Bill Text: IL SB3723 | 2023-2024 | 103rd General Assembly | Engrossed


Bill Title: Reinserts the provisions of the introduced bill with the following changes. Deletes the definition of the term "involuntary termination of residency". Provides that, when the Department of Public Health orders the immediate readmission of a resident to an establishment, readmission is not required if a condition which would have allowed transfer or discharge develops within the time that the resident's residency was involuntarily terminated. Makes changes in provisions prohibiting an establishment from terminating residency due to an emergency situation under certain circumstances. Makes changes in provisions concerning fines the Department shall assess if an establishment does not readmit a resident after the Department has ordered readmission. Deletes references to a resident's right to retain residency at an establishment during any hospital stay totaling 10 days or less following a hospital admission. Deletes references to Type 1 violations. Makes other changes. Amends the Nursing Home Care Act. Deletes provisions related to the definitions of "discharge", "high risk designation", and "transfer". Deletes a provision relating to a resident's refusal of treatment not constituting grounds for discharge. Deletes references to Type A violations. Deletes provisions concerning fines the Department shall assess if an establishment does not readmit a resident after the Department has ordered readmission. Deletes references directing a resident's own physician, if any, to conduct an in-person assessment or make a determination that the resident should be discharged because of the resident's health care needs, instead of a facility's physician. Deletes a provision requiring a resident who is in the process of appealing the denial of the resident's application for the Medical Assistance Program to be considered a Medicaid applicant during the appeal process. Removes provisions concerning the long term care ombudsman requesting a hearing on behalf of a resident under certain circumstances. Makes other changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-06-26 - Pursuant to Senate Rule 3-9(b) / Referred to Assignments [SB3723 Detail]

Download: Illinois-2023-SB3723-Engrossed.html

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1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Assisted Living and Shared Housing Act is
5amended by changing Sections 10, 15, 75, 80, 90, and 95 as
6follows:
7 (210 ILCS 9/10)
8 Sec. 10. Definitions. For purposes of this Act:
9 "Activities of daily living" means eating, dressing,
10bathing, toileting, transferring, or personal hygiene.
11 "Assisted living establishment" or "establishment" means a
12home, building, residence, or any other place where sleeping
13accommodations are provided for at least 3 unrelated adults,
14at least 80% of whom are 55 years of age or older and where the
15following are provided consistent with the purposes of this
16Act:
17 (1) services consistent with a social model that is
18 based on the premise that the resident's unit in assisted
19 living and shared housing is his or her own home;
20 (2) community-based residential care for persons who
21 need assistance with activities of daily living, including
22 personal, supportive, and intermittent health-related
23 services available 24 hours per day, if needed, to meet

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1 the scheduled and unscheduled needs of a resident;
2 (3) mandatory services, whether provided directly by
3 the establishment or by another entity arranged for by the
4 establishment, with the consent of the resident or
5 resident's representative; and
6 (4) a physical environment that is a homelike setting
7 that includes the following and such other elements as
8 established by the Department: individual living units
9 each of which shall accommodate small kitchen appliances
10 and contain private bathing, washing, and toilet
11 facilities, or private washing and toilet facilities with
12 a common bathing room readily accessible to each resident.
13 Units shall be maintained for single occupancy except in
14 cases in which 2 residents choose to share a unit.
15 Sufficient common space shall exist to permit individual
16 and group activities.
17 "Assisted living establishment" or "establishment" does
18not mean any of the following:
19 (1) A home, institution, or similar place operated by
20 the federal government or the State of Illinois.
21 (2) A long term care facility licensed under the
22 Nursing Home Care Act, a facility licensed under the
23 Specialized Mental Health Rehabilitation Act of 2013, a
24 facility licensed under the ID/DD Community Care Act, or a
25 facility licensed under the MC/DD Act. However, a facility
26 licensed under any of those Acts may convert distinct

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1 parts of the facility to assisted living. If the facility
2 elects to do so, the facility shall retain the Certificate
3 of Need for its nursing and sheltered care beds that were
4 converted.
5 (3) A hospital, sanitarium, or other institution, the
6 principal activity or business of which is the diagnosis,
7 care, and treatment of human illness and that is required
8 to be licensed under the Hospital Licensing Act.
9 (4) A facility for child care as defined in the Child
10 Care Act of 1969.
11 (5) A community living facility as defined in the
12 Community Living Facilities Licensing Act.
13 (6) A nursing home or sanitarium operated solely by
14 and for persons who rely exclusively upon treatment by
15 spiritual means through prayer in accordance with the
16 creed or tenants of a well-recognized church or religious
17 denomination.
18 (7) A facility licensed by the Department of Human
19 Services as a community-integrated living arrangement as
20 defined in the Community-Integrated Living Arrangements
21 Licensure and Certification Act.
22 (8) A supportive residence licensed under the
23 Supportive Residences Licensing Act.
24 (9) The portion of a life care facility as defined in
25 the Life Care Facilities Act not licensed as an assisted
26 living establishment under this Act; a life care facility

