Bill Text: IL SB3239 | 2025-2026 | 104th General Assembly | Introduced

---

Bill Title: Amends Illinois Health Facilities Planning Act. Provides that the Health Facilities and Services Review Board may review the applicable criteria in the consideration of any application for an exemption submitted under the Act. Provides that, upon review and consideration, the State Board may approve, deny, or defer for additional information an application for a Certificate of Need or Certificate of Exemption. Makes changes in provisions concerning administrative hearings; powers and duties of State Board; powers of the State Board staff; and review and investigation of applications for permits.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Introduced - Dead) 2026-05-08 - Rule 3-9(a) / Re-referred to Assignments [SB3239 Detail]

Download: Illinois-2025-SB3239-Introduced.html

---

104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026SB3239 Introduced 2/2/2026, by Sen. Omar Aquino SYNOPSIS AS INTRODUCED:
20 ILCS 3960/2 from Ch. 111 1/2, par. 1152
20 ILCS 3960/3 from Ch. 111 1/2, par. 1153
20 ILCS 3960/4 from Ch. 111 1/2, par. 1154
20 ILCS 3960/4.2
20 ILCS 3960/5 from Ch. 111 1/2, par. 1155
20 ILCS 3960/6 from Ch. 111 1/2, par. 1156
20 ILCS 3960/6.2
20 ILCS 3960/8.5
20 ILCS 3960/8.7
20 ILCS 3960/10 from Ch. 111 1/2, par. 1160
20 ILCS 3960/11 from Ch. 111 1/2, par. 1161
20 ILCS 3960/12 from Ch. 111 1/2, par. 1162
20 ILCS 3960/12.2
20 ILCS 3960/13 from Ch. 111 1/2, par. 1163
Amends Illinois Health Facilities Planning Act. Provides that the Health Facilities and Services Review Board may review the applicable criteria in the consideration of any application for an exemption submitted under the Act. Provides that, upon review and consideration, the State Board may approve, deny, or defer for additional information an application for a Certificate of Need or Certificate of Exemption. Makes changes in provisions concerning administrative hearings; powers and duties of State Board; powers of the State Board staff; and review and investigation of applications for permits.
LRB104 20078 SPS 33529 b
A BILL FOR
SB3239 LRB104 20078 SPS 33529 b
AN ACT concerning State government.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Health Facilities Planning Act is
amended by changing Sections 2, 3, 4, 4.2, 5, 6, 6.2, 8.5, 8.7,
10, 11, 12, 12.2, and 13 as follows:
(20 ILCS 3960/2) (from Ch. 111 1/2, par. 1152)
(Section scheduled to be repealed on December 31, 2029)
Sec. 2. Purpose of the Act. This Act shall establish a
procedure (1) which requires a person establishing,
constructing or modifying a health care facility, as herein
defined, to have the qualifications, background, character and
financial resources to adequately provide a proper service for
the community; (2) that promotes the orderly and economic
development of health care facilities in the State of Illinois
that avoids unnecessary duplication of such facilities; and
(3) that promotes planning for and development of health care
facilities needed for comprehensive health care especially in
areas where the health planning process has identified unmet
needs.
The changes made to this Act by this amendatory Act of the
96th General Assembly are intended to accomplish the following
objectives: to improve the financial ability of the public to

SB3239 - 2 - LRB104 20078 SPS 33529 b
obtain necessary health services; to establish an orderly and
comprehensive health care delivery system that will guarantee
the availability of quality health care to the general public;
to maintain and improve the provision of essential health care
services and increase the accessibility of those services to
the medically underserved and indigent; to assure that the
reduction and closure of health care services or facilities is
performed in an orderly and timely manner, and that these
actions are deemed to be in the best interests of the public;
and to assess the financial burden to patients caused by
unnecessary health care construction and modification.
Evidence-based assessments, projections and decisions will be
applied regarding capacity, quality, value and equity in the
delivery of health care services in Illinois. The integrity of
the Certificate of Need Permit and Certificate of Exemption
processes are process is ensured through ethical practices and
effective communication revised ethics and communications
procedures. Cost containment and support for safety net
services must continue to be central tenets of the Certificate
of Need Permit and Certificate of Exemption processes process.
(Source: P.A. 99-527, eff. 1-1-17.)
(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
(Section scheduled to be repealed on December 31, 2029)
Sec. 3. Definitions. As used in this Act:
"Certificate of Need" or "permit" means the authorization

SB3239 - 3 - LRB104 20078 SPS 33529 b
for a health care facility to conduct activities or
transactions that require Board approval under this Act,
including constructing or modifying the health care facility
and acquiring major medical equipment.
"Certificate of Exemption" or "exemption" means the
authorization for a health care facility to conduct activities
or transactions that are exempt from the permitting
requirements under this Act, including changes of ownership,
discontinuation of a single category of service, and the
establishment or expansion of a neonatal intensive care
service or the addition of beds.
"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
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.

SB3239 - 4 - LRB104 20078 SPS 33529 b
(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.
(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 meet the
requirements of 42 CFR 494 in order to be certified for
participation in Medicare and Medicaid under Titles XVIII

SB3239 - 5 - LRB104 20078 SPS 33529 b
and XIX of the federal Social Security 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.
(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

SB3239 - 6 - LRB104 20078 SPS 33529 b
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.
(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.

SB3239 - 7 - LRB104 20078 SPS 33529 b
(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
the Nursing Home Care Act.
(9) (Blank).
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

SB3239 - 8 - LRB104 20078 SPS 33529 b
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.
"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

SB3239 - 9 - LRB104 20078 SPS 33529 b
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 item (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 this Act.
"Discontinuation" means to, on a voluntary or involuntary
basis, cease the operation of a health care facility or
discontinue a category of service.
"Establish" means the construction of a health care

SB3239 - 10 - LRB104 20078 SPS 33529 b
facility or the replacement of an existing health care
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.

