Bill Amendment: IL HB4674 | 2021-2022 | 102nd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: NURSING HOMES-INSPECTIONS

Status: 2022-05-27 - Public Act . . . . . . . . . 102-0947 [HB4674 Detail]

Download: Illinois-2021-HB4674-Senate_Amendment_002.html

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Sen. Mattie Hunter

Filed: 3/23/2022

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AMENDMENT TO HOUSE BILL 4674
AMENDMENT NO. ______. Amend House Bill 4674 by replacing
everything after the enacting clause with the following:
"Section 5. The Nursing Home Care Act is amended by
changing Sections 3-212 and 3-702 as follows:
(210 ILCS 45/3-212) (from Ch. 111 1/2, par. 4153-212)
Sec. 3-212. Inspection.
(a) The Department, whenever it deems necessary in
accordance with subsection (b), shall inspect, survey and
evaluate every facility to determine compliance with
applicable licensure requirements and standards. Submission of
a facility's current Consumer Choice Information Report
required by Section 2-214 shall be verified at time of
inspection. An inspection should occur within 120 days prior
to license renewal. The Department may periodically visit a
facility for the purpose of consultation. An inspection,

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survey, or evaluation, other than an inspection of financial
records, shall be conducted without prior notice to the
facility. A visit for the sole purpose of consultation may be
announced. The Department shall provide training to surveyors
about the appropriate assessment, care planning, and care of
persons with mental illness (other than Alzheimer's disease or
related disorders) to enable its surveyors to determine
whether a facility is complying with State and federal
requirements about the assessment, care planning, and care of
those persons.
(a-1) An employee of a State or unit of local government
agency charged with inspecting, surveying, and evaluating
facilities who directly or indirectly gives prior notice of an
inspection, survey, or evaluation, other than an inspection of
financial records, to a facility or to an employee of a
facility is guilty of a Class A misdemeanor.
An inspector or an employee of the Department who
intentionally prenotifies a facility, orally or in writing, of
a pending complaint investigation or inspection shall be
guilty of a Class A misdemeanor. Superiors of persons who have
prenotified a facility shall be subject to the same penalties,
if they have knowingly allowed the prenotification. A person
found guilty of prenotifying a facility shall be subject to
disciplinary action by his or her employer.
If the Department has a good faith belief, based upon
information that comes to its attention, that a violation of

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this subsection has occurred, it must file a complaint with
the Attorney General or the State's Attorney in the county
where the violation took place within 30 days after discovery
of the information.
(a-2) An employee of a State or unit of local government
agency charged with inspecting, surveying, or evaluating
facilities who willfully profits from violating the
confidentiality of the inspection, survey, or evaluation
process shall be guilty of a Class 4 felony and that conduct
shall be deemed unprofessional conduct that may subject a
person to loss of his or her professional license. An action to
prosecute a person for violating this subsection (a-2) may be
brought by either the Attorney General or the State's Attorney
in the county where the violation took place.
(a-3) The Department shall, by rule, establish guidelines
for required continuing education of all employees who
inspect, survey, or evaluate a facility. The Department shall
offer continuing education opportunities at least quarterly.
Employees of a State agency charged with inspecting,
surveying, or evaluating a facility are required to complete
at least 10 hours of continuing education annually on topics
that support the survey process, including, but not limited
to, trauma-informed care, infection control, abuse and
neglect, and civil monetary penalties. Qualifying hours of
continuing education intended to fulfill the requirements of
this subsection shall only be offered by the Department.

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Content presented during the continuing education shall be
consistent throughout the State, regardless of survey region.
The continuing education required under this subsection is
separate from any continuing education required for any
license that the employee holds.
(b) In determining whether to make more than the required
number of unannounced inspections, surveys and evaluations of
a facility the Department shall consider one or more of the
following: previous inspection reports; the facility's history
of compliance with standards, rules and regulations
promulgated under this Act and correction of violations,
penalties or other enforcement actions; the number and
severity of complaints received about the facility; any
allegations of resident abuse or neglect; weather conditions;
health emergencies; other reasonable belief that deficiencies
exist.
(b-1) The Department shall not be required to determine
whether a facility certified to participate in the Medicare
program under Title XVIII of the Social Security Act, or the
Medicaid program under Title XIX of the Social Security Act,
and which the Department determines by inspection under this
Section or under Section 3-702 of this Act to be in compliance
with the certification requirements of Title XVIII or XIX, is
in compliance with any requirement of this Act that is less
stringent than or duplicates a federal certification
requirement. In accordance with subsection (a) of this Section