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1 may apply under this Act to convert sections of the
2 community to assisted living.
3 (10) A free-standing hospice facility licensed under
4 the Hospice Program Licensing Act.
5 (11) A shared housing establishment.
6 (12) A supportive living facility as described in
7 Section 5-5.01a of the Illinois Public Aid Code.
8 "Department" means the Department of Public Health.
9 "Director" means the Director of Public Health.
10 "Emergency situation" means imminent danger of death or
11serious physical harm to a resident of an establishment.
12 "License" means any of the following types of licenses
13issued to an applicant or licensee by the Department:
14 (1) "Probationary license" means a license issued to
15 an applicant or licensee that has not held a license under
16 this Act prior to its application or pursuant to a license
17 transfer in accordance with Section 50 of this Act.
18 (2) "Regular license" means a license issued by the
19 Department to an applicant or licensee that is in
20 substantial compliance with this Act and any rules
21 promulgated under this Act.
22 "Licensee" means a person, agency, association,
23corporation, partnership, or organization that has been issued
24a license to operate an assisted living or shared housing
25establishment.
26 "Licensed health care professional" means a registered

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1professional nurse, an advanced practice registered nurse, a
2physician assistant, and a licensed practical nurse.
3 "Mandatory services" include the following:
4 (1) 3 meals per day available to the residents
5 prepared by the establishment or an outside contractor;
6 (2) housekeeping services including, but not limited
7 to, vacuuming, dusting, and cleaning the resident's unit;
8 (3) personal laundry and linen services available to
9 the residents provided or arranged for by the
10 establishment;
11 (4) security provided 24 hours each day including, but
12 not limited to, locked entrances or building or contract
13 security personnel;
14 (5) an emergency communication response system, which
15 is a procedure in place 24 hours each day by which a
16 resident can notify building management, an emergency
17 response vendor, or others able to respond to his or her
18 need for assistance; and
19 (6) assistance with activities of daily living as
20 required by each resident.
21 "Negotiated risk" is the process by which a resident, or
22his or her representative, may formally negotiate with
23providers what risks each are willing and unwilling to assume
24in service provision and the resident's living environment.
25The provider assures that the resident and the resident's
26representative, if any, are informed of the risks of these

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1decisions and of the potential consequences of assuming these
2risks.
3 "Owner" means the individual, partnership, corporation,
4association, or other person who owns an assisted living or
5shared housing establishment. In the event an assisted living
6or shared housing establishment is operated by a person who
7leases or manages the physical plant, which is owned by
8another person, "owner" means the person who operates the
9assisted living or shared housing establishment, except that
10if the person who owns the physical plant is an affiliate of
11the person who operates the assisted living or shared housing
12establishment and has significant control over the day to day
13operations of the assisted living or shared housing
14establishment, the person who owns the physical plant shall
15incur jointly and severally with the owner all liabilities
16imposed on an owner under this Act.
17 "Physician" means a person licensed under the Medical
18Practice Act of 1987 to practice medicine in all of its
19branches.
20 "Resident" means a person residing in an assisted living
21or shared housing establishment.
22 "Resident's representative" means a person, other than the
23owner, agent, or employee of an establishment or of the health
24care provider unless related to the resident, designated in
25writing by a resident or a court to be his or her
26representative. This designation may be accomplished through

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1the Illinois Power of Attorney Act, pursuant to the
2guardianship process under the Probate Act of 1975, or
3pursuant to an executed designation of representative form
4specified by the Department.
5 "Self" means the individual or the individual's designated
6representative.
7 "Shared housing establishment" or "establishment" means a
8publicly or privately operated free-standing residence for 16
9or fewer persons, at least 80% of whom are 55 years of age or
10older and who are unrelated to the owners and one manager of
11the residence, where the following are provided:
12 (1) services consistent with a social model that is
13 based on the premise that the resident's unit is his or her
14 own home;
15 (2) community-based residential care for persons who
16 need assistance with activities of daily living, including
17 housing and personal, supportive, and intermittent
18 health-related services available 24 hours per day, if
19 needed, to meet the scheduled and unscheduled needs of a
20 resident; and
21 (3) mandatory services, whether provided directly by
22 the establishment or by another entity arranged for by the
23 establishment, with the consent of the resident or the
24 resident's representative.
25 "Shared housing establishment" or "establishment" does not
26mean any of the following:

