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

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3723 Introduced 2/9/2024, by Sen. Kimberly A. Lightford SYNOPSIS AS INTRODUCED:
See Index
Amends the Assisted Living and Shared Housing Act. Adds provisions concerning involuntary terminations of residency, hearings when residency is involuntarily terminated, and readmission of residents. Provides that an establishment shall notify a resident when the establishment's ability to meet the resident's needs may be affected. Provides that if an establishment initiates a termination of residency, then the resident shall be provided with written notice. Provides that the Department of Public Health shall (rather than may) offer assistance to an establishment and resident in preparation for a residency termination. Provides that an establishment that improperly terminates the residency of a resident shall be assessed a violation. Makes additions to provisions concerning resident rights. Makes other changes. Amends the Nursing Home Care Act. Makes changes to provisions concerning the involuntary transfer or discharge of a resident, hearings when a resident is involuntarily transferred or discharged, and the readmission of residents. Provides that a resident has a right not to be unlawfully transferred or discharged from a facility. Makes other changes. Amends the Assisted Living and Shared Housing Act and the Nursing Home Care Act. Provides that in certain circumstances the Department shall order immediate readmission of a resident. Provides that failure to readmit a resident after receiving an order to do so from the Department shall result in a specified daily fine. Provides that the Department shall adopt rules related to conflicts of interest for persons who conduct specified hearings.
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A BILL FOR
SB3723 LRB103 36302 CES 66400 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Assisted Living and Shared Housing Act is
amended by changing Sections 10, 15, 75, 80, 90, and 95 as
follows:
(210 ILCS 9/10)
Sec. 10. Definitions. For purposes of this Act:
"Activities of daily living" means eating, dressing,
bathing, toileting, transferring, or personal hygiene.
"Assisted living establishment" or "establishment" means a
home, building, residence, or any other place where sleeping
accommodations are provided for at least 3 unrelated adults,
at least 80% of whom are 55 years of age or older and where the
following are provided consistent with the purposes of this
Act:
(1) services consistent with a social model that is
based on the premise that the resident's unit in assisted
living and shared housing is his or her own home;
(2) community-based residential care for persons who
need assistance with activities of daily living, including
personal, supportive, and intermittent health-related
services available 24 hours per day, if needed, to meet

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

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

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may apply under this Act to convert sections of the
community to assisted living.
(10) A free-standing hospice facility licensed under
the Hospice Program Licensing Act.
(11) A shared housing establishment.
(12) A supportive living facility as described in
Section 5-5.01a of the Illinois Public Aid Code.
"Department" means the Department of Public Health.
"Director" means the Director of Public Health.
"Emergency situation" means imminent danger of death or
serious physical harm to a resident of an establishment.
"Involuntary termination of residency" means the full
release of any resident from a facility, without the informed
consent of the resident, freely given and not coerced.
"Involuntary termination of residency" includes an assisted
living or shared housing establishment's failure to readmit a
resident following hospitalization, other medical leave, or
other absence from the establishment.
"License" means any of the following types of licenses
issued to an applicant or licensee by the Department:
(1) "Probationary license" means a license issued to
an applicant or licensee that has not held a license under
this Act prior to its application or pursuant to a license
transfer in accordance with Section 50 of this Act.
(2) "Regular license" means a license issued by the
Department to an applicant or licensee that is in

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substantial compliance with this Act and any rules
promulgated under this Act.
"Licensee" means a person, agency, association,
corporation, partnership, or organization that has been issued
a license to operate an assisted living or shared housing
establishment.
"Licensed health care professional" means a registered
professional nurse, an advanced practice registered nurse, a
physician assistant, and a licensed practical nurse.
"Mandatory services" include the following:
(1) 3 meals per day available to the residents
prepared by the establishment or an outside contractor;
(2) housekeeping services including, but not limited
to, vacuuming, dusting, and cleaning the resident's unit;
(3) personal laundry and linen services available to
the residents provided or arranged for by the
establishment;
(4) security provided 24 hours each day including, but
not limited to, locked entrances or building or contract
security personnel;
(5) an emergency communication response system, which
is a procedure in place 24 hours each day by which a
resident can notify building management, an emergency
response vendor, or others able to respond to his or her
need for assistance; and
(6) assistance with activities of daily living as

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required by each resident.
"Negotiated risk" is the process by which a resident, or
his or her representative, may formally negotiate with
providers what risks each are willing and unwilling to assume
in service provision and the resident's living environment.
The provider assures that the resident and the resident's
representative, if any, are informed of the risks of these
decisions and of the potential consequences of assuming these
risks.
"Owner" means the individual, partnership, corporation,
association, or other person who owns an assisted living or
shared housing establishment. In the event an assisted living
or shared housing establishment is operated by a person who
leases or manages the physical plant, which is owned by
another person, "owner" means the person who operates the
assisted living or shared housing establishment, except that
if the person who owns the physical plant is an affiliate of
the person who operates the assisted living or shared housing
establishment and has significant control over the day to day
operations of the assisted living or shared housing
establishment, the person who owns the physical plant shall
incur jointly and severally with the owner all liabilities
imposed on an owner under this Act.
"Physician" means a person licensed under the Medical
Practice Act of 1987 to practice medicine in all of its
branches.

