Bill Amendment: IL HB4518 | 2015-2016 | 99th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: HEALTH FACILITIES PLANNING

Status: 2016-07-31 - Pursuant to Senate Rule 3-9(b) / Referred to Assignments [HB4518 Detail]

Download: Illinois-2015-HB4518-House_Amendment_001.html

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Rep. William Davis

Filed: 3/25/2016

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AMENDMENT TO HOUSE BILL 4518
AMENDMENT NO. ______. Amend House Bill 4518 by replacing
everything after the enacting clause with the following:
"Section 5. The Illinois Health Facilities Planning Act is
amended by changing Sections 3, 4, 8.5, 10, and 14.1 as
follows:
(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
(Section scheduled to be repealed on December 31, 2019)
Sec. 3. Definitions. As used in this Act:
"Health care facilities" means and includes the following
facilities, organizations, and related persons:
(1) An ambulatory surgical treatment center required
to be licensed pursuant to the Ambulatory Surgical
Treatment Center Act.
(2) An institution, place, building, or agency
required to be licensed pursuant to the Hospital Licensing

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Act.
(3) Skilled and intermediate long term care facilities
licensed under the Nursing Home Care Act.
(A) If a demonstration project under the Nursing
Home Care Act applies for a certificate of need to
convert to a nursing facility, it shall meet the
licensure and certificate of need requirements in
effect as of the date of application.
(B) Except as provided in item (A) of this
subsection, this Act does not apply to facilities
granted waivers under Section 3-102.2 of the Nursing
Home Care Act.
(3.5) Skilled and intermediate care facilities
licensed under the ID/DD Community Care Act or the MC/DD
Act. No permit or exemption is required for a facility
licensed under the ID/DD Community Care Act or the MC/DD
Act prior to the reduction of the number of beds at a
facility. If there is a total reduction of beds at a
facility licensed under the ID/DD Community Care Act or the
MC/DD Act, this is a discontinuation or closure of the
facility. If a facility licensed under the ID/DD Community
Care Act or the MC/DD Act reduces the number of beds or
discontinues the facility, that facility must notify the
Board as provided in Section 14.1 of this Act.
(3.7) Facilities licensed under the Specialized Mental
Health Rehabilitation Act of 2013.

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(4) Hospitals, nursing homes, ambulatory surgical
treatment centers, or kidney disease treatment centers
maintained by the State or any department or agency
thereof.
(5) Kidney disease treatment centers, including a
free-standing hemodialysis unit required to be licensed
under the End Stage Renal Disease Facility Act.
(A) This Act does not apply to a dialysis facility
that provides only dialysis training, support, and
related services to individuals with end stage renal
disease who have elected to receive home dialysis.
(B) This Act does not apply to a dialysis unit
located in a licensed nursing home that offers or
provides dialysis-related services to residents with
end stage renal disease who have elected to receive
home dialysis within the nursing home.
(C) The Board, however, may require dialysis
facilities and licensed nursing homes under items (A)
and (B) of this subsection to report statistical
information on a quarterly basis to the Board to be
used by the Board to conduct analyses on the need for
proposed kidney disease treatment centers.
(6) An institution, place, building, or room used for
the performance of outpatient surgical procedures that is
leased, owned, or operated by or on behalf of an
out-of-state facility.

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(7) An institution, place, building, or room used for
provision of a health care category of service, including,
but not limited to, cardiac catheterization and open heart
surgery.
(8) An institution, place, building, or room housing
major medical equipment used in the direct clinical
diagnosis or treatment of patients, and whose project cost
is in excess of the capital expenditure minimum.
"Health care facilities" does not include the following
entities or facility transactions:
(1) Federally-owned facilities.
(2) Facilities used solely for healing by prayer or
spiritual means.
(3) An existing facility located on any campus facility
as defined in Section 5-5.8b of the Illinois Public Aid
Code, provided that the campus facility encompasses 30 or
more contiguous acres and that the new or renovated
facility is intended for use by a licensed residential
facility.
(4) Facilities licensed under the Supportive
Residences Licensing Act or the Assisted Living and Shared
Housing Act.
(5) Facilities designated as supportive living
facilities that are in good standing with the program
established under Section 5-5.01a of the Illinois Public
Aid Code.

