(210 ILCS 5/3)
(from Ch. 111 1/2, par. 157-8.3)
As used in this Act, unless the context otherwise requires, the
following words and phrases shall have the meanings ascribed to them:
(A) "Ambulatory surgical treatment center" means any institution, place
or building devoted primarily to the maintenance and operation of
facilities for the performance of surgical procedures. "Ambulatory surgical treatment center" includes any place that meets and complies with the definition of an ambulatory surgical treatment center under the rules adopted by the Department.
Such facility shall not provide beds or other accommodations for the
overnight stay of patients; however, facilities devoted exclusively to the
treatment of children may provide accommodations and beds for their patients
for up to 23 hours following admission. Individual patients shall be
discharged in an ambulatory condition without danger to the continued well
being of the patients or shall be transferred to a hospital.
The term "ambulatory surgical treatment center" does not include any of the
(1) Any institution, place, building or agency
required to be licensed pursuant to the "Hospital Licensing Act", approved July 1, 1953, as amended.
(2) Any person or institution required to be licensed
pursuant to the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, or the MC/DD Act.
(3) Hospitals or ambulatory surgical treatment
centers maintained by the State or any department or agency thereof, where such department or agency has authority under law to establish and enforce standards for the hospitals or ambulatory surgical treatment centers under its management and control.
(4) Hospitals or ambulatory surgical treatment
centers maintained by the Federal Government or agencies thereof.
(5) Any place, agency, clinic, or practice, public or
private, whether organized for profit or not, devoted exclusively to the performance of dental or oral surgical procedures.
(6) Any facility in which the performance of abortion
procedures, including procedures to terminate a pregnancy or to manage pregnancy loss, is limited to those performed without general, epidural, or spinal anesthesia, and which is not otherwise required to be an ambulatory surgical treatment center. For purposes of this paragraph, "general, epidural, or spinal anesthesia" does not include local anesthesia or intravenous sedation. Nothing in this paragraph shall be construed to limit any such facility from voluntarily electing to apply for licensure as an ambulatory surgical treatment center.
(B) "Person" means any individual, firm, partnership, corporation,
company, association, or joint stock association, or the legal successor
(C) "Department" means the Department of Public Health of the State of
(D) "Director" means the Director of the Department of Public Health of
the State of Illinois.
(E) "Physician" means a person licensed to practice medicine in all of
its branches in the State of Illinois.
(F) "Dentist" means a person licensed to practice dentistry under the
Illinois Dental Practice Act.
(G) "Podiatric physician" means a person licensed to practice podiatry under
the Podiatric Medical Practice Act of 1987.
(Source: P.A. 101-13, eff. 6-12-19.)
(210 ILCS 5/6)
(from Ch. 111 1/2, par. 157-8.6)
Upon receipt of an application for a license, the Director may
deny the application for any of the following reasons:
(1) Conviction of the applicant, or if the applicant
is a firm, partnership or association, of any of its members, or if 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 2 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, if the Director determines, after investigation, that such person has not been sufficiently rehabilitated to warrant the public trust; or other satisfactory evidence that the moral character of the applicant, or manager, or supervisor of the facility is not reputable;
(2) The licensure status or record of the applicant,
or if the applicant is a firm, partnership or association, of any of its members, or if a corporation, of any of its officers or directors, or of the person designated to manage or supervise the facility, from any other state where the applicant has done business in a similar capacity indicates that granting a license to the applicant would be detrimental to the interests of the public; or
(3) The applicant has insufficient financial or other
resources to operate and conduct the facility in accordance with the requirements of this Act and the minimum standards, rules and regulations promulgated thereunder.