SB3239 - 11 - LRB104 20078 SPS 33529 b
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

SB3239 - 12 - LRB104 20078 SPS 33529 b
all other capital expenditures.
"Financial commitment" means the commitment of at least
33% of total funds assigned to cover total project cost, which
occurs by the actual expenditure of 33% or more of the total
project cost or the commitment to expend 33% or more of the
total project cost by signed contracts or other legal means.
"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; components in a patient
care unit used as educational space, consultation and
touchdown rooms, and on-call rooms; 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. "Non-clinical service
area" does not include health and fitness centers, areas in a

SB3239 - 13 - LRB104 20078 SPS 33529 b
patient care unit, or areas that are required by Department
licensing standards, including life safety code regulations,
such as hallways and other interdependent components to a
clinical area.
"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".
"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

SB3239 - 14 - LRB104 20078 SPS 33529 b
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 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

SB3239 - 15 - LRB104 20078 SPS 33529 b
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
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.

SB3239 - 16 - LRB104 20078 SPS 33529 b
"Patient care unit" means a physically identifiable and
organized unit in a clearly defined administrative and
geographic area that meets applicable standards of service in
which nursing care and therapeutic services are provided on a
continuous basis and to which specific nursing and support
staff are assigned. "Patient care unit" does not include
education spaces, consultation and touchdown rooms, and
on-call rooms that are not required by Department licensing
standards.
"Provider" includes, but is not limited to, a hospital,
long-term care facility, end-stage renal dialysis facility,
ambulatory surgical treatment center, freestanding emergency
center, or birth center.
(Source: P.A. 104-365, eff. 1-1-26.)
(20 ILCS 3960/4) (from Ch. 111 1/2, par. 1154)
(Section scheduled to be repealed on December 31, 2029)
Sec. 4. Health Facilities and Services Review Board;
membership; appointment; term; compensation; quorum.
(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

SB3239 - 17 - LRB104 20078 SPS 33529 b
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) The State Board shall consist of 11 voting members.
All members shall be residents of Illinois and at least 4 shall
reside outside the Chicago Metropolitan Statistical Area
Census Data. 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. One member shall be a representative
from the community with experience on the effects of
discontinuing health care services or the closure of health
care facilities on the surrounding community; provided,
however, that all other members of the Board shall be
appointed before this member shall be appointed. A spouse,
parent, sibling, or child of a Board member cannot be an
employee, agent, or under contract with services or facilities

SB3239 - 18 - LRB104 20078 SPS 33529 b
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 Board, as established by
this amendatory Act of the 96th General Assembly, have been
appointed and can begin to take action as a Board.
(c) The State Board shall be appointed by the Governor,
with the advice and consent of the Senate. Not more than 6 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

SB3239 - 19 - LRB104 20078 SPS 33529 b
ex-officio, non-voting members of the State Board.
(d) Of those 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 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.
(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.

SB3239 - 20 - LRB104 20078 SPS 33529 b
(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) Six members of the State Board shall constitute a
quorum. The affirmative vote of 6 of the members of the State
Board shall be necessary for any action requiring a vote to be
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

SB3239 - 21 - LRB104 20078 SPS 33529 b
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. 102-4, eff. 4-27-21.)
(20 ILCS 3960/4.2)
(Section scheduled to be repealed on December 31, 2029)
Sec. 4.2. Ex parte communications.
(a) Except in the disposition of matters that agencies are
authorized by law to entertain or dispose of on an ex parte
basis including, but not limited to rulemaking, the State
Board, any State Board member, employee, or a hearing officer
shall not engage in ex parte communication in connection with
the substance of any formally filed application for a permit
with any person or party or the representative of any party.
This subsection (a) applies when the Board, member, employee,
or administrative law judge hearing officer knows, or should
know upon reasonable inquiry, that the application or
exemption has been formally filed with the State Board.
Nothing in this Section shall prohibit State Board employees
staff members from providing technical assistance to
applicants. Nothing in this Section shall prohibit State Board
employees staff from verifying or clarifying an applicant's
information as it prepares the State Board Staff Report. Once

SB3239 - 22 - LRB104 20078 SPS 33529 b
an application for permit or exemption is filed and deemed
complete, a written record of any communication between State
Board employees staff and an applicant shall be prepared by
staff and made part of the public record, using a prescribed,
standardized format, and shall be included in the application
file.
(b) A State Board member or employee may communicate with
other members or employees and any State Board member or
hearing officer may have the aid and advice of one or more
personal assistants.
(c) An ex parte communication received by the State Board,
any State Board member, employee, or an administrative law
judge a hearing officer shall be made a part of the record of
the matter, including all written communications, all written
responses to the communications, and a memorandum stating the
substance of all oral communications and all responses made
and the identity of each person from whom the ex parte
communication was received.
(d) "Ex parte communication" means any written or oral a
communication between a person who is not a State Board member
or employee and a State Board member or employee that imparts
or requests material information or makes a material argument
regarding potential action reflects on the substance of a
pending or impending permit or exemption application or State
Board proceeding and that takes place outside the open record
of the proceeding. "Ex parte communication" does not include:

SB3239 - 23 - LRB104 20078 SPS 33529 b
(i) statements by a person publicly made in a public forum;
(ii) statements regarding matters of procedure and practice,
such as the format of application materials, the number of
copies required, the manner of filing, and the status of a
matter; and (iii) statements made between a State Board member
or employee and another State Board member or employee.
Communications regarding matters of procedure and practice,
such as the format of pleading, number of copies required,
manner of service, and status of proceedings, are not
considered ex parte communications. Technical assistance with
respect to an application, not intended to influence any
decision on the application, may be provided by employees to
the applicant. Any technical assistance shall be documented in
writing by the applicant and employees within 10 business days
after the technical assistance is provided and made part of
the open record.
(e) For purposes of this Section, "employee" means a
person the State Board or the Agency employs on a full-time,
part-time, contract, or intern basis.
(f) The State Board, State Board member, or administrative
law judge hearing examiner presiding over the proceeding, in
the event of a violation of this Section, must take whatever
action is necessary to ensure that the violation does not
prejudice any party or adversely affect the fairness of the
proceedings.
(g) Nothing in this Section shall be construed to prevent