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(6) Facilities established and operating under the
Alternative Health Care Delivery Act as a children's
community-based health care center alternative health care
model demonstration program or as an Alzheimer's Disease
Management Center alternative health care model
demonstration program.
(7) The closure of an entity or a portion of an entity
licensed under the Nursing Home Care Act, the Specialized
Mental Health Rehabilitation Act of 2013, the ID/DD
Community Care Act, or the MC/DD Act, with the exception of
facilities operated by a county or Illinois Veterans Homes,
that elect to convert, in whole or in part, to an assisted
living or shared housing establishment licensed under the
Assisted Living and Shared Housing Act and with the
exception of a facility licensed under the Specialized
Mental Health Rehabilitation Act of 2013 in connection with
a proposal to close a facility and re-establish the
facility in another location.
(8) Any change of ownership of a health care facility
that is licensed under the Nursing Home Care Act, the
Specialized Mental Health Rehabilitation Act of 2013, the
ID/DD Community Care Act, or the MC/DD Act, with the
exception of facilities operated by a county or Illinois
Veterans Homes. Changes of ownership of facilities
licensed under the Nursing Home Care Act must meet the
requirements set forth in Sections 3-101 through 3-119 of

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the Nursing Home Care Act.
With the exception of those health care facilities
specifically included in this Section, nothing in this Act
shall be intended to include facilities operated as a part of
the practice of a physician or other licensed health care
professional, whether practicing in his individual capacity or
within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional group. Further, this Act shall not apply to
physicians or other licensed health care professional's
practices where such practices are carried out in a portion of
a health care facility under contract with such health care
facility by a physician or by other licensed health care
professionals, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups, unless the entity constructs, modifies,
or establishes a health care facility as specifically defined
in this Section. This Act shall apply to construction or
modification and to establishment by such health care facility
of such contracted portion which is subject to facility
licensing requirements, irrespective of the party responsible
for such action or attendant financial obligation.
"Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.

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"Consumer" means any person other than a person (a) whose
major occupation currently involves or whose official capacity
within the last 12 months has involved the providing,
administering or financing of any type of health care facility,
(b) who is engaged in health research or the teaching of
health, (c) who has a material financial interest in any
activity which involves the providing, administering or
financing of any type of health care facility, or (d) who is or
ever has been a member of the immediate family of the person
defined by (a), (b), or (c).
"State Board" or "Board" means the Health Facilities and
Services Review Board.
"Construction or modification" means the establishment,
erection, building, alteration, reconstruction, modernization,
improvement, extension, discontinuation, change of ownership,
of or by a health care facility, or the purchase or acquisition
by or through a health care facility of equipment or service
for diagnostic or therapeutic purposes or for facility
administration or operation, or any capital expenditure made by
or on behalf of a health care facility which exceeds the
capital expenditure minimum; however, any capital expenditure
made by or on behalf of a health care facility for (i) the
construction or modification of a facility licensed under the
Assisted Living and Shared Housing Act or (ii) a conversion
project undertaken in accordance with Section 30 of the Older
Adult Services Act shall be excluded from any obligations under

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this Act.
"Establish" means the construction of a health care
facility or the replacement of an existing facility on another
site or the initiation of a category of service.
"Major medical equipment" means medical equipment which is
used for the provision of medical and other health services and
which costs in excess of the capital expenditure minimum,
except that such term does not include medical equipment
acquired by or on behalf of a clinical laboratory to provide
clinical laboratory services if the clinical laboratory is
independent of a physician's office and a hospital and it has
been determined under Title XVIII of the Social Security Act to
meet the requirements of paragraphs (10) and (11) of Section
1861(s) of such Act. In determining whether medical equipment
has a value in excess of the capital expenditure minimum, the
value of studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the
acquisition of such equipment shall be included.
"Capital Expenditure" means an expenditure: (A) made by or
on behalf of a health care facility (as such a facility is
defined in this Act); and (B) which under generally accepted
accounting principles is not properly chargeable as an expense
of operation and maintenance, or is made to obtain by lease or
comparable arrangement any facility or part thereof or any
equipment for a facility or part; and which exceeds the capital
expenditure minimum.