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1 (1) A home, institution, or similar place operated by
2 the federal government or the State of Illinois.
3 (2) A long term care facility licensed under the
4 Nursing Home Care Act, a facility licensed under the
5 Specialized Mental Health Rehabilitation Act of 2013, a
6 facility licensed under the ID/DD Community Care Act, or a
7 facility licensed under the MC/DD Act. A facility licensed
8 under any of those Acts may, however, convert sections of
9 the facility to assisted living. If the facility elects to
10 do so, the facility shall retain the Certificate of Need
11 for its nursing beds that were converted.
12 (3) A hospital, sanitarium, or other institution, the
13 principal activity or business of which is the diagnosis,
14 care, and treatment of human illness and that is required
15 to be licensed under the Hospital Licensing Act.
16 (4) A facility for child care as defined in the Child
17 Care Act of 1969.
18 (5) A community living facility as defined in the
19 Community Living Facilities Licensing Act.
20 (6) A nursing home or sanitarium operated solely by
21 and for persons who rely exclusively upon treatment by
22 spiritual means through prayer in accordance with the
23 creed or tenants of a well-recognized church or religious
24 denomination.
25 (7) A facility licensed by the Department of Human
26 Services as a community-integrated living arrangement as

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1 defined in the Community-Integrated Living Arrangements
2 Licensure and Certification Act.
3 (8) A supportive residence licensed under the
4 Supportive Residences Licensing Act.
5 (9) A life care facility as defined in the Life Care
6 Facilities Act; a life care facility may apply under this
7 Act to convert sections of the community to assisted
8 living.
9 (10) A free-standing hospice facility licensed under
10 the Hospice Program Licensing Act.
11 (11) An assisted living establishment.
12 (12) A supportive living facility as described in
13 Section 5-5.01a of the Illinois Public Aid Code.
14 "Total assistance" means that staff or another individual
15performs the entire activity of daily living without
16participation by the resident.
17(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
18 (210 ILCS 9/15)
19 Sec. 15. Assessment and service plan requirements. Prior
20to admission to any establishment covered by this Act, a
21comprehensive assessment that includes an evaluation of the
22prospective resident's physical, cognitive, and psychosocial
23condition shall be completed. At least annually, a
24comprehensive assessment shall be completed, and upon
25identification of a significant change in the resident's

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1condition, including, but not limited to, a diagnosis of
2Alzheimer's disease or a related dementia, the resident shall
3be reassessed. The Department may by rule specify
4circumstances under which more frequent assessments of skin
5integrity and nutritional status shall be required. The
6comprehensive assessment shall be completed by a physician.
7Based on the assessment, the resident's interests and
8preferences, dislikes, and any known triggers for behavior
9that endangers the resident or others, a written service plan
10shall be developed and mutually agreed upon by the provider,
11and the resident, and the resident's representative, if any.
12The service plan, which shall be reviewed annually, or more
13often as the resident's condition, preferences, or service
14needs change, shall serve as a basis for the service delivery
15contract between the provider and the resident. The resident
16and the resident's representative, if any, shall, upon
17request, be given a copy of the most recent assessment; a
18supplemental assessment, if any, completed by the
19establishment; and a service plan. Based on the assessment,
20the service plan may provide for the disconnection or removal
21of any appliance.
22(Source: P.A. 91-656, eff. 1-1-01.)
23 (210 ILCS 9/75)
24 Sec. 75. Residency requirements.
25 (a) No individual shall be accepted for residency or

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1remain in residence if the establishment cannot provide or
2secure appropriate services, if the individual requires a
3level of service or type of service for which the
4establishment is not licensed or which the establishment does
5not provide, or if the establishment does not have the staff
6appropriate in numbers and with appropriate skill to provide
7such services.
8 (b) Only adults may be accepted for residency.
9 (c) A person shall not be accepted for residency if:
10 (1) the person poses a serious threat to himself or
11 herself or to others;
12 (2) the person is not able to communicate his or her
13 needs and no resident representative residing in the
14 establishment, and with a prior relationship to the
15 person, has been appointed to direct the provision of
16 services;
17 (3) the person requires total assistance with 2 or
18 more activities of daily living;
19 (4) the person requires the assistance of more than
20 one paid caregiver at any given time with an activity of
21 daily living;
22 (5) the person requires more than minimal assistance
23 in moving to a safe area in an emergency;
24 (6) the person has a severe mental illness, which for
25 the purposes of this Section means a condition that is
26 characterized by the presence of a major mental disorder