SB3239 - 24 - LRB104 20078 SPS 33529 b
the State Board or any member of the State Board from
consulting with the attorney for the State Board.
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
101-81, eff. 7-12-19.)
(20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
(Section scheduled to be repealed on December 31, 2029)
Sec. 5. Construction, modification, or establishment of
health care facilities or acquisition of major medical
equipment; permits or exemptions.
(a) The State Board shall consider and decide applications
for permits and exemptions in a manner that protects access to
essential health care services, promotes orderly health
planning, and safeguards the public health and continuity of
care.
(b) No person shall construct, modify or establish a
health care facility or acquire major medical equipment
without first obtaining a permit or exemption from the State
Board.
(c) The Board may review the applicable criteria in the
consideration of any application for an exemption submitted
under this Act. The submission of an application and
information required by the State Board, as established by
rule, shall not obligate the State Board to grant an
exemption. Upon review and consideration, the State Board may
approve, deny, or defer for additional information an

SB3239 - 25 - LRB104 20078 SPS 33529 b
application for an exemption, as deemed appropriate. If an
exemption is denied, the applicant shall file an application
for a permit.
(d) The State Board shall not delegate to the staff of the
State Board or any other person or entity the authority to
grant permits or exemptions whenever the staff or other person
or entity would be required to exercise any discretion
affecting the decision to grant a permit or exemption.
(e) The State Board may, by rule, delegate authority to
the Chairman to grant permits or exemptions when applications
meet all of the State Board's review criteria and are
unopposed.
(f) A permit or exemption shall be obtained prior to the
acquisition of major medical equipment or to the construction,
establishment, or modification of a health care facility
which:
(1) (a) requires a total capital expenditure in excess
of the capital expenditure minimum; or
(2) (b) substantially changes the scope or changes the
functional operation of the facility; or
(3) (c) changes the bed capacity of a health care
facility by increasing the total number of beds or by
distributing beds among various categories of service or
by relocating beds from one physical facility or site to
another by more than 20 beds or more than 10% of total bed
capacity as defined by the State Board, whichever is less,

SB3239 - 26 - LRB104 20078 SPS 33529 b
over a 2-year period.
(g) A permit shall be valid only for the defined
construction or modification modifications, site determined by
legal street address or corresponding legal description,
project amount, and person or persons named in the application
for such permit. The State Board may approve the transfer of an
existing permit without regard to whether the permit to be
transferred has yet been financially committed, except for
permits to establish a new facility or category of service. A
permit shall be valid until such time as the project has been
completed, provided that the project commences and proceeds to
completion with due diligence by the completion date or
extension date approved by the Board.
(h) A permit holder must do the following: (i) submit the
final completion and cost report for the project within 90
days after the approved project completion date or extension
date and (ii) submit annual progress reports no earlier than
30 days before and no later than 30 days after each anniversary
date of the Board's approval of the permit until the project is
completed. To maintain a valid permit and to monitor progress
toward project commencement and completion, routine
post-permit reports shall be limited to annual progress
reports and the final completion and cost report. Annual
progress reports shall include information regarding the
committed funds expended toward the approved project. For
projects to be completed in 12 months or less, the permit

SB3239 - 27 - LRB104 20078 SPS 33529 b
holder shall report financial commitment in the final
completion and cost report. For projects to be completed
between 12 to 24 months, the permit holder shall report
financial commitment in the first annual report. For projects
to be completed in more than 24 months, the permit holder shall
report financial commitment in the second annual progress
report. The report shall contain information regarding
expenditures and financial commitments. The State Board may
extend the financial commitment period after considering a
permit holder's showing of good cause and request for
additional time to complete the project. The State Board may
approve the transfer of an existing permit without regard to
whether the permit to be transferred has been financially
committed, except for permits to establish a new facility or
category of service.
The permit Certificate of Need process required under this
Act is designed to restrain rising health care costs by
preventing unnecessary construction or modification of health
care facilities. The Board must assure that the establishment,
construction, or modification of a health care facility or the
acquisition of major medical equipment is consistent with the
public interest and that the proposed project is consistent
with the orderly and economic development or acquisition of
those facilities and equipment and is in accord with the
standards, criteria, or plans of need adopted and approved by
the Board. Board decisions regarding the construction of

SB3239 - 28 - LRB104 20078 SPS 33529 b
health care facilities must consider capacity, quality, value,
and equity. Projects may deviate from the costs, fees, and
expenses provided in their project cost information for the
project's cost components, provided that the final total
project cost does not exceed the approved permit amount.
Project alterations shall not increase the total approved
permit amount by more than the limit set forth under the
Board's rules.
The acquisition by any person of major medical equipment
that will not be owned by or located in a health care facility
and that will not be used to provide services to inpatients of
a health care facility shall be exempt from review provided
that a notice is filed in accordance with exemption
requirements.
Notwithstanding any other provision of this Act, no permit
or exemption is required for the construction or modification
of a non-clinical service area of a health care facility.
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18.)
(20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
(Section scheduled to be repealed on December 31, 2029)
Sec. 6. Application for permit or exemption; exemption
regulations.
(a) An application for a permit or exemption shall be made
to the State Board upon forms provided by the State Board. This
application shall contain such information as the State Board

SB3239 - 29 - LRB104 20078 SPS 33529 b
deems necessary. The State Board shall not require an
applicant to file a Letter of Intent before an application is
filed. Such application shall include affirmative evidence on
which the State Board or Chairman may make its decision on the
approval or denial of the permit or exemption, including, but
not limited to, affirmative evidence:
(1) that the applicant is fit, willing, and able to
provide a proper standard of health care service for the
community with regard to the qualification, background and
character of the applicant;
(2) that economic feasibility is demonstrated in terms
of effect on the existing and projected operating budget
of the applicant and of the health care facility,
including:
(A) the applicant's ability to establish and
operate the facility in accordance with licensure
regulations set forth in State law; and
(B) the projected impact on the total health care
expenditures in the facility and community;
(3) that safeguards are provided that assure that the
establishment, construction, or modification of the health
care facility or acquisition of major medical equipment is
consistent with the public interest; and
(4) that the proposed project is consistent with the
orderly and economic development of the facilities and
equipment and is in accord with standards, criteria, or