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For the purpose of this paragraph, the cost of any studies,
surveys, designs, plans, working drawings, specifications, and
other activities essential to the acquisition, improvement,
expansion, or replacement of any plant or equipment with
respect to which an expenditure is made shall be included in
determining if such expenditure exceeds the capital
expenditures minimum. Unless otherwise interdependent, or
submitted as one project by the applicant, components of
construction or modification undertaken by means of a single
construction contract or financed through the issuance of a
single debt instrument shall not be grouped together as one
project. Donations of equipment or facilities to a health care
facility which if acquired directly by such facility would be
subject to review under this Act shall be considered capital
expenditures, and a transfer of equipment or facilities for
less than fair market value shall be considered a capital
expenditure for purposes of this Act if a transfer of the
equipment or facilities at fair market value would be subject
to review.
"Capital expenditure minimum" means $11,500,000 for
projects by hospital applicants, $6,500,000 for applicants for
projects related to skilled and intermediate care long-term
care facilities licensed under the Nursing Home Care Act, and
$3,000,000 for projects by all other applicants, which shall be
annually adjusted to reflect the increase in construction costs
due to inflation, for major medical equipment and for all other

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capital expenditures.
"Non-clinical service area" means an area (i) for the
benefit of the patients, visitors, staff, or employees of a
health care facility and (ii) not directly related to the
diagnosis, treatment, or rehabilitation of persons receiving
services from the health care facility. "Non-clinical service
areas" include, but are not limited to, chapels; gift shops;
news stands; computer systems; tunnels, walkways, and
elevators; telephone systems; projects to comply with life
safety codes; educational facilities; student housing;
patient, employee, staff, and visitor dining areas;
administration and volunteer offices; modernization of
structural components (such as roof replacement and masonry
work); boiler repair or replacement; vehicle maintenance and
storage facilities; parking facilities; mechanical systems for
heating, ventilation, and air conditioning; loading docks; and
repair or replacement of carpeting, tile, wall coverings,
window coverings or treatments, or furniture. Solely for the
purpose of this definition, "non-clinical service area" does
not include health and fitness centers.
"Areawide" means a major area of the State delineated on a
geographic, demographic, and functional basis for health
planning and for health service and having within it one or
more local areas for health planning and health service. The
term "region", as contrasted with the term "subregion", and the
word "area" may be used synonymously with the term "areawide".

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"Local" means a subarea of a delineated major area that on
a geographic, demographic, and functional basis may be
considered to be part of such major area. The term "subregion"
may be used synonymously with the term "local".
"Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
"Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.
"Director" means the Director of the Illinois Department of
Public Health.
"Agency" or "Department" means the Illinois Department of
Public Health.
"Alternative health care model" means a facility or program
authorized under the Alternative Health Care Delivery Act.
"Out-of-state facility" means a person that is both (i)
licensed as a hospital or as an ambulatory surgery center under
the laws of another state or that qualifies as a hospital or an
ambulatory surgery center under regulations adopted pursuant
to the Social Security Act and (ii) not licensed under the
Ambulatory Surgical Treatment Center Act, the Hospital
Licensing Act, or the Nursing Home Care Act. Affiliates of
out-of-state facilities shall be considered out-of-state
facilities. Affiliates of Illinois licensed health care
facilities 100% owned by an Illinois licensed health care
facility, its parent, or Illinois physicians licensed to

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practice medicine in all its branches shall not be considered
out-of-state facilities. Nothing in this definition shall be
construed to include an office or any part of an office of a
physician licensed to practice medicine in all its branches in
Illinois that is not required to be licensed under the
Ambulatory Surgical Treatment Center Act.
"Change of ownership of a health care facility" means a
change in the person who has ownership or control of a health
care facility's physical plant and capital assets. A change in
ownership is indicated by the following transactions: sale,
transfer, acquisition, lease, change of sponsorship, or other
means of transferring control.
"Related person" means any person that: (i) is at least 50%
owned, directly or indirectly, by either the health care
facility or a person owning, directly or indirectly, at least
50% of the health care facility; or (ii) owns, directly or
indirectly, at least 50% of the health care facility.
"Charity care" means care provided by a health care
facility for which the provider does not expect to receive
payment from the patient or a third-party payer.
"Freestanding emergency center" means a facility subject
to licensure under Section 32.5 of the Emergency Medical
Services (EMS) Systems Act.
"Category of service" means a grouping by generic class of
various types or levels of support functions, equipment, care,
or treatment provided to patients or residents, including, but