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1 as classified in the Diagnostic and Statistical Manual of
2 Mental Disorders, Fourth Edition (DSM-IV) (American
3 Psychiatric Association, 1994), where the individual is a
4 person with a substantial disability due to mental illness
5 in the areas of self-maintenance, social functioning,
6 activities of community living and work skills, and the
7 disability specified is expected to be present for a
8 period of not less than one year, but does not mean
9 Alzheimer's disease and other forms of dementia based on
10 organic or physical disorders;
11 (7) the person requires intravenous therapy or
12 intravenous feedings unless self-administered or
13 administered by a qualified, licensed health care
14 professional;
15 (8) the person requires gastrostomy feedings unless
16 self-administered or administered by a licensed health
17 care professional;
18 (9) the person requires insertion, sterile irrigation,
19 and replacement of catheter, except for routine
20 maintenance of urinary catheters, unless the catheter care
21 is self-administered or administered by a licensed health
22 care professional;
23 (10) the person requires sterile wound care unless
24 care is self-administered or administered by a licensed
25 health care professional;
26 (11) (blank);

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1 (12) the person is a diabetic requiring routine
2 insulin injections unless the injections are
3 self-administered or administered by a licensed health
4 care professional;
5 (13) the person requires treatment of stage 3 or stage
6 4 decubitus ulcers or exfoliative dermatitis;
7 (14) the person requires 5 or more skilled nursing
8 visits per week for conditions other than those listed in
9 items (13) and (15) of this subsection for a period of 3
10 consecutive weeks or more except when the course of
11 treatment is expected to extend beyond a 3 week period for
12 rehabilitative purposes and is certified as temporary by a
13 physician; or
14 (15) other reasons prescribed by the Department by
15 rule.
16 (d) A resident with a condition listed in items (1)
17through (15) of subsection (c) shall have his or her residency
18terminated.
19 (e) Residency shall be terminated when services available
20to the resident in the establishment are no longer adequate to
21meet the needs of the resident. The establishment shall notify
22the resident and the resident's representative, if any, when
23there is a significant change in the resident's condition that
24affects the establishment's ability to meet the resident's
25needs. The requirements of subsection (c) of Section 80 shall
26then apply. This provision shall not be interpreted as

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1limiting the authority of the Department to require the
2residency termination of individuals.
3 (f) Subsection (d) of this Section shall not apply to
4terminally ill residents who receive or would qualify for
5hospice care and such care is coordinated by a hospice program
6licensed under the Hospice Program Licensing Act or other
7licensed health care professional employed by a licensed home
8health agency and the establishment and all parties agree to
9the continued residency.
10 (g) Items (3), (4), (5), and (9) of subsection (c) shall
11not apply to a quadriplegic, paraplegic, or individual with
12neuro-muscular diseases, such as muscular dystrophy and
13multiple sclerosis, or other chronic diseases and conditions
14as defined by rule if the individual is able to communicate his
15or her needs and does not require assistance with complex
16medical problems, and the establishment is able to accommodate
17the individual's needs. The Department shall prescribe rules
18pursuant to this Section that address special safety and
19service needs of these individuals.
20 (h) For the purposes of items (7) through (10) of
21subsection (c), a licensed health care professional may not be
22employed by the owner or operator of the establishment, its
23parent entity, or any other entity with ownership common to
24either the owner or operator of the establishment or parent
25entity, including but not limited to an affiliate of the owner
26or operator of the establishment. Nothing in this Section is

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1meant to limit a resident's right to choose his or her health
2care provider.
3 (i) Subsection (h) is not applicable to residents admitted
4to an assisted living establishment under a life care contract
5as defined in the Life Care Facilities Act if the life care
6facility has both an assisted living establishment and a
7skilled nursing facility. A licensed health care professional
8providing health-related or supportive services at a life care
9assisted living or shared housing establishment must be
10employed by an entity licensed by the Department under the
11Nursing Home Care Act or the Home Health, Home Services, and
12Home Nursing Agency Licensing Act.
13(Source: P.A. 103-444, eff. 1-1-24.)
14 (210 ILCS 9/80)
15 Sec. 80. Involuntary termination of residency.
16 (a) Residency shall be involuntarily terminated only for
17the following reasons:
18 (1) as provided in Section 75 of this Act;
19 (2) nonpayment of contracted charges after the
20 resident and the resident's representative have received a
21 minimum of 30 days' 30-days written notice of the
22 delinquency and the resident or the resident's
23 representative has had at least 15 days to cure the
24 delinquency; or
25 (3) failure to execute a service delivery contract or