SB3239 - 30 - LRB104 20078 SPS 33529 b
plans of need adopted and approved under Section 12.
(b) The State Board shall establish by regulation the
procedures and criteria governing the submission, review, and
requirements regarding issuance of exemptions. The State Board
may determine whether an application meets the criteria for an
exemption and may approve, deny, or defer for additional
information an application for an exemption. The submission of
an application and information required by the State Board, as
established by rule, shall not obligate the State Board to
grant an exemption. If an exemption is denied, the applicant
shall file an application for a permit. An exemption shall be
approved when information required by the Board by rule is
submitted. Projects eligible for an exemption, rather than a
permit, include a , but are not limited to, change of ownership
of a health care facility and discontinuation of one a
category of service, other than a health care facility
maintained by the State or any agency or department thereof or
a nursing home maintained by a county. The Board may accept an
application for an exemption for the discontinuation of a
category of service at a health care facility only once in a
12-month 6-month period following (1) the previous application
for exemption at the same health care facility or (2) the final
decision of the Board regarding the discontinuation of a
category of service at the same health care facility,
whichever occurs later. A discontinuation of a category of
service shall otherwise require an application for a permit if

SB3239 - 31 - LRB104 20078 SPS 33529 b
an application for an exemption has already been approved
accepted within the 12-month 6-month period. For a change of
ownership among related persons of a health care facility, the
State Board shall provide by rule for an expedited process for
obtaining an exemption. For the purposes of this Section,
"change of ownership among related persons" means a
transaction in which the parties to the transaction are under
common control or ownership before and after the transaction
is complete.
(c) All applications shall be signed by the applicant and
shall be verified by any 2 officers or authorized
representatives thereof.
(c-5) Any written review or findings of the Board staff
set forth in the State Board Staff Report concerning an
application for a permit must be made available to the public
and the applicant at least 14 calendar days before the meeting
of the State Board at which the review or findings are
considered. The applicant and members of the public may
submit, to the State Board, written responses regarding the
facts set forth in the review or findings of the Board staff.
Members of the public and the applicant shall have until 10
days before the meeting of the State Board to submit any
written response concerning the Board staff's written review
or findings. The Board staff may revise any findings to
address corrections of factual errors cited in the public
response. At the meeting, the State Board may, in its

SB3239 - 32 - LRB104 20078 SPS 33529 b
discretion, permit the submission of other additional written
materials.
(d) Upon receipt of an application for a permit, the State
Board may determine whether an application meets the criteria
for a permit and may shall approve, deny, or defer for
additional information an application for a permit. and
authorize the issuance of a permit if it finds (1) that the
applicant is fit, willing, and able to provide a proper
standard of health care service for the community with
particular regard to the qualification, background and
character of the applicant, (2) that economic feasibility is
demonstrated in terms of effect on the existing and projected
operating budget of the applicant and of the health care
facility; in terms of the applicant's ability to establish and
operate such facility in accordance with licensure regulations
promulgated under pertinent state laws; and in terms of the
projected impact on the total health care expenditures in the
facility and community, (3) that safeguards are provided that
assure that the establishment, construction or modification of
the health care facility or acquisition of major medical
equipment is consistent with the public interest, and (4) that
the proposed project is consistent with the orderly and
economic development of such facilities and equipment and is
in accord with standards, criteria, or plans of need adopted
and approved pursuant to the provisions of Section 12 of this
Act.

SB3239 - 33 - LRB104 20078 SPS 33529 b
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
101-83, eff. 7-15-19.)
(20 ILCS 3960/6.2)
(Section scheduled to be repealed on December 31, 2029)
Sec. 6.2. Review of permits and exemptions; public
hearings; State Board Staff Reports.
(a) Upon receipt of an application for an exemption or a
permit to establish, construct, or modify a health care
facility, the State Board staff shall notify the applicant in
writing within 10 business working days either that the
application is or is not substantially complete. If the
application is substantially complete, the State Board staff
shall notify the applicant of the beginning of the review
process. If the application is not substantially complete, the
Board staff shall explain within the 10-day period why the
application is incomplete.
(b) The State Board staff shall afford a reasonable amount
of time as established by the State Board, but not to exceed
120 days, for the review of the application. The 120-day
period begins on the day the application is found to be
substantially complete, as that term is defined by the State
Board. During the 120-day period, the applicant may request an
extension. An applicant may modify the application, as
established by the State Board by rule, at any time before a
final administrative decision has been made on the

SB3239 - 34 - LRB104 20078 SPS 33529 b
application.
The State Board staff shall submit its State Board Staff
Report to the State Board for its decision-making regarding
approval or denial of the permit.
(c) When an application for an exemption or a permit is
initially reviewed by State Board staff, as provided in this
Section, the State Board shall, upon request by the applicant
or an interested person, afford an opportunity for a public
hearing within a reasonable amount of time after receipt of
the complete application, but not to exceed 90 days after
receipt of the complete application. Notice of the hearing
shall be made promptly, not less than 10 business days before
the hearing, by certified mail to the applicant and, not less
than 10 business days before the hearing, by publication on
the State Board's website, in the principal office and
website, if available, of the local government a newspaper of
general circulation in the area or community to be affected,
and in the location where the meeting is to be held. The
hearing shall be held in the area or community in which the
proposed project is to be located and shall be for the purpose
of allowing the applicant and any interested person to present
public testimony concerning the approval, denial, renewal, or
revocation of the permit or exemption. All interested persons
attending the hearing shall be given a reasonable opportunity
to present their views or arguments in writing or orally, and a
record of all of the testimony shall accompany any findings of

SB3239 - 35 - LRB104 20078 SPS 33529 b
the State Board staff. The State Board shall adopt reasonable
rules and regulations governing the procedure and conduct of
the hearings.
(d) The staff of the State Board shall submit its State
Board Staff Report to the State Board for approval or denial of
the permit or exemption.
(Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18.)
(20 ILCS 3960/8.5)
(Section scheduled to be repealed on December 31, 2029)
Sec. 8.5. Certificate of exemption for change of ownership
of a health care facility; discontinuation of a category of
service; public notice and public hearing.
(a) The State Board may grant, deny, or defer for
additional information an application for a certificate of
exemption for a change of ownership or the discontinuation of
one category of service. The State Board's determination shall
be based on a review and consideration of the applicable
criteria, application and supporting documentation, State
Board Staff Report, public comment, public hearing testimony,
and any other information that State Board deems relevant. If
an application for a certificate of exemption is denied, the
applicant shall file an application for a permit.
(a-2) (a) Upon a finding that an application for a change
of ownership is complete, the State Board shall publish a
legal notice on 3 consecutive days on the State Board's