The Director shall only issue a license if he finds that the applicant
facility complies with this Act and the rules, regulations and standards
promulgated pursuant thereto and:
(a) is under the medical supervision of one or more
(b) permits a surgical procedure to be performed only
by a physician, podiatric physician, or dentist who at the time is privileged to have his patients admitted by himself or an associated physician and is himself privileged to perform surgical procedures in at least one Illinois hospital. A dentist may be privileged at the ambulatory surgical treatment center if it is determined that the patient under the care of the dentist requires sedation beyond the training that the dentist possesses. The determination of need for sedation shall be made by the medical director of the facility where the procedure is to be performed. A dentist performing a surgical procedure requiring sedation at a facility must either have admitting privileges at a nearby hospital where patients would receive care in the event of an emergency arising during a dental surgical procedure or have a memorandum of understanding with a physician who has admitting privileges at such a hospital; and
(c) maintains adequate medical records for each
A license, unless sooner suspended or revoked, shall be renewable
annually upon approval by the Department and payment of a license fee of
$300. Each license shall be issued only for the premises and persons named in
the application and shall not be transferable or assignable. The licenses shall
be posted in a conspicuous place on the licensed premises. A placard or
registry of all physicians on staff in the facility shall be centrally located
and available for inspection to any interested person. The Department may,
either before or after the issuance of a license, request the cooperation of
the State Fire Marshal. The report and recommendations of this agency shall be
in writing and shall state with particularity its findings with respect to
compliance or noncompliance with such minimum standards, rules and regulations.
The Director may issue a provisional license to any ambulatory
surgical treatment center which does not substantially comply with the
provisions of this Act and the standards, rules and regulations
promulgated by virtue thereof provided that he finds that such
ambulatory surgical treatment center will undertake changes and
corrections which upon completion will render the ambulatory surgical
treatment center in substantial compliance with the provisions of this
Act, and the standards, rules and regulations adopted hereunder, and
provided that the health and safety of the patients of the ambulatory
surgical treatment center will be protected during the period for which
such provisional license is issued. The Director shall advise the
licensee of the conditions under which such provisional license is
issued, including the manner in which the facilities fail to comply with
the provisions of the Act, standards, rules and regulations, and the
time within which the changes and corrections necessary for such
ambulatory surgical treatment center to substantially comply with this
Act, and the standards, rules and regulations of the Department relating
thereto shall be completed.
A person or facility not licensed under this Act or the Hospital Licensing
Act shall not hold itself out to the public as a "surgery center" or as a
"center for surgery".
(Source: P.A. 101-323, eff. 8-9-19.)
(210 ILCS 5/6.5)
Clinical privileges; advanced practice registered nurses.
All ambulatory surgical treatment centers (ASTC) licensed under this Act
comply with the following requirements:
(1) No ASTC policy, rule, regulation, or practice
shall be inconsistent with the provision of adequate collaboration and consultation in accordance with Section 54.5 of the Medical Practice Act of 1987.
(2) Operative surgical procedures shall be performed
only by a physician licensed to practice medicine in all its branches under the Medical Practice Act of 1987, a dentist licensed under the Illinois Dental Practice Act, or a podiatric physician licensed under the Podiatric Medical Practice Act of 1987, with medical staff membership and surgical clinical privileges granted by the consulting committee of the ASTC. A licensed physician, dentist, or podiatric physician may be assisted by a physician licensed to practice medicine in all its branches, dentist, dental assistant, podiatric physician, licensed advanced practice registered nurse, licensed physician assistant, licensed registered nurse, licensed practical nurse, surgical assistant, surgical technician, or other individuals granted clinical privileges to assist in surgery by the consulting committee of the ASTC. Payment for services rendered by an assistant in surgery who is not an ambulatory surgical treatment center employee shall be paid at the appropriate non-physician modifier rate if the payor would have made payment had the same services been provided by a physician.
(2.5) A registered nurse licensed under the Nurse
Practice Act and qualified by training and experience in operating room nursing shall be present in the operating room and function as the circulating nurse during all invasive or operative procedures. For purposes of this paragraph (2.5), "circulating nurse" means a registered nurse who is responsible for coordinating all nursing care, patient safety needs, and the needs of the surgical team in the operating room during an invasive or operative procedure.
