103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3446

 

Introduced 2/8/2024, by Sen. Javier L. Cervantes

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 45/3-212  from Ch. 111 1/2, par. 4153-212

    Amends the Nursing Home Care Act. Provides that the Department of Public Health shall conduct 3 unannounced visits to a facility per quarter to determine bedside care staffing levels. Provides that a facility that does not meet established bedside care staffing levels has committed a type "B" violation and is subject to a fine under the Act. Provides that the Department shall conduct a physical roll call during an inspection. Provides that employee identification cards must belong to the employee with the identification in the employee's possession. The employees present at the facility must match the published shift schedule. Provides that management shall not be considered as part of a shift schedule, unless the manager was added to the schedule no later than the start of the shift or in the case of an emergency and a manager is needed for bedside care. Provides that, for a facility that is not in compliance, the Department may remove the facility operator or assess a fine of no more than $10,000. Provides that an operator of a facility that is not in compliance must submit a plan of correction to the Department which the Department shall consider upon review of the facility's noncompliance. Provides that the Department shall post a notice about ghost schedules on its public Internet website and in common areas of a facility that is not compliant. Effective immediately.


LRB103 38889 CES 69026 b

 

 

A BILL FOR

 

SB3446LRB103 38889 CES 69026 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Nursing Home Care Act is amended by
5changing Section 3-212 as follows:
 
6    (210 ILCS 45/3-212)  (from Ch. 111 1/2, par. 4153-212)
7    Sec. 3-212. Inspection.
8    (a) The Department, whenever it deems necessary in
9accordance with subsection (b), shall inspect, survey and
10evaluate every facility to determine compliance with
11applicable licensure requirements and standards. Submission of
12a facility's current Consumer Choice Information Report
13required by Section 2-214 shall be verified at time of
14inspection. An inspection should occur within 120 days prior
15to license renewal. The Department may periodically visit a
16facility for the purpose of consultation. An inspection,
17survey, or evaluation, other than an inspection of financial
18records, shall be conducted without prior notice to the
19facility. A visit for the sole purpose of consultation may be
20announced. The Department shall provide training to surveyors
21about the appropriate assessment, care planning, and care of
22persons with mental illness (other than Alzheimer's disease or
23related disorders) to enable its surveyors to determine

 

 

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1whether a facility is complying with State and federal
2requirements about the assessment, care planning, and care of
3those persons.
4    (a-1) An employee of a State or unit of local government
5agency charged with inspecting, surveying, and evaluating
6facilities who directly or indirectly gives prior notice of an
7inspection, survey, or evaluation, other than an inspection of
8financial records, to a facility or to an employee of a
9facility is guilty of a Class A misdemeanor.
10    An inspector or an employee of the Department who
11intentionally prenotifies a facility, orally or in writing, of
12a pending complaint investigation or inspection shall be
13guilty of a Class A misdemeanor. Superiors of persons who have
14prenotified a facility shall be subject to the same penalties,
15if they have knowingly allowed the prenotification. A person
16found guilty of prenotifying a facility shall be subject to
17disciplinary action by his or her employer.
18    If the Department has a good faith belief, based upon
19information that comes to its attention, that a violation of
20this subsection has occurred, it must file a complaint with
21the Attorney General or the State's Attorney in the county
22where the violation took place within 30 days after discovery
23of the information.
24    (a-2) An employee of a State or unit of local government
25agency charged with inspecting, surveying, or evaluating
26facilities who willfully profits from violating the

 

 

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1confidentiality of the inspection, survey, or evaluation
2process shall be guilty of a Class 4 felony and that conduct
3shall be deemed unprofessional conduct that may subject a
4person to loss of his or her professional license. An action to
5prosecute a person for violating this subsection (a-2) may be
6brought by either the Attorney General or the State's Attorney
7in the county where the violation took place.
8    (a-3) The Department shall, by rule, establish guidelines
9for required continuing education of all employees who
10inspect, survey, or evaluate a facility. The Department shall
11offer continuing education opportunities at least quarterly.
12Employees of a State agency charged with inspecting,
13surveying, or evaluating a facility are required to complete
14at least 10 hours of continuing education annually on topics
15that support the survey process, including, but not limited
16to, trauma-informed care, infection control, abuse and
17neglect, and civil monetary penalties. Qualifying hours of
18continuing education intended to fulfill the requirements of
19this subsection shall only be offered by the Department.
20Content presented during the continuing education shall be
21consistent throughout the State, regardless of survey region.
22At least 5 of the 10 hours of continuing education required
23under this subsection shall be separate and distinct from any
24continuing education hours required for any license that the
25employee holds. Any continuing education hours provided by the
26Department in addition to the 10 hours of continuing education

 

 

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1required under this subsection may count towards continuing
2education hours required for any license that the employee
3holds.
4    (a-4) The Department shall conduct 3 unannounced visits to
5a facility per quarter to determine bedside care staffing
6levels. Any facility that does not meet established bedside
7care staffing levels has committed a type "B" violation and
8shall be subject to a fine under Section 3-305 of this Act.
9        (1) The Department shall conduct a physical roll call
10    during an inspection under (a-4) of this Section. For
11    purposes of this Section, employee identification cards
12    must belong to the employee with the identification in the
13    employee's possession. The employees present at the
14    facility must match the published shift schedule.
15    Management shall not be considered as part of a shift
16    schedule, unless the manager was added to the schedule no
17    later than the start of the shift or in the case of an
18    emergency and a manager is needed for bedside care.
19        (2) If the facility is not compliant with subsection
20    (1), the Department may remove the facility operator or
21    assess a fine of no more than $10,000. The operator must
22    submit a plan of correction to the Department which the
23    Department shall consider upon review of the facility's
24    non-compliance.
25        (3) The Department shall post the following on the
26    Department's public Internet website and in the facility