SB3239 - 36 - LRB104 20078 SPS 33529 b
website and in the principal office and website, if available,
of the local government in the area or community to be affected
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 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 and to the Office of the Attorney General.
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 shall contain the proposed need not contain signed
transaction documents or, if not available at the time of
filing, at a minimum, include so long as it includes the

SB3239 - 37 - LRB104 20078 SPS 33529 b
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 or operator 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. Upon the The issuance of the
certificate of exemption shall be contingent upon the
applicant shall submit 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 State Board Chair
shall take action on an application for an exemption for a
change of ownership among related persons at the next meeting

SB3239 - 38 - LRB104 20078 SPS 33529 b
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
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.
The changes made by this amendatory Act of the 103rd
General Assembly are inoperative on and after January 1, 2027.
(a-3) (Blank).
(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 approval
issuance of the exemption by the State Board, the health care

SB3239 - 39 - LRB104 20078 SPS 33529 b
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 the affected
area or community 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 or describe the proposed change of
ownership at the public hearing.
(c) (Blank). 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 publications of professional and trade associations.
(d) The changes made to this Section by this amendatory
Act of the 101st General Assembly shall apply to all

SB3239 - 40 - LRB104 20078 SPS 33529 b
applications submitted after the effective date of this
amendatory Act of the 101st General Assembly.
(Source: P.A. 103-526, eff. 1-1-24.)
(20 ILCS 3960/8.7)
(Section scheduled to be repealed on December 31, 2029)
Sec. 8.7. Application for permit for discontinuation of a
health care facility or category of service; public notice and
public hearing.
(a) The State Board may grant, deny, or defer for
additional information an application for a permit for a
discontinuation of a health care facility or more than one
category of service simultaneously. The State Board's
determination shall be based on a review and consideration of
the applicable criteria, application and supporting
documentation, State Board Staff Report, public comment,
public hearing testimony, and any other information that the
State Board deems relevant.
(a-5) (a) Upon a finding that an application to
discontinue close a health care facility or discontinue more
than one categories a category of service is complete, the
State Board shall publish a legal notice on the State Board's
website and in the principal office and website, if available,
of the local government in the area or community to be affected
3 consecutive days in a newspaper of general circulation in
the area or community to be affected and afford the public an

SB3239 - 41 - LRB104 20078 SPS 33529 b
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 website and sent to the State Representative
and State Senator of the district in which the health care
facility is located. In addition, the health care facility
shall provide notice of closure to the local media that the
health care facility would routinely notify about facility
events.
An application to close a health care facility shall only
be deemed complete if it includes evidence that the health
care facility provided written notice at least 30 days prior
to filing the application of its intent to do so to the
municipality in which it is located, the State Representative
and State Senator of the district in which the health care
facility is located, the State Board, the Director of Public
Health, and the Director of Healthcare and Family Services.
The changes made to this subsection by this amendatory Act of
the 101st General Assembly shall apply to all applications
submitted after the effective date of this amendatory Act of
the 101st General Assembly.

SB3239 - 42 - LRB104 20078 SPS 33529 b
(b) No later than 30 days after issuance of a permit to
discontinue close a health care facility or discontinue more
than one category a category of service, the permit holder
shall give written notice of the closure or discontinuation to
the State Senator and State Representative serving the
legislative district in which the health care facility is
located.
(c)(1) If there is a pending lawsuit that challenges an
application to discontinue a health care facility that either
names the Board as a party or alleges fraud in the filing of
the application, the Board may defer action on the application
until all litigation related to the application is complete
for up to 6 months after the date of the initial deferral of
the application.
(2) The Board may defer action on an application to
discontinue a hospital that is pending before the Board as of
the effective date of this amendatory Act of the 102nd General
Assembly for up to 60 days after the effective date of this
amendatory Act of the 102nd General Assembly.
(3) The Board may defer taking final action on an
application to discontinue a hospital that is filed on or
after January 12, 2021, until the earlier to occur of: (i) the
expiration of the statewide disaster declaration proclaimed by
the Governor of the State of Illinois due to the COVID-19
pandemic that is in effect on January 12, 2021, or any
extension thereof, or July 1, 2021, whichever occurs later; or

SB3239 - 43 - LRB104 20078 SPS 33529 b
(ii) the expiration of the declaration of a public health
emergency due to the COVID-19 pandemic as declared by the
Secretary of the U.S. Department of Health and Human Services
that is in effect on January 12, 2021, or any extension
thereof, or July 1, 2021, whichever occurs later. This
paragraph (3) is repealed as of the date of the expiration of
the statewide disaster declaration proclaimed by the Governor
of the State of Illinois due to the COVID-19 pandemic that is
in effect on January 12, 2021, or any extension thereof, or
July 1, 2021, whichever occurs later.
(d) (Blank). The changes made to this Section by this
amendatory Act of the 101st General Assembly shall apply to
all applications submitted after the effective date of this
amendatory Act of the 101st General Assembly.
(e) An application for a permit under this Section is
required for the discontinuation of a hospital regardless of
whether the facility is licensed independently or licensed
under a dual campus license.
(Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20;
102-4, eff. 4-27-21.)
(20 ILCS 3960/10) (from Ch. 111 1/2, par. 1160)
(Section scheduled to be repealed on December 31, 2029)
Sec. 10. Administrative hearings following an initial
denial or revocation of a permit. Presenting information
relevant to the approval of a permit or certificate or in

SB3239 - 44 - LRB104 20078 SPS 33529 b
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, fails to pass, 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.
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 which
fails to pass shall be considered an initial denial of the
application for a permit, as the case may be. Such action of an
initial denial or an action by the State Board to revoke a
permit shall be communicated to the applicant or holder of the
permit. 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 or the Agency 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

SB3239 - 45 - LRB104 20078 SPS 33529 b
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
administrative hearing 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 by either a court reporter or some
other reliable means of recording 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 administrative hearing transcript may be
obtained by any interested party granted the right to
intervene on payment of the cost of preparing such copy or
copies.
The State Board or administrative law judge hearing
officer shall upon its own or the administrative law judge's
his motion, or on the written request of any party to the
administrative hearing proceeding who has, in the State
Board's or administrative law judge's 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

