shall specify the conditions (if any) which must be satisfied by the
resident before the facility shall return the deposit. Upon the satisfaction
of all such conditions, the deposit shall be returned to the resident. If the
deposit is nonrefundable, the contract shall provide express notice of such
nonrefundability.
q) The contract shall specify the rights, duties and
obligations of the resident, except that the specification of a resident's
rights may be furnished on a separate document which complies with the
requirements of Section 2-211 of the Act. (Section 2-202(g)(6) of the Act)
r) The contract shall designate the name of the resident's
representative, if any. The resident shall provide the facility with a
copy of the written agreement between the resident and the resident's
representative which authorizes the resident's representative to inspect and
copy the resident's records and authorizes the resident's representative to
execute the contract on behalf of the resident required by Section 2-202 of the
Act. (Section 2-202(h) of the Act)
s) The contract shall provide that if the resident is
compelled by a change in physical or mental health to leave the facility, the
contract and all obligations under it shall terminate on seven days notice.
No prior notice of termination of the contract shall be required, however,
in the case of a resident's death. The contract shall also provide that
in all other situations, a resident may terminate the contract and all
obligations under it with 30 days notice. All charges shall be prorated as of
the date on which the contract terminates, and, if any payments have been made
in advance, the excess shall be refunded to the resident. This provision
shall not apply to life-care contracts through which a facility agrees to
provide maintenance and care for a resident throughout the remainder of the
resident's life nor to continuing-care contracts through which a facility
agrees to supplement all available forms of financial support in providing
maintenance and care for a resident throughout the remainder of the resident's
life. (Section 2-202(i) of the Act)
t) All facilities which offer to provide a resident with nursing
services, medical services or personal care services, in addition to
maintenance services, 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, for a term in excess
of one year or for life pursuant to a life care contract, shall meet all of the
provisions of the Life Care Facilities Act (Ill. Rev. Stat. 1991, ch. 111½,
par. 4160-1 et seq.) [210 ILCS 40], including the obtaining of a permit from
the Department, before they may enter into such contracts. (Section 2(c) of
the Life Care Facilities Act)
u) In addition to all other contract specifications contained
in this Section, admission contracts shall also specify:
1) whether the facility accepts Medicaid clients;
2) whether the facility requires a deposit of the resident or
his family prior to the establishment of Medicaid eligibility;
3) in the event that a deposit is required, a clear and
concise statement of the procedure to be followed for the return of such
deposit to the resident or the appropriate family member or guardian of the
person;
4) that all deposits made to a facility by a resident, or on
behalf of a resident, shall be returned by the facility within 30 days of the
establishment of Medicaid eligibility, unless such deposits must be drawn upon
or encumbered in accordance with Medicaid eligibility requirements established
by the Illinois Department of Public Aid. (Section 2-202(j) of the Act)
v) It shall be a business offense for a facility to knowingly
and intentionally both retain a resident's deposit and accept Medicaid payments
on behalf of the resident. (Section 2-202(k) of the Act)
(Source: Amended at 18 Ill. Reg. 15868, effective October 15, 1994)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.640 RESIDENTS' ADVISORY COUNCIL
Section 300.640 Residents'
Advisory Council
a) Each facility shall establish a residents' advisory council
consisting of at least five resident members. If there are not five residents
capable of functioning on the residents' advisory council, as determined by the
Interdisciplinary Team, residents' representatives shall take the place of the
required number of residents. The administrator shall designate another
member of the facility staff other than the administrator to coordinate
the establishment of, and render assistance to, the council. (Section
2-203 of the Act)
b) Each facility shall develop and implement a plan for assuring
a liaison with concerned individuals and groups in the local community. Ways
in which this requirement can be met include, but are not limited to, the
following:
1) the inclusion of community members such as volunteers, family
members, residents' friends, residents' advocates, or community
representatives, etc. on the council;
2) the establishment of a separate community advisory group with
persons of the residents' choosing; or
3) finding a church or civic group to "adopt" the
facility.
c) The resident members shall be elected to the council by vote
of their fellow residents and the nonresident members shall be elected to the
council by vote of the resident members of the council.
d) In facilities of 50 or fewer beds, the council may consist of
all of the residents of the facility, if the residents choose to operate this
way.
e) All residents' advisory councils shall elect at least a
Chairperson or President and a Vice Chairperson or Vice President from among
the members of the council. These persons shall preside at the meetings of the
council, assisted by the facility staff person designated by the administrator
to provide such assistance.
f) Some facilities may wish to establish mini-residents' advisory
councils for various smaller units within the facility. If this is done, each
such unit shall be represented on an overall facility residents' advisory
council with the composition described in subsection (a) of this Section.
g) All residents' advisory council meetings shall be open to
participation by all residents and by their representatives.
h) No employee or affiliate of any facility shall be a member
of any council. Such persons may attend to discuss interests or functions
of the non-members when invited by a majority of the officers of the council.
(Section 2-203(a) of the Act)
i) The council shall meet at least once each month with the
staff coordinator who shall provide assistance to the council in preparing and
disseminating a report of each meeting to all residents, the administrator, and
the staff. (Section 2-203(b) of the Act)
j) Records of the council meetings shall be maintained in the
office of the administrator. (Section 2-203(c) of the Act)
k) The residents' advisory council may communicate to the
administrator the opinions and concerns of the residents. The council shall
review procedures for implementing resident rights and facility
responsibilities and make recommendations for changes or additions which will
strengthen the facility's policies and procedures as they affect residents'
rights and facility responsibilities. (Section 2-203(d) of the Act)
l) The council shall be a forum for:
1) Obtaining and disseminating information;
2) Soliciting and adopting recommendations for facility programming
and improvements;
3) Early identification of problems;
4) Recommending orderly resolution of problems. (Section
2-203(e) of the Act)
m) The council may present complaints on behalf of a resident
to the Department, or to any other person it considers appropriate.
(Section 2-203(f) of the Act)
n) Families
and friends of residents who live in the community retain the right to form
family councils.
1) If
there is a family council in the facility, or if one is formed at the request
of family members or the ombudsman, a facility shall make information about
the family council available to all current and prospective residents, their
families and their representatives. The information shall be provided by the
family council, prospective members or the ombudsman.
2) If a
family council is formed, facilities shall provide a place for the family
council to meet.
(Source: Amended at 31 Ill.
Reg. 8813, effective June 6, 2007)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.650 PERSONNEL POLICIES
Section 300.650 Personnel
Policies
a) Each facility shall develop and maintain written personnel
policies that are followed in the operation of the facility. These policies
shall include, at a minimum, each of the following requirements.
b) Employee Records
1) Employment application forms shall be completed for each
employee and kept on file in the facility. Completed forms shall be available
to Department personnel for review.
2) Individual personnel files for each employee shall contain
date of birth; home address; educational background; experience, including
types and places of employment; date of employment and position employed to
fill in this facility; and (if no longer employed in this facility) last date
employed and reasons for leaving.
3) Facilities shall maintain a confidential medical file for each
employee that shall contain health records, including the employee's
vaccination and testing records, initial health evaluation and the results of
the tuberculin skin test required under Section 300.655, and any other
pertinent health records.
4) Individual personnel records for each employee shall also
contain records of evaluation of performance.
c) Prior to employing any individual in a position that requires
a State license, the facility shall contact the Illinois Department of Financial
and Professional Regulation to verify that the individual's license is active.
A copy of the license shall be placed in the individual's personnel file.
d) The facility shall check the Health Care Worker Registry for
the work eligibility status of all applicants who are under the jurisdiction of
the Healthcare Worker Background Check Act prior to hiring.
e) All personnel shall have either training or experience, or
both, in the job assigned to them.
f) Orientation and In-Service Training
1) All new employees, including student interns, shall complete
an orientation program covering, at a minimum, the following: general facility
and resident orientation; job orientation, emphasizing allowable duties of the
new employee; resident safety, including fire and disaster, emergency care and
basic resident safety; infection prevention and control; and understanding and
communicating with the type of residents being cared for in the facility. In
addition, all new direct care staff, including student interns, shall complete
an orientation program covering the facility's policies and procedures for
resident care services before being assigned to provide direct care to
residents. This orientation program shall include information on the
prevention and treatment of decubitus ulcers and the importance of nutrition in
general health care.
2) All employees, except student interns shall attend in-service
training programs pertaining to their assigned duties at least annually. These
in-service training programs shall include the facility's policies, including
infection prevention and control policies required in Section 300.696, skill
training and ongoing education to enable all personnel to perform their duties
effectively. The in-service training sessions regarding personal care, nursing
and restorative services shall include information on the prevention and
treatment of decubitus ulcers. In-service training concerning dietary services
shall include information on the effects of diet in treatment of various
diseases or medical conditions and the importance of laboratory test results in
determining therapeutic diets. Written records of program content for each
session and of personnel attending each session shall be kept.
3) All facilities shall provide training and education on the
requirements of Section 2-106.1 of the Act and Section 300.686 of
this Part to all personnel involved in providing care to residents, and
train and educate those personnel on the methods and procedures to effectively
implement the facility's policies. Training and education provided under
Section 2-106.1 of the Act and Section 300.686 shall be documented in
each personnel file. (Section 2-106.1(b-15) of the Act)
g) Employees shall be assigned duties that are directly related to
their functions, as identified in their job descriptions. Exceptions may be
made in emergencies.
h) Licensed staff who administer life sustaining treatments and
high-acuity services as described in Sections 300.697(d) and 300.1035(b)(2)
shall be adequately trained to administer those treatments.
i) Personnel policies shall include a plan to provide personnel
coverage for regular staff when they are absent.
(Source:
Amended at 49 Ill. Reg. 6468, effective April 22, 2025)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.651 WHISTLEBLOWER PROTECTION
Section 300.651 Whistleblower Protection
a) For
the purposes of this Section, "retaliatory action" means the
reprimand, discharge, suspension, demotion, denial of promotion or transfer, or
change in the terms and conditions of employment of any employee of a facility
that is taken in retaliation for the employee's involvement in a protected
activity as set forth in Section 3-810 of the Act and this Section
300.651. (Section 3-810(a) of the Act)
b) A
facility shall not take any retaliatory action against an employee of the
facility, including a nursing home administrator, because the employee does any
of the following:
1) Discloses
or threatens to disclose to a supervisor or to a public body an activity,
inaction, policy, or practice implemented by a facility that the employee
reasonably believes is in violation of a law, rule, or regulation.
2) Provides
information to or testifies before any public body conducting an investigation,
hearing, or inquiry into any violation of a law, rule, or regulation by a
nursing home administrator.
3) Assists
or participates in a proceeding to enforce the provisions of the Act
and this Part. (Section 3-810(b) of the Act)
c) A
violation of the Act and this Section may be established only upon a
finding that the employee of the facility engaged in conduct described in
subsection (b) of Section 3-810 of the Act and this Section 300.651 and
this conduct was a contributing factor in the retaliatory action alleged by the
employee. There is no violation of this Section, however, if the
facility demonstrates by clear and convincing evidence that it would have taken
the same unfavorable personnel action in the absence of that conduct.
(Section 3-810(c) of the Act)
d) The
employee of the facility may be awarded all remedies necessary to make the
employee whole and to prevent future violations of this Section.