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1 to substantially comply with its terms and conditions,
2 failure to comply with the assessment requirements
3 contained in Section 15, or failure to substantially
4 comply with the terms and conditions of the lease
5 agreement.
6 (b) A 30-day 30 day written notice of residency
7termination shall be provided to the resident, the resident's
8representative, or both, the Department, and the long term
9care ombudsman, which shall include the reason for the pending
10action, the date of the proposed move, and a notice, the
11content and form to be set forth by rule, of the resident's
12right to appeal, the steps that the resident or the resident's
13representative must take to initiate an appeal, and a
14statement of the resident's right to continue to reside in the
15establishment until a decision is rendered. The notice shall
16include a toll free telephone number to initiate an appeal and
17a written hearing request form, together with a postage paid,
18pre-addressed envelope to the Department. If the resident or
19the resident's representative, if any, cannot read English,
20the notice must be provided in a language the individual
21receiving the notice can read or the establishment must
22provide a translator who has been trained to assist the
23resident or the resident's representative in the appeal
24process. In emergency situations as defined in Section 10 of
25this Act, the 30-day provision of the written notice may be
26waived.

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1 (c) The establishment shall attempt to resolve with the
2resident or the resident's representative, if any,
3circumstances that if not remedied have the potential of
4resulting in an involuntary termination of residency and shall
5document those efforts in the resident's file. This action may
6occur prior to or during the 30 day notice period, but must
7occur prior to the termination of the residency. In emergency
8situations as defined in Section 10 of this Act, the
9requirements of this subsection may be waived.
10 (d) A request for a hearing shall stay an involuntary
11termination of residency until a decision has been rendered by
12the Department, according to a process adopted by rule. During
13this time period, the establishment may not terminate or
14reduce any service without the consent of the resident or the
15resident's representative, if any, for the purpose of making
16it more difficult or impossible for the resident to remain in
17the establishment.
18 (e) The establishment shall offer the resident and the
19resident's representative, if any, residency termination and
20relocation assistance including information on available
21alternative placement. Residents shall be involved in planning
22the move and shall choose among the available alternative
23placements except when an emergency situation makes prior
24resident involvement impossible. Emergency placements are
25deemed temporary until the resident's input can be sought in
26the final placement decision. No resident shall be forced to

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1remain in a temporary or permanent placement.
2 (f) The Department may offer assistance to the
3establishment and the resident in the preparation of residency
4termination and relocation plans to assure safe and orderly
5transition and to protect the resident's health, safety,
6welfare, and rights. In nonemergencies, and where possible in
7emergencies, the transition plan shall be designed and
8implemented in advance of transfer or residency termination.
9 (g) An establishment may not initiate a termination of
10residency due to an emergency situation if the establishment
11is able to safely care for the resident and (1) the resident
12has been hospitalized and the resident's physician, the
13establishment's manager, and the establishment's director of
14nursing state that returning to the establishment would not
15create an imminent danger of death or serious physical harm to
16the resident; or (2) the emergency can be negated by changes in
17activities, health care, personal care, or available rooming
18accommodations, consistent with the license and services of
19the establishment. The Department may not find an
20establishment to be in violation of Section 75 of this Act for
21failing to initiate an emergency discharge in these
22circumstances.
23 (h) If the Department determines that an involuntary
24termination of residency does not meet the requirements of
25this Act, the Department shall issue a written decision
26stating that the involuntary termination of residency is

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1denied. If the action of the establishment giving rise to the
2request for hearings is the establishment's failure to readmit
3the resident following hospitalization, other medical leave of
4absence, or other absence, the Department shall order the
5immediate readmission of the resident to the establishment
6unless a condition which would have allowed transfer or
7discharge develops within that timeframe.
8 (i) If an order to readmit is entered pursuant to
9subsection (h), the establishment shall immediately comply. As
10used in this subsection, "comply" means the establishment and
11the resident have agreed on a schedule for readmission or the
12resident is living in the establishment.
13 (j) An establishment that does not readmit a resident
14after the Department has ordered readmission shall be assessed
15a fine. The establishment shall be required to submit an
16acceptable plan of correction to the Department within 30 days
17after the violation is affirmed.
18 (k) Once a notice of appeal is filed, the Department shall
19hold a hearing unless the notice of appeal is withdrawn. If the
20notice of appeal is withdrawn based upon a representation made
21by the establishment to the resident and the Department,
22including the hearing officer, that a resident who has been
23previously denied readmission will be readmitted, failure to
24comply with the representation shall be considered a failure
25to comply with a Department order pursuant to subsection (h)
26and shall result in the imposition of a fine as provided in