SB3239 - 46 - LRB104 20078 SPS 33529 b
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 administrative law judge hearing officer,
such fees shall be paid in the same manner as other expenses of
the State 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 administrative hearing proceeding, may, in its discretion,
compel the attendance of witnesses, the production of books,
papers, records, or memoranda and the giving of testimony
before it or its administrative law judge 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

SB3239 - 47 - LRB104 20078 SPS 33529 b
the court.
(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
(20 ILCS 3960/11) (from Ch. 111 1/2, par. 1161)
(Section scheduled to be repealed on December 31, 2029)
Sec. 11. Any person who is adversely affected by a final
decision of the State Board may have such decision judicially
reviewed. The provisions of the Administrative Review Law, as
now or hereafter amended, and the rules adopted pursuant
thereto shall apply to and govern all proceedings for the
judicial review of final administrative decisions of the State
Board. The term "administrative decisions" is as defined in
Section 3-101 of the Code of Civil Procedure. In order to
comply with subsection (b) of Section 3-108 of the
Administrative Review Law of the Code of Civil Procedure, upon
the filing of an administrative judicial review action, the
State Board shall transcribe each State Board meeting using a
certified court reporter. The transcript shall contain the
record of the findings and decisions of the State Board.
(Source: P.A. 98-1086, eff. 8-26-14.)
(20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)
(Section scheduled to be repealed on December 31, 2029)
Sec. 12. Powers and duties of State Board. For purposes of
this Act, the State Board shall exercise the following powers
and duties:

SB3239 - 48 - LRB104 20078 SPS 33529 b
(1) Prescribe rules, regulations, standards, criteria,
procedures or reviews which may vary according to the
purpose for which a particular review is being conducted
or the type of project reviewed and which are required to
carry out the provisions and purposes of this Act.
Policies and procedures of the State Board shall take into
consideration the priorities and needs of medically
underserved areas and other health care services, giving
special consideration to the impact of projects on access
to safety net services.
(2) Adopt procedures for public notice and hearing on
all proposed rules, regulations, standards, criteria, and
plans required to carry out the provisions of this Act.
(3) (Blank).
(4) Develop criteria and standards for health care
facilities planning, conduct statewide inventories of
health care facilities, maintain an updated inventory on
the Board's web site reflecting the most recent bed and
service changes and updated need determinations when new
census data become available or new need formulae are
adopted, and develop health care facility plans which
shall be utilized in the review of applications for permit
under this Act. Such health facility plans shall be
coordinated by the Board with pertinent State Plans.
Inventories pursuant to this Section of skilled or
intermediate care facilities licensed under the Nursing

SB3239 - 49 - LRB104 20078 SPS 33529 b
Home Care Act, skilled or intermediate care facilities
licensed under the ID/DD Community Care Act, skilled or
intermediate care facilities licensed under the MC/DD Act,
facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013, or nursing homes licensed
under the Hospital Licensing Act shall be conducted on an
annual basis no later than July 1 of each year and shall
include among the information requested a list of all
services provided by a facility to its residents and to
the community at large and differentiate between active
and inactive beds.
In developing health care facility plans, the State
Board shall consider, but shall not be limited to, the
following:
(a) The size, composition and growth of the
population of the area to be served;
(b) The number of existing and planned facilities
offering similar programs;
(c) The extent of utilization of existing
facilities;
(d) The availability of facilities which may serve
as alternatives or substitutes;
(e) The availability of personnel necessary to the
operation of the facility;
(f) Multi-institutional planning and the
establishment of multi-institutional systems where

SB3239 - 50 - LRB104 20078 SPS 33529 b
feasible;
(g) The financial and economic feasibility of
proposed construction or modification; and
(h) In the case of health care facilities
established by a religious body or denomination, the
needs of the members of such religious body or
denomination may be considered to be public need.
The health care facility plans which are developed and
adopted in accordance with this Section shall form the
basis for the plan of the State to deal most effectively
with statewide health needs in regard to health care
facilities.
(5) Coordinate with other state agencies having
responsibilities affecting health care facilities,
including those of licensure and cost reporting.
(6) Solicit, accept, hold and administer on behalf of
the State any grants or bequests of money, securities or
property for use by the State Board in the administration
of this Act; and enter into contracts consistent with the
appropriations for purposes enumerated in this Act.
(7) (Blank).
(8) Prescribe rules, regulations, standards, and
criteria for the conduct of an expeditious review of
applications for permits for projects of construction or
modification of a health care facility, which projects are
classified as emergency, substantive, or non-substantive

SB3239 - 51 - LRB104 20078 SPS 33529 b
in nature.
Substantive projects shall include no more than the
following:
(a) Projects to construct (1) a new or replacement
facility located on a new site or (2) a replacement
facility located on the same site as the original
facility and the cost of the replacement facility
exceeds the capital expenditure minimum, which shall
be reviewed by the Board within 120 days;
(b) Projects proposing a (1) new service within an
existing healthcare facility or (2) discontinuation of
a service within an existing healthcare facility,
which shall be reviewed by the Board within 60 days; or
(c) Projects proposing a change in the bed
capacity of a health care facility by an increase in
the total number of beds or by a redistribution of beds
among various categories of service or by a relocation
of beds from one physical facility or site to another
by more than 20 beds or more than 10% of total bed
capacity, as defined by the State Board, whichever is
less, over a 2-year period.
The Chairman may approve applications for exemption
that meet the criteria set forth in rules or refer them to
the full Board. The Chairman may approve any unopposed
application for permit that meets all of the review
criteria or refer them to the full Board.

SB3239 - 52 - LRB104 20078 SPS 33529 b
Such rules shall not prevent the conduct of a public
hearing upon the timely request of an interested party.
Such reviews shall not exceed 60 days from the date the
application is declared to be complete.
(9) Prescribe rules, regulations, standards, and
criteria pertaining to the granting of permits for
construction and modifications which are emergent in
nature and must be undertaken immediately to prevent or
correct structural deficiencies or hazardous conditions
that may harm or injure persons using the facility, as
defined in the rules and regulations of the State Board.
This procedure is exempt from public hearing requirements
of this Act.
(10) Prescribe rules, regulations, standards and
criteria for the conduct of an expeditious review, not
exceeding 60 days, of applications for permits for
projects to construct or modify health care facilities
which are needed for the care and treatment of persons who
have acquired immunodeficiency syndrome (AIDS) or related
conditions.
(10.5) Provide its basis or rationale when voting on
an item before it at a State Board meeting in order to
comply with subsection (b) of Section 3-108 of the Code of
Civil Procedure.
(11) Issue written decisions upon request of the
applicant or an adversely affected party to the Board.