Remedies imposed by the court may include, but are not limited to, all of the
following:
1) Reinstatement
of the employee to either the same position held before the retaliatory action
or to an equivalent position;
2) Two
times the amount of back pay;
3) Interest
on the back pay;
4) Reinstatement
of full fringe benefits and seniority rights; and
5) Payment
of reasonable costs and attorney's fees. (Section 3-810(d) of the Act)
(Source: Added at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.655 INITIAL HEALTH EVALUATION FOR EMPLOYEES
Section 300.655 Initial
Health Evaluation for Employees
a) Each employee shall have an initial health evaluation which
shall be used to insure that employees are not placed in positions which would
pose undue risk of infection to themselves, other employees, residents, or
visitors.
b) The initial health evaluation shall be conducted not more than
30 days prior to the employee beginning employment in the facility. The
evaluation shall be completed not more than 30 days after the employee begins
employment in the facility.
c) The initial health evaluation shall include a health
inventory. This inventory shall be obtained from the employee and shall
include the employee's immunization status and any available history of
conditions which would predispose the employee to acquiring or transmitting
infectious diseases. This inventory shall include any history of exposure to,
or treatment for, tuberculosis. The inventory shall also include any history
of hepatitis, dermatologic conditions, or chronic draining infections or open
wounds.
d) The initial health evaluation shall include a physical
examination. The examination shall include at a minimum any procedures needed
in order to:
1) Detect any unusual susceptibility to infection and any
conditions which would increase the likelihood of the transmission of disease
to residents, other employees, or visitors.
2) Determine that the employee appears to be physically able to
perform the job functions which the facility intends to assign to the employee.
e) The initial health evaluation shall include a tuberculin skin
test which is conducted in accordance with the requirements of Section
300.1025. The test must meet one of the following timeframes:
1) The test must be completed no more than 90 days prior to the
date of initial employment in the facility, or
2) The test must be commenced no more than ten days after the
date of initial employment in the facility.
(Source: Added at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.660 NURSING ASSISTANTS
Section 300.660 Nursing
Assistants
a) A facility shall not employ an individual as a nursing
assistant, home health aide, psychiatric services rehabilitation aide, or newly
hired as an individual who may have access to a resident, a resident's living
quarters, or a resident's personal, financial, or medical records, nurse aide unless
the facility has inquired of the Department's Health Care Worker Registry and
the individual is listed on the Health Care Worker Registry as eligible to work
for a health care employer.
b) The facility shall not employ an individual as a nursing
assistant if that individual is not on the Health Care Worker Registry unless
the individual is enrolled in a training program as defined in Section
3-206(a)(5) of the Act. (Section 3-206.01(a) of the Act)
c) The facility shall ensure that each nursing assistant complies
with one of the following conditions:
1) Is approved on the Department's Health Care Worker Registry.
"Approved" means that the nurse aide has met the training or
equivalency requirements of Section 300.663 of this Part and does not have a
disqualifying criminal background check without a waiver.
2) Within 120 days after initial employment, submits
documentation to the Department in accordance with Section 300.663 of this Part
to be registered on the Health Care Worker Registry.
d) The facility shall ensure that each person employed by the
facility as a nursing assistant has met each of the following requirements:
1) Is at least sixteen years of age, of temperate habits and
good moral character, honest, reliable and trustworthy (Section 3-206
(a)(1) of the Act);
2) Is able to speak and understand the English language or a
language understood by a substantial percentage of the facility's residents
(Section 3-206(a)(2) of the Act);
3) Has provided evidence of prior employment or
occupation, if any, and residence for two years prior to present
employment (Section 3-206(a)(3) of the Act);
4) Has completed at least eight years of grade school
or has provided proof of equivalent knowledge (Section 3-206(a)(4)
of the Act);
5) Has
completed the training or equivalency requirements for certified nursing
assistants, or has begun a current course of training for certified nursing
assistants, approved by the Department, within 45 days of initial employment in
the capacity of a certified nursing assistant at any facility. Such
courses of training shall be successfully completed within 120 days of initial
employment in the capacity of certified nursing assistant at a facility,
except as follows:
A) Nursing
assistants who are enrolled in approved courses in community colleges or other
educational institutions on a term, semester, or trimester basis, shall be
exempt from the 120-day completion time limit. During a statewide public
health emergency, as defined in the Illinois Emergency Management Agency Act,
all nursing assistants shall, to the extent feasible, complete the training.
(Section 3-206(a)(5) of the Act)
B) The
Department may accept comparable training in lieu of the 120-hour course for
student nurses, foreign nurses, military personnel, or employees of the
Department of Human Services. (Section 3-206(a)(5) of the Act)
6) Is familiar
with and has general skills related to resident care.
e) The facility shall develop and implement
procedures, which shall be approved by the Department, for an ongoing competency
review process, which shall take place within the facility, for certified
nursing assistants.
f) At the time of each regularly scheduled
licensure survey, or at the time of a complaint investigation, the Department
may require any certified nursing assistant to demonstrate, either
through written examination or action, or both, sufficient knowledge in all
areas of required training and competency in the principles,
techniques, and procedures covered by the certified nursing assistant training
program curriculum described in 77 Ill. Adm. Code 395 when possible problems in
the care provided by aides or other evidences of inadequate training are
observed. The State- approved
manual skills evaluation testing format and forms will be used to determine
competency of a certified nursing assistant when appropriate. If such knowledge or
competency is inadequate the Department shall require the certified nursing
assistant to complete in-service training and review in the facility until the certified
nursing assistant demonstrates to the Department, either through written
examination or action, or both, sufficient knowledge in all areas of required
training. The in-service training shall address the certified
nursing assistant training principles and techniques relative to the procedures
in which the certified nursing assistants are found to be deficient during
inspection (see 77 Ill. Adm. Code 395). (Section 3-206(a)(5) of the Act)
g) The facility shall certify that each nursing assistant
employed by the facility meets the requirements of this Section. Such
certification shall be retained by the facility as part of the employee's
personnel record.
(Source: Amended at 48 Ill. Reg. 3317,
effective February 16, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.661 HEALTH CARE WORKER BACKGROUND CHECK
Section 300.661 Health Care
Worker Background Check
A facility shall comply with the
Health Care Worker Background Check Act and the Health Care Worker Background
Check Code.
(Source: Amended at 45 Ill.
Reg. 11096, effective August 27, 2021)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.662 RESIDENT ATTENDANTS
Section 300.662 Resident
Attendants
a) As used in this Section, "resident attendant"
means an individual who assists residents in a facility with the following
activities:
1) eating and drinking; and
2) personal hygiene limited to washing a resident's hands and
face, brushing and combing a resident's hair, oral hygiene, shaving residents
with an electric razor, and applying makeup. (Section 3-206.03(a) of the
Act)
b) The term "resident attendant" does not include an
individual who:
1) is a licensed health professional or a registered
dietitian;
2) volunteers without monetary compensation;
3) is a nursing assistant; or
4) performs any nursing or nursing-related services for
residents of a facility. (Section 3-206.03(b) of the Act)
c) A facility may employ resident attendants to assist the
nurse aides with the activities authorized under subsection (a) of this
Section. The resident attendants shall not count in the minimum staffing
requirements under this Part. (Section 3-206.03(b) of the Act)
d) Each person employed by the facility as a resident attendant
shall meet the following requirements:
1) Be at least 16 years of age; and
2) Be able to speak and understand the English language or a
language understood by a substantial percentage of the facility's residents.
e) Resident attendants shall be supervised by and shall report to
a nurse.
f) The facility shall develop and implement policies and
procedures concerning the duties of resident attendants in accordance with this
Section, and shall document such duties in a written job description.
g) As part of the comprehensive assessment (see Section
300.1220), each resident shall be evaluated to determine whether the resident
may or may not be fed, hydrated or provided personal hygiene by a resident
attendant. Such evaluation shall include, but not be limited to, the
resident's level of care; the resident's functional status in regard to
feeding, hydration, and personal hygiene; the resident's ability to cooperate
and communicate with staff.
h) A facility may not use on a full-time or other paid basis
any individual as a resident attendant in the facility unless the individual:
1) has completed a Department-approved training and
competency evaluation program encompassing the tasks the individual provides;
and
2) is competent to provide feeding, hydration, and personal
hygiene services. (Section 3-206.03(c) of the Act) The individual shall be
deemed to be competent if he/she is able to perform a hands-on return
demonstration of the required skills, as determined by a nurse.
i) The facility shall maintain documentation of completion of
the training program and determination of competency for each person employed
as a resident attendant.
j) A facility-based training and competency evaluation
program shall be conducted by a nurse and/or dietician and shall include
one or more of the following units:
1) A feeding unit that is at least five hours in length
and that is specific to the needs of the residents, and that includes the
anatomy of digestion and swallowing; feeding techniques; developing an
awareness of eating limitations; potential feeding problems and complications;
resident identification; necessary equipment and materials; resident privacy;
handwashing; use of disposable gloves; verbal and nonverbal communication
skills; behavioral issues and management techniques; signs of choking; signs
and symptoms of aspiration; and Heimlich maneuver;
2) A hydration unit that is at least three hours in
length and that includes the anatomy of digestion and swallowing; hydration
technique; resident identification; necessary equipment and materials;
potential hydration problems and complications; verbal and nonverbal
communication skills; behavioral issues and management techniques; use of
disposable gloves; signs of choking; signs and symptoms of aspiration;
handwashing; and resident privacy;
3) A personal hygiene unit that is at least five hours
in length and includes oral hygiene technique, denture care; potential oral
hygiene problems and complications; resident identification; verbal and
nonverbal communication skills; behavioral issues and management techniques;
resident privacy; handwashing; use of disposable gloves; hair combing and
brushing; face and handwashing technique; necessary equipment and materials;
shaving technique. (Section 3-206.03(d) of the Act)
k) All training shall also include a unit in safety and resident
rights that is at least five hours in length and that includes resident rights;
fire safety, use of a fire extinguisher, evacuation procedures; emergency and
disaster preparedness; infection control; and use of the call system.
l) Each resident attendant shall be given instruction by a nurse
or dietician concerning the specific feeding, hydration, and/or personal
hygiene care needs of the resident whom he or she will be assigned to assist.
m) Training programs shall be reviewed and approved by the
Department every two years. (Section 3-206.03(d) of the Act)
n) Training programs shall not be implemented prior to initial
Department approval.
o) Application for initial approval of facility-based and
non-facility-based training programs shall be in writing and shall include:
1) An outline containing the methodology, content, and objectives
for the training program. The outline shall address the curriculum
requirements set forth in subsection (h) of this Section for each unit included
in the program;
2) A schedule for the training program;
3) Resumes describing the education, experience, and
qualifications of each program instructor, including a copy of any valid
Illinois licenses, as applicable; and
4) A copy or description of the tools that will be used to
evaluate competency.
p) The Department will evaluate the initial application and
proposed program for conformance to the program requirements contained in this
Section. Based on this review, the Department will:
1) Grant approval of the proposed program for a period of two
years;
2) Grant approval of the proposed program contingent on the
receipt of additional materials, or revision, needed to remedy any minor
deficiencies in the application or proposed program, which would not prevent
the program from being implemented, such as deficiencies in the number of hours
assigned to cover different areas of content, which can be corrected by
submitting a revised schedule or outline; or
3) Deny approval of the proposed program based on major
deficiencies in the application or proposed program that would prevent the
program from being implemented, such as deficiencies in the qualifications of
instructors or missing areas of content.
q) Programs shall be resubmitted to the Department for review
within 60 days prior to expiration of program approval.
r) If the Department finds that an approved program does not
comply with the requirements of this Section, the Department will notify the
facility in writing of non-compliance of the program and the reason for the
finding.
s) If the Department finds that any conditions stated in the
written notice of non-compliance issued under subsection (r) of this Section
have not been corrected within 30 days after the date of issuance of such
notice, the Department will revoke its approval of the program.
t) Any change in program content or objectives shall be
submitted to the Department at least 30 days prior to program delivery. The
Department will review the proposed change based on the requirements of this
Section and will either approve or disapprove the change. The Department will
notify the facility in writing of the approval or disapproval.
u) A person seeking employment as a resident attendant is
subject to the Health Care Worker Background Check Act (Section 3-206.03(f)
of the Act) and Section 300.661 of this Part.