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or subsection (d) of Section 3-702, the Department shall
determine whether a certified facility is in compliance with
requirements of this Act that exceed federal certification
requirements. If a certified facility is found to be out of
compliance with federal certification requirements, the
results of an inspection conducted pursuant to Title XVIII or
XIX of the Social Security Act may be used as the basis for
enforcement remedies authorized and commenced, with the
Department's discretion to evaluate whether penalties are
warranted, under this Act. Enforcement of this Act against a
certified facility shall be commenced pursuant to the
requirements of this Act, unless enforcement remedies sought
pursuant to Title XVIII or XIX of the Social Security Act
exceed those authorized by this Act. As used in this
subsection, "enforcement remedy" means a sanction for
violating a federal certification requirement or this Act.
(c) Upon completion of each inspection, survey and
evaluation, the appropriate Department personnel who conducted
the inspection, survey or evaluation shall submit a physical
or electronic copy of their report to the licensee upon
exiting the facility, and shall submit the actual report to
the appropriate regional office of the Department. Such report
and any recommendations for action by the Department under
this Act shall be transmitted to the appropriate offices of
the associate director of the Department, together with
related comments or documentation provided by the licensee

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which may refute findings in the report, which explain
extenuating circumstances that the facility could not
reasonably have prevented, or which indicate methods and
timetables for correction of deficiencies described in the
report. Without affecting the application of subsection (a) of
Section 3-303, any documentation or comments of the licensee
shall be provided within 10 days of receipt of the copy of the
report. Such report shall recommend to the Director
appropriate action under this Act with respect to findings
against a facility. The Director shall then determine whether
the report's findings constitute a violation or violations of
which the facility must be given notice. Such determination
shall be based upon the severity of the finding, the danger
posed to resident health and safety, the comments and
documentation provided by the facility, the diligence and
efforts to correct deficiencies, correction of the reported
deficiencies, the frequency and duration of similar findings
in previous reports and the facility's general inspection
history. Violations shall be determined under this subsection
no later than 75 days after completion of each inspection,
survey and evaluation.
(d) The Department shall maintain all inspection, survey
and evaluation reports for at least 5 years in a manner
accessible to and understandable by the public.
(e) Revisit surveys. The Department shall conduct a
revisit to its licensure and certification surveys, consistent

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with federal regulations and guidelines.
(f) Notwithstanding any other provision of this Act, the
Department shall, no later than 180 days after the effective
date of this amendatory Act of the 98th General Assembly,
implement a single survey process that encompasses federal
certification and State licensure requirements, health and
life safety requirements, and an enhanced complaint
investigation initiative.
(1) To meet the requirement of a single survey
process, the portions of the health and life safety survey
associated with federal certification and State licensure
surveys must be started within 7 working days of each
other. Nothing in this paragraph (1) of subsection (f) of
this Section applies to a complaint investigation.
(2) The enhanced complaint and incident report
investigation initiative shall permit the facility to
challenge the amount of the fine due to the excessive
length of the investigation which results in one or more
of the following conditions:
(A) prohibits the timely development and
implementation of a plan of correction;
(B) creates undue financial hardship impacting the
quality of care delivered to the resident;
(C) delays initiation of corrective training; and
(D) negatively impacts quality assurance and
patient improvement standards.

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This paragraph (2) does not apply to complaint
investigations exited within 14 working days or a
situation that triggers an extended survey.
(Source: P.A. 98-104, eff. 7-22-13.)
(210 ILCS 45/3-702) (from Ch. 111 1/2, par. 4153-702)
Sec. 3-702. (a) A person who believes that this Act or a
rule promulgated under this Act may have been violated may
request an investigation. The request may be submitted to the
Department in writing, by telephone, by electronic means, or
by personal visit. An oral complaint shall be reduced to
writing by the Department. The Department shall make
available, through its website and upon request, information
regarding the oral and phone intake processes and the list of
questions that will be asked of the complainant. The
Department shall request information identifying the
complainant, including the name, address and telephone number,
to help enable appropriate follow-up. The Department shall act
on such complaints via on-site visits or other methods deemed
appropriate to handle the complaints with or without such
identifying information, as otherwise provided under this
Section. The complainant shall be informed that compliance
with such request is not required to satisfy the procedures
for filing a complaint under this Act. The Department must
notify complainants that complaints with less information
provided are far more difficult to respond to and investigate.