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"Resident" means a person residing in an assisted living
or shared housing establishment.
"Resident's representative" means a person, other than the
owner, agent, or employee of an establishment or of the health
care provider unless related to the resident, designated in
writing by a resident or a court to be his or her
representative. This designation may be accomplished through
the Illinois Power of Attorney Act, pursuant to the
guardianship process under the Probate Act of 1975, or
pursuant to an executed designation of representative form
specified by the Department.
"Self" means the individual or the individual's designated
representative.
"Shared housing establishment" or "establishment" means a
publicly or privately operated free-standing residence for 16
or fewer persons, at least 80% of whom are 55 years of age or
older and who are unrelated to the owners and one manager of
the residence, where the following are provided:
(1) services consistent with a social model that is
based on the premise that the resident's unit is his or her
own home;
(2) community-based residential care for persons who
need assistance with activities of daily living, including
housing and personal, supportive, and intermittent
health-related services available 24 hours per day, if
needed, to meet the scheduled and unscheduled needs of a

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resident; and
(3) mandatory services, whether provided directly by
the establishment or by another entity arranged for by the
establishment, with the consent of the resident or the
resident's representative.
"Shared housing establishment" or "establishment" does not
mean any of the following:
(1) A home, institution, or similar place operated by
the federal government or the State of Illinois.
(2) A long term care facility licensed under the
Nursing Home Care Act, a facility licensed under the
Specialized Mental Health Rehabilitation Act of 2013, a
facility licensed under the ID/DD Community Care Act, or a
facility licensed under the MC/DD Act. A facility licensed
under any of those Acts may, however, convert sections of
the facility to assisted living. If the facility elects to
do so, the facility shall retain the Certificate of Need
for its nursing beds that were converted.
(3) A hospital, sanitarium, or other institution, the
principal activity or business of which is the diagnosis,
care, and treatment of human illness and that is required
to be licensed under the Hospital Licensing Act.
(4) A facility for child care as defined in the Child
Care Act of 1969.
(5) A community living facility as defined in the
Community Living Facilities Licensing Act.

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(6) A nursing home or sanitarium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer in accordance with the
creed or tenants of a well-recognized church or religious
denomination.
(7) A facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act.
(8) A supportive residence licensed under the
Supportive Residences Licensing Act.
(9) A life care facility as defined in the Life Care
Facilities Act; a life care facility may apply under this
Act to convert sections of the community to assisted
living.
(10) A free-standing hospice facility licensed under
the Hospice Program Licensing Act.
(11) An assisted living establishment.
(12) A supportive living facility as described in
Section 5-5.01a of the Illinois Public Aid Code.
"Total assistance" means that staff or another individual
performs the entire activity of daily living without
participation by the resident.
(Source: P.A. 99-180, eff. 7-29-15; 100-513, eff. 1-1-18.)
(210 ILCS 9/15)

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Sec. 15. Assessment and service plan requirements. Prior
to admission to any establishment covered by this Act, a
comprehensive assessment that includes an evaluation of the
prospective resident's physical, cognitive, and psychosocial
condition shall be completed. At least annually, a
comprehensive assessment shall be completed, and upon
identification of a significant change in the resident's
condition, including, but not limited to, a diagnosis of
Alzheimer's disease or a related dementia, the resident shall
be reassessed. The Department may by rule specify
circumstances under which more frequent assessments of skin
integrity and nutritional status shall be required. The
comprehensive assessment shall be completed by a physician.
Based on the assessment, the resident's interests and
preferences, dislikes, and any known triggers for behavior
that endangers the resident or others, a written service plan
shall be developed and mutually agreed upon by the provider,
and the resident, and the resident's representative, if any.
The service plan, which shall be reviewed annually, or more
often as the resident's condition, preferences, or service
needs change, shall serve as a basis for the service delivery
contract between the provider and the resident. The resident
and the resident's representative, if any, shall be given a
copy of the most recent assessment; a supplemental assessment,
if any, done by the establishment; and a service plan. Based on
the assessment, the service plan may provide for the

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disconnection or removal of any appliance.
(Source: P.A. 91-656, eff. 1-1-01.)
(210 ILCS 9/75)
Sec. 75. Residency requirements.
(a) No individual shall be accepted for residency or
remain in residence if the establishment cannot provide or
secure appropriate services, if the individual requires a
level of service or type of service for which the
establishment is not licensed or which the establishment does
not provide, or if the establishment does not have the staff
appropriate in numbers and with appropriate skill to provide
such services.
(b) Only adults may be accepted for residency.
(c) A person shall not be accepted for residency if:
(1) the person poses a serious threat to himself or
herself or to others;
(2) the person is not able to communicate his or her
needs and no resident representative residing in the
establishment, and with a prior relationship to the
person, has been appointed to direct the provision of
services;
(3) the person requires total assistance with 2 or
more activities of daily living;
(4) the person requires the assistance of more than
one paid caregiver at any given time with an activity of