(Source: Added at 24 Ill. Reg. 17330, effective November 1, 2000)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.663 REGISTRY OF CERTIFIED NURSING ASSISTANTS
Section 300.663 Registry of
Certified Nursing Assistants
a) An individual will be included on the Health Care Worker
Registry as a certified nursing assistant when the individual has successfully
completed a training program approved in accordance with the Long-Term Care
Assistants and Aides Training Programs Code, successfully completes the
required competency examination, and meets background check information
required in Section 300.661 of this Part, and when there are no findings of
abuse, neglect, or misappropriation of property in accordance with Section
955.310 of the Health Care Worker Background Check Code.
b) An individual who has not completed a Department-approved nurse
aide training program in Illinois will be included on the Health Care Worker
Registry as a certified nursing assistant if the individual has met background
check information required in Section 300.661 of this Part and submits
documentation supporting one of the following equivalencies:
1) Documentation of current registration from another state
indicating that the requirements of 42 CFR 483.151 − 483.156 have been
met and that there are no documented findings of abuse, neglect, or
misappropriation of property.
2) Documentation of successful completion of a nursing arts
course (e.g., Basics in Nursing, Fundamentals of Nursing, Nursing 101) with at
least 40 hours of supervised clinical experience in an accredited nurse
training program as evidenced by a diploma, certificate or other written
verification from the school and, within 120 days after employment, successful
completion of the written portion of the Department-established certified nursing
assistant competency test.
3) Documentation of successful completion of a United States
military training program that includes the content of a Department-approved
nurse aide training program as provided in 77 Ill. Adm. Code 395; at least 40
hours of supervised clinical experience, as evidenced by a diploma,
certification, DD-214, or other written verification, and, within 120 days
after employment, successful completion of the written portion of the
Department-established certified nursing assistant competency test.
4) Documentation of completion of a nursing program in a foreign
country, including the following, and, within 120 days after employment,
successful completion of the written portion of the Department-established certified
nursing assistant competency test:
A) A copy of the license, diploma, registration or other proof of
completion of the program;
B) A copy of the Social Security card; and
C) Visa or proof of citizenship.
c) An individual shall notify the Health Care Worker Registry of
any change of address within 30 days and of any name change within 30 days
and shall submit proof of any name change to the Department. (Section 26 of the
Health Care Worker Background Check Act)
d) An individual may satisfy the supervised clinical
experience requirement for placement on the Health Care Worker Registry through
supervised clinical experience at an assisted living establishment licensed
under the Assisted Living and Shared Housing Act. (Section 3-206(5) of the
Act)
(Source: Amended at 45 Ill. Reg. 11096, effective August 27, 2021)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.664 CERTIFIED NURSING ASSISTANT INTERNS
Section 300.664
Certified Nursing Assistant Interns
a) A certified nursing
assistant intern shall report to a facility's charge nurse or nursing
supervisor and may only be assigned duties authorized in Section 2310-434 of
the Department of Public Health Powers and Duties Law of the Civil
Administrative Code of Illinois by a supervising nurse. (Section 3-614(a)
of the Act)
b) A facility shall
notify its certified and licensed staff members, in writing, that a certified
nursing assistant intern may only provide the services and perform the
procedures permitted under Section 2310-434 of the Department of Public Health
Powers and Duties Law of the Civil Administrative Code of Illinois.
1) The notification
shall detail which duties may be delegated to a certified nursing assistant
intern.
2) The facility shall
establish a policy describing the authorized duties, supervision, and
evaluation of certified nursing assistant interns available upon request of the
Department and any surveyor. (Section 3-614(b) of the Act)
c) If a facility learns
that a certified nursing assistant intern is performing work outside the scope
of the duties authorized in Section 2310-434 of the Department of Public Health
Powers and Duties Law of the Civil Administrative Code of Illinois, the
facility shall:
1) Stop the certified nursing assistant
intern from performing the work;
2) Inspect the work and
correct mistakes, if the work performed was done improperly;
3) Assign the work to the appropriate
personnel; and
4) Ensure that a
thorough assessment of any resident involved in the work performed is completed
by a registered nurse. (Section 3-614(c) of the Act)
d) A facility that
employs a certified nursing assistant intern in violation of this Section shall
be subject to civil penalties or fines under Section 3-305 of the Act. (Section
3-614(d) of the Act)
e) A minimum of 50% of
nursing and personal care time shall be provided by a certified nursing
assistant, but no more than 15% of nursing and personal care time may be
provided by a certified nursing assistant intern. (Section 3-614(e) of the
Act)
f) This
Section will be repealed effective November 1, 2027.
(Source: Added at 48 Ill. Reg. 13796, effective August
28, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.665 STUDENT INTERNS
Section 300.665 Student
Interns
a) No person who meets the definition of student intern in
Section 300.330 shall be required to complete a current course of training for
nursing assistants.
b) The facility may utilize student interns to perform basic
nursing assistant skills for which they have been evaluated and deemed
competent by an approved evaluator using the State approved manual skills
competency evaluation testing format and forms (see 77 Ill. Adm. Code 395.300),
but shall not allow interns to provide rehabilitation nursing (see Section
300.1210(b), in-bed bathing, assistance with skin care, foot care, or to
administer enemas, except under the direct, immediate supervision of a licensed
nurse.
c) No facility shall have more than fifteen percent of its
nursing assistant staff positions held by student interns.
(Source: Amended at 17 Ill. Reg. 19279, effective October 26, 1993)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.670 DISASTER PREPAREDNESS
Section 300.670 Disaster
Preparedness
a) For the purpose of this Section only, "disaster"
means an occurrence, as a result of a natural force or mechanical failure such
as water, wind or fire, or a lack of essential resources such as electrical
power, that poses a threat to the safety and welfare of residents, personnel,
and others present in the facility.
b) Each facility shall have policies covering disaster
preparedness, including a written plan for staff, residents and others to
follow. The plan shall include, but not be limited to, the following:
1) Proper instruction in the use of fire extinguishers for all
personnel employed on the premises;
2) A diagram of the evacuation route, which shall be posted and
made familiar to all personnel employed on the premises;
3) A written plan for moving residents to safe locations within
the facility in the event of a tornado warning or severe thunderstorm warning;
and
4) An established means of facility notification when the
National Weather Service issues a tornado or severe thunderstorm warning that
covers the area in which the facility is located. The notification mechanism shall
be other than commercial radio or television. Approved notification measures
include being within range of local tornado warning sirens, an operable
National Oceanic and Atmospheric Administration weather radio in the facility,
or arrangements with local public safety agencies (police, fire, emergency
management agency) to be notified if a warning is issued.
c) Fire drills shall be held at least quarterly for each shift of
facility personnel. Disaster drills for other than fire shall be held twice
annually for each shift of facility personnel. Drills shall be held under
varied conditions to:
1) Ensure that all personnel on all shifts are trained to perform
assigned tasks;
2) Ensure that all personnel on all shifts are familiar with the
use of the fire-fighting equipment in the facility; and
3) Evaluate the effectiveness of disaster plans and procedures.
d) Fire drills shall include simulation of the evacuation of
residents to safe areas during at least one drill each year on each shift.
e) The facility shall provide for the evacuation of physically
handicapped persons, including those who are hearing or sight impaired.
f) If the welfare of the residents precludes an actual evacuation
of an entire building, the facility shall conduct drills involving the
evacuation of successive portions of the building under conditions that assure
the capability of evacuating the entire building with the personnel usually
available, should the need arise.
g) A written evaluation of each drill shall be submitted to the
facility administrator and shall be maintained for one year.
h) A written plan shall be developed for temporarily relocating
the residents for any disaster requiring relocation and at any time that the
temperature in residents' bedrooms falls below 55°F. for 12 hours or more.
i) Reporting of Disasters
1) Upon the occurrence of any disaster requiring hospital
service, police, fire department or coroner, the facility administrator or
designee shall provide a preliminary report to the Department either by using
the nursing home hotline or by directly contacting the appropriate Department
Regional Office during business hours. This preliminary report shall include,
at a minimum:
A) The name and location of the facility;
B) The type of disaster;
C) The number of injuries or deaths to residents;
D) The number of beds not usable due to the occurrence;
E) An estimate of the extent of damages to the facility;
F) The type of assistance needed, if any; and
G) A list of other State or local agencies notified about the
problem.
2) If the disaster will not require direct Departmental
assistance, the facility shall provide a preliminary report within 24 hours
after the occurrence. Additionally, the facility shall submit a full written
account to the Department within seven days after the occurrence, which
includes the information specified in subsection (i)(1) of this Section and a
statement of actions taken by the facility after the preliminary report.
j) Each facility shall establish and implement policies and
procedures in a written plan to provide for the health, safety, welfare and
comfort of all residents when the heat index/apparent temperature (see Section
300.Table D), as established by the National Oceanic and Atmospheric
Administration, inside the facility exceeds 80°F.
k) Coordination with Local Authorities
1) Annually, each facility shall forward copies of all disaster
policies and plans required under this Section to the local health authority
and local emergency management agency having jurisdiction.
2) Annually, each facility shall forward copies of its emergency
water supply agreements, required under Section 300.2620(d), to the local
health authority and local emergency management agency having jurisdiction.
3) Each facility shall provide a description of its emergency
source of electrical power, including the services connected to the source, to
the local health authority and local emergency management agency having jurisdiction.
The facility shall inform the local health authority and local emergency
management agency at any time that the emergency source of power or services
connected to the source are changed.
4) When requested by the local health authority and the local
emergency management agency, the facility shall participate in emergency
planning activities.
(Source: Amended at 37 Ill.