(3) An advanced practice registered nurse is not
required to possess prescriptive authority or a written collaborative agreement meeting the requirements of the Nurse Practice Act to provide advanced practice registered nursing services in an ambulatory surgical treatment center. An advanced practice registered nurse must possess clinical privileges granted by the consulting medical staff committee and ambulatory surgical treatment center in order to provide services. Individual advanced practice registered nurses may also be granted clinical privileges to order, select, and administer medications, including controlled substances, to provide delineated care. The attending physician must determine the advanced practice registered nurse's role in providing care for his or her patients, except as otherwise provided in the consulting staff policies. The consulting medical staff committee shall periodically review the services of advanced practice registered nurses granted privileges.
(4) The anesthesia service shall be under the
direction of a physician licensed to practice medicine in all its branches who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. An anesthesiologist, Board certified or Board eligible, is recommended. Anesthesia services may only be administered pursuant to the order of a physician licensed to practice medicine in all its branches, licensed dentist, or licensed podiatric physician.
(A) The individuals who, with clinical privileges
granted by the medical staff and ASTC, may administer anesthesia services are limited to the following:
(i) an anesthesiologist; or
(ii) a physician licensed to practice
medicine in all its branches; or
(iii) a dentist with authority to administer
anesthesia under Section 8.1 of the Illinois Dental Practice Act; or
(iv) a licensed certified registered nurse
(v) a podiatric physician licensed under the
Podiatric Medical Practice Act of 1987.
(B) For anesthesia services, an anesthesiologist
shall participate through discussion of and agreement with the anesthesia plan and shall remain physically present and be available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions. In the absence of 24-hour availability of anesthesiologists with clinical privileges, an alternate policy (requiring participation, presence, and availability of a physician licensed to practice medicine in all its branches) shall be developed by the medical staff consulting committee in consultation with the anesthesia service and included in the medical staff consulting committee policies.
(C) A certified registered nurse anesthetist is
not required to possess prescriptive authority or a written collaborative agreement meeting the requirements of Section 65-35 of the Nurse Practice Act to provide anesthesia services ordered by a licensed physician, dentist, or podiatric physician. Licensed certified registered nurse anesthetists are authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed with by the anesthesiologist or, in the absence of an available anesthesiologist with clinical privileges, agreed with by the operating physician, operating dentist, or operating podiatric physician in accordance with the medical staff consulting committee policies of a licensed ambulatory surgical treatment center.
(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18
(210 ILCS 5/6.7)
Registered nurse administration of limited levels of sedation or analgesia.
(a) Nothing in this Act precludes a registered nurse from administering medications for the delivery of local or minimal sedation ordered by a physician licensed to practice medicine in all its branches, podiatric physician, or dentist.
(b) If the ASTC policy allows the registered nurse to deliver moderate sedation ordered by a physician licensed to practice medicine in all its branches, podiatric physician, or dentist, the following are required:
(1) The registered nurse must be under the
supervision of a physician licensed to practice medicine in all its branches, podiatric physician, or dentist during the delivery or monitoring of moderate sedation and have no other responsibilities during the procedure.
(2) The registered nurse must maintain current
Advanced Cardiac Life Support certification or Pediatric Advanced Life Support certification as appropriate to the age of the patient.
(3) The supervising physician licensed to practice
medicine in all its branches, podiatric physician, or dentist must have training and experience in delivering and monitoring moderate sedation and possess clinical privileges at the ASTC to administer moderate sedation or analgesia.
(4) The supervising physician licensed to practice
medicine in all its branches, podiatric physician, or dentist must remain physically present and available on the premises during the delivery of moderate sedation for diagnosis, consultation, and treatment of emergency medical conditions.
(5) The supervising physician licensed to practice
medicine in all its branches, podiatric physician, or dentist must maintain current Advanced Cardiac Life Support certification or Pediatric Advanced Life Support certification as appropriate to the age of the patient.