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daily living;
(5) the person requires more than minimal assistance
in moving to a safe area in an emergency;
(6) the person has a severe mental illness, which for
the purposes of this Section means a condition that is
characterized by the presence of a major mental disorder
as classified in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) (American
Psychiatric Association, 1994), where the individual is a
person with a substantial disability due to mental illness
in the areas of self-maintenance, social functioning,
activities of community living and work skills, and the
disability specified is expected to be present for a
period of not less than one year, but does not mean
Alzheimer's disease and other forms of dementia based on
organic or physical disorders;
(7) the person requires intravenous therapy or
intravenous feedings unless self-administered or
administered by a qualified, licensed health care
professional;
(8) the person requires gastrostomy feedings unless
self-administered or administered by a licensed health
care professional;
(9) the person requires insertion, sterile irrigation,
and replacement of catheter, except for routine
maintenance of urinary catheters, unless the catheter care

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is self-administered or administered by a licensed health
care professional;
(10) the person requires sterile wound care unless
care is self-administered or administered by a licensed
health care professional;
(11) (blank);
(12) the person is a diabetic requiring routine
insulin injections unless the injections are
self-administered or administered by a licensed health
care professional;
(13) the person requires treatment of stage 3 or stage
4 decubitus ulcers or exfoliative dermatitis;
(14) the person requires 5 or more skilled nursing
visits per week for conditions other than those listed in
items (13) and (15) of this subsection for a period of 3
consecutive weeks or more except when the course of
treatment is expected to extend beyond a 3 week period for
rehabilitative purposes and is certified as temporary by a
physician; or
(15) other reasons prescribed by the Department by
rule.
(d) A resident with a condition listed in items (1)
through (15) of subsection (c) shall have his or her residency
terminated.
(e) Residency shall be terminated when services available
to the resident in the establishment are no longer adequate to

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meet the needs of the resident. The establishment shall notify
the resident and the resident's representative, if any, when
there is a significant change in the resident's condition that
affects the establishment's ability to meet the resident's
needs. The requirements of subsection (c) of Section 80 shall
then apply. This provision shall not be interpreted as
limiting the authority of the Department to require the
residency termination of individuals.
(f) Subsection (d) of this Section shall not apply to
terminally ill residents who receive or would qualify for
hospice care and such care is coordinated by a hospice program
licensed under the Hospice Program Licensing Act or other
licensed health care professional employed by a licensed home
health agency and the establishment and all parties agree to
the continued residency.
(g) Items (3), (4), (5), and (9) of subsection (c) shall
not apply to a quadriplegic, paraplegic, or individual with
neuro-muscular diseases, such as muscular dystrophy and
multiple sclerosis, or other chronic diseases and conditions
as defined by rule if the individual is able to communicate his
or her needs and does not require assistance with complex
medical problems, and the establishment is able to accommodate
the individual's needs. The Department shall prescribe rules
pursuant to this Section that address special safety and
service needs of these individuals.
(h) For the purposes of items (7) through (10) of

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subsection (c), a licensed health care professional may not be
employed by the owner or operator of the establishment, its
parent entity, or any other entity with ownership common to
either the owner or operator of the establishment or parent
entity, including but not limited to an affiliate of the owner
or operator of the establishment. Nothing in this Section is
meant to limit a resident's right to choose his or her health
care provider.
(i) Subsection (h) is not applicable to residents admitted
to an assisted living establishment under a life care contract
as defined in the Life Care Facilities Act if the life care
facility has both an assisted living establishment and a
skilled nursing facility. A licensed health care professional
providing health-related or supportive services at a life care
assisted living or shared housing establishment must be
employed by an entity licensed by the Department under the
Nursing Home Care Act or the Home Health, Home Services, and
Home Nursing Agency Licensing Act.
(Source: P.A. 103-444, eff. 1-1-24.)
(210 ILCS 9/80)
Sec. 80. Involuntary termination of residency.
(a) Residency shall be involuntarily terminated only for
the following reasons:
(1) as provided in Section 75 of this Act;
(2) nonpayment of contracted charges after the

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resident and the resident's representative have received a
minimum of 30 days' 30-days written notice of the
delinquency and the resident or the resident's
representative has had at least 15 days to cure the
delinquency; or
(3) failure to execute a service delivery contract or
to substantially comply with its terms and conditions,
failure to comply with the assessment requirements
contained in Section 15, or failure to substantially
comply with the terms and conditions of the lease
agreement.
(b) A 30-day 30 day written notice of residency
termination shall be provided to the resident, the resident's
representative, or both, the Department, and the long term
care ombudsman, which shall include the reason for the pending
action, the date of the proposed move, and a notice, the
content and form to be set forth by rule, of the resident's
right to appeal, the steps that the resident or the resident's
representative must take to initiate an appeal, and a
statement of the resident's right to continue to reside in the
establishment until a decision is rendered. The notice shall
include a toll free telephone number to initiate an appeal and
a written hearing request form, together with a postage paid,
pre-addressed envelope to the Department. If the resident or
the resident's representative, if any, cannot read English,
the notice must be provided in a language the individual