Reg. 2298, effective February 4, 2013)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.680 RESTRAINTS
Section 300.680 Restraints
a) The facility shall have written policies controlling the use
of physical restraints including, but not limited to, leg restraints, arm
restraints, hand mitts, soft ties or vests, wheelchair safety bars and lap
trays, and all facility practices that meet the definition of a restraint, such
as tucking in a sheet so tightly that a bed-bound resident cannot move; bed
rails used to keep a resident from getting out of bed; chairs that prevent
rising; or placing a resident who uses a wheelchair so close to a wall that the
wall prevents the resident from rising. Adaptive equipment is not considered a
physical restraint. Wrist bands or devices on clothing that trigger electronic
alarms to warn staff that a resident is leaving a room do not, in and of
themselves, restrict freedom of movement and should not be considered as
physical restraints. The policies shall be followed in the operation of the
facility and shall comply with the Act and this Part. These policies shall be
developed by the medical advisory committee or the advisory physician with
participation by nursing and administrative personnel.
b) No physical restraints with locks shall be used.
c) Physical restraints shall not be used on a resident for the
purpose of discipline or convenience.
d) The use of chemical restraints is prohibited.
(Source: Amended at 20 Ill. Reg. 12208, effective September 10, 1996)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.682 NONEMERGENCY USE OF PHYSICAL RESTRAINTS
Section 300.682 Nonemergency
Use of Physical Restraints
a) Physical restraints shall only be used when required to treat
the resident's medical symptoms or as a therapeutic intervention, as ordered by
a physician, and based on:
1) the assessment of the resident's capabilities and an
evaluation and trial of less restrictive alternatives that could prove
effective;
2) the assessment of a specific physical condition or medical
treatment that requires the use of physical restraints, and how the use of
physical restraints will assist the resident in reaching his or her highest
practicable physical, mental or psychosocial well being;
3) consultation with appropriate health professionals, such as
rehabilitation nurses and occupational or physical therapists, which indicates
that the use of less restrictive measures or therapeutic interventions has
proven ineffective; and
4) demonstration by the care planning process that using a
physical restraint as a therapeutic intervention will promote the care and
services necessary for the resident to attain or maintain the highest
practicable physical, mental or psychosocial well being. (Section 2-106(c)
of the Act)
b) A physical restraint may be used only with the informed
consent of the resident, the resident's guardian, or other authorized
representative. (Section 2-106(c) of the Act) Informed consent includes
information about potential negative outcomes of physical restraint use,
including incontinence, decreased range of motion, decreased ability to
ambulate, symptoms of withdrawal or depression, or reduced social contact.
c) The informed consent may authorize the use of a physical
restraint only for a specified period of time. The effectiveness of the
physical restraint in treating medical symptoms or as a therapeutic
intervention and any negative impact on the resident shall be assessed by the
facility throughout the period of time the physical restraint is used.
d) After 50 percent of the period of physical restraint use
authorized by the informed consent has expired, but not less than 5 days before
it has expired, information about the actual effectiveness of the physical
restraint in treating the resident's medical symptoms or as a therapeutic
intervention and about any actual negative impact on the resident shall be
given to the resident, resident's guardian, or other authorized representative
before the facility secures an informed consent for an additional period of
time. Information about the effectiveness of the physical restraint program
and about any negative impact on the resident shall be provided in writing.
e) A physical restraint may be applied only by staff trained
in the application of the particular type of restraint. (Section 2-106(d)
Act)
f) Whenever a period of use of a physical restraint is
initiated, the resident shall be advised of his or her right to have a person
or organization of his or her choosing, including the Guardianship and Advocacy
Commission, notified of the use of the physical restraint. A period
of use is initiated when a physical restraint is applied to a resident for the
first time under a new or renewed informed consent for the use of physical
restraints. A recipient who is under guardianship may request that a person
or organization of his or her choosing be notified of the physical restraint,
whether or not the guardian approves the notice. If the resident so chooses,
the facility shall make the notification within 24 hours, including any
information about the period of time that the physical restraint is to
be used. Whenever the Guardianship and Advocacy Commission is notified that a
resident has been restrained, it shall contact the resident to determine the
circumstances of the restraint and whether further action is warranted.
(Section 2-106(e) of the Act) If the resident requests that the Guardianship
and Advocacy Commission be contacted, the facility shall provide the following
information in writing to the Guardianship and Advocacy Commission:
1) the reason the physical restraint was needed;
2) the type of physical restraint that was used;
3) the interventions utilized or considered prior to physical
restraint and the impact of these interventions;
4) the length of time the physical restraint was to be applied;
and
5) the name and title of the facility person who should be
contacted for further information.
g) Whenever a physical restraint is used on a resident
whose primary mode of communication is sign language, the resident shall be
permitted to have his or her hands free from restraint for brief periods each
hour, except when this freedom may result in physical harm to the resident or
others. (Section 2-106(f) of the Act)
h) The plan of care shall contain a schedule or plan of
rehabilitative/habilitative training to enable the most feasible progressive
removal of physical restraints or the most practicable progressive use of less
restrictive means to enable the resident to attain or maintain the highest
practicable physical, mental or psychosocial well being.
i) A resident wearing a physical restraint shall have it
released for a few minutes at least once every two hours, or more often if
necessary. During these times, residents shall be assisted with ambulation, as
their condition permits, and provided a change in position, skin care and
nursing care, as appropriate.
j) No form of seclusion shall be permitted.
(Source: Added at 20 Ill. Reg. 12208, effective September 10, 1996)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.684 EMERGENCY USE OF PHYSICAL RESTRAINTS
Section 300.684 Emergency
Use of Physical Restraints
a) If a resident needs emergency care, physical restraints
may be used for brief periods to permit treatment to proceed unless the
facility has notice that the resident has previously made a valid refusal of
the treatment in question. (Section 2-106(c) of the Act)
b) For this Section only, "emergency care" means the
unforeseen need for immediate treatment inside or outside the facility that is
necessary to:
1) save the resident's life;
2) prevent the resident from doing serious mental or physical
harm to himself/herself; or
3) prevent the resident from injuring another individual.
c) If a resident needs emergency care and other less restrictive
interventions have proved ineffective, a physical restraint may be used briefly
to permit treatment to proceed. The attending physician shall be contacted
immediately for orders. If the attending physician is not available, the
facility's advisory physician or Medical Director shall be contacted. If a
physician is not immediately available, a nurse with supervisory responsibility
may approve, in writing, the use of physical restraints. A confirming order,
which may be obtained by telephone, shall be obtained from the physician as
soon as possible, but no later than within eight hours. The effectiveness of
the physical restraint in treating medical symptoms or as a therapeutic
intervention and any negative impact on the resident shall be assessed by the
facility throughout the period of time the physical restraint is used. The
resident must be in view of a staff person at all times until either the
resident has been examined by a physician or the physical restraint is
removed. The resident's needs for toileting, ambulation, hydration, nutrition,
repositioning, and skin care must be met while the physical restraint is being
used.
d) The emergency use of a physical restraint must be documented
in the resident's record, including:
1) the behavior incident that prompted the use of the physical
restraint;
2) the date and times the physical restraint was applied and
released;
3) the name and title of the person responsible for the
application and supervision of the physical restraint;
4) the action by the resident's physician upon notification of
the physical restraint use;
5) the new or revised orders issued by the physician;
6) the effectiveness of the physical restraint in treating
medical symptoms or as a therapeutic intervention and any negative impact on
the resident; and
7) the date of the scheduled care planning conference or the
reason a care planning conference is not needed, in light of the resident's
emergency need for physical restraints.
e) The facility's emergency use of physical restraints shall
comply with Sections 300.682(e), (f), (g), and (j).
(Source: Added at 20 Ill. Reg. 12208, effective September 10, 1996)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.686 UNNECESSARY, PSYCHOTROPIC, AND ANTIPSYCHOTIC MEDICATIONS
Section 300.686 Unnecessary,
Psychotropic, and Antipsychotic Medications
a) For the purposes of this Section, the following definitions
shall apply:
1) "Adverse
consequence" – unwanted, uncomfortable, or dangerous effects that a
medication may have, such as impairment or decline in an individual's mental or
physical condition or functional or psychosocial status. It may include, but is
not limited to, various types of adverse medication reactions and interactions
(e.g., medication-medication, medication-food, and medication-disease).
2) "Antipsychotic
medication" – a medication that is used to treat symptoms of psychosis
such as delusions, hearing voices, hallucinations, paranoia, or confused
thoughts. Antipsychotic medications are used in the treatment of schizophrenia,
severe depression, and severe anxiety. Older antipsychotic medications tend to
be called typical antipsychotics. Those developed more recently are called atypical
antipsychotics.
3) "Dose"
– the total amount/strength/concentration of a medication given at one time or
over a period of time. The individual dose is the amount/strength/concentration
received at each administration. The amount received over a 24-hour period may
be referred to as the daily dose.
4) "Duplicative
therapy" – multiple medications of the same pharmacological class or
category or any medication therapy that substantially duplicates a particular
effect of another medication that the individual is taking.
5) "Emergency"
– has the same meaning as in Section 1-112 of the Act and Section
300.330 of this Part. (Section 2-106.1(b-3) of the Act)
6) "Excessive
dose" – the total amount of any medication (including duplicative therapy)
given at one time or over a period of time that is greater than the amount
recommended by the manufacturer's label, package or insert, and the accepted
standards of practice for a resident's age and condition.
7) "Gradual
dose reduction" – the stepwise tapering of a dose to determine if
symptoms, conditions or risks can be managed by a lower dose or if the dose or
medication can be discontinued.
8) "Informed
consent" – documented, written permission for specific medications, given
freely, without coercion or deceit, by a capable resident, or by a resident's
surrogate decision maker, after the resident, or the resident's surrogate
decision maker, has been fully informed of, and had an opportunity to consider,
the nature of the medications, the likely benefits and most common risks to the
resident of receiving the medications, any other likely and most common
consequences of receiving or not receiving the medications, and possible
alternatives to the proposed medications.
9) "Licensed
nurse" – an advanced practice registered nurse, a registered nurse, or
a licensed practical nurse, as defined in the Nurse Practice Act. (Section
2-106.1(d) of the Act)
10) "Psychotropic
medication" – medication that is used for or listed as used for
psychotropic, antidepressant, antimanic or antianxiety behavior modification or
behavior management purposes in the Prescribers Digital Reference database,
the Lexicomp-online database, or the American Society of Health-System
Pharmacists database. Psychotropic medication also includes any medication
listed in 42 CFR 483.45(c)(3). (Section 2-106.1(b-3) of the Act)
11) "Surrogate decision maker" – an individual
representing the resident's interests in regard to consent to receive
psychotropic medications, as permitted by Section 2-106.1(b-3) of the
Act and this Section. (Section 2-106.1(b-3) of the Act)
b) State laws, regulations, and policies related to
psychotropic medication are intended to ensure psychotropic medications are
used only when the medication is appropriate to treat a resident's specific,
diagnosed, and documented condition and the medication is beneficial to the
resident, as demonstrated by monitoring and documentation of the resident's
response to the medication. (Section 2-106.1(b) of the Act)
c) Psychotropic medication shall only be given in both
emergency and nonemergency situations if the diagnosis of the resident supports
the benefit of the medication and clinical documentation in the resident's medical
record supports the benefit of the medication over the contraindications
related to other prescribed medications. (Section 2-106.1(b-3) of the Act)
d) A resident shall not be given unnecessary drugs. An
unnecessary drug is any drug used:
1) In an excessive dose, including in duplicative therapy;
2) For excessive duration;
3) Without adequate monitoring;
4) Without adequate indications for its use;
5) In the presence of adverse consequences that indicate the medications
should be reduced or discontinued (Section 2-106.1(a) of the Act); or
6) Any combination of the circumstances stated in subsections (d)(1)
through (5).
e) Residents shall not be given antipsychotic medications unless
antipsychotic medication therapy is ordered by a physician or an authorized
prescribing professional, as documented in the resident's comprehensive
assessment, to treat a specific symptom or suspected condition as diagnosed and
documented in the clinical record or to rule out the possibility of one of the
conditions in accordance with Appendix F.
f) Residents who use antipsychotic medications shall receive
gradual dose reductions and behavior interventions, unless clinically contraindicated,
in an effort to discontinue these medications in accordance with Appendix F.
