Bill Text: IL HB3392 | 2025-2026 | 104th General Assembly | Enrolled

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Bill Title: Amends the Assisted Living and Shared Housing Act. Provides that the comprehensive assessment of a resident must be completed by a physician, a nurse practitioner, or a physician assistant. In addition to the specified requirements, provides that a license may be issued to an establishment that is under the supervision of a full-time director who, in addition to the other specified credentials, has a college degree in health administration or who completes an approved program within 6 months after hiring. Adds intramuscular injections to the list of medications in the definition of "medication administration" in provisions concerning service requirements. Provides that repeated technical infractions within a calendar year may result in a Type 3 violation. In provisions concerning the dementia-specific standard with inter-rater reliability used to assess individual residents, provides that the assessment must be approved by the resident's physician, physician assistant who has experience in geriatric dementia care, or advanced practice registered nurse who has experience in geriatric dementia care (rather than approved by only the resident's physician) and shall occur prior to acceptance for residency, annually, and at such time that a change in the resident's condition is identified by a family member, staff of the establishment, or the resident's physician, physician assistant, or advanced practice registered nurse (rather than a family member, staff of the establishment, or the resident's physician). Effective immediately.

Sponsorship: Partisan Bill (Republican 4)

Status: (Passed) 2026-07-24 - Public Act . . . . . . . . . 104-0589 [HB3392 Detail]

Download: Illinois-2025-HB3392-Enrolled.html

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HB3392 Enrolled LRB104 10477 BAB 20552 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Assisted Living and Shared Housing Act is
amended by changing Sections 15, 35, 70, 135, and 150 as
follows:
(210 ILCS 9/15)
Sec. 15. Assessment and service plan requirements. Prior
to admission to any establishment covered by this Act, a
comprehensive assessment that includes an evaluation of the
prospective resident's physical, cognitive, and psychosocial
condition shall be completed by a physician, a physician
assistant, or an advanced practice registered nurse. At least
annually, a comprehensive assessment shall be completed, and
upon identification of a significant change in the resident's
condition, including, but not limited to, a diagnosis of
Alzheimer's disease or a related dementia, the resident shall
be reassessed. The Department may by rule specify
circumstances under which more frequent assessments of skin
integrity and nutritional status shall be required. The
comprehensive assessment shall be completed by a physician, a
physician assistant, or an advanced practice registered nurse.
Based on the assessment, the resident's interests and

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preferences, dislikes, and any known triggers for behavior
that endangers the resident or others, a written service plan
shall be developed and mutually agreed upon by the provider,
the resident, and the resident's representative, if any. The
service plan, which shall be reviewed annually, or more often
as the resident's condition, preferences, or service needs
change, shall serve as a basis for the service delivery
contract between the provider and the resident. The resident
and the resident's representative, if any, shall, upon
request, be given a copy of the most recent assessment; a
supplemental assessment, if any, completed by the
establishment; and a service plan. Based on the assessment,
the service plan may provide for the disconnection or removal
of any appliance.
(Source: P.A. 104-191, eff. 1-1-26.)
(210 ILCS 9/35)
Sec. 35. Issuance of license.
(a) Upon receipt and review of an application for a
license and review of the applicant establishment, the
Director may issue a license if he or she finds:
(1) that the individual applicant, or the corporation,
partnership, or other entity if the applicant is not an
individual, is a person responsible and suitable to
operate or to direct or participate in the operation of an
establishment by virtue of financial capacity, appropriate

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business or professional experience, a record of lawful
compliance with lawful orders of the Department and lack
of revocation of a license issued under this Act, the
Nursing Home Care Act, the Specialized Mental Health
Rehabilitation Act of 2013, the ID/DD Community Care Act,
or the MC/DD Act during the previous 5 years;
(2) that the establishment is under the supervision of
a full-time director who is at least 21 years of age and
has a high school diploma or equivalent plus either:
(A) 2 years of management experience or 2 years of
experience in positions of progressive responsibility
in health care, housing with services, or adult day
care or providing similar services to the elderly; or
(B) 2 years of management experience or 2 years of
experience in positions of progressive responsibility
in hospitality and training in health care and housing
with services management as defined by rule; or
(C) a college degree in health administration or
the completion of an approved program within 6 months
after hiring;
(3) that the establishment has staff sufficient in
number with qualifications, adequate skills, education,
and experience to meet the 24 hour scheduled and
unscheduled needs of residents and who participate in
ongoing training to serve the resident population;
(4) that all employees who are subject to the Health

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Care Worker Background Check Act meet the requirements of
that Act;
(5) that the applicant is in substantial compliance
with this Act and such other requirements for a license as
the Department by rule may establish under this Act;
(6) that the applicant pays all required fees;
(7) that the applicant has provided to the Department
an accurate disclosure document in accordance with the
Alzheimer's Disease and Related Dementias Special Care
Disclosure Act and in substantial compliance with Section
150 of this Act.
In addition to any other requirements set forth in this
Act, as a condition of licensure under this Act, the director
of an establishment must participate in at least 20 hours of
training every 2 years to assist him or her in better meeting
the needs of the residents of the establishment and managing
the operation of the establishment.
Any license issued by the Director shall state the
physical location of the establishment, the date the license
was issued, and the expiration date. All licenses shall be
valid for one year, except as provided in Sections 40 and 45.
Each license shall be issued only for the premises and persons
named in the application, and shall not be transferable or
assignable.
(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)