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not limited to, classes such as medical-surgical, pediatrics,
or cardiac catheterization. A category of service may include
subcategories or levels of care that identify a particular
degree or type of care within the category of service. Nothing
in this definition shall be construed to include the practice
of a physician or other licensed health care professional while
functioning in an office providing for the care, diagnosis, or
treatment of patients. A category of service that is subject to
the Board's jurisdiction must be designated in rules adopted by
the Board.
"State Board Staff Report" means the document that sets
forth the review and findings of the State Board staff, as
prescribed by the State Board, regarding applications subject
to Board jurisdiction.
(Source: P.A. 98-414, eff. 1-1-14; 98-629, eff. 1-1-15; 98-651,
eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. 7-20-15;
99-180, eff. 7-29-15.)
(20 ILCS 3960/4) (from Ch. 111 1/2, par. 1154)
(Section scheduled to be repealed on December 31, 2019)
Sec. 4. Health Facilities and Services Review Board;
membership; appointment; term; compensation; quorum.
Notwithstanding any other provision in this Section, members of
the State Board holding office on the day before the effective
date of this amendatory Act of the 96th General Assembly shall
retain their authority.

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(a) There is created the Health Facilities and Services
Review Board, which shall perform the functions described in
this Act. The Department shall provide operational support to
the Board as necessary, including the provision of office
space, supplies, and clerical, financial, and accounting
services. The Board may contract for functions or operational
support as needed. The Board may also contract with experts
related to specific health services or facilities and create
technical advisory panels to assist in the development of
criteria, standards, and procedures used in the evaluation of
applications for permit and exemption.
(b) Beginning March 1, 2010, the State Board shall consist
of 9 voting members. All members shall be residents of Illinois
and at least 4 shall reside outside the Chicago Metropolitan
Statistical Area. Consideration shall be given to potential
appointees who reflect the ethnic and cultural diversity of the
State. Neither Board members nor Board staff shall be convicted
felons or have pled guilty to a felony.
Each member shall have a reasonable knowledge of the
practice, procedures and principles of the health care delivery
system in Illinois, including at least 5 members who shall be
knowledgeable about health care delivery systems, health
systems planning, finance, or the management of health care
facilities currently regulated under the Act. One member shall
be a representative of a non-profit health care consumer
advocacy organization. A spouse, parent, sibling, or child of a

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Board member cannot be an employee, agent, or under contract
with services or facilities subject to the Act. Prior to
appointment and in the course of service on the Board, members
of the Board shall disclose the employment or other financial
interest of any other relative of the member, if known, in
service or facilities subject to the Act. Members of the Board
shall declare any conflict of interest that may exist with
respect to the status of those relatives and recuse themselves
from voting on any issue for which a conflict of interest is
declared. No person shall be appointed or continue to serve as
a member of the State Board who is, or whose spouse, parent,
sibling, or child is, a member of the Board of Directors of,
has a financial interest in, or has a business relationship
with a health care facility.
Notwithstanding any provision of this Section to the
contrary, the term of office of each member of the State Board
serving on the day before the effective date of this amendatory
Act of the 96th General Assembly is abolished on the date upon
which members of the 9-member Board, as established by this
amendatory Act of the 96th General Assembly, have been
appointed and can begin to take action as a Board. Members of
the State Board serving on the day before the effective date of
this amendatory Act of the 96th General Assembly may be
reappointed to the 9-member Board. Prior to March 1, 2010, the
Health Facilities Planning Board shall establish a plan to
transition its powers and duties to the Health Facilities and

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Services Review Board.
(c) The State Board shall be appointed by the Governor,
with the advice and consent of the Senate. Not more than 5 of
the appointments shall be of the same political party at the
time of the appointment.
The Secretary of Human Services, the Director of Healthcare
and Family Services, and the Director of Public Health, or
their designated representatives, shall serve as ex-officio,
non-voting members of the State Board.
(d) Of those 9 members initially appointed by the Governor
following the effective date of this amendatory Act of the 96th
General Assembly, 3 shall serve for terms expiring July 1,
2011, 3 shall serve for terms expiring July 1, 2012, and 3
shall serve for terms expiring July 1, 2013. Thereafter, each
appointed member shall hold office for a term of 3 years,
provided that any member appointed to fill a vacancy occurring
prior to the expiration of the term for which his or her
predecessor was appointed shall be appointed for the remainder
of such term and the term of office of each successor shall
commence on July 1 of the year in which his predecessor's term
expires. Each member appointed after the effective date of this
amendatory Act of the 96th General Assembly shall hold office
until his or her successor is appointed and qualified. The
Governor may reappoint a member for additional terms, but no
member shall serve more than 3 terms, subject to review and
re-approval every 3 years.