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receiving the notice can read or the establishment must
provide a translator who has been trained to assist the
resident or the resident's representative in the appeal
process. In emergency situations as defined in Section 10 of
this Act, the 30-day provision of the written notice may be
waived.
(c) The establishment shall attempt to resolve with the
resident or the resident's representative, if any,
circumstances that if not remedied have the potential of
resulting in an involuntary termination of residency and shall
document those efforts in the resident's file. This action may
occur prior to or during the 30 day notice period, but must
occur prior to the termination of the residency. In emergency
situations as defined in Section 10 of this Act, the
requirements of this subsection may be waived.
(d) A request for a hearing shall stay an involuntary
termination of residency until a decision has been rendered by
the Department, according to a process adopted by rule. During
this time period, the establishment may not terminate or
reduce any service without the consent of the resident or the
resident's representative, if any, for the purpose of making
it more difficult or impossible for the resident to remain in
the establishment.
(e) The establishment shall offer the resident and the
resident's representative, if any, resident and the resident's
representative, if any, residency termination and relocation

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assistance including information on available alternative
placement. Residents shall be involved in planning the move
and shall choose among the available alternative placements
except when an emergency situation makes prior resident
involvement impossible. Emergency placements are deemed
temporary until the resident's input can be sought in the
final placement decision. No resident shall be forced to
remain in a temporary or permanent placement.
(f) The Department may offer assistance to the
establishment and the resident in the preparation of residency
termination and relocation plans to assure safe and orderly
transition and to protect the resident's health, safety,
welfare, and rights. In nonemergencies, and where possible in
emergencies, the transition plan shall be designed and
implemented in advance of transfer or residency termination.
(g) An establishment may not initiate a termination of
residency due to an emergency situation if the establishment
is able to safely care for the resident and (1) a resident has
been hospitalized and the resident's physician states that
returning to the establishment would not create an imminent
danger of death or serious physical harm to a resident; or (2)
the emergency can be negated by changes in staffing,
activities, health care, personal care, or rooming
accommodations, consistent with the license of the
establishment. The Department may not find an establishment to
be in violation of Section 75 of this Act for failing to

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initiate an emergency discharge in these circumstances.
(h) If the Department determines that an involuntary
termination of residency does not meet the requirements of
this Act, the Department shall issue a written decision
stating that the involuntary termination of residency is
denied. If the action of the establishment giving rise to the
request for hearings is the establishment's failure to readmit
the resident following hospitalization, other medical leave of
absence, or other absence, the Department shall order the
immediate readmission of the resident to the establishment.
(i) If an order to readmit is entered pursuant to
subsection (h), the establishment shall immediately comply. As
used in this subsection, "comply" means the establishment and
the resident have agreed on a schedule for readmission or the
resident is living in the establishment. If the resident,
resident's representative, a long-term care ombudsman, or any
other individual notifies the Department that the
establishment is not complying with an agreed-upon schedule,
or that the establishment is not complying with the
representation described in subsection (k), a surveyor shall
make an on-site inspection to determine compliance.
(j) An establishment that does not readmit a resident
after the Department has ordered readmission shall be assessed
a fine in accordance with a Type 1 violation. Additionally, a
daily fine of $1,250 beginning on the third day after the
readmission order was issued by the Department shall be

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assessed. This fine shall be imposed for every day thereafter,
until the establishment notifies the Department that it is in
compliance with the order and a surveyor makes an on-site
inspection to determine if there is compliance or the resident
confirms to the Department that there is compliance, as
defined in subsection (i) of this Section. The establishment
shall be required to submit an acceptable plan of correction
to the Department within 30 days after the violation is
affirmed.
(k) Once a notice of appeal is filed, the Department shall
hold a hearing unless the notice of appeal is withdrawn. If the
notice of appeal is withdrawn based upon a representation made
by the establishment to the resident and the Department,
including the hearing officer, that a resident who has been
previously denied readmission will be readmitted, failure to
comply with the representation shall be considered a failure
to comply with a Department order pursuant to subsection (h)
and shall result in the imposition of a fine as provided in
subsection (j) of this Section.
(l) A long term care ombudsman may request a hearing on
behalf of a resident and secure representation of a resident
if, in the judgment of the long term care ombudsman, doing so
is in the best interests of the resident and the resident does
not object.
(Source: P.A. 91-656, eff. 1-1-01.)