SB3239 - 53 - LRB104 20078 SPS 33529 b
Requests for a written decision shall be made within 15
days after the Board meeting in which a final decision has
been made. A "final decision" for purposes of this Act is
the decision to approve or deny an application, or take
other actions permitted under this Act, at the time and
date of the meeting that such action is scheduled by the
Board. The transcript of the State Board meeting shall be
incorporated into the Board's final decision. The staff of
the Board shall prepare a written copy of the final
decision and the Board shall approve a final copy for
inclusion in the formal record. The Board shall consider,
for approval, the written draft of the final decision no
later than the next scheduled Board meeting. The written
decision shall identify the applicable criteria and
factors listed in this Act and the Board's regulations
that were taken into consideration by the Board when
coming to a final decision. If the Board denies or fails to
approve an application for permit or exemption, the Board
shall Prepare and include in the final decision of a
denial or non-approval of a permit a detailed explanation
as to why the application was denied and identify what
specific criteria or standards the applicant did not meet
fulfill.
(12) (Blank).
(13) Provide a mechanism for the public to comment on,
and request changes to, draft rules and standards.

SB3239 - 54 - LRB104 20078 SPS 33529 b
(14) Implement public information campaigns to
regularly inform the general public about the opportunity
for public hearings and public hearing procedures.
(15) Establish a separate set of rules and guidelines
for long-term care that recognizes that nursing homes are
a different business line and service model from other
regulated facilities. An open and transparent process
shall be developed that considers the following: how
skilled nursing fits in the continuum of care with other
care providers, modernization of nursing homes,
establishment of more private rooms, development of
alternative services, and current trends in long-term care
services. The Chairman of the Board shall appoint a
permanent Health Services Review Board Long-term Care
Facility Advisory Subcommittee that shall develop and
recommend to the Board the rules to be established by the
Board under this paragraph (15). The Subcommittee shall
also provide continuous review and commentary on policies
and procedures relative to long-term care and the review
of related projects. The Subcommittee shall make
recommendations to the Board no later than January 1, 2016
and every January thereafter pursuant to the
Subcommittee's responsibility for the continuous review
and commentary on policies and procedures relative to
long-term care. In consultation with other experts from
the health field of long-term care, the Board and the

SB3239 - 55 - LRB104 20078 SPS 33529 b
Subcommittee shall study new approaches to the current bed
need formula and Health Service Area boundaries to
encourage flexibility and innovation in design models
reflective of the changing long-term care marketplace and
consumer preferences and submit its recommendations to the
Chairman of the Board no later than January 1, 2017. The
Subcommittee shall evaluate, and make recommendations to
the State Board regarding, the buying, selling, and
exchange of beds between long-term care facilities within
a specified geographic area or drive time. The Board shall
file the proposed related administrative rules for the
separate rules and guidelines for long-term care required
by this paragraph (15) by no later than September 30,
2011. The Subcommittee shall be provided a reasonable and
timely opportunity to review and comment on any review,
revision, or updating of the criteria, standards,
procedures, and rules used to evaluate project
applications as provided under Section 12.3 of this Act.
The Chairman of the Board shall appoint voting members
of the Subcommittee, who shall serve for a period of 3
years, with one-third of the terms expiring each January,
to be determined by lot. Appointees shall include, but not
be limited to, recommendations from each of the 3
statewide long-term care associations, with an equal
number to be appointed from each. Compliance with this
provision shall be through the appointment and

SB3239 - 56 - LRB104 20078 SPS 33529 b
reappointment process. All appointees serving as of April
1, 2015 shall serve to the end of their term as determined
by lot or until the appointee voluntarily resigns,
whichever is earlier.
One representative from the Department of Public
Health, the Department of Healthcare and Family Services,
the Department on Aging, and the Department of Human
Services may each serve as an ex-officio non-voting member
of the Subcommittee. The Chairman of the Board shall
select a Subcommittee Chair, who shall serve for a period
of 3 years.
(16) Prescribe the format of the State Board Staff
Report. A State Board Staff Report shall pertain to
applications that include, but are not limited to,
applications for permit or exemption, applications for
permit renewal, applications for extension of the
financial commitment period, applications requesting a
declaratory ruling, or applications under the Health Care
Worker Self-Referral Act. State Board Staff Reports shall
compare applications to the relevant review criteria under
the Board's rules.
(17) Establish a separate set of rules and guidelines
for facilities licensed under the Specialized Mental
Health Rehabilitation Act of 2013. An application for the
re-establishment of a facility in connection with the
relocation of the facility shall not be granted unless the

SB3239 - 57 - LRB104 20078 SPS 33529 b
applicant has a contractual relationship with at least one
hospital to provide emergency and inpatient mental health
services required by facility consumers, and at least one
community mental health agency to provide oversight and
assistance to facility consumers while living in the
facility, and appropriate services, including case
management, to assist them to prepare for discharge and
reside stably in the community thereafter. No new
facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013 shall be established after June
16, 2014 (the effective date of Public Act 98-651) except
in connection with the relocation of an existing facility
to a new location. An application for a new location shall
not be approved unless there are adequate community
services accessible to the consumers within a reasonable
distance, or by use of public transportation, so as to
facilitate the goal of achieving maximum individual
self-care and independence. At no time shall the total
number of authorized beds under this Act in facilities
licensed under the Specialized Mental Health
Rehabilitation Act of 2013 exceed the number of authorized
beds on June 16, 2014 (the effective date of Public Act
98-651).
(18) Elect a Vice Chairman to preside over State Board
meetings and otherwise act in place of the Chairman when
the Chairman is unavailable.