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(e) State Board members, while serving on business of the
State Board, shall receive actual and necessary travel and
subsistence expenses while so serving away from their places of
residence. Until March 1, 2010, a member of the State Board who
experiences a significant financial hardship due to the loss of
income on days of attendance at meetings or while otherwise
engaged in the business of the State Board may be paid a
hardship allowance, as determined by and subject to the
approval of the Governor's Travel Control Board.
(f) The Governor shall designate one of the members to
serve as the Chairman of the Board, who shall be a person with
expertise in health care delivery system planning, finance or
management of health care facilities that are regulated under
the Act. The Chairman shall annually review Board member
performance and shall report the attendance record of each
Board member to the General Assembly.
(g) The State Board, through the Chairman, shall prepare a
separate and distinct budget approved by the General Assembly
and shall hire and supervise its own professional staff
responsible for carrying out the responsibilities of the Board.
(h) The State Board shall meet at least every 45 days, or
as often as the Chairman of the State Board deems necessary, or
upon the request of a majority of the members.
(i) Five members of the State Board shall constitute a
quorum. The affirmative vote of 5 of the members of the State
Board shall be necessary for any action requiring a vote to be

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taken by the State Board. A vacancy in the membership of the
State Board shall not impair the right of a quorum to exercise
all the rights and perform all the duties of the State Board as
provided by this Act.
(j) A State Board member shall disqualify himself or
herself from the consideration of any application for a permit
or exemption in which the State Board member or the State Board
member's spouse, parent, sibling, or child: (i) has an economic
interest in the matter; or (ii) is employed by, serves as a
consultant for, or is a member of the governing board of the
applicant or a party opposing the application.
(k) The Chairman, Board members, and Board staff must
comply with the Illinois Governmental Ethics Act.
(Source: P.A. 96-31, eff. 6-30-09; 97-1115, eff. 8-27-12.)
(20 ILCS 3960/8.5)
(Section scheduled to be repealed on December 31, 2019)
Sec. 8.5. Certificate of exemption for change of ownership
of a health care facility; discontinuation of a health care
facility or category of service; public notice and public
hearing.
(a) Upon a finding that an application for a change of
ownership is complete, the State Board shall publish a legal
notice on one day in a newspaper of general circulation in the
area or community to be affected and afford the public an
opportunity to request a hearing. If the application is for a

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facility located in a Metropolitan Statistical Area, an
additional legal notice shall be published in a newspaper of
limited circulation, if one exists, in the area in which the
facility is located. If the newspaper of limited circulation is
published on a daily basis, the additional legal notice shall
be published on one day. The applicant shall pay the cost
incurred by the Board in publishing the change of ownership
notice in newspapers as required under this subsection. The
legal notice shall also be posted on the Health Facilities and
Services Review Board's web site and sent to the State
Representative and State Senator of the district in which the
health care facility is located. An application for change of
ownership of a hospital shall not be deemed complete without a
signed certification that for a period of 2 years after the
change of ownership transaction is effective, the hospital will
not adopt a charity care policy that is more restrictive than
the policy in effect during the year prior to the transaction.
An application for a change of ownership need not contain
signed transaction documents so long as it includes the
following key terms of the transaction: names and background of
the parties; structure of the transaction; the person who will
be the licensed or certified entity after the transaction; the
ownership or membership interests in such licensed or certified
entity both prior to and after the transaction; fair market
value of assets to be transferred; and the purchase price or
other form of consideration to be provided for those assets.

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The issuance of the certificate of exemption shall be
contingent upon the applicant submitting a statement to the
Board within 90 days after the closing date of the transaction,
or such longer period as provided by the Board, certifying that
the change of ownership has been completed in accordance with
the key terms contained in the application. If such key terms
of the transaction change, a new application shall be required.
Where a change of ownership is among related persons, and
there are no other changes being proposed at the health care
facility that would otherwise require a permit or exemption
under this Act, the applicant shall submit an application
consisting of a standard notice in a form set forth by the
Board briefly explaining the reasons for the proposed change of
ownership. Once such an application is submitted to the Board
and reviewed by the Board staff, the Board Chair shall take
action on an application for an exemption for a change of
ownership among related persons within 45 days after the
application has been deemed complete, provided the application
meets the applicable standards under this Section. If the Board
Chair has a conflict of interest or for other good cause, the
Chair may request review by the Board. Notwithstanding any
other provision of this Act, for purposes of this Section, a
change of ownership among related persons means a transaction
where the parties to the transaction are under common control
or ownership before and after the transaction is completed.
Nothing in this Act shall be construed as authorizing the