(c) Local, minimal, and moderate sedation shall be defined by the Division of Professional Regulation of the Department of Financial and Professional Regulation. Registered nurses shall be limited to administering medications for moderate sedation at doses rapidly reversible pharmacologically as determined by rule by the Division of Professional Regulation of the Department of Financial and Professional Regulation.
(Source: P.A. 98-214, eff. 8-9-13.)
(210 ILCS 5/8)
(from Ch. 111 1/2, par. 157-8.8)
Facility plan review; fees.
(a) Before commencing construction of new facilities or specified types
of alteration or additions to an existing ambulatory surgical treatment
center involving major construction, as defined by rule by the
Department, with an estimated cost greater than $100,000,
architectural drawings and specifications therefor shall be
submitted to the Department for review and approval.
A facility may submit architectural drawings and specifications for other
construction projects for Department review according to subsection (b) that
shall not be subject to fees under subsection (d).
Review of drawings and specifications shall be conducted by an employee of
the Department meeting the qualifications established by the Department of
Central Management Services
class specifications for such an individual's position or by a person
contracting with the Department who meets those class specifications.
Final approval of the
drawings and specifications for compliance with design and construction
standards shall be obtained from the Department before the alteration,
addition, or new construction is begun.
(b) The Department shall inform an applicant in writing within 10 working
days after receiving drawings and specifications and the required fee, if any,
from the applicant whether the applicant's submission is complete or
incomplete. Failure to provide the applicant with this notice within 10
working days shall result in the submission being deemed complete for purposes
of initiating the 60-day review period under this Section. If the submission
is incomplete, the Department shall inform the applicant of the deficiencies
with the submission in writing. If the submission is complete and the required
fee, if any, has been paid,
the Department shall approve or disapprove drawings and specifications
submitted to the Department no later than 60 days following receipt by the
Department. The drawings and specifications shall be of sufficient detail, as
provided by Department rule, to enable the Department to render a determination
of compliance with design and construction standards under this Act.
If the Department finds that the drawings are not of sufficient detail for it
to render a determination of compliance, the plans shall be determined to be
incomplete and shall not be considered for purposes of initiating the 60 day
If a submission of drawings and specifications is incomplete, the applicant
may submit additional information. The 60-day review period shall not commence
until the Department determines that a submission of drawings and
specifications is complete or the submission is deemed complete.
If the Department has not approved or disapproved the
drawings and specifications within 60 days, the construction, major alteration,
or addition shall be deemed approved. If the drawings and specifications are
disapproved, the Department shall state in writing, with specificity, the
reasons for the disapproval. The entity submitting the drawings and
specifications may submit additional information in response to the written
comments from the Department or request a reconsideration of the disapproval.
A final decision of approval or disapproval shall be made within 45 days of the
receipt of the additional information or reconsideration request. If denied,
the Department shall state the specific reasons for the denial.
(c) The Department shall provide written approval for occupancy pursuant
to subsection (g) and shall not issue a violation to a facility as a result of
a licensure or complaint survey based upon the facility's physical structure
(1) the Department reviewed and approved or deemed
approved the drawings and specifications for compliance with design and construction standards;
(2) the construction, major alteration, or addition
(3) the law or rules have not been amended since the
(4) the conditions at the facility indicate that
there is a reasonable degree of safety provided for the patients.
(d) The Department shall charge the following fees in connection with its
reviews conducted before June 30, 2004 under this Section:
(3) If the estimated dollar value of the alteration,
addition, or new construction is $100,000 or more but less than $500,000, the fee shall be the greater of $2,400 or 1.2% of that value.
(4) If the estimated dollar value of the alteration,
addition, or new construction is $500,000 or more but less than $1,000,000, the fee shall be the greater of $6,000 or 0.96% of that value.
(5) If the estimated dollar value of the alteration,
addition, or new construction is $1,000,000 or more but less than $5,000,000, the fee shall be the greater of $9,600 or 0.22% of that value.
(6) If the estimated dollar value of the alteration,
addition, or new construction is $5,000,000 or more, the fee shall be the greater of $11,000 or 0.11% of that value, but shall not exceed $40,000.
