TITLE 89: SOCIAL SERVICES
CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER d: MEDICAL PROGRAMS
PART 146 SPECIALIZED HEALTH CARE DELIVERY SYSTEMS
SECTION 146.230 SERVICES
Section 146.230 Services
a) An SLF must combine housing, personal and health related services in response to the individual needs of residents who need help in activities of daily living. Supportive services shall be available 24 hours per day to meet scheduled and unscheduled needs in a way that promotes resident self-direction and participation in decisions that emphasize independence, individuality, privacy, dignity and autonomy in a residential setting.
b) Nursing Services
1) The SLF shall conduct a comprehensive resident assessment and service plan for each SLF resident as required under Section 146.245.
2) When a resident is unable to administer his or her own medications, a licensed nurse shall administer the medications.
3) Nursing services shall include medication set-up (such as preparing weekly pill caddies with that week's medication) and follow-up care, and shall be conducted by a licensed nurse.
4) Other nursing services include episodic and intermittent health promotion or disease prevention counseling and teaching self-care in meeting routine and special health care needs that can be done by other staff under the supervision of a registered nurse.
5) All nursing services shall be provided in accordance with the Nurse Practice Act [225 ILCS 65].
c) Personal Care
1) The SLF shall provide personal care services for residents, including but not limited to assistance with bathing, eating, dressing, personal hygiene, grooming, toileting, ambulation and transfer.
2) Personal care services shall be delivered by certified nursing assistants who meet the qualifications described in Section 146.235(f)(1).
d) Medication Administration, Oversight and Assistance in Self-Administration
1) The SLF shall provide the following:
A) Reminding the resident to take his or her medications;
B) Taking medication from where it is stored in the apartment and handing it to the resident when requested to do so by the resident;
C) Opening or uncapping medication containers for residents; and
D) Assisting residents in the removal of the medication from the container and assisting the resident in consuming or applying the medication when requested to do so by the resident (i.e., placing a dose in a container and placing the container to the mouth of the resident).
2) The services identified in subsection (d)(1)(D) shall only be delivered by a licensed nurse.
3) Medication administration shall be documented according to the needs of each resident. Documentation for medication administration shall include, but not be limited to, the following:
A) Name of resident;
B) Name of medication, dosage, directions and route of administration;
C) Date and time medication is scheduled to be administered;
D) Date and time medication was administered; and
E) Signature or initials of employee administering the medication.
4) Medication oversight shall be documented according to the needs of each resident. Documentation for medication oversight shall include, but not be limited to, the following:
A) Name of resident;
B) Name of medication, dosage, directions and route of administration;
C) Type of oversight needed; i.e., reminders, assisting with opening container, etc.;
D) Date and time medication is scheduled to be taken;
E) Documentation showing that resident has taken, or refused to take, the medication; and
F) Signature or initials of employee providing oversight.
1) The SLF shall provide three meals per day, or two meals per day (noon and evening meals) and a breakfast bar. The menu shall include food choices that allow a resident to choose foods that will meet the requirements of a therapeutic diet as ordered by a resident's physician. The menu for each resident shall meet the basic food pattern for a general diet for an adult following the recommendations of the Food and Nutrition Board, National Academy of Sciences.
2) The SLF shall make available beverages, including coffee, fruit juice and snack foods, at no cost to the residents.
3) The SLF shall offer the same menu options to all residents regardless of payment source.
4) The SLF shall keep all menus served on file for not less than six months.
5) The SLF shall maintain on the premises supplies of staple foods for a minimum of a one week period and of perishable foods for a minimum of a two day period. Supplies shall be appropriate to meet the requirements of the menu.
6) The SLF shall keep records of all food purchased on file for not less than six months.
7) The SLF shall store, prepare, distribute and serve food in a manner to protect against contaminants and spoilage and to insure the preparation and serving of food at safe and palatable temperatures.
8) The SLF shall provide and maintain clean and sanitary central kitchen and dining areas. The SLF shall ensure a sanitary and adequate supply of eating and drinking utensils and pots and pans for preparing food in the central kitchen and dining areas.
9) The SLF shall provide residents with written information about menu plans. Menu cycles shall not be repeated within a one week time frame. There shall be an established mechanism for residents to provide input into the selection and preparation of food served.