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(b) The substance of the complaint shall be provided in
writing to the licensee, owner, or administrator no earlier
than at the commencement of an on-site inspection of the
facility which takes place pursuant to the complaint.
(c) The Department shall not disclose the name of the
complainant unless the complainant consents in writing to the
disclosure or the investigation results in a judicial
proceeding, or unless disclosure is essential to the
investigation. The complainant shall be given the opportunity
to withdraw the complaint before disclosure. Upon the request
of the complainant, the Department may permit the complainant
or a representative of the complainant to accompany the person
making the on-site inspection of the facility.
(d) Upon receipt of a complaint, the Department shall
determine whether this Act or a rule promulgated under this
Act has been or is being violated. The Department shall
investigate all complaints alleging abuse or neglect within 7
days after the receipt of the complaint except that complaints
of abuse or neglect which indicate that a resident's life or
safety is in imminent danger shall be investigated within 24
hours after receipt of the complaint. All other complaints
shall be investigated within 30 days after the receipt of the
complaint. The Department employees investigating a complaint
shall conduct a brief, informal exit conference with the
facility to alert its administration of any suspected serious
deficiency that poses a direct threat to the health, safety or

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welfare of a resident to enable an immediate correction for
the alleviation or elimination of such threat. Such
information and findings discussed in the brief exit
conference shall become a part of the investigating record but
shall not in any way constitute an official or final notice of
violation as provided under Section 3-301. All complaints
shall be classified as "an invalid report", "a valid report",
or "an undetermined report". For any complaint classified as
"a valid report", the Department must determine within 30
working days after any Department employee enters a facility
to begin an on-site inspection if any rule or provision of this
Act has been or is being violated.
(d-1) The Department shall, whenever possible, combine an
on-site investigation of a complaint in a facility with other
inspections in order to avoid duplication of inspections.
(e) In all cases, the Department shall inform the
complainant of its findings within 10 days of its
determination unless otherwise indicated by the complainant,
and the complainant may direct the Department to send a copy of
such findings to another person. The Department's findings may
include comments or documentation provided by either the
complainant or the licensee pertaining to the complaint. The
Department shall also notify the facility of such findings
within 10 days of the determination, but the name of the
complainant or residents shall not be disclosed in this notice
to the facility. The notice of such findings shall include a

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copy of the written determination; the correction order, if
any; the warning notice, if any; the inspection report; or the
State licensure form on which the violation is listed.
(f) A written determination, correction order, or warning
notice concerning a complaint, together with the facility's
response, shall be available for public inspection, but the
name of the complainant or resident shall not be disclosed
without his consent.
(g) A complainant who is dissatisfied with the
determination or investigation by the Department may request a
hearing under Section 3-703. The facility shall be given
notice of any such hearing and may participate in the hearing
as a party. If a facility requests a hearing under Section
3-703 which concerns a matter covered by a complaint, the
complainant shall be given notice and may participate in the
hearing as a party. A request for a hearing by either a
complainant or a facility shall be submitted in writing to the
Department within 30 days after the mailing of the
Department's findings as described in subsection (e) of this
Section. Upon receipt of the request the Department shall
conduct a hearing as provided under Section 3-703.
(g-5) The Department shall conduct an annual review of all
survey activity from the preceding fiscal year and make a
report concerning the complaint and survey process. The report
shall include, but not be limited to: that includes the total
number of complaints received; the breakdown of 24-hour,

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7-day, and 30-day complaints; , the breakdown of anonymous and
non-anonymous complaints; and whether the number of complaints
that were substantiated versus unsubstantiated; or not, the
total number of substantiated complaints that were completed
in the time frame determined under subsection (d); the total
number of informal dispute resolutions requested; the total
number of informal dispute resolution requests approved; the
total number of informal dispute resolutions that were
overturned or reduced in severity; the total number of nurse
surveyors hired during the calendar year; the total number of
nurse surveyors who left Department employment; the average
length of tenure for nurse surveyors employed by the
Department at the time the report is created; the total number
of times the Department recommended a discretionary denial of
payment for new Medicare or Medicaid admissions and how much
time existed between the start of that denial and when the
facility was notified, with a start date for the denial of
payment that is (i) less than 15 days after the date of the
Department's notice to the facility, (ii) at least 15 days and
less than 31 days after the date of the Department's notice to
the facility, (iii) at least 31 days and less than 60 days
after the date of the Department's notice to the facility, and
(iv) at least 60 days after the date of the Department's notice
to the facility; , and any other complaint information
requested by the Long-Term Care Facility Advisory Board
created under Section 2-204 of this Act or the Illinois

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Long-Term Care Council created under Section 4.04a of the
Illinois Act on the Aging. This report shall be provided to the
Long-Term Care Facility Advisory Board, the Illinois Long-Term
Care Council, and the General Assembly. The Long-Term Care
Facility Advisory Board and the Illinois Long-Term Care
Council shall review the report and suggest any changes deemed
necessary to the Department for review and action, including
how to investigate and substantiate anonymous complaints.
(h) Any person who knowingly transmits a false report to
the Department commits the offense of disorderly conduct under
subsection (a)(8) of Section 26-1 of the Criminal Code of
2012.
(Source: P.A. 102-432, eff. 8-20-21.)".