The fees provided in this subsection (d) shall not apply to major
construction projects involving facility changes that are required by
Department rule amendments.
The fees provided in this subsection (d) shall also not apply to major
construction projects if 51% or more of the estimated cost of the project is
attributed to capital equipment. For major construction projects where 51% or
more of the estimated cost of the project is attributed to capital equipment,
the Department shall by rule establish a fee that is reasonably related to the
cost of reviewing the project.
The Department shall not commence the facility plan review process under this
Section until the applicable fee has been paid.
(e) All fees received by the Department under this Section shall be
deposited into the Health Facility Plan Review Fund, a special fund created in
the State Treasury. Moneys shall be appropriated from that Fund to the
Department only to pay the costs of conducting reviews under this Section.
All fees paid by ambulatory surgical treatment centers under subsection (d)
shall be used only to cover the costs relating to the Department's review of
ambulatory surgical treatment center projects under this Section.
None of the moneys in the Health Facility Plan Review Fund shall be used to
reduce the amount of General Revenue Fund moneys appropriated to the Department
for facility plan reviews conducted pursuant to this Section.
(f) (1) The provisions of this amendatory Act of 1997
concerning drawings and specifications shall apply only to drawings and specifications submitted to the Department on or after October 1, 1997.
(2) On and after the effective date of this
amendatory Act of 1997 and before October 1, 1997, an applicant may submit or resubmit drawings and specifications to the Department and pay the fees provided in subsection (d). If an applicant pays the fees provided in subsection (d) under this paragraph (2), the provisions of subsection (b) shall apply with regard to those drawings and specifications.
(g) The Department shall conduct an on-site inspection of the completed
project no later than 30 days after notification from the applicant that the
project has been completed and all certifications required by the Department
have been received and accepted by the Department. The Department shall
provide written approval for occupancy to the applicant within 5 working days
of the Department's final inspection, provided the applicant has demonstrated
substantial compliance as defined by Department rule. Occupancy of new major
construction is prohibited until Department approval is received, unless the
Department has not acted within the time frames provided in this subsection
(g), in which case the construction shall be deemed approved. Occupancy
shall be authorized after any required health
inspection by the Department has been conducted.
(h) The Department shall establish, by rule, a procedure to conduct interim
on-site review of large or complex construction projects.
(i) The Department shall establish, by rule, an expedited process for
emergency repairs or replacement of like equipment.
(j) Nothing in this Section shall be construed to apply to maintenance,
upkeep, or renovation that does not affect the structural integrity of the
building, does not add beds or services over the number for which the facility
is licensed, and provides a reasonable degree of safety for the patients.
(Source: P.A. 90-327, eff. 8-8-97; 90-600, eff. 6-25-98; 91-712, eff. 7-1-00.)
(210 ILCS 5/10)
(from Ch. 111 1/2, par. 157-8.10)
The Department shall prescribe and publish minimum standards, rules and
regulations necessary to implement the provisions of this Act which shall
include, but not be limited to:
(a) construction of the facility including, but not
limited to, plumbing, heating, lighting, and ventilation which shall ensure the health, safety, comfort and privacy of patients and protection from fire hazard;
(b) number and qualifications of all personnel,
including administrative and nursing personnel, having responsibility for any part of the care provided to the patients;
(c) equipment essential to the health, welfare and
safety of the patients; and
(d) facilities, programs and services to be provided
in connection with the care of patients in ambulatory surgical treatment centers.
(Source: P.A. 78-227
(210 ILCS 5/10d)
(from Ch. 111 1/2, par. 157-8.10d)
Fines and penalties.
(a) When the Director determines that
a facility has failed to comply with this Act or the Illinois Adverse Health Care Events Reporting Law of 2005 or any rule adopted
under either of those Acts, the Department may issue a notice of fine assessment which shall
specify the violations for which the fine is assessed. The Department may
assess a fine of up to $500 per violation per day commencing on the date
the violation was identified and ending on the date the violation is
corrected, or action is taken to suspend, revoke or deny renewal of the
license, whichever comes first.