 

 

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1    common areas: "Ghost schedules are commonly referred to in
2    the nursing home and independent living center industry.
3    These schedules typically will have management staff act
4    as bedside care staff for the purposes of staffing audits
5    to demonstrate complete staffing levels. These schedules
6    give the impression that the facility is fully staffed
7    when it is not."
8    (b) In determining whether to make more than the required
9number of unannounced inspections, surveys and evaluations of
10a facility the Department shall consider one or more of the
11following: previous inspection reports; the facility's history
12of compliance with standards, rules and regulations
13promulgated under this Act and correction of violations,
14penalties or other enforcement actions; the number and
15severity of complaints received about the facility; any
16allegations of resident abuse or neglect; weather conditions;
17health emergencies; other reasonable belief that deficiencies
18exist.
19    (b-1) The Department shall not be required to determine
20whether a facility certified to participate in the Medicare
21program under Title XVIII of the Social Security Act, or the
22Medicaid program under Title XIX of the Social Security Act,
23and which the Department determines by inspection under this
24Section or under Section 3-702 of this Act to be in compliance
25with the certification requirements of Title XVIII or XIX, is
26in compliance with any requirement of this Act that is less

 

 

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1stringent than or duplicates a federal certification
2requirement. In accordance with subsection (a) of this Section
3or subsection (d) of Section 3-702, the Department shall
4determine whether a certified facility is in compliance with
5requirements of this Act that exceed federal certification
6requirements. If a certified facility is found to be out of
7compliance with federal certification requirements, the
8results of an inspection conducted pursuant to Title XVIII or
9XIX of the Social Security Act may be used as the basis for
10enforcement remedies authorized and commenced, with the
11Department's discretion to evaluate whether penalties are
12warranted, under this Act. Enforcement of this Act against a
13certified facility shall be commenced pursuant to the
14requirements of this Act, unless enforcement remedies sought
15pursuant to Title XVIII or XIX of the Social Security Act
16exceed those authorized by this Act. As used in this
17subsection, "enforcement remedy" means a sanction for
18violating a federal certification requirement or this Act.
19    (c) Upon completion of each inspection, survey and
20evaluation, the appropriate Department personnel who conducted
21the inspection, survey or evaluation shall submit a physical
22or electronic copy of their report to the licensee upon
23exiting the facility, and shall submit the actual report to
24the appropriate regional office of the Department. Such report
25and any recommendations for action by the Department under
26this Act shall be transmitted to the appropriate offices of

 

 

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1the associate director of the Department, together with
2related comments or documentation provided by the licensee
3which may refute findings in the report, which explain
4extenuating circumstances that the facility could not
5reasonably have prevented, or which indicate methods and
6timetables for correction of deficiencies described in the
7report. Without affecting the application of subsection (a) of
8Section 3-303, any documentation or comments of the licensee
9shall be provided within 10 days of receipt of the copy of the
10report. Such report shall recommend to the Director
11appropriate action under this Act with respect to findings
12against a facility. The Director shall then determine whether
13the report's findings constitute a violation or violations of
14which the facility must be given notice. Such determination
15shall be based upon the severity of the finding, the danger
16posed to resident health and safety, the comments and
17documentation provided by the facility, the diligence and
18efforts to correct deficiencies, correction of the reported
19deficiencies, the frequency and duration of similar findings
20in previous reports and the facility's general inspection
21history. Violations shall be determined under this subsection
22no later than 75 days after completion of each inspection,
23survey and evaluation.
24    (d) The Department shall maintain all inspection, survey
25and evaluation reports for at least 5 years in a manner
26accessible to and understandable by the public.

 

 

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1    (e) Revisit surveys. The Department shall conduct a
2revisit to its licensure and certification surveys, consistent
3with federal regulations and guidelines.
4    (f) Notwithstanding any other provision of this Act, the
5Department shall, no later than 180 days after the effective
6date of this amendatory Act of the 98th General Assembly,
7implement a single survey process that encompasses federal
8certification and State licensure requirements, health and
9life safety requirements, and an enhanced complaint
10investigation initiative.
11        (1) To meet the requirement of a single survey
12    process, the portions of the health and life safety survey
13    associated with federal certification and State licensure
14    surveys must be started within 7 working days of each
15    other. Nothing in this paragraph (1) of subsection (f) of
16    this Section applies to a complaint investigation.
17        (2) The enhanced complaint and incident report
18    investigation initiative shall permit the facility to
19    challenge the amount of the fine due to the excessive
20    length of the investigation which results in one or more
21    of the following conditions:
22            (A) prohibits the timely development and
23        implementation of a plan of correction;
24            (B) creates undue financial hardship impacting the
25        quality of care delivered to the resident;
26            (C) delays initiation of corrective training; and

 

 

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1            (D) negatively impacts quality assurance and
2        patient improvement standards.
3    This paragraph (2) does not apply to complaint
4    investigations exited within 14 working days or a
5    situation that triggers an extended survey.
6(Source: P.A. 102-947, eff. 1-1-23.)
 
7    Section 99. Effective date. This Act takes effect upon
8becoming law.