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(210 ILCS 9/70)
Sec. 70. Service requirements. An establishment must
provide all mandatory services and may provide optional
services, including medication reminders, supervision of
self-administered medication and medication administration as
defined by this Section and nonmedical services defined by
rule, whether provided directly by the establishment or by
another entity arranged for by the establishment with the
consent of the resident or the resident's representative.
For the purposes of this Section, "medication reminders"
means reminding residents to take pre-dispensed,
self-administered medication, observing the resident, and
documenting whether or not the resident took the medication.
For the purposes of this Section, "supervision of
self-administered medication" means assisting the resident
with self-administered medication using any combination of the
following: reminding residents to take medication, reading the
medication label to residents, checking the self-administered
medication dosage against the label of the medication,
confirming that residents have obtained and are taking the
dosage as prescribed, and documenting in writing that the
resident has taken (or refused to take) the medication. If
residents are physically unable to open the container, the
container may be opened for them. Supervision of
self-administered medication shall be under the direction of a
licensed health care professional or, in the case of a

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certified medication aide, under the supervision and
delegation of a registered nurse as authorized by Section
50-75 of the Nurse Practice Act.
For the purposes of this Section, "medication
administration" refers to a licensed health care professional
employed by an establishment engaging in administering insulin
and vitamin B12 B-12 injections, oral medications, topical
treatments, eye and ear drops, or nitroglycerin patches, or
intramuscular injections. A certified medication aide may
administer medications under the supervision and delegation of
a registered nurse as authorized by Section 50-75 of the Nurse
Practice Act, except (i) Schedule II controlled substances as
set forth in the Illinois Controlled Substances Act and (ii)
any subcutaneous, intramuscular, intradermal, or intravenous
medication.
The Department shall specify by rule procedures for
medication reminders, supervision of self-administered
medication, and medication administration.
Nothing in this Act shall preclude a physician licensed
under the Medical Practice Act of 1987 from providing services
within the scope of his or her license to any resident.
(Source: P.A. 103-886, eff. 8-9-24.)
(210 ILCS 9/135)
Sec. 135. Civil penalties.
(a) The Department may assess a civil penalty not to

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exceed $5,000 against any establishment subject to this Act
for violations of this Act. Each day a violation continues
shall be deemed a separate violation.
(b) Beginning 180 days after the adoption of rules under
this Act, the Department may assess a civil penalty not to
exceed $3,000 against any establishment subject to this Act
for caring for a resident who exceeds the care needs defined in
this Act. Each day a violation continues shall be deemed a
separate violation.
(c) The Department is authorized to hold hearings in
contested cases regarding appeals of the penalties assessed
pursuant to this Section.
(d) Repeated technical infractions within a calendar year
may result in a Type 3 violation.
(Source: P.A. 91-656, eff. 1-1-01.)
(210 ILCS 9/150)
Sec. 150. Alzheimer and dementia programs.
(a) In addition to this Section, Alzheimer and dementia
programs shall comply with all of the other provisions of this
Act.
(b) No person shall be admitted or retained if the
assisted living or shared housing establishment cannot provide
or secure appropriate care, if the resident requires a level
of service or type of service for which the establishment is
not licensed or which the establishment does not provide, or

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if the establishment does not have the staff appropriate in
numbers and with appropriate skill to provide such services.
(c) No person shall be accepted for residency or remain in
residence if the person's mental or physical condition has so
deteriorated to render residency in such a program to be
detrimental to the health, welfare or safety of the person or
of other residents of the establishment. The Department by
rule shall identify a validated dementia-specific standard
with inter-rater reliability that will be used to assess
individual residents. The assessment must be approved by the
resident's physician, physician assistant who has experience
in geriatric dementia care, or advanced practice registered
nurse who has experience in geriatric dementia care and shall
occur prior to acceptance for residency, annually, and at such
time that a change in the resident's condition is identified
by a family member, staff of the establishment, or the
resident's physician, physician assistant, or advanced
practice registered nurse. Assessments completed annually or
due to a change in the resident's condition must be signed by a
physician.
(d) No person shall be accepted for residency or remain in
residence if the person is dangerous to self or others and the
establishment would be unable to eliminate the danger through
the use of appropriate treatment modalities.
(e) No person shall be accepted for residency or remain in
residence if the person meets the criteria provided in

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subsections (b) through (g) of Section 75 of this Act.
(f) An establishment that offers to provide a special
program or unit for persons with Alzheimer's disease and
related disorders shall:
(1) disclose to the Department and to a potential or
actual resident of the establishment information as
specified under the Alzheimer's Disease and Related
Dementias Special Care Disclosure Act;
(2) ensure that a resident's representative is
designated for the resident;
(3) develop and implement policies and procedures that
ensure the continued safety of all residents in the
establishment, including, but not limited to, those who:
(A) may wander; and
(B) may need supervision and assistance when
evacuating the building in an emergency;
(4) provide coordination of communications with each
resident, resident's representative, relatives and other
persons identified in the resident's service plan;
(5) provide cognitive stimulation and activities to
maximize functioning;
(6) provide an appropriate number of staff for its
resident population, as established by rule;
(7) require the director or administrator and direct
care staff to complete sufficient comprehensive and
ongoing dementia and cognitive deficit training, the

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content of which shall be established by rule; and
(8) develop emergency procedures and staffing patterns
to respond to the needs of residents.
(g) Individual residents shall be assessed prior to
admission using assessment tools that are approved or
recommended by recognized Alzheimer's and dementia care
experts, ensuring that the tools are validated for accurately
identifying and evaluating cognitive impairments related to
Alzheimer's disease and other forms of dementia. These tools
shall be reviewed and updated as needed to align with current
best practices and clinical standards in dementia care.
(Source: P.A. 104-295, eff. 1-1-26.)
Section 99. Effective date. This Act takes effect upon
becoming law.