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(210 ILCS 9/90)
Sec. 90. Contents of service delivery contract. A contract
between an establishment and a resident must be entitled
"assisted living establishment contract" or "shared housing
establishment contract" as applicable, shall be printed in no
less than 12 point type, and shall include at least the
following elements in the body or through supporting documents
or attachments:
(1) the name, street address, and mailing address of
the establishment;
(2) the name and mailing address of the owner or
owners of the establishment and, if the owner or owners
are not natural persons, the type of business entity of
the owner or owners;
(3) the name and mailing address of the managing agent
of the establishment, whether hired under a management
agreement or lease agreement, if the managing agent is
different from the owner or owners;
(4) the name and address of at least one natural
person who is authorized to accept service on behalf of
the owners and managing agent;
(5) a statement describing the license status of the
establishment and the license status of all providers of
health-related or supportive services to a resident under
arrangement with the establishment;
(6) the duration of the contract;

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(7) the base rate to be paid by the resident and a
description of the services to be provided as part of this
rate;
(8) a description of any additional services to be
provided for an additional fee by the establishment
directly or by a third party provider under arrangement
with the establishment;
(9) the fee schedules outlining the cost of any
additional services;
(10) a description of the process through which the
contract may be modified, amended, or terminated;
(11) a description of the establishment's complaint
resolution process available to residents and notice of
the availability of the Department on Aging's Senior
Helpline for complaints;
(12) the name of the resident's designated
representative, if any;
(13) the resident's obligations in order to maintain
residency and receive services including compliance with
all assessments required under Section 15;
(14) the billing and payment procedures and
requirements;
(15) a statement affirming the resident's freedom to
receive services from service providers with whom the
establishment does not have a contractual arrangement,
which may also disclaim liability on the part of the

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establishment for those services;
(16) a statement that medical assistance under Article
V or Article VI of the Illinois Public Aid Code is not
available for payment for services provided in an
establishment, excluding contracts executed with residents
residing in licensed establishments participating in the
Department on Aging's Comprehensive Care in Residential
Settings Demonstration Project;
(17) a statement detailing the admission, risk
management, and residency termination criteria and
procedures;
(18) a written explanation, prepared by the Office of
State Long Term Care Ombudsman, statement listing the
rights specified in Sections 80 and Section 95, including
an acknowledgment by the establishment and acknowledging
that, by contracting with the assisted living or shared
housing establishment, the resident does not forfeit those
rights;
(19) a statement detailing the Department's annual
on-site review process including what documents contained
in a resident's personal file shall be reviewed by the
on-site reviewer as defined by rule; and
(20) a statement outlining whether the establishment
charges a community fee and, if so, the amount of the fee
and whether it is refundable; if the fee is refundable,
the contract must describe the conditions under which it

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is refundable and how the amount of the refund is
determined.
(Source: P.A. 93-775, eff. 1-1-05; 94-256, eff. 7-19-05.)
(210 ILCS 9/95)
Sec. 95. Resident rights. No resident shall be deprived of
any rights, benefits, or privileges guaranteed by law, the
Constitution of the State of Illinois, or the Constitution of
the United States solely on account of his or her status as a
resident of an establishment, nor shall a resident forfeit any
of the following rights:
(1) the right to retain and use personal property and
a place to store personal items that is locked and secure;
(2) the right to refuse services and to be advised of
the consequences of that refusal;
(3) the right to respect for bodily privacy and
dignity at all times, especially during care and
treatment;
(4) the right to the free exercise of religion;
(5) the right to privacy with regard to mail, phone
calls, and visitors;
(6) the right to uncensored access to the State
Ombudsman or his or her designee;
(7) the right to be free of retaliation for
criticizing the establishment or making complaints to
appropriate agencies;

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(8) the right to be free of chemical and physical
restraints;
(9) the right to be free of abuse or neglect or to
refuse to perform labor;
(10) the right to confidentiality of the resident's
medical records;
(11) the right of access and the right to copy the
resident's personal files maintained by the establishment;
(12) the right to 24 hours access to the
establishment;
(13) the right to a minimum of 90 days' 90-days notice
of a planned establishment closure;
(14) the right to a minimum of 30 days' 30-days notice
of an involuntary residency termination, except where the
resident poses a threat to himself or others, or in other
emergency situations, and the right to appeal such
termination; if an establishment withdraws a notice of
involuntary termination of residency, then the resident
has the right to maintain residency at the establishment;
and
(15) the right to a 30-day notice of delinquency and
at least 15 days right to cure delinquency; .
(16) the right to not be unlawfully transferred or
discharged;
(17) the right to retain residency during any hospital
stay totaling 10 days or less following a hospital

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admission; and
(18) the right not to be charged for any period during
which the resident was unlawfully denied residency.
(Source: P.A. 91-656, eff. 1-1-01.)
Section 10. The Nursing Home Care Act is amended by
changing Sections 1-111, 1-114.005, 1-128, 2-104, 2-111,
3-401, 3-401.1, 3-402, 3-404, 3-405, 3-410, 3-411, and 3-413
and by adding Sections 3-305.6 and 3-413.1 as follows:
(210 ILCS 45/1-111) (from Ch. 111 1/2, par. 4151-111)
Sec. 1-111. "Discharge" means the full release of any
resident from a facility. "Discharge" includes a nursing
facility's failure to readmit following hospitalization, other
medical leave, or other absence.
(Source: P.A. 81-223.)
(210 ILCS 45/1-114.005)
Sec. 1-114.005. High risk designation. "High risk
designation" means a violation of a provision of the Illinois
Administrative Code or statute that has been identified by the
Department through rulemaking or designated in statute to be
inherently necessary to protect the health, safety, and
welfare of a resident. "High risk designation" includes an
unlawful discharge of a resident.
(Source: P.A. 96-1372, eff. 7-29-10.)

