Bill Text: IL SB3897 | 2021-2022 | 102nd General Assembly | Introduced

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Bill Title: Amends the Nursing Home Care Act. Provides that, for the purpose of computing staff to resident ratios, direct care staff shall include resident attendants.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Introduced - Dead) 2022-02-10 - Rule 2-10 Committee Deadline Established As February 18, 2022 [SB3897 Detail]

Download: Illinois-2021-SB3897-Introduced.html

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102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 SB3897 Introduced 1/21/2022, by Sen. Laura Fine SYNOPSIS AS INTRODUCED:
210 ILCS 45/3-202.05
Amends the Nursing Home Care Act. Provides that, for the purpose of computing staff to resident ratios, direct care staff shall include resident attendants.
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A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nursing Home Care Act is amended by
changing Section 3-202.05 as follows:
(210 ILCS 45/3-202.05)
Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
thereafter.
(a) For the purpose of computing staff to resident ratios,
direct care staff shall include:
(1) registered nurses;
(2) licensed practical nurses;
(3) certified nurse assistants;
(4) psychiatric services rehabilitation aides;
(5) rehabilitation and therapy aides;
(6) psychiatric services rehabilitation coordinators;
(7) assistant directors of nursing;
(8) 50% of the Director of Nurses' time; and
(9) 30% of the Social Services Directors' time; and .
(10) resident attendants.
The Department shall, by rule, allow certain facilities
subject to 77 Ill. Admin. Code 300.4000 and following (Subpart
S) to utilize specialized clinical staff, as defined in rules,

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to count towards the staffing ratios.
Within 120 days of the effective date of this amendatory
Act of the 97th General Assembly, the Department shall
promulgate rules specific to the staffing requirements for
facilities federally defined as Institutions for Mental
Disease. These rules shall recognize the unique nature of
individuals with chronic mental health conditions, shall
include minimum requirements for specialized clinical staff,
including clinical social workers, psychiatrists,
psychologists, and direct care staff set forth in paragraphs
(4) through (6) and any other specialized staff which may be
utilized and deemed necessary to count toward staffing ratios.
Within 120 days of the effective date of this amendatory
Act of the 97th General Assembly, the Department shall
promulgate rules specific to the staffing requirements for
facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013. These rules shall recognize the
unique nature of individuals with chronic mental health
conditions, shall include minimum requirements for specialized
clinical staff, including clinical social workers,
psychiatrists, psychologists, and direct care staff set forth
in paragraphs (4) through (6) and any other specialized staff
which may be utilized and deemed necessary to count toward
staffing ratios.
(b) (Blank).
(b-5) For purposes of the minimum staffing ratios in this

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Section, all residents shall be classified as requiring either
skilled care or intermediate care.
As used in this subsection:
"Intermediate care" means basic nursing care and other
restorative services under periodic medical direction.
"Skilled care" means skilled nursing care, continuous
skilled nursing observations, restorative nursing, and other
services under professional direction with frequent medical
supervision.
(c) Facilities shall notify the Department within 60 days
after the effective date of this amendatory Act of the 96th
General Assembly, in a form and manner prescribed by the
Department, of the staffing ratios in effect on the effective
date of this amendatory Act of the 96th General Assembly for
both intermediate and skilled care and the number of residents
receiving each level of care.
(d)(1) (Blank).
(2) (Blank).
(3) (Blank).
(4) (Blank).
(5) Effective January 1, 2014, the minimum staffing ratios
shall be increased to 3.8 hours of nursing and personal care
each day for a resident needing skilled care and 2.5 hours of
nursing and personal care each day for a resident needing
intermediate care.
(e) Ninety days after the effective date of this

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amendatory Act of the 97th General Assembly, a minimum of 25%
of nursing and personal care time shall be provided by
licensed nurses, with at least 10% of nursing and personal
care time provided by registered nurses. These minimum
requirements shall remain in effect until an acuity based
registered nurse requirement is promulgated by rule concurrent
with the adoption of the Resource Utilization Group
classification-based payment methodology, as provided in
Section 5-5.2 of the Illinois Public Aid Code. Registered
nurses and licensed practical nurses employed by a facility in
excess of these requirements may be used to satisfy the
remaining 75% of the nursing and personal care time
requirements. Notwithstanding this subsection, no staffing
requirement in statute in effect on the effective date of this
amendatory Act of the 97th General Assembly shall be reduced
on account of this subsection.
(f) The Department shall submit proposed rules for
adoption by January 1, 2020 establishing a system for
determining compliance with minimum staffing set forth in this
Section and the requirements of 77 Ill. Adm. Code 300.1230
adjusted for any waivers granted under Section 3-303.1.
Compliance shall be determined quarterly by comparing the
number of hours provided per resident per day using the
Centers for Medicare and Medicaid Services' payroll-based
journal and the facility's daily census, broken down by
intermediate and skilled care as self-reported by the facility

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to the Department on a quarterly basis. The Department shall
use the quarterly payroll-based journal and the self-reported
census to calculate the number of hours provided per resident
per day and compare this ratio to the minimum staffing
standards required under this Section, as impacted by any
waivers granted under Section 3-303.1. Discrepancies between
job titles contained in this Section and the payroll-based
journal shall be addressed by rule. The manner in which the
Department requests payroll-based journal information to be
submitted shall align with the federal Centers for Medicare
and Medicaid Services' requirements that allow providers to
submit the quarterly data in an aggregate manner.
(g) The Department shall submit proposed rules for
adoption by January 1, 2020 establishing monetary penalties
for facilities not in compliance with minimum staffing
standards under this Section. No monetary penalty may be
issued for noncompliance during the implementation period,
which shall be July 1, 2020 through December 31, 2021. If a
facility is found to be noncompliant during the implementation
period, the Department shall provide a written notice
identifying the staffing deficiencies and require the facility
to provide a sufficiently detailed correction plan to meet the
statutory minimum staffing levels. Monetary penalties shall be
imposed beginning no later than January 1, 2022 and quarterly
thereafter and shall be based on the latest quarter for which
the Department has data. Monetary penalties shall be

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established based on a formula that calculates on a daily
basis the cost of wages and benefits for the missing staffing
hours. All notices of noncompliance shall include the
computations used to determine noncompliance and establishing
the variance between minimum staffing ratios and the
Department's computations. The penalty for the first offense
shall be 125% of the cost of wages and benefits for the missing
staffing hours. The penalty shall increase to 150% of the cost
of wages and benefits for the missing staffing hours for the
second offense and 200% the cost of wages and benefits for the
missing staffing hours for the third and all subsequent
offenses. The penalty shall be imposed regardless of whether
the facility has committed other violations of this Act during
the same period that the staffing offense occurred. The
penalty may not be waived, but the Department shall have the
discretion to determine the gravity of the violation in
situations where there is no more than a 10% deviation from the
staffing requirements and make appropriate adjustments to the
penalty. The Department is granted discretion to waive the
penalty when unforeseen circumstances have occurred that
resulted in call-offs of scheduled staff. This provision shall
be applied no more than 6 times per quarter. Nothing in this
Section diminishes a facility's right to appeal.
(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21.)