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1subsection (j) of this Section.
2(Source: P.A. 91-656, eff. 1-1-01.)
3 (210 ILCS 9/90)
4 Sec. 90. Contents of service delivery contract. A contract
5between an establishment and a resident must be entitled
6"assisted living establishment contract" or "shared housing
7establishment contract" as applicable, shall be printed in no
8less than 12 point type, and shall include at least the
9following elements in the body or through supporting documents
10or attachments:
11 (1) the name, street address, and mailing address of
12 the establishment;
13 (2) the name and mailing address of the owner or
14 owners of the establishment and, if the owner or owners
15 are not natural persons, the type of business entity of
16 the owner or owners;
17 (3) the name and mailing address of the managing agent
18 of the establishment, whether hired under a management
19 agreement or lease agreement, if the managing agent is
20 different from the owner or owners;
21 (4) the name and address of at least one natural
22 person who is authorized to accept service on behalf of
23 the owners and managing agent;
24 (5) a statement describing the license status of the
25 establishment and the license status of all providers of

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1 health-related or supportive services to a resident under
2 arrangement with the establishment;
3 (6) the duration of the contract;
4 (7) the base rate to be paid by the resident and a
5 description of the services to be provided as part of this
6 rate;
7 (8) a description of any additional services to be
8 provided for an additional fee by the establishment
9 directly or by a third party provider under arrangement
10 with the establishment;
11 (9) the fee schedules outlining the cost of any
12 additional services;
13 (10) a description of the process through which the
14 contract may be modified, amended, or terminated;
15 (11) a description of the establishment's complaint
16 resolution process available to residents and notice of
17 the availability of the Department on Aging's Senior
18 Helpline for complaints;
19 (12) the name of the resident's designated
20 representative, if any;
21 (13) the resident's obligations in order to maintain
22 residency and receive services including compliance with
23 all assessments required under Section 15;
24 (14) the billing and payment procedures and
25 requirements;
26 (15) a statement affirming the resident's freedom to

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1 receive services from service providers with whom the
2 establishment does not have a contractual arrangement,
3 which may also disclaim liability on the part of the
4 establishment for those services;
5 (16) a statement that medical assistance under Article
6 V or Article VI of the Illinois Public Aid Code is not
7 available for payment for services provided in an
8 establishment, excluding contracts executed with residents
9 residing in licensed establishments participating in the
10 Department on Aging's Comprehensive Care in Residential
11 Settings Demonstration Project;
12 (17) a statement detailing the admission, risk
13 management, and residency termination criteria and
14 procedures;
15 (18) a written explanation, prepared by the Office of
16 State Long Term Care Ombudsman, statement listing the
17 rights specified in Sections 80 and Section 95, including
18 an acknowledgment by the establishment and acknowledging
19 that, by contracting with the assisted living or shared
20 housing establishment, the resident does not forfeit those
21 rights;
22 (19) a statement detailing the Department's annual
23 on-site review process including what documents contained
24 in a resident's personal file shall be reviewed by the
25 on-site reviewer as defined by rule; and
26 (20) a statement outlining whether the establishment

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1 charges a community fee and, if so, the amount of the fee
2 and whether it is refundable; if the fee is refundable,
3 the contract must describe the conditions under which it
4 is refundable and how the amount of the refund is
5 determined.
6(Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)
7 (210 ILCS 9/95)
8 Sec. 95. Resident rights. No resident shall be deprived of
9any rights, benefits, or privileges guaranteed by law, the
10Constitution of the State of Illinois, or the Constitution of
11the United States solely on account of his or her status as a
12resident of an establishment, nor shall a resident forfeit any
13of the following rights:
14 (1) the right to retain and use personal property and
15 a place to store personal items that is locked and secure;
16 (2) the right to refuse services and to be advised of
17 the consequences of that refusal;
18 (3) the right to respect for bodily privacy and
19 dignity at all times, especially during care and
20 treatment;
21 (4) the right to the free exercise of religion;
22 (5) the right to privacy with regard to mail, phone
23 calls, and visitors;
24 (6) the right to uncensored access to the State
25 Ombudsman or his or her designee;