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(210 ILCS 45/1-128) (from Ch. 111 1/2, par. 4151-128)
Sec. 1-128. "Transfer" means a change in status of a
resident's living arrangements from one facility to another
facility. "Transfer" includes a nursing facility's failure to
readmit a resident following hospitalization, other medical
leave, or other absence, resulting in the resident being moved
to another institutional setting.
(Source: P.A. 81-223.)
(210 ILCS 45/2-104) (from Ch. 111 1/2, par. 4152-104)
Sec. 2-104. (a) A resident shall be permitted to retain
the services of his own personal physician at his own expense
or under an individual or group plan of health insurance, or
under any public or private assistance program providing such
coverage. However, the facility is not liable for the
negligence of any such personal physician. Every resident
shall be permitted to obtain from his own physician or the
physician attached to the facility complete and current
information concerning his medical diagnosis, treatment and
prognosis in terms and language the resident can reasonably be
expected to understand. Every resident shall be permitted to
participate in the planning of his total care and medical
treatment to the extent that his condition permits. No
resident shall be subjected to experimental research or
treatment without first obtaining his informed, written

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consent. The conduct of any experimental research or treatment
shall be authorized and monitored by an institutional review
board appointed by the Director. The membership, operating
procedures and review criteria for the institutional review
board shall be prescribed under rules and regulations of the
Department and shall comply with the requirements for
institutional review boards established by the federal Food
and Drug Administration. No person who has received
compensation in the prior 3 years from an entity that
manufactures, distributes, or sells pharmaceuticals,
biologics, or medical devices may serve on the institutional
review board.
The institutional review board may approve only research
or treatment that meets the standards of the federal Food and
Drug Administration with respect to (i) the protection of
human subjects and (ii) financial disclosure by clinical
investigators. The Office of State Long Term Care Ombudsman
and the State Protection and Advocacy organization shall be
given an opportunity to comment on any request for approval
before the board makes a decision. Those entities shall not be
provided information that would allow a potential human
subject to be individually identified, unless the board asks
the Ombudsman for help in securing information from or about
the resident. The board shall require frequent reporting of
the progress of the approved research or treatment and its
impact on residents, including immediate reporting of any

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adverse impact to the resident, the resident's representative,
the Office of the State Long Term Care Ombudsman, and the State
Protection and Advocacy organization. The board may not
approve any retrospective study of the records of any resident
about the safety or efficacy of any care or treatment if the
resident was under the care of the proposed researcher or a
business associate when the care or treatment was given,
unless the study is under the control of a researcher without
any business relationship to any person or entity who could
benefit from the findings of the study.
No facility shall permit experimental research or
treatment to be conducted on a resident, or give access to any
person or person's records for a retrospective study about the
safety or efficacy of any care or treatment, without the prior
written approval of the institutional review board. No nursing
home administrator, or person licensed by the State to provide
medical care or treatment to any person, may assist or
participate in any experimental research on or treatment of a
resident, including a retrospective study, that does not have
the prior written approval of the board. Such conduct shall be
grounds for professional discipline by the Department of
Financial and Professional Regulation.
The institutional review board may exempt from ongoing
review research or treatment initiated on a resident before
the individual's admission to a facility and for which the
board determines there is adequate ongoing oversight by

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another institutional review board. Nothing in this Section
shall prevent a facility, any facility employee, or any other
person from assisting or participating in any experimental
research on or treatment of a resident, if the research or
treatment began before the person's admission to a facility,
until the board has reviewed the research or treatment and
decided to grant or deny approval or to exempt the research or
treatment from ongoing review.
The institutional review board requirements of this
subsection (a) do not apply to investigational drugs,
biological products, or devices used by a resident with a
terminal illness as set forth in the Right to Try Act.
(b) All medical treatment and procedures shall be
administered as ordered by a physician. All new physician
orders shall be reviewed by the facility's director of nursing
or charge nurse designee within 24 hours after such orders
have been issued to assure facility compliance with such
orders.
All physician's orders and plans of treatment shall have
the authentication of the physician. For the purposes of this
subsection (b), "authentication" means an original written
signature or an electronic signature system that allows for
the verification of a signer's credentials. A stamp signature,
with or without initials, is not sufficient.
According to rules adopted by the Department, every woman
resident of child-bearing age shall receive routine

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obstetrical and gynecological evaluations as well as necessary
prenatal care.
(c) Every resident shall be permitted to refuse medical
treatment and to know the consequences of such action, unless
such refusal would be harmful to the health and safety of
others and such harm is documented by a physician in the
resident's clinical record. The resident's refusal shall free
the facility from the obligation to provide the treatment. If
a resident's refusal of treatment does not endanger other
residents or staff, then the refusal of treatment is not
grounds for discharge.
(d) Every resident, resident's guardian, or parent if the
resident is a minor shall be permitted to inspect and copy all
his clinical and other records concerning his care and
maintenance kept by the facility or by his physician. The
facility may charge a reasonable fee for duplication of a
record.
(Source: P.A. 99-270, eff. 1-1-16.)
(210 ILCS 45/2-111) (from Ch. 111 1/2, par. 4152-111)
Sec. 2-111. A resident shall not be transferred or
discharged in violation of this Act. A resident may not be
charged for any period during which the resident was
unlawfully denied the right to reside in a facility. A
resident may be discharged from a facility after he gives the
administrator, a physician, or a nurse of the facility written