In compliance with subsection 2-106.1(b-3) of the Act and this Section, the
facility shall obtain informed consent for each dose reduction.
g) Except in the case of an emergency, psychotropic medication
shall not be administered without the informed consent of the resident
or the resident's surrogate decision maker. (Section 2-106.1(b-3) of the
Act) Additional informed consent is not required for changes in the
prescription so long as those changes are described in the original written
informed consent form, as required by subsection (h)(12)(A). The informed
consent may provide for a medication administration program of sequentially
increased doses or a combination of medications to establish the lowest
effective dose that will achieve the desired therapeutic outcome, pursuant to
subsection (h)(12)(A). The most common side effects of the medications shall
be described. In an emergency, a facility shall:
1) Document the alleged emergency in detail, including the
facts surrounding the medication's need, pursuant to the requirements of
Section 300.1820; and
2) Present this documentation to the resident and the
resident's representative or other surrogate decision maker no later than
24 hours after the administration of emergency psychotropic medication.
(Section 2-106.1(b-3) of the Act)
h) Protocol for Securing Informed Consent for Psychotropic Medication
1) Except in the case of an emergency as described in subsection
(g), a facility shall obtain voluntary informed consent, in writing,
from a resident or the resident's surrogate decision maker before administering
or dispensing a psychotropic medication to that resident. When informed
consent is not required for a change in dosage as described in subsection (h)(12)(A),
the facility shall note in the resident's file that the resident was informed
of the dosage change prior to the administration of the medication or that
verbal, written, or electronic notice has been communicated to the resident's
surrogate decision maker that a change in dosage has occurred. (Section
2-106.1(b-3) of the Act)
2) No resident shall be administered psychotropic medication
prior to a discussion between the resident or the resident's surrogate
decision maker, or both, and the resident's physician or a physician
the resident was referred to, a registered pharmacist, or a licensed nurse
about the most common possible risks and benefits of a recommended
medication and the use of standardized consent forms designated by the
Department. (Section 2-106.1(b-3) of the Act)
3) Prior to initiating any detailed discussion designed to secure
informed consent, a licensed health care professional shall inform the resident
or the resident's surrogate decision maker that the resident's physician has
prescribed a psychotropic medication for the resident, and that informed
consent is required from the resident or the resident's surrogate decision
maker before the resident may be given the medication.
4) The discussion shall include information about:
A) The name of the medication;
B) The condition or symptoms that the medication is intended to
treat, and how the medication is expected to treat those symptoms;
C) How the medication is intended to affect those symptoms;
D) Other common effects or side effects of the medication, and any
reasons (e.g., age, health status, other medications) that the resident is more
or less likely to experience side effects;
E) Dosage information, including how much medication would be
administered, how often, and the method of administration (e.g., orally or by
injection; with, before, or after food);
F) Any tests and related procedures that are required for the
safe and effective administration of the medication;
G) Any food or activities the resident should avoid while taking
the medication;
H) Any possible alternatives to taking the medication that could
accomplish the same purpose; and
I) Any possible consequences to the resident of not taking the
medication.
5) Pursuant to Section 2-105 of the Act, the discussion designed
to secure informed consent shall be private, between the resident or the
resident's surrogate decision maker and the resident's physician, or a physician
the resident was referred to, or a registered pharmacist, or a licensed nurse.
6) In addition to the oral discussion, the resident or his or her
surrogate decision maker shall be given the information in subsection (h)(4) in
writing, in a form designated or developed by the Department. Each form shall
be written in plain language understandable to the resident or the
resident's surrogate decision maker, be able to be downloaded from the
Department's official website or another website designated by the Department,
shall include information specific to the psychotropic medication for
which consent is being sought, and will be used for every resident for
whom psychotropic drugs are prescribed. (Section 2-106.1(b-3) of the Act)
7) If the written information is in a language not understood by
the resident or his or her surrogate decision maker, the facility, in
compliance with the Language Assistance Services Act and the Language
Assistance Services Code, shall provide, at no cost to the resident or the resident's
surrogate decision maker, an interpreter capable of communicating with the
resident or his or her surrogate decision maker and the authorized prescribing
professional conducting the discussion.
8) The authorized prescribing professional shall guide the
resident through the written information. The written information shall
include a place for the resident or his or her surrogate decision maker to
give, or to refuse to give, informed consent. The written information shall be
placed in the resident's record. Informed consent is not secured until the
resident or surrogate decision maker has given written informed consent. If
the resident has dementia and the facility is unable to contact the resident's
surrogate decision maker, the facility shall not administer psychotropic
medication to the resident except in an emergency as provided by subsection (g).
9) Informed consent shall be sought first from a resident,
then from a surrogate decision maker, in the following order or
priority:
A) The resident's guardian of the person if one has been named
by a court of competent jurisdiction.
B) In the absence of a court-ordered guardian, informed consent
shall be sought from a health care agent under the Illinois Power of Attorney
Act who has authority to give consent.
C) If neither a court-ordered guardian of the person, nor a
health care agent under the Power of Attorney Act, is available, and the
attending physician determines that the resident lacks capacity to make
decisions, informed consent shall be sought from the resident's
attorney-in-fact designated under the Mental Health Treatment Preference
Declaration Act, if applicable, or the resident's representative. (Section
2-106.1(b-3) of the Act)
10) Regardless of the availability of a surrogate decision maker,
the resident may be notified and present at any discussion required by this
Section. Upon request, the resident or the resident's surrogate decision maker
shall be given, at a minimum, written information about the medication and an
oral explanation of common side effects of the medication to facilitate the
resident in identifying the medication and in communicating the existence of
side effects to the direct care staff.
11) The facility shall inform the resident, surrogate decision
maker, or both of the existence of a copy of:
A) The resident's care plan;
B) The facility policies and procedures adopted in compliance
with Section 2-106.1(b-15) of the Act, and this Section; and
C) A notification that the most recent of the resident's care
plans and the facility's policies are available to the resident or surrogate
decision maker upon request.
12) The maximum possible period for informed consent shall be
until:
A) A change in the prescription occurs, either as to type of
psychotropic medication or an increase or decrease in dosage, dosage range, or
titration schedule of the prescribed medication that was not included in the
original informed consent; or
B) A resident's care plan changes in a way that affects the
prescription or dosage of the psychotropic medication. (Section 2-106.1(b-3)
of the Act).
13) A resident or their surrogate decision maker shall not be asked
to consent to the administration of a new psychotropic medication in a dosage
or frequency that exceeds the maximum recommended daily dosage as found in the
Prescribers Digital Reference database, the Lexicomp-online database, or the
American Society of Health-System Pharmacists database unless the reason for
exceeding the recommended daily dosage is explained to the resident or their
surrogate decision maker by a licensed medical professional, and the reason for
exceeding the recommended daily dosage is justified by the prescribing professional
in the clinical record. The dosage and frequency shall be reviewed and
re-justified by the licensed prescriber on a weekly basis and reviewed by a
consulting pharmacist. The justification for exceeding the recommended daily
dosage shall be recorded in the resident's record and shall be approved within
seven calendar days after obtaining informed consent, in writing, by the
medical director of the facility.
14) Pursuant to Section 2-104(c) of the Act, the resident or the
resident's surrogate decision maker shall be informed, at the time of the
discussion required by subsection (h)(2), that their informed consent may be
withdrawn at any time, and that, even with informed consent, the resident may
refuse to take the medication.
15) The facility shall obtain informed consent using forms provided
by the Department on its official website, or on forms approved by the
Department, pursuant to Section 2-106.1(b-3) of the Act. The facility shall
document on the consent form whether the resident is capable of giving informed
consent for medication therapy, including for receiving psychotropic
medications. If the resident is not capable of giving informed consent, the
identity of the resident's surrogate decision maker shall be placed in the
resident's record.
16) No facility shall deny continued residency to a person on
the basis of the person's or resident's, or the person's or resident's
surrogate decision maker's, refusal of the administration of psychotropic
medication, unless the facility can demonstrate that the resident's refusal would
place the health and safety of the resident, the facility staff, other
residents, or visitors at risk. A facility that alleges that the
resident's refusal to consent to the administration of psychotropic medication
will place the health and safety of the resident, the facility staff, other
residents, or visitors at risk shall:
A) Document the alleged risk in detail, along with a
description of all nonpharmacological or alternative care options attempted and
why they were unsuccessful;
B) Present this documentation to the resident or the resident's
surrogate decision maker, to the Department, and to the Office of the State
Long Term Care Ombudsman; and
C) Inform the resident or their surrogate decision maker
of their right to appeal an involuntary transfer or discharge to
the Department as provided in the Act and this Part. (Section
2-106.1(b-10) of the Act)
i) All facilities shall implement written policies and
procedures for compliance with Section 2-106.1 of the Act and this Section.
A facility's failure to make available to the Department the
documentation required under this subsection is sufficient to demonstrate its
intent to not comply with Section 2-106.1 of the Act and this
Section and shall be grounds for review by the Department. (Section
2-106.1(b-15) of the Act)
j) Upon the receipt of a report of any violation of Section
2-106.1 of the Act and this Section, the Department will investigate
and, upon finding sufficient evidence of a violation of Section 2-106.1 of the
Act and this Section, may proceed with disciplinary action against the
licensee of the facility. In any administrative disciplinary action under this
subsection, the Department will have the discretion to determine the gravity of
the violation and, taking into account mitigating and aggravating circumstances
and facts, may adjust the disciplinary action accordingly. (Section
2-106.1(b-20) of the Act)
k) A violation of informed consent that, for an individual
resident, lasts for seven days or more under this Section is, at a minimum, a
Type "B" violation. A second violation of informed consent within a
year from a previous violation in the same facility regardless of the duration
of the second violation is, at a minimum, a Type "B" violation.
(Section 2-106.1(b-25) of the Act)
l) Any violation of Section 2-106.1 of the Act and this
Section by a facility may be enforced by an action brought by the Department
in the name of the People of Illinois for injunctive relief, civil penalties,
or both injunctive relief and civil penalties. The Department may initiate the
action upon its own complaint or the complaint of any other interested party.
(Section 2-106.1(b-30) of the Act)
m) Any resident who has been administered a psychotropic
medication in violation of Section 2-106.1 of the Act and this
Section may bring an action for injunctive relief, civil damages, and costs
and attorney's fees against any facility responsible for the violation.