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1 (7) the right to be free of retaliation for
2 criticizing the establishment or making complaints to
3 appropriate agencies;
4 (8) the right to be free of chemical and physical
5 restraints;
6 (9) the right to be free of abuse or neglect or to
7 refuse to perform labor;
8 (10) the right to confidentiality of the resident's
9 medical records;
10 (11) the right of access and the right to copy the
11 resident's personal files maintained by the establishment;
12 (12) the right to 24 hours access to the
13 establishment;
14 (13) the right to a minimum of 90 days' 90-days notice
15 of a planned establishment closure;
16 (14) the right to a minimum of 30 days' 30-days notice
17 of an involuntary residency termination, except where the
18 resident poses a threat to himself or others, or in other
19 emergency situations, and the right to appeal such
20 termination; if an establishment withdraws a notice of
21 involuntary termination of residency, then the resident
22 has the right to maintain residency at the establishment;
23 and
24 (15) the right to a 30-day notice of delinquency and
25 at least 15 days right to cure delinquency; and .
26 (16) the right to not be unlawfully transferred or

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1 discharged.
2(Source: P.A. 91-656, eff. 1-1-01.)
3 Section 10. The Nursing Home Care Act is amended by
4changing Sections 1-114.005, 2-111, 3-401, 3-402, 3-404,
53-405, 3-411, and 3-413 and by adding Sections 3-305.6 and
63-413.1 as follows:
7 (210 ILCS 45/1-114.005)
8 Sec. 1-114.005. High risk designation. "High risk
9designation" means a violation of a provision of the Illinois
10Administrative Code or statute that has been identified by the
11Department through rulemaking or designated in statute to be
12inherently necessary to protect the health, safety, and
13welfare of a resident.
14(Source: P.A. 96-1372, eff. 7-29-10.)
15 (210 ILCS 45/2-111) (from Ch. 111 1/2, par. 4152-111)
16 Sec. 2-111. A resident shall not be transferred or
17discharged in violation of this Act. A resident may be
18discharged from a facility after he gives the administrator, a
19physician, or a nurse of the facility written notice of his
20desire to be discharged. If a guardian has been appointed for a
21resident or if the resident is a minor, the resident shall be
22discharged upon written consent of his guardian or if the
23resident is a minor, his parent unless there is a court order

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1to the contrary. In such cases, upon the resident's discharge,
2the facility is relieved from any responsibility for the
3resident's care, safety or well-being. A resident has the
4right to not be unlawfully transferred or discharged.
5(Source: P.A. 81-223.)
6 (210 ILCS 45/3-305.6 new)
7 Sec. 3-305.6. Failure to readmit a resident. A facility
8that fails to comply with an order of the Department to readmit
9a resident, pursuant to Section 3-703, who wishes to return to
10the facility and is appropriate for that level of care and
11services provided, shall be assessed a fine.
12 As used in this Section, "comply with an order" means that
13a resident is living in a facility or that a facility and a
14resident have agreed on a schedule for readmission.
15 (210 ILCS 45/3-401) (from Ch. 111 1/2, par. 4153-401)
16 Sec. 3-401. A facility may involuntarily transfer or
17discharge a resident only for one or more of the following
18reasons:
19 (a) the facility is unable to meet the medical needs
20 of the resident, as documented in the resident's clinical
21 record by the resident's physician for medical reasons for
22 medical reasons;
23 (b) for the resident's physical safety;
24 (c) for the physical safety of other residents, the

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1 facility staff or facility visitors; or
2 (d) for either late payment or nonpayment for the
3 resident's stay, except as prohibited by Titles XVIII and
4 XIX of the federal Social Security Act. For purposes of
5 this Section, "late payment" means non-receipt of payment
6 after submission of a bill. If payment is not received
7 within 45 days after submission of a bill, a facility may
8 send a notice to the resident and responsible party
9 requesting payment within 30 days. If payment is not
10 received within such 30 days, the facility may thereupon
11 institute transfer or discharge proceedings by sending a
12 notice of transfer or discharge to the resident and
13 responsible party by registered or certified mail. The
14 notice shall state, in addition to the requirements of
15 Section 3-403 of this Act, that the responsible party has
16 the right to pay the amount of the bill in full up to the
17 date the transfer or discharge is to be made and then the
18 resident shall have the right to remain in the facility.
19 Such payment shall terminate the transfer or discharge
20 proceedings. This subsection does not apply to those
21 residents whose care is provided for under the Illinois
22 Public Aid Code. The Department shall adopt rules setting
23 forth the criteria and procedures to be applied in cases
24 of involuntary transfer or discharge permitted under this
25 Section.
26 In the absence of other bases for transfer or discharge in