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Board to impose any conditions, obligations, or limitations,
other than those required by this Section, with respect to the
issuance of an exemption for a change of ownership, including,
but not limited to, the time period before which a subsequent
change of ownership of the health care facility could be
sought, or the commitment to continue to offer for a specified
time period any services currently offered by the health care
facility.
(a-3) Upon a finding that an application to close a health
care facility is complete, the State Board shall publish a
legal notice on 3 consecutive days in a newspaper of general
circulation in the area or community to be affected and afford
the public an opportunity to request a hearing. If the
application is for a facility located in a Metropolitan
Statistical Area, an additional legal notice shall be published
in a newspaper of limited circulation, if one exists, in the
area in which the facility is located. If the newspaper of
limited circulation is published on a daily basis, the
additional legal notice shall be published on 3 consecutive
days. The legal notice shall also be posted on the Health
Facilities and Services Review Board's web site and sent to the
State Representative and State Senator of the district in which
the health care facility is located. No later than 90 days
after a discontinuation of a health facility, the applicant
must submit a statement to the State Board certifying that the
discontinuation is complete.

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(a-5) Upon a finding that an application to discontinue a
category of service is complete and provides the requested
information, as specified by the State Board, an exemption
shall be issued. No later than 30 days after the issuance of
the exemption, the health care facility must give written
notice of the discontinuation of the category of service to the
State Senator and State Representative serving the legislative
district in which the health care facility is located. No later
than 90 days after a discontinuation of a category of service,
the applicant must submit a statement to the State Board
certifying that the discontinuation is complete.
(b) If a public hearing is requested, it shall be held at
least 15 days but no more than 30 days after the date of
publication of the legal notice in the community in which the
facility is located. The hearing shall be held in a place of
reasonable size and accessibility and a full and complete
written transcript of the proceedings shall be made. All
interested persons attending the hearing shall be given a
reasonable opportunity to present their positions in writing or
orally. The applicant shall provide a summary of the proposal
for distribution at the public hearing.
(c) For the purposes of this Section "newspaper of limited
circulation" means a newspaper intended to serve a particular
or defined population of a specific geographic area within a
Metropolitan Statistical Area such as a municipality, town,
village, township, or community area, but does not include

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publications of professional and trade associations.
(Source: P.A. 98-1086, eff. 8-26-14; 99-154, eff. 7-28-15.)
(20 ILCS 3960/10) (from Ch. 111 1/2, par. 1160)
(Section scheduled to be repealed on December 31, 2019)
Sec. 10. Presenting information relevant to the approval of
a permit or certificate or in opposition to the denial of the
application; notice of outcome and review proceedings. When a
motion by the State Board, to approve an application for a
permit or a certificate of recognition, fails to pass, or when
a motion to deny an application for a permit or a certificate
of recognition is passed, the applicant or the holder of the
permit, as the case may be, and such other parties as the State
Board permits, will be given an opportunity to appear before
the State Board and present such information as may be relevant
to the approval of a permit or certificate or in opposition to
the denial of the application.
Subsequent to an appearance by the applicant before the
State Board or default of such opportunity to appear, a motion
by the State Board to approve an application for a permit or a
certificate of recognition which fails to pass or a motion to
deny an application for a permit or a certificate of
recognition which passes shall be considered denial of the
application for a permit or certificate of recognition, as the
case may be. Such action of denial or an action by the State
Board to revoke a permit or a certificate of recognition shall

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be communicated to the applicant or holder of the permit or
certificate of recognition. Such person or organization shall
be afforded an opportunity for a hearing before an
administrative law judge, who is appointed by the Chairman of
the State Board. A written notice of a request for such hearing
shall be served upon the Chairman of the State Board within 30
days following notification of the decision of the State Board.
The administrative law judge shall take actions necessary to
ensure that the hearing is completed within a reasonable period
of time, but not to exceed 120 days, except for delays or
continuances agreed to by the person requesting the hearing.
Following its consideration of the report of the hearing, or
upon default of the party to the hearing, the State Board shall
make its final determination, specifying its findings and
conclusions within 90 days of receiving the written report of
the hearing. A copy of such determination shall be sent by
certified mail or served personally upon the party.
A full and complete record shall be kept of all
proceedings, including the 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
State Board or hearing officer. All testimony shall be reported
but need not be transcribed unless the decision is appealed in
accordance with the Administrative Review Law, as now or
hereafter amended. A copy or copies of the transcript may be
obtained by any interested party on payment of the cost of