SB3723 - 32 - LRB103 36302 CES 66400 b
notice of his desire to be discharged. If a guardian has been
appointed for a resident or if the resident is a minor, the
resident shall be discharged upon written consent of his
guardian or if the resident is a minor, his parent unless there
is a court order to the contrary. In such cases, upon the
resident's discharge, the facility is relieved from any
responsibility for the resident's care, safety or well-being.
A resident has the right to not be unlawfully transferred or
discharged. An unlawful transfer or discharge is, at minimum,
a Type A violation.
(Source: P.A. 81-223.)
(210 ILCS 45/3-305.6 new)
Sec. 3-305.6. Failure to readmit a resident. A facility
that fails to comply with an order of the Department to readmit
a resident who wishes to return to the facility and is
appropriate for that level of care, shall be assessed a fine in
accordance with a Type A violation. Additionally, a daily fine
of $1,250 beginning on the third day after the readmission
order was issued by the Department shall be assessed. This
fine shall be imposed for every day thereafter, until the
facility notifies the Department that it is in compliance with
the order and a surveyor conducts an on-site inspection that
confirms compliance or the resident or resident's
representative confirms to the Department in writing that
there is compliance.

SB3723 - 33 - LRB103 36302 CES 66400 b
As used in this Section, "compliance with the order" means
a resident is living in a facility, or a facility and a
resident have agreed on a schedule for readmission. If a
resident subsequently notifies the Department that a facility
is not complying with an agreed-upon schedule, a surveyor
shall make an on-site inspection to determine compliance.
(210 ILCS 45/3-401) (from Ch. 111 1/2, par. 4153-401)
Sec. 3-401. A facility may involuntarily transfer or
discharge a resident only for one or more of the following
reasons:
(a) the facility is unable to meet the medical needs
of the resident, as documented in the resident's clinical
record by the resident's physician for medical reasons for
medical reasons;
(b) for the resident's physical safety;
(c) for the physical safety of other residents, the
facility staff or facility visitors; or
(d) for either late payment or nonpayment for the
resident's stay, except as prohibited by Titles XVIII and
XIX of the federal Social Security Act. For purposes of
this Section, "late payment" means non-receipt of payment
after submission of a bill. If payment is not received
within 45 days after submission of a bill, a facility may
send a notice to the resident and responsible party
requesting payment within 30 days. If payment is not

SB3723 - 34 - LRB103 36302 CES 66400 b
received within such 30 days, the facility may thereupon
institute transfer or discharge proceedings by sending a
notice of transfer or discharge to the resident and
responsible party by registered or certified mail. The
notice shall state, in addition to the requirements of
Section 3-403 of this Act, that the responsible party has
the right to pay the amount of the bill in full up to the
date the transfer or discharge is to be made and then the
resident shall have the right to remain in the facility.
Such payment shall terminate the transfer or discharge
proceedings. This subsection does not apply to those
residents whose care is provided for under the Illinois
Public Aid Code. The Department shall adopt rules setting
forth the criteria and procedures to be applied in cases
of involuntary transfer or discharge permitted under this
Section.
In nonemergency situations, prior to issuing the notice of
transfer or discharge of a resident under subsection (a), (b),
or (c) of this Section, an attending physician shall conduct
an in-person assessment and provide an explanation that in the
physician's medical opinion, the safety threshold under the
Act and the federal regulations has or has not been breached
with the findings documented in the resident's clinical
record. When the resident has the resident's own physician,
that physician and not a physician working for the facility
should be the physician that conducts the in-person assessment

SB3723 - 35 - LRB103 36302 CES 66400 b
of the resident. In the absence of other bases for transfer or
discharge in this Section, unless it has complied with the
prior notice and other procedural requirements of this Act, a
facility may not refuse to readmit a resident following a
medical leave of absence if the resident's need for care does
not exceed the provisions of the facility's license.
(Source: P.A. 91-357, eff. 7-29-99.)
(210 ILCS 45/3-401.1) (from Ch. 111 1/2, par. 4153-401.1)
Sec. 3-401.1. (a) A facility participating in the Medical
Assistance Program is prohibited from failing or refusing to
retain as a resident any person because he or she is a
recipient of or an applicant for the Medical Assistance
Program. A resident who is in the process of appealing the
denial of his or her application for the Medical Assistance
Program is considered to be a Medicaid applicant under this
Section.
(a-5) After the effective date of this amendatory Act of
1997, a facility of which only a distinct part is certified to
participate in the Medical Assistance Program may refuse to
retain as a resident any person who resides in a part of the
facility that does not participate in the Medical Assistance
Program and who is unable to pay for his or her care in the
facility without Medical Assistance only if:
(1) the facility, no later than at the time of
admission and at the time of the resident's contract