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1this Section, unless it has complied with the prior notice and
2other procedural requirements of this Act, a facility may not
3refuse to readmit a resident following a medical leave of
4absence if the resident's need for care does not exceed the
5provisions of the facility's license or current services
6offered.
7(Source: P.A. 91-357, eff. 7-29-99.)
8 (210 ILCS 45/3-402) (from Ch. 111 1/2, par. 4153-402)
9 Sec. 3-402. Involuntary transfer or discharge of a
10resident from a facility shall be preceded by the discussion
11required under Section 3-408 and by a minimum written notice
12of 30 21 days, except in one of the following instances:
13 (a) When an emergency transfer or discharge is ordered by
14the resident's attending physician because of the resident's
15health care needs. The State Long Term Care Ombudsman shall be
16notified at the time of the emergency transfer or discharge.
17 (b) When the transfer or discharge is mandated by the
18physical safety of other residents, the facility staff, or
19facility visitors, as documented in the clinical record. The
20Department, the Office of State Long Term Care Ombudsman, and
21the resident's managed care organization, if applicable, and
22the State Long Term Care Ombudsman shall be notified prior to
23any such involuntary transfer or discharge. The Department
24shall immediately offer transfer, or discharge and relocation
25assistance to residents transferred or discharged under this

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1subparagraph (b), and the Department may place relocation
2teams as provided in Section 3-419 of this Act.
3 (c) When an identified offender is within the provisional
4admission period defined in Section 1-120.3. If the Identified
5Offender Report and Recommendation prepared under Section
62-201.6 shows that the identified offender poses a serious
7threat or danger to the physical safety of other residents,
8the facility staff, or facility visitors in the admitting
9facility and the facility determines that it is unable to
10provide a safe environment for the other residents, the
11facility staff, or facility visitors, the facility shall
12transfer or discharge the identified offender within 3 days
13after its receipt of the Identified Offender Report and
14Recommendation.
15(Source: P.A. 103-320, eff. 1-1-24.)
16 (210 ILCS 45/3-404) (from Ch. 111 1/2, par. 4153-404)
17 Sec. 3-404. A request for a hearing made under Section
183-403 shall stay a transfer or discharge pending a hearing or
19appeal of the decision, unless a condition which would have
20allowed transfer or discharge in less than 30 21 days as
21described under paragraphs (a) and (b) of Section 3-402
22develops in the interim.
23(Source: P.A. 81-223.)
24 (210 ILCS 45/3-405) (from Ch. 111 1/2, par. 4153-405)

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1 Sec. 3-405. A copy of the notice required by Section 3-402
2shall be placed in the resident's clinical record and a copy
3shall be transmitted to the Department, the State Long Term
4Care Ombudsman, the resident, and the resident's
5representative, if any, the resident's managed care
6organization, if applicable, and the Office of State Long Term
7Care Ombudsman.
8(Source: P.A. 103-320, eff. 1-1-24.)
9 (210 ILCS 45/3-411) (from Ch. 111 1/2, par. 4153-411)
10 Sec. 3-411. The Department of Public Health, when the
11basis for involuntary transfer or discharge is other than
12action by the Department of Healthcare and Family Services
13(formerly Department of Public Aid) with respect to the Title
14XIX Medicaid recipient, shall hold a hearing at the resident's
15facility not later than 10 days after a hearing request is
16filed, and render a decision within 14 days after the filing of
17the hearing request. The Department has continuing
18jurisdiction over the transfer or discharge irrespective of
19the timing of the hearing and decision. Once a request for a
20hearing is filed, the Department shall hold a hearing unless
21the request is withdrawn by the resident. If the request for a
22hearing is withdrawn based upon a representation made by the
23facility to the resident and the Department, including the
24hearing officer, that a resident who has been denied
25readmission will be readmitted, and the resident or resident

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1representative notifies the Department that the facility is
2still denying readmission, failure to readmit is considered
3failure to comply with a Department order to readmit pursuant
4to Section 3-305.6, including the imposition of a fine under
5Section 3-305.6.
6(Source: P.A. 95-331, eff. 8-21-07.)
7 (210 ILCS 45/3-413) (from Ch. 111 1/2, par. 4153-413)
8 Sec. 3-413. If the Department determines that a transfer
9or discharge is authorized under Section 3-401, the resident
10shall not be required to leave the facility before the 34th day
11following receipt of the notice required under Section 3-402,
12or the 10th day following receipt of the Department's
13decision, whichever is later, unless a condition which would
14have allowed transfer or discharge in less than 30 21 days as
15described under paragraphs (a) and (b) of Section 3-402
16develops in the interim. The Department maintains jurisdiction
17over the transfer or discharge irrespective of the timing of
18the notice and discharge.
19(Source: P.A. 81-223.)
20 (210 ILCS 45/3-413.1 new)
21 Sec. 3-413.1. Denial of transfer or discharge. If the
22Department determines that a transfer or discharge is not
23authorized under Section 3-401, then the Department shall
24issue a written decision stating that the transfer or

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