10) The SLF shall allow residents to obtain, prepare and store food in residential apartments if doing so does not represent a health or safety hazard to others.
11) The SLF shall provide residents with meal service in their apartments as a time limited service during periods of documented illness.
1) If requested by a resident, the SLF shall provide laundry services at least weekly at no charge to the resident.
2) The SLF shall provide for the appropriate handling, cleaning, and storage of routine personal laundry, laundry soiled with body secretions and all other laundry. This includes all detergent and fabric softeners required to perform normal routine laundry service at no cost to the resident.
3) The SLF shall provide on-site laundry equipment for resident use in accordance with Section 146.210.
4) Laundry service does not include dry cleaning services.
1) The SLF shall provide for general housekeeping services at least weekly (house cleaning, bed making, changing of linens, dusting and vacuuming).
2) The SLF shall take into account individual habits and lifestyle preferences when providing all housekeeping services in residential apartments.
3) The SLF shall maintain all public areas in a clean and orderly condition.
4) The SLF shall maintain all common bathing rooms in a clean and orderly condition.
1) The SLF shall maintain all residential apartments in good repair.
2) The SLF shall keep the building and grounds clean and free of hazards, with all systems maintained in good working order.
i) Social and Recreational Programming
1) The SLF shall facilitate the involvement of individual and community volunteer activities with and for residents.
2) The SLF shall provide programs at least twice weekly, which include on-site programs as well as off-site trips, allowing for social and recreational programs for the residents. Transportation shall be provided or arranged at no cost to the resident by the SLF for scheduled activities off-site.
3) The SLF shall provide access to opportunities for scheduled and unscheduled individual and group socialization within the SLF and in the larger community.
4) The SLF shall make available to each resident information about community resources and make community integration part of the SLF's recreational, socialization and vocational activities.
j) Ancillary Services
1) The SLF shall provide or arrange transportation, at no charge to the residents, for scheduled shopping, community and social activities. The community outings shall reflect the interests, choices and needs of the residents and be scheduled on a regular basis and be reflected in the residents' calendar.
2) The SLF shall assist a resident in obtaining needed and preferred services offered outside the SLF at his or her request. Upon request by a resident, the SLF shall assist in making medical appointments and arranging for transportation to and from the source of medical treatment (payment for medical transportation shall be made in accordance with 89 Ill. Adm. Code 140.490 through 140.492).
3) The SLF shall provide shopping assistance when a resident is temporarily unable to shop.
k) 24 Hour Response/Security Staff
1) The SLF shall have response/security staff awake and available on the premises 24 hours a day to respond to scheduled or unpredictable needs and emergency calls from residents. Staff shall possess certification in emergency resuscitation. The SLF shall provide no fewer than one staff person for facilities with one to 75 residents, a second staff person for facilities with 76 to l50 residents, and a third staff person for facilities with 151 or more residents. In determining the number of staff, the SLF shall consider the number of floors in the building, and the medical needs of the residents. At least one certified nursing assistant shall be on-site 24 hours a day to respond to resident needs.
2) The SLF shall provide security 24 hours a day, including lockable entrances (accessibility controlled by SLF staff for security purposes during overnight hours) and on-site personnel. All residents shall have 24 hour access.
3) Rehabilitated nursing facilities shall have separate staff on-site in the SLF.
l) Health Promotion and Exercise Programming
1) The SLF shall offer and encourage the use of health promotion and exercise programs for its residents.
2) The SLF shall develop programs to be held not less frequently than three times per week geared toward promoting better health and fitness of the residents. These programs are in addition to the social and recreational programming described in this Section.
m) Emergency Call System
1) The SLF shall ensure that at least two electronic devices are available in each apartment to enable the resident to secure help in an emergency. At least one device shall be located in each bathroom. The requirement for additional devices shall be met with a device located in each bedroom or through a portable emergency home response system.
2) The SLF shall have electronic devices available in each common area, each public restroom, each common bathing room and each resident laundry room to enable residents to secure help in an emergency.
3) The emergency call system shall be capable of direct and immediate notification to staff or shall be manned by personnel 24 hours a day for transmission to available staff for assistance.
n) Daily Check
The SLF shall implement a system to check on the welfare of each resident daily.
(Source: Amended at 33 Ill. Reg. 11803, effective August 1, 2009)