(b) In determining whether a fine is to be assessed or the amount of such
fine, the Director shall consider the following factors:
(1) The gravity of the violation, including the
probability that death or serious physical or mental harm to a patient will result or has resulted, the severity of the actual or potential harm, and the extent to which the provisions of the applicable statutes or rules were violated;
(2) The reasonable diligence exercised by the
licensee and efforts to correct violations;
(3) Any previous violations committed by the
(4) The financial benefit to the facility of
committing or continuing the violation.
(Source: P.A. 94-242, eff. 7-18-05.)
(210 ILCS 5/10g)
(from Ch. 111 1/2, par. 157-8.10g)
Notice of administrative actions; hearing procedures.
(a) Notice of all administrative actions taken under this Act shall be
effected by registered mail, certified mail, or personal service and shall
set forth the particular reasons for the proposed action and provide the
applicant or licensee with an opportunity to request a hearing. If a
hearing request is not received within 10 days, the right to a hearing
(b) The procedure governing hearings authorized by this Section shall be
in accordance with rules promulgated by the Department consistent with this
Act. A hearing shall be conducted by the Director or by an individual
designated in writing by the Director as hearing officer. A full and
complete record shall be kept of all proceedings, including notice of
hearing, complaint, and all other documents in the nature of pleadings,
written motions filed in the proceedings, and the report and orders of the
Director and hearing officer. All testimony shall be reported but need not
be transcribed unless the decision is appealed pursuant to Section 11 of
this Act. A copy or copies of the transcript may be obtained by any
interested party on payment of the cost of preparing such copy or copies.
(c) The Director or hearing officer shall, upon his own motion or on the
written request of any party to the proceeding, issue subpoenas requiring
the attendance and testimony of witnesses and subpoenas duces tecum
requiring the production of books, papers, records or memoranda. The fees
of witnesses for attendance and travel shall be the same as the fees of
witnesses before any circuit court of this State. Such fees shall be paid
when the witness is excused from further attendance. When the witness is
subpoenaed at the instance of the Director or hearing officer, such fees
shall be paid in the same manner as other expenses of the Department. When
the witness is subpoenaed at the instance of any other party to a
proceeding, the Department may require that the cost of service of the
subpoena or subpoena duces tecum and the fee of the witness be borne by the
party at whose instance the witness is summoned. In such case, the
Department, in its discretion, may require a deposit to cover the cost of
such service and witness fees. A subpoena or subpoena duces tecum issued
under this Section shall be served in the same manner as a subpoena issued by a court.
(d) Any circuit court of this State, upon the application of the
Director or the application of any other party to the proceeding, may, in
its discretion, compel the attendance of witnesses, the production of
books, papers, records or memoranda, and the giving of testimony before the
Director or hearing officer conducting an investigation or holding a
hearing authorized by this Act, by an attachment for contempt, or
otherwise, in the same manner as production of evidence may be compelled
before the court.
(e) The Director or hearing officer, or any party in a hearing before the
Department, may cause the deposition of witnesses within the State to be
taken in the manner prescribed by law for depositions in civil actions in
courts of this State, and may compel the attendance of witnesses and the
production of books, papers, records or memoranda.
(f) The Director or Hearing Officer shall make findings of fact in such
hearing and the Director shall render his decision within 60 days
after the termination or waiving of the hearing unless additional time is
required by him for a proper disposition of the matter. When the hearing
has been conducted by a hearing officer, the Director shall review the
record and findings of fact before rendering a decision. A copy of the
findings of fact and decision of the Director shall be served upon the
applicant or licensee in person, by registered mail, or by certified mail
in the same manner as the service of the notice of hearing. The decision
denying, suspending, or revoking a license shall become final 35 days after
it is mailed or served, unless the applicant or licensee, within the 35-day
period, petitions for review pursuant to Section 11 of this Act.
(Source: P.A. 86-1292.)