(Section 2-106.1(b-35) of the Act)
n) An action under this Section shall be filed within two years
after either the date of discovery of the violation that gave rise to the claim
or the last date of an instance of a noncompliant administration of
psychotropic medication to the resident, whichever is later. (Section
2-106.1(b-40) of the Act)
o) A facility subject to action under Section 2-106.1 of the
Act and this Section shall be liable for damages of up to $500 for each
day, after discovery of a violation, that the facility violates the
requirements of Section 2-106.1 of the Act and this Section. (Section
2-106.1(b-45) of the Act)
p) The rights provided for in Section 2-106.1 of the Act
and this Section are cumulative to existing resident rights. No part of this
Section shall be interpreted as abridging, abrogating, or otherwise diminishing
existing resident rights or causes of action at law or equity. (Section
2-106.1(b-55) of the Act)
q) In addition to the penalties described in this Section
and any other penalty prescribed by law, a facility that is found to have
violated Section 2-106.1 of the Act and this Section, or the federal
certification requirement that informed consent be obtained before
administering a psychotropic medication, shall thereafter be required to obtain
the signatures of two licensed health care professionals on every form
purporting to give informed consent for the administration of a psychotropic
medication, certifying the personal knowledge of each health care professional
that the consent was obtained in compliance with the requirements of
Section 2-106.1 of the Act and this Section. (Section 2-106.1(b-3) of the Act)
(Source: Amended at 48 Ill. Reg. 3317,
effective February 16, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.690 INCIDENTS AND ACCIDENTS
Section 300.690 Incidents
and Accidents
a) The facility shall maintain a file of all written reports of
each incident and accident affecting a resident that is not the expected
outcome of a resident's condition or disease process. A descriptive summary of
each incident or accident affecting a resident shall also be recorded in the
progress notes or nurse's notes of that resident.
b) The facility shall notify the Department of any serious
incident or accident. For purposes of this Section, "serious" means
any incident or accident that causes physical harm or injury to a resident.
c) The facility shall, by fax or phone, notify the Regional
Office within 24 hours after each reportable incident or accident. If a
reportable incident or accident results in the death of a resident, the facility
shall, after contacting local law enforcement pursuant to Section 300.695,
notify the Regional Office by phone only. For the purposes of this Section,
"notify the Regional Office by phone only" means talk with a
Department representative who confirms over the phone that the requirement to
notify the Regional Office by phone has been met. If the facility is unable to
contact the Regional Office, it shall notify the Department's toll-free
complaint registry hotline. The facility shall send a narrative summary of
each reportable accident or incident to the Department within seven days after
the occurrence.
(Source: Amended at 37 Ill.
Reg. 2298, effective February 4, 2013)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.695 CONTACTING LOCAL LAW ENFORCEMENT
Section 300.695 Contacting
Local Law Enforcement
a) For the purpose of this Section, the following definitions
shall apply:
1) "911" − an emergency answer and response
system in which the caller need only dial 9-1-1 on a telephone to obtain
emergency services, including police, fire, medical ambulance and rescue.
2) Physical abuse − see Section 300.30.
3) Sexual abuse − sexual penetration, intentional sexual
touching or fondling, or sexual exploitation (i.e., use of an individual for
another person's sexual gratification, arousal, advantage, or profit).
b) The facility shall immediately contact local law enforcement
authorities (e.g., telephoning 911 where available) in the following
situations:
1) Physical abuse involving physical injury inflicted on a
resident by a staff member or visitor;
2) Physical abuse involving physical injury inflicted on a
resident by another resident, except in situations where the behavior is
associated with dementia or developmental disability;
3) Sexual abuse of a resident by a staff member, another
resident, or a visitor;
4) When a crime has been committed in a facility by a person
other than a resident; or
5) When a resident death has occurred other than by disease
processes.
c) The facility shall develop and implement a policy concerning
local law enforcement notification, including:
1) Ensuring the safety of residents in situations requiring local
law enforcement notification;
2) Contacting local law enforcement in situations involving
physical abuse of a resident by another resident;
3) Contacting police, fire, ambulance and rescue services in
accordance with recommended procedure;
4) Seeking advice concerning preservation of a potential crime
scene;
5) Facility investigation of the situation.
d) Facility staff shall be trained in implementing the policy
developed pursuant to subsection (c).
e) The facility shall also comply with other reporting
requirements of this Part.
(Source: Added at 26 Ill. Reg. 4846, effective April 1, 2002)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.696 INFECTION PREVENTION AND CONTROL
Section 300.696 Infection Prevention and Control
a) A facility shall have an infection prevention and
control program for the surveillance, investigation, prevention, and control of
healthcare-associated infections and other infectious diseases. The program
shall be under the management of the facility’s infection preventionist who is
qualified through education, training, experience, or certification in
infection prevention and control.
b) Written
policies and procedures for surveillance, investigation, prevention, and
control of infectious agents and healthcare-associated infections in the
facility shall be established and followed, including for the appropriate use
of personal protective equipment as provided in the Centers for Disease Control
and Prevention’s Guideline for Isolation Precautions, Hospital Respiratory
Protection Program Toolkit, and the Occupational Safety and Health
Administration’s Respiratory Protection Guidance. The policies and procedures must
be consistent with and include the requirements of the Control of Communicable
Diseases Code, and the Control of Sexually Transmissible Infections Code.
1) All staff shall be trained at least annually on
basic infection prevention and control practices based on job responsibilities.
Training records shall be maintained for three years. For the purposes of this
Section, “staff” means those individuals who work in the facility on a regular
(that is, at least once a week) basis, including individuals who may not be
physically in the facility for a period of time due to illness, disability, or
scheduled time off, but who are expected to return to work. This also includes
individuals under contract or arrangement, including hospice and dialysis
staff, physical therapists, occupational therapists, mental health
professionals, or volunteers, who are in the facility on a regular basis.
2) Students
enrolled in accredited health care training programs who are providing direct
care during internships or clinical rotations must have completed infection
prevention and control training prior to working in the facility. The facility
shall ensure access to documentation of completed infection prevention and
control training for all interns and students and provide a copy of this record
upon request by the Department.
3) Facility
activities shall be monitored on an ongoing basis by the Infection
Preventionist to ensure adherence to all infection prevention and control
policies and procedures.
4) Infection
prevention and control policies and procedures shall be maintained in the
facility and made available upon request to facility staff, the resident and
the resident’s family or resident’s representative, the Department, the
certified local health department, and the public.
c) A
group, e.g., an infection prevention and control committee, quality assurance
committee, or other facility entity, shall periodically, but no less than
annually, review the measures and outcomes of investigations and activities to prevent
and control infections, documented by written, signed, and dated minutes of the
meeting.
d) Each
facility shall adhere to the following guidelines and toolkits of the Centers
for Disease Control and Prevention, United States Public Health Service,
Department of Health and Human Services, Agency for Healthcare Research and
Quality, and Occupational Safety and Health Administration (see Section
300.340):
1) Guideline
for Prevention of Catheter-Associated Urinary Tract Infections
2) Guideline
for Hand Hygiene in Health-Care Settings
3) Guidelines
for Prevention of Intravascular Catheter-Related Infections
4) Guideline
for Prevention of Surgical Site Infection
5) Guidelines
for Preventing Healthcare-Associated Pneumonia
6) Guideline
for Isolation Precautions: Preventing Transmission of Infectious Agents in
Healthcare Settings
7) Infection
Control in Healthcare Personnel: Infrastructure and Routine Practices for
Occupational Infection Prevention and Control Services
8) The
Core Elements of Antibiotic Stewardship for Nursing Homes
9) The
Core Elements of Antibiotic Stewardship for Nursing Homes, Appendix A: Policy
and Practice Actions to Improve Antibiotic Use
10) Nursing
Home Antimicrobial Stewardship Guide
11) Toolkit
3. Minimum Criteria for Common Infections Toolkit
12) TB
Infection Control in Health Care Settings
13) Interim
Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread
in Nursing Homes
14) Implementation
of Personal Protective Equipment (PPE) in Nursing Homes to Prevent Spread of
Novel or Targeted Multidrug-resistant Organisms (MDROs)
15) Hospital
Respiratory Protection Program Toolkit: Resources for Respirator Program
Administrators
16) Respiratory
Protection Guidance for the Employers of Those Working in Nursing Homes,
Assisted Living, and Other Long-Term Care Facilities During the COVID-19
Pandemic
17) Guidelines
for Environmental Infection Control in Health-Care Facilities
e) The
facility shall establish an infection prevention and control program (IPCP) that
includes, at a minimum, an antibiotic stewardship program that includes
antibiotic use protocols and a system to monitor antibiotic use.
f) Infectious
Disease Surveillance Testing and Outbreak Response
1) The
facility shall have a testing plan and response strategy in place to address
infectious disease outbreaks. Pursuant to the plan and response strategy, the
facility shall test residents and facility staff for infectious diseases listed
in Section 690.100 of the Control of Communicable Diseases Code in a manner
that is consistent with current guidelines and standards of practice.
2) Each
facility shall conduct testing of residents and staff for the control or
detection of infectious diseases when:
A) The
facility is experiencing an outbreak; or
B) Directed
by the Department or the certified local health department where the chance of
transmission is high, including, but not limited to, regional outbreaks,
epidemics, or pandemics. For the purposes of this Section, “outbreak” has the
same meaning as defined in the Control of Communicable Diseases Code.
3) Documentation
A) For
residents, document in each resident’s record any time a test was completed,
including the result of the test, or whether testing was refused or
contraindicated.
B) For facility
staff and volunteers, maintain a testing log documenting any time a test was
completed, including the result of the test, or whether testing was refused or
contraindicated. The testing log shall include all facility staff and
volunteers.
4) Upon
confirmation that a resident, staff member, volunteer, student, or student
intern tests positive with an infectious disease, or displays symptoms
consistent with an infectious disease, each facility shall take immediate steps
to prevent the transmission by implementing practices that include but are not
limited to cohorting, isolation and quarantine, environmental cleaning and
disinfecting, hand hygiene, and use of appropriate personal protective
equipment.
5) Each
facility shall have written procedures for addressing residents, staff members,
volunteers, students, and student interns who refuse testing or are unable to
be tested.
6) Each
facility shall make arrangements with a testing laboratory to process any
specimens collected under subsection (f) and shall ensure complete information
for the individual being tested is submitted with each specimen as required by
the laboratory requisition form.
7) For
testing done under subsection (f), each facility shall report to the
Department, on a form and manner as prescribed by the Department, the number of
residents, staff members, volunteers, students, and student interns tested, and
the number of positive, negative, and indeterminate cases.
g) Certified
facilities shall comply with 42 CFR 483.80(h).
h) Facilities
shall not restrict visitation without a reasonable clinical or safety cause and
shall facilitate in-person visitation whenever feasible, in accordance with
Department and CDC guidance for infection prevention.
(Source: Amended at 46 Ill.