09900HB4518ham001 - 25 - LRB099 17095 RJF 46440 a
preparing such copy or copies.
The State Board or hearing officer shall upon its own or
his motion, or on the written request of any party to the
proceeding who has, in the State Board's or hearing officer's
opinion, demonstrated the relevancy of such request to the
outcome of the proceedings, issue subpoenas requiring the
attendance and the giving of testimony by 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 the circuit court of this State.
When the witness is subpoenaed at the instance of the State
Board, or its hearing officer, such fees shall be paid in the
same manner as other expenses of the Board, and when the
witness is subpoenaed at the instance of any other party to any
such proceeding the State Board may, in accordance with its
rules, 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 State Board in its discretion, may require a deposit to
cover the cost of such service and witness fees. A subpoena or
subpoena duces tecum so issued shall be served in the same
manner as a subpoena issued out of a court.
Any circuit court of this State upon the application of the
State Board or upon the application of any other party to the
proceeding, may, in its discretion, compel the attendance of

09900HB4518ham001 - 26 - LRB099 17095 RJF 46440 a
witnesses, the production of books, papers, records, or
memoranda and the giving of testimony before it or its 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.
(Source: P.A. 97-1115, eff. 8-27-12; 98-1086, eff. 8-26-14.)
(20 ILCS 3960/14.1)
Sec. 14.1. Denial of permit; other sanctions.
(a) The State Board may deny an application for a permit or
may revoke or take other action as permitted by this Act with
regard to a permit as the State Board deems appropriate,
including the imposition of fines as set forth in this Section,
for any one or a combination of the following:
(1) The acquisition of major medical equipment without
a permit or in violation of the terms of a permit.
(2) The establishment, construction, modification, or
change of ownership of a health care facility without a
permit or exemption or in violation of the terms of a
permit.
(3) The violation of any provision of this Act or any
rule adopted under this Act.
(4) The failure, by any person subject to this Act, to
provide information requested by the State Board or Agency
within 30 days after a formal written request for the

09900HB4518ham001 - 27 - LRB099 17095 RJF 46440 a
information.
(5) The failure to pay any fine imposed under this
Section within 30 days of its imposition.
(a-5) For facilities licensed under the ID/DD Community
Care Act, no permit shall be denied on the basis of prior
operator history, other than for actions specified under item
(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
Act. For facilities licensed under the MC/DD Act, no permit
shall be denied on the basis of prior operator history, other
than for actions specified under item (2), (4), or (5) of
Section 3-117 of the MC/DD Act. For facilities licensed under
the Specialized Mental Health Rehabilitation Act of 2013, no
permit shall be denied on the basis of prior operator history,
other than for actions specified under subsections (a) and (b)
item (2), (4), or (5) of Section 4-109 3-117 of the Specialized
Mental Health Rehabilitation Act of 2013. For facilities
licensed under the Nursing Home Care Act, no permit shall be
denied on the basis of prior operator history, other than for:
(i) actions specified under item (2), (3), (4), (5), or (6) of
Section 3-117 of the Nursing Home Care Act; (ii) actions
specified under item (a)(6) of Section 3-119 of the Nursing
Home Care Act; or (iii) actions within the preceding 5 years
constituting a substantial and repeated failure to comply with
the Nursing Home Care Act or the rules and regulations adopted
by the Department under that Act. The State Board shall not
deny a permit on account of any action described in this

09900HB4518ham001 - 28 - LRB099 17095 RJF 46440 a
subsection (a-5) without also considering all such actions in
the light of all relevant information available to the State
Board, including whether the permit is sought to substantially
comply with a mandatory or voluntary plan of correction
associated with any action described in this subsection (a-5).
(b) Persons shall be subject to fines as follows:
(1) A permit holder who fails to comply with the
requirements of maintaining a valid permit shall be fined
an amount not to exceed 1% of the approved permit amount
plus an additional 1% of the approved permit amount for
each 30-day period, or fraction thereof, that the violation
continues.
(2) A permit holder who alters the scope of an approved
project or whose project costs exceed the allowable permit
amount without first obtaining approval from the State
Board shall be fined an amount not to exceed the sum of (i)
the lesser of $25,000 or 2% of the approved permit amount
and (ii) in those cases where the approved permit amount is
exceeded by more than $1,000,000, an additional $20,000 for
each $1,000,000, or fraction thereof, in excess of the
approved permit amount.
(2.5) A permit holder who fails to comply with the
post-permit and reporting requirements set forth in
Sections Section 5 and 8.5 shall be fined an amount not to
exceed $10,000 plus an additional $10,000 for each 30-day
period, or fraction thereof, that the violation continues.