SB3239 - 58 - LRB104 20078 SPS 33529 b
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
101-83, eff. 7-15-19.)
(20 ILCS 3960/12.2)
(Section scheduled to be repealed on December 31, 2029)
Sec. 12.2. Powers of the State Board staff. For purposes
of this Act, the staff shall exercise the following powers and
duties:
(1) Review applications for permits and exemptions in
accordance with the standards, criteria, and plans of need
established by the State Board under this Act and certify
its finding to the State Board.
(1.5) Post the following on the Board's web site:
relevant (i) rules, (ii) standards, (iii) criteria, (iv)
State norms, (v) references used by Board staff in making
determinations about whether application criteria are met,
and (vi) notices of project-related filings, including
notice of public comments related to the application.
(2) Charge and collect an amount determined by the
State Board and the staff to be reasonable fees for the
processing of applications by the State Board. The State
Board shall set the amounts by rule. Application fees for
continuing care retirement communities, and other health
care models that include regulated and unregulated
components, shall apply only to those components subject
to regulation under this Act. All fees and fines collected

SB3239 - 59 - LRB104 20078 SPS 33529 b
under the provisions of this Act shall be deposited into
the Illinois Health Facilities Planning Fund to be used
for the expenses of administering this Act.
(2.1) Publish the following reports on the State Board
website:
(A) An annual accounting, aggregated by category
and with names of parties redacted, of fees, fines,
and other revenue collected as well as expenses
incurred, in the administration of this Act.
(B) An annual report, with names of the parties
redacted, that summarizes all settlement agreements
entered into with the State Board that resolve an
alleged instance of noncompliance with State Board
requirements under this Act.
(C) (Blank).
(D) Board reports showing the degree to which an
application conforms to the review standards, a
summation of relevant public testimony, and any
additional information that staff wants to
communicate.
(3) Coordinate with other State agencies having
responsibilities affecting health care facilities,
including licensure and cost reporting agencies.
(4) Issue advisory opinions upon request. Staff
advisory opinions do not constitute determinations by the
State Board. Determinations by the State Board are made

SB3239 - 60 - LRB104 20078 SPS 33529 b
through the declaratory ruling process.
For purposes of this Section, "staff" means a person the
State Board or the Agency employs on a full-time, part-time,
contract, or intern basis.
(Source: P.A. 100-681, eff. 8-3-18; 101-83, eff. 7-15-19.)
(20 ILCS 3960/13) (from Ch. 111 1/2, par. 1163)
(Section scheduled to be repealed on December 31, 2029)
Sec. 13. Review and investigation Investigation of
applications for permits. The State Board and State Board
employees shall make or cause to be made such a review of all
submitted applications or investigations as it deems necessary
in connection with an application for a permit or exemption,
or in connection with a determination of whether or not a
project or transaction construction or modification that has
been commenced is in accord with the exemption or permit
issued by the State Board, or whether a project or transaction
construction or modification has been commenced without a
permit or exemption having been obtained. The State Board may
issue subpoenas duces tecum requiring the production of
records and may administer oaths to such witnesses.
Any circuit court of this State, upon the application of
the State Board or upon the application of any proper party to
such proceedings, may, in its discretion, compel the
attendance of witnesses, the production of books, papers,
records, or memoranda and the giving of testimony before the

SB3239 - 61 - LRB104 20078 SPS 33529 b
State Board, by a proceeding as for contempt, or otherwise, in
the same manner as production of evidence may be compelled
before the court.
The State Board shall require all health facilities
operating in this State to provide such reasonable reports at
such times and containing such information as is needed by it
to carry out the purposes and provisions of this Act. Prior to
collecting information from health facilities, the State Board
shall make reasonable efforts through a public process to
consult with health facilities and associations that represent
them to determine whether data and information requests will
result in useful information for health planning, whether
sufficient information is available from other sources, and
whether data requested is routinely collected by health
facilities and is available without retrospective record
review. Data and information requests shall not impose undue
paperwork burdens on health care facilities and personnel.
Health facilities not complying with this requirement shall be
reported to licensing, accrediting, certifying, or payment
agencies as being in violation of State law. Health care
facilities and other parties at interest shall have reasonable
access, under rules established by the State Board, to all
planning information submitted in accord with this Act
pertaining to their area.
Among the reports to be required by the State Board are
facility questionnaires for health care facilities licensed

SB3239 - 62 - LRB104 20078 SPS 33529 b
under the Ambulatory Surgical Treatment Center Act, the
Hospital Licensing Act, the Nursing Home Care Act, the ID/DD
Community Care Act, the MC/DD Act, or the Specialized Mental
Health Rehabilitation Act of 2013 and health care facilities
that are required to meet the requirements of 42 CFR 494 in
order to be certified for participation in Medicare and
Medicaid under Titles XVIII and XIX of the federal Social
Security Act. These questionnaires shall be conducted on an
annual basis and compiled by the State Board. For health care
facilities licensed under the Nursing Home Care Act or the
Specialized Mental Health Rehabilitation Act of 2013, these
reports shall include, but not be limited to, the
identification of specialty services provided by the facility
to patients, residents, and the community at large. Annual
reports for facilities licensed under the ID/DD Community Care
Act and facilities licensed under the MC/DD Act shall be
different from the annual reports required of other health
care facilities and shall be specific to those facilities
licensed under the ID/DD Community Care Act or the MC/DD Act.
The Health Facilities and Services Review Board shall consult
with associations representing facilities licensed under the
ID/DD Community Care Act and associations representing
facilities licensed under the MC/DD Act when developing the
information requested in these annual reports. For health care
facilities that contain long term care beds, the reports shall
also include the number of staffed long term care beds,

SB3239 - 63 - LRB104 20078 SPS 33529 b
physical capacity for long term care beds at the facility, and
long term care beds available for immediate occupancy. For
purposes of this paragraph, "long term care beds" means beds
(i) licensed under the Nursing Home Care Act, (ii) licensed
under the ID/DD Community Care Act, (iii) licensed under the
MC/DD Act, (iv) licensed under the Hospital Licensing Act, or
(v) licensed under the Specialized Mental Health
Rehabilitation Act of 2013 and certified as skilled nursing or
nursing facility beds under Medicaid or Medicare.
(Source: P.A. 100-681, eff. 8-3-18; 100-957, eff. 8-19-18;
101-81, eff. 7-12-19.)