Reg. 6033, effective April 1, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.697 INFECTION PREVENTIONISTS
Section 300.697
Infection Preventionists
A facility
shall designate a person or persons as Infection Preventionists (IP) to develop
and implement policies governing control of infections and communicable
diseases. The IPs shall be qualified through education, training, experience,
or certification or a combination of such qualifications. The IP's
qualifications shall be documented and shall be made available for inspection
by the Department. (Section 2-213(d) of the Act). The facility’s infection
prevention and control program as required by Section 300.696(e) shall be under
the management of an IP.
a) IPs shall complete, or
provide proof of completion of, initial infection control and prevention
training, provided by CDC or equivalent training, covering topics listed in
subsection (b)(1) to the facility, within 30 days after accepting an IP
position. Documentation of required initial infection control and prevention
training shall be maintained in the employee file.
b) Effective July 1, 2022,
a qualified IP candidate shall:
1) Have completed at least
19 hours of training in infection prevention and control including, but not
limited to, training in the following areas:
A) Principles of Standard Precautions
B) Principles of Transmission-Based Precautions
C) Prevention of Healthcare-Associated Infections
D) Hand Hygiene
E) Environmental Cleaning, Sterilization,
Disinfection, and Asepsis
F) Environment of Care and Water Management
G) Employee/Occupational Health
H) Surveillance and Epidemiological
Investigations
I) Antimicrobial Stewardship
2) Have clinical work
experience related to infection prevention and control in
health care settings including, but not limited to, hospitals or long-term care
settings.
c) A facility shall have at
least one IP on-site for a minimum of 20 hours per week to develop and
implement policies governing prevention and control of infectious diseases.
d) Facilities with more
than 100 licensed beds or facilities that offer high-acuity services, including
but not limited to on-site dialysis, infusion therapy, or ventilator care shall
have at least one IP on-site for a minimum of 40 hours per week to develop and
implement policies governing control of infectious diseases. For the purposes
of this subsection (d), "infusion therapy" refers to parenteral,
infusion, or intravenous therapies that require ongoing monitoring and
maintenance of the infusion site (e.g. central, percutaneously inserted central
catheter, epidural, and venous access devices).
e) A facility’s IP shall
coordinate with the facility group listed in Section 300.696(c) to ensure
compliance with Section 300.696.
(Source: Added at
46 Ill. Reg. 6033, effective April 1, 2022)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.699 ELECTRONIC MONITORING
Section 300.699 Electronic Monitoring
A facility shall comply with Section 2-115 and subsections
3-318(a)(8) and (9) of the Act, with the Authorized Electronic Monitoring in
Long-Term Care Facilities Act, and with the Authorized Electronic Monitoring in
Long-Term Care Facilities Code.
(Source: Amended at 48 Ill. Reg. 3317,
effective February 16, 2024)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.700 TESTING FOR LEGIONELLA BACTERIA
Section 300.700 Testing for Legionella Bacteria
a) A facility shall develop a policy for testing
its water supply for Legionella bacteria. The policy shall
include the frequency with which testing is conducted. The policy and the
results of any tests and corrective actions taken shall be made
available to the Department upon request. (Section
3-206.06 of the Act)
b) The policy shall be based on the ASHRAE
Guideline "Managing the Risk of Legionellosis Associated with Building
Water Systems" and the Centers for Disease Control and Prevention's" Toolkit
for Controlling Legionella in Common Sources of Exposure". The policy
shall include, at a minimum:
1) A procedure to conduct a facility risk assessment to identify
potential Legionella and other waterborne pathogens in the facility water
system;
2) A water management program that identifies specific testing
protocols and acceptable ranges for control measures; and
3) A system to document the results of testing and corrective
actions taken.
(Source: Added at 46 Ill. Reg. 10460,
effective May 31, 2022)
SUBPART D: PERSONNEL
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.810 GENERAL
Section 300.810 General
a) Sufficient staff in numbers and qualifications shall be on duty
all hours of each day to provide services that meet the total needs of the
residents. As a minimum, there shall be at least one staff member awake,
dressed, and on duty at all times. (A, B)
b) The number and categories of personnel to be provided shall be
based on the following:
1) Number of residents.
2) Amount and kind of personal care, nursing care, supervision,
and program needed to meet the particular needs of the residents at all times.
3) Size, physical condition, and the layout of the building
including proximity of service areas to the resident's rooms.
4) Medical orders.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.820 CATEGORIES OF PERSONNEL
Section 300.820 Categories
of Personnel
a) The facility shall provide an administrator as set forth in
Subpart B. (B)
b) The facility shall provide a Resident Services Director who is
assigned responsibility for the coordination and monitoring of the resident's
overall plan of care. The director of nurses or an individual on the
professional staff of the facility may fill this assignment to assure that
residents' plans of care are individualized, written in terms of short and
long-range goals, understandable and utilized; their needs are met through
appropriate staff interventions and community resources; and residents are involved,
whenever possible, in the preparation of their plan of care. (B,)
c) The facility shall provide activity personnel as set forth in
Section 300.1410(b). (B)
d) The facility shall provide dietary personnel as set forth in
Sections 300.2010 and 300.2020. (B)
e) The facility shall designate a staff member(s) to provide
social services to residents. (B)
f) The facility shall provide nursing personnel as set forth in
Subpart F. (B)
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.830 CONSULTATION SERVICES
Section 300.830 Consultation
Services
a) The facility shall have all arrangements for each consultant's
services in a written agreement setting forth the services to be provided.
These agreements shall be updated annually.
b) If the staff member designated to provide social services is
not a social worker, the facility shall have an effective arrangement with a
social worker to provide social service consultation. Skilled nursing
facilities must provide a social worker to meet this requirement.
c) The facility shall have a written agreement for activity
program consultation if required under Section 300.1410(c).
d) Specific restorative services (physical therapy, occupational
therapy, etc.) provided by the facility shall include consultation as set forth
in Section 300.1420(a).
e) The facility shall arrange for an advisory physician or
medical advisory committee as set forth in Section 300.1010.
f) The facility shall arrange for an advisory dentist and dental
hygienist if desired, as set forth in Section 300.1050.
g) The facility shall arrange for a consultant pharmacist as set
forth in Section 300.1610.
h) Skilled Nursing Facilities shall arrange for consultation from
a health information management consultant as set forth in Section 300.1860.
i) Facilities shall arrange for a dietary consultant as set
forth in Section 300.2010(b).
(Source: Amended at 26 Ill. Reg. 10523, effective July 1, 2002)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.840 PERSONNEL POLICIES
Section 300.840 Personnel
Policies
The personnel policies required
in Section 300.650, Section 300.651, and other personnel policies established
by the facility, shall be followed in the operation of the facility.
(Source: Amended at 35 Ill.
Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.850 EMPLOYEE ASSISTANCE PROGRAM
Section 300.850 Employee Assistance Program
a) For
the purposes of this Section, an "employee assistance program" is a
program that supports individual physical and mental well-being and that is
provided by the facility or through an insurance or employee benefits program
offered by the facility. Employee assistance programs may include, but are not
limited to, programs that offer professional counseling, stress management,
mental wellness support, smoking cessation, and other support services.
b) 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.
c) 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 a nurse shall sign during
onboarding at the facility, and upon request of the employee.
d) The
signed information form shall be added to the nurse's personnel file. The
facility may provide this information to nurses electronically. (Section
3-613 of the Act from PA 102-1007)
(Source: Added at 48 Ill. Reg. 3317,
effective February 16, 2024)
SUBPART E: MEDICAL AND DENTAL CARE OF RESIDENTS
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1010 MEDICAL CARE POLICIES
Section 300.1010 Medical
Care Policies
a) Advisory Physician or Medical Advisory Committee
1) There shall be an advisory physician, or a medical advisory
committee composed of physicians, who shall be responsible for advising the
administrator on the overall medical management of the residents and the staff
of the facility. If the facility employs a house physician, he may be the
advisory physician. (B)
2) Additional for Skilled Nursing Facilities. There shall be a
medical advisory committee composed of two (2) or more physicians who shall be
responsible for advising the administrator on the overall medical management of
the residents and the staff in the facility. If the facility employs a house
physician, the house physician may be one member of this committee.
b) The facility shall have and follow a written program of
medical services which sets forth the following: the philosophy of care and
policies and procedures to implement it; the structure and function of the
medical advisory committee, if the facility has one; the health services
provided; arrangements for transfer when medically indicated; and procedures
for securing the cooperation of residents' personal physicians. The medical
program shall be approved in writing by the advisory physician or the medical
advisory committee. (B)
c) Every resident shall be under the care of a physician.
d) All residents, or their guardians, shall be permitted their
choice of a physician.
e) All resident shall be seen by their physician as often as
necessary to assure adequate health care. (Medicare/Medicaid requires
certification visits.)
f) Physician treatment plans, orders and similar documentation
shall have an original written signature of the physician. A stamp signature,
with or without initials, is not sufficient.
g) Each resident admitted shall have a physical examination,
within five days prior to admission or within 72 hours after admission. The
examination report shall include at a minimum each of the following:
1) An evaluation of the resident's condition, including height
and weight, diagnoses, plan of treatment, recommendations, treatment orders,
personal care needs, and permission for participation in activity programs as
appropriate.
2) Documentation of the presence or absence of tuberculosis
infection by tuberculin skin test in accordance with Section 300.1025.
3) Documentation of the presence or absence of incipient or
manifest decubitus ulcers (commonly known as bed sores), with grade, size and
location specified, and orders for treatment, if present. (A photograph of
incipient or manifest decubitus ulcers is recommended on admission.)
4) Orders from the physician regarding weighting of the
resident, and the frequency of such weighing, if ordered.
h) The facility shall notify the resident's physician of any
accident, injury, or significant change in a resident's condition that
threatens the health, safety or welfare of a resident, including, but not
limited to, the presence of incipient or manifest decubitus ulcers or a weight
loss or gain of five percent or more within a period of 30 days. The facility
shall obtain and record the physician's plan of care for the care or treatment
of such accident, injury or change in condition at the time of notification.
(B)
i) At the time of an accident or injury, immediate treatment
shall be provided by personnel trained in first aid procedures. (B)
(Source: Amended at 16 Ill. Reg. 17089, effective November 3, 1992)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1020 COMMUNICABLE DISEASE POLICIES
Section 300.1020
Communicable Disease Policies
a) The facility shall comply with the Control of Communicable
Diseases Code (77 Ill. Adm. Code 690).
b) A resident who is suspected of or diagnosed as having any
communicable, contagious or infectious disease, as defined in the Control of
Communicable Diseases Code, shall be placed in isolation, if required, in
accordance with the Control of Communicable Diseases Code. If the facility
believes that it cannot provide the necessary infection control measures, it
must initiate an involuntary transfer and discharge pursuant to Article III,
Part 4 of the Act and Section 300.620 of this Part. In determining whether a
transfer or discharge is necessary, the burden of proof rests on the facility.
c) All illnesses required to be reported under the Control of
Communicable Diseases Code and Control of Sexually Transmissible Diseases Code
(77 Ill. Adm. Code 693) shall be reported immediately to the local health
department and to the Department. The facility shall furnish all pertinent
information relating to such occurrences. In addition, the facility shall
inform the Department of all incidents of scabies and other skin infestations.
(Source: Amended at 29 Ill.
Reg. 12852, effective August 2, 2005)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1025 TUBERCULIN SKIN TEST PROCEDURES
Section 300.1025 Tuberculin
Skin Test Procedures
Tuberculin skin tests for
employees and residents shall be conducted in accordance with the Control of
Tuberculosis Code (77 Ill. Adm. Code 696).
(Source: Amended at 23 Ill. Reg. 8106, effective July 15, 1999)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1030 MEDICAL EMERGENCIES
Section 300.1030 Medical
Emergencies
a) The advisory physician or medical advisory committee shall
develop policies and procedures to be followed during the various medical
emergencies that may occur from time to time in long-term care facilities.