09900HB4518ham001 - 29 - LRB099 17095 RJF 46440 a
This fine shall continue to accrue until the date that (i)
the post-permit requirements are met and the post-permit or
post-exemption reports are received by the State Board or
(ii) the matter is referred by the State Board to the State
Board's legal counsel. The accrued fine is not waived by
the permit holder submitting the required information and
reports. Prior to any fine beginning to accrue, the Board
shall notify, in writing, a permit holder of the due date
for the post-permit and reporting requirements no later
than 30 days before the due date for the requirements. This
paragraph (2.5) takes effect 6 months after August 27, 2012
(the effective date of Public Act 97-1115).
(3) A person who acquires major medical equipment or
who establishes a category of service without first
obtaining a permit or exemption, as the case may be, shall
be fined an amount not to exceed $10,000 for each such
acquisition or category of service established plus an
additional $10,000 for each 30-day period, or fraction
thereof, that the violation continues.
(4) A person who constructs, modifies, establishes, or
changes ownership of a health care facility without first
obtaining a permit or exemption shall be fined an amount
not to exceed $25,000 plus an additional $25,000 for each
30-day period, or fraction thereof, that the violation
continues.
(5) A person who discontinues a health care facility or

09900HB4518ham001 - 30 - LRB099 17095 RJF 46440 a
a category of service without first obtaining a permit or
exemption shall be fined an amount not to exceed $10,000
plus an additional $10,000 for each 30-day period, or
fraction thereof, that the violation continues. For
purposes of this subparagraph (5), facilities licensed
under the Nursing Home Care Act, the ID/DD Community Care
Act, or the MC/DD Act, with the exceptions of facilities
operated by a county or Illinois Veterans Homes, are exempt
from this permit requirement. However, facilities licensed
under the Nursing Home Care Act, the ID/DD Community Care
Act, or the MC/DD Act must comply with Section 3-423 of the
Nursing Home Care Act, Section 3-423 of the ID/DD Community
Care Act, or Section 3-423 of the MC/DD Act and must
provide the Board and the Department of Human Services with
30 days' written notice of their intent to close.
Facilities licensed under the ID/DD Community Care Act or
the MC/DD Act also must provide the Board and the
Department of Human Services with 30 days' written notice
of their intent to reduce the number of beds for a
facility.
(6) A person subject to this Act who fails to provide
information requested by the State Board or Agency within
30 days of a formal written request shall be fined an
amount not to exceed $1,000 plus an additional $1,000 for
each 30-day period, or fraction thereof, that the
information is not received by the State Board or Agency.

09900HB4518ham001 - 31 - LRB099 17095 RJF 46440 a
(b-5) The State Board may accept in-kind services instead
of or in combination with the imposition of a fine. This
authorization is limited to cases where the non-compliant
individual or entity has waived the right to an administrative
hearing or opportunity to appear before the Board regarding the
non-compliant matter.
(c) Before imposing any fine authorized under this Section,
the State Board shall afford the person or permit holder, as
the case may be, an appearance before the State Board and an
opportunity for a hearing before a hearing officer appointed by
the State Board. The hearing shall be conducted in accordance
with Section 10. Requests for an appearance before the State
Board must be made within 30 days after receiving notice that a
fine will be imposed.
(d) All fines collected under this Act shall be transmitted
to the State Treasurer, who shall deposit them into the
Illinois Health Facilities Planning Fund.
(e) Fines imposed under this Section shall continue to
accrue until: (i) the date that the matter is referred by the
State Board to the Board's legal counsel; or (ii) the date that
the health care facility becomes compliant with the Act,
whichever is earlier.
(Source: P.A. 98-463, eff. 8-16-13; 99-114, eff. 7-23-15;
99-180, eff. 7-29-15; revised 10-14-15.)".