These medical emergencies include, but are not limited to:
1) Pulmonary emergencies (for example, airway obstruction,
foreign body aspiration, and acute respiratory distress, failure, or arrest).
2) Cardiac emergencies (for example, ischemic pain, cardiac
failure, or cardiac arrest).
3) Traumatic injuries (for example, fractures, burns, and
lacerations).
4) Toxicologic emergencies (for example, untoward drug reactions
and overdoses).
5) Other medical emergencies (for example, convulsions and
shock).
b) The facility shall maintain in a suitable location the
equipment to be used during these emergencies. This equipment shall include at
a minimum the following: a portable oxygen kit, including a face mask and/or
cannula; an airway; and bag-valve mask manual ventilating device.
c) At least one staff person shall be on duty at all times who
has been properly trained to handle the medical emergencies in subsection (a).
This staff person may also be counted in fulfilling the requirement of
subsection (d) if the staff person meets the specified certification
requirements.
d) When two or more staff are on duty in the facility, at least
two staff people on duty in the facility shall have current certification in
the provision of basic life support by an American Heart Association or
American Red Cross certified training program. When there is only one person
on duty in the facility, that person shall be certified. Any facility employee
who is on duty in the facility may be utilized to meet this requirement.
(Source: Amended at 49 Ill. Reg. 6468, effective April 22, 2025)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1035 LIFE-SUSTAINING TREATMENTS
Section 300.1035
Life-Sustaining Treatments
a) Every facility shall respect the residents' right to make
decisions relating to their own medical treatment, including the right to
accept, reject, or limit life‑sustaining treatment. Every facility shall
establish a policy concerning the implementation of such rights. Included
within this policy shall be:
1) implementation of Living Wills or Powers of Attorney for
Health Care in accordance with the Living Will Act (Ill. Rev. Stat. 1991, ch.
110½, pars. 701 et seq.) [755 ILCS 35] and the Powers of Attorney for Health
Care Law (Ill. Rev. Stat. 1991, ch. 110½, pars. 804-1 et seq.) [755 ILCS 45];
2) the implementation of physician orders limiting
resuscitation such as those commonly referred to as
"do-not-resuscitate" orders. This policy may only prescribe the
format, method of documentation and duration of any physician orders limiting
resuscitation. Any orders under this policy shall be honored by the facility.
(Section 2-104.2 of the Act);
3) procedures for providing life-sustaining treatments available
to residents at the facility;
4) procedures detailing staff's responsibility with respect to
the provision of life-sustaining treatment when a resident has chosen to accept,
reject or limit life-sustaining treatment, or when a resident has failed or has
not yet been given the opportunity to make these choices;
5) procedures for educating both direct and indirect care staff
in the application of those specific provisions of the policy for which they
are responsible.
b) For the purposes of this Section:
1) "Agent" means a person acting under a Health Care
Power of Attorney in accordance with the Powers of Attorney for Health Care
Law.
2) "Life-sustaining treatment" means any medical
treatment, procedure, or intervention that, in the judgment of the attending
physician, when applied to a resident, would serve only to prolong the dying
process. Those procedures can include, but are not limited to, cardiopulmonary
resuscitation (CPR), assisted ventilation, renal dialysis, surgical procedures,
blood transfusions, and the administration of drugs, antibiotics, and
artificial nutrition and hydration. Those procedures do not include performing
the Heimlich maneuver or clearing the airway, as indicated.
3) "Surrogate" means a surrogate decision maker acting
in accordance with the Health Care Surrogate Act (Ill. Rev. Stat. 1991, ch.
110½, par. 851-1 et seq.) [755 ILCS 40].
c) Within 30 days of admission for new residents, and within one
year of the effective date of this Section for all residents who were admitted
prior to the effective date of this Section, residents, agents, or surrogates
shall be given written information describing the facility's policies required
by this Section and shall be given the opportunity to:
1) execute a Living Will or Power of Attorney for Health Care in
accordance with State law, if they have not already done so; and/or
2) decline consent to any or all of the life-sustaining treatment
available at the facility.
d) Any decision made by a resident, an agent, or a surrogate
pursuant to subsection (c) of this Section must be recorded in the resident's
medical record. Any subsequent changes or modifications must also be recorded
in the medical record.
e) The facility shall honor all decisions made by a resident, an
agent, or a surrogate pursuant to subsection (c) of this Section and may not
discriminate in the provision of health care on the basis of such decision or
will transfer care in accordance with the Living Will Act, the Powers of
Attorney for Health Care Law, the Health Care Surrogate Act or the Right of
Conscience Act (Ill. Rev. Stat. 1991, ch. 111½, pars. 5301 et seq.) [745 ILCS
70]
f) The resident, agent, or surrogate may change his or her
decision regarding life-sustaining treatment by notifying the treating facility
of this decision change orally or in writing in accordance with State law.
g) The physician shall confirm the resident's choice by writing
appropriate orders in the patient record or will transfer care in accordance
with the Living Will Act, the Powers of Attorney for Health Care Law, the
Health Care Surrogate Act or the Right of Conscience Act.
h) If no choice is made pursuant to subsection (c) of this
Section, and in the absence of any physician's order to the contrary, then the
facility's policy with respect to the provision of life-sustaining treatment
shall control until and if such a decision is made by the resident, agent, or
surrogate in accordance with the requirements of the Health Care Surrogate Act.
(Source: Added at 17 Ill. Reg. 16194, effective January 1, 1994)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1040 CARE AND TREATMENT OF SEXUAL ASSAULT SURVIVORS
Section
300.1040 Care and Treatment of Sexual Assault Survivors
a) For the purposes of this
Section, the following definitions shall apply:
1) Ambulance
Provider – an individual or entity that owns and operates a business or service
using ambulances or emergency medical services vehicles to transport emergency
patients.
2) Sexual Assault
– an act of nonconsensual sexual conduct or sexual penetration, as defined in
Section 12-12 of the Criminal Code of 1961, including, without limitation, acts
prohibited under Sections 12-13 through 12-16 of the Criminal Code of 1961.
b) The
facility shall adhere to the following protocol for the care and treatment
of residents who are suspected of having been sexually assaulted in a
long term care facility or elsewhere (Section 3-808 of the Act):
1) Notify
local law enforcement pursuant to the requirements of Section 300.695;
2) Call an
ambulance provider if medical care is needed;
3) Move
the survivor, as quickly as reasonably possible, to a closed environment to
ensure privacy while waiting for emergency or law enforcement personnel to
arrive. The facility shall ensure the welfare and privacy of the survivor,
including the use of incident code to avoid embarrassment; and
4) Offer
to call a friend or family member and a sexual assault crisis advocate, when
available, to accompany the survivor.
c) The
facility shall take all reasonable steps to preserve evidence of the alleged
sexual assault, and not to launder or dispose of the resident's clothing or bed
linens until local law enforcement can determine whether they have evidentiary
value, including encouraging the survivor not to change clothes or bathe, if he
or she has not done so since the sexual assault.
d) The
facility shall notify the Department and draft a descriptive summary of the
alleged sexual assault pursuant to the requirements of Section 300.690.
(Source: Old Section repealed at 20 Ill.
Reg. 12160, effective September
10, 1996; new Section added at 35 Ill. Reg. 11419, effective June 29, 2011)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1050 DENTAL STANDARDS
Section 300.1050 Dental
Standards
a) Each long-term care facility shall have a dental program which
will provide for in-service education to residents and staff under direction of
dental personnel including at a minimum the following: (B)
1) Information regarding nutrition and diet control measures
which are dental health oriented.
2) Instruction in proper oral hygiene methods.
3) Instruction concerning the importance of maintenance of proper
oral hygiene and where appropriate including family members (as in the case of
residents leaving the long-term care facility).
b) The direct care staff shall receive in-service education
annually. This will be provided by a dentist or a dental hygienist. (B)
1) Direct care staff shall be educated in ultrasonic or manual
denture and partial denture cleaning techniques.
2) Direct care staff shall be educated in proper brushing and
oral health care for residents who are unable to care for their own health.
3) Direct care staff shall be educated in examining the mouth in
order to recognize abnormal conditions for necessary referral.
4) Direct care staff shall be educated regarding nutrition and
diet control measures and the effect on dental health.
5) Supplemental dental training films shall be included with any
other health training films seen on a rotating basis.
c) The long-term care facility's dental program shall provide for
each resident having proper daily personal dental hygiene attention, with the
nursing staff responsible for continuity of care which includes, but is not
limited to, the following: (B)
1) Assistance in cleaning mouth with electric or hand brush if
resident is unable to do so.
2) Weekly ultrasonic cleaning of dentures and partials is
strongly recommended.
d) There shall be comprehensive treatment services for all
residents which include, but are not limited to, the following: (B)
1) Provision for dental treatment
2) Provision for emergency treatment by a qualified dentist
e) Each facility shall have a denture and dental prosthesis
marking system which takes into account the identification marking system
contained in Section 49 of the Illinois Dental Practice Act (Ill. Rev. Stat.
1987, ch. 111, par. 2349). Policies and Procedures shall be written and
contained in the facility's Policies and Procedure Manual. It shall include, at
a minimum, provisions for: (B)
1) Marking individual dentures or dental protheses, if not marked
prior to admission to the facility, within ten days of admittance; and
2) individually marked denture cups for denture storage at night.
(Source: Amended at 13 Ill. Reg. 4684, effective March 24, 1989)
 | TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER d: LONG-TERM CARE FACILITIES
PART 300
SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE
SECTION 300.1060 VACCINATIONS
Section 300.1060 Vaccinations
a) A
facility shall annually administer or arrange for administration of 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. (Section 2-213(a) of the Act)
b) A
facility shall document in the resident's medical record that an annual
vaccination against influenza was administered, arranged, refused or medically
contraindicated. (Section 2-213(a) of the Act)
c) A
facility shall administer or arrange for administration of a pneumococcal
vaccination to each resident 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. (Section 2-213(b) of the Act)
d) A
facility shall document in each resident's medical record that a vaccination
against pneumococcal pneumonia was offered and administered, refused, or
medically contraindicated. (Section 2-213(b) of the Act)
e) A
facility shall distribute educational information provided by the
Department on all vaccines recommended by the Centers for Disease Control
and Prevention's Advisory Committee on Immunization Practices (available
at:
https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf),
including, but not limited to the risks associated with shingles and how to
protect oneself against the varicella-zoster virus. The facility shall
provide the information to each resident who requests the information and
each newly admitted resident. The facility may distribute the information to
residents electronically. (Section 2-213(e) of the Act)
f) A
facility shall document in the resident's medical record that he or she was
verbally screened for risk factors associated with hepatitis B, hepatitis C,
and HIV, and whether or not the resident was immunized against hepatitis B.
(Section 2-213(c) of the Act)
g) All
persons determined to be susceptible to the hepatitis B virus shall be offered
immunization within 10 days after admission to any nursing facility.
(Section 2-213(c) of the Act)
(Source: Amended at 45 Ill.
Reg. 11096, effective August 27, 2021)
SUBPART F: NURSING AND PERSONAL CARE
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