SB3723 - 36 - LRB103 36302 CES 66400 b
renewal, explains to the resident (unless he or she is
incompetent), and to the resident's representative, and to
the person making payment on behalf of the resident for
the resident's stay, in writing, that the facility may
discharge the resident if the resident is no longer able
to pay for his or her care in the facility without Medical
Assistance;
(2) the resident (unless he or she is incompetent),
the resident's representative, and the person making
payment on behalf of the resident for the resident's stay,
acknowledge in writing that they have received the written
explanation.
(a-10) For the purposes of this Section, a recipient or
applicant shall be considered a resident in the facility
during any hospital stay totaling 10 days or less following a
hospital admission. The Department of Healthcare and Family
Services shall recoup funds from a facility when, as a result
of the facility's refusal to readmit a recipient after
hospitalization for 10 days or less, the recipient incurs
hospital bills in an amount greater than the amount that would
have been paid by that Department (formerly the Illinois
Department of Public Aid) for care of the recipient in the
facility. The amount of the recoupment shall be the difference
between the Department of Healthcare and Family Services'
(formerly the Illinois Department of Public Aid's) payment for
hospital care and the amount that Department would have paid

SB3723 - 37 - LRB103 36302 CES 66400 b
for care in the facility.
(b) A facility which violates this Section shall be guilty
of a business offense and fined not less than $500 nor more
than $1,000 for the first offense and not less than $1,000 nor
more than $5,000 for each subsequent offense.
(Source: P.A. 95-331, eff. 8-21-07.)
(210 ILCS 45/3-402) (from Ch. 111 1/2, par. 4153-402)
Sec. 3-402. Involuntary transfer or discharge of a
resident from a facility shall be preceded by the discussion
required under Section 3-408 and by a minimum written notice
of 30 21 days, except in one of the following instances:
(a) When the resident's attending physician has completed
an assessment and determines the resident should be discharged
because of the resident's health care needs, an emergency
discharge may be ordered. When an emergency transfer or
discharge is ordered by the resident's attending physician
because of the resident's health care needs. The State Long
Term Care Ombudsman shall be notified at the time of the
emergency transfer or discharge.
(b) When the transfer or discharge is mandated by the
physical safety of other residents, the facility staff, or
facility visitors, as documented in the clinical record. The
Department, the Office of State Long Term Care Ombudsman, and
the resident's managed care organization, if applicable, and
the State Long Term Care Ombudsman shall be notified prior to

SB3723 - 38 - LRB103 36302 CES 66400 b
any such involuntary transfer or discharge. The Department
shall immediately offer transfer, or discharge and relocation
assistance to residents transferred or discharged under this
subparagraph (b), and the Department may place relocation
teams as provided in Section 3-419 of this Act.
(c) When an identified offender is within the provisional
admission period defined in Section 1-120.3. If the Identified
Offender Report and Recommendation prepared under Section
2-201.6 shows that the identified offender poses a serious
threat or danger to the physical safety of other residents,
the facility staff, or facility visitors in the admitting
facility and the facility determines that it is unable to
provide a safe environment for the other residents, the
facility staff, or facility visitors, the facility shall
transfer or discharge the identified offender within 3 days
after its receipt of the Identified Offender Report and
Recommendation.
(Source: P.A. 103-320, eff. 1-1-24.)
(210 ILCS 45/3-404) (from Ch. 111 1/2, par. 4153-404)
Sec. 3-404. A request for a hearing made under Section
3-403 shall stay a transfer or discharge pending a hearing or
appeal of the decision, unless a condition which would have
allowed transfer or discharge in less than 30 21 days as
described under paragraphs (a) and (b) of Section 3-402
develops in the interim.

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(Source: P.A. 81-223.)
(210 ILCS 45/3-405) (from Ch. 111 1/2, par. 4153-405)
Sec. 3-405. A copy of the notice required by Section 3-402
shall be placed in the resident's clinical record and a copy
shall be transmitted to the Department, the State Long Term
Care Ombudsman, the resident, and the resident's
representative, if any, the resident's managed care
organization, if applicable, and the Office of State Long Term
Care Ombudsman.
(Source: P.A. 103-320, eff. 1-1-24.)
(210 ILCS 45/3-410) (from Ch. 111 1/2, par. 4153-410)
Sec. 3-410. A resident subject to involuntary transfer or
discharge from a facility, the resident's guardian or if the
resident is a minor, his parent shall have the opportunity to
file a request for a hearing with the Department within 10 days
following receipt of the written notice of the involuntary
transfer or discharge by the facility. A long term care
ombudsman may request a hearing on behalf of the resident, and
secure representation for the resident, if, in the judgment of
the long term care ombudsman, doing so is in the best interests
of the resident, and the resident does not object.
(Source: P.A. 81-223.)
(210 ILCS 45/3-411) (from Ch. 111 1/2, par. 4153-411)

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Sec. 3-411. The Department of Public Health, when the
basis for involuntary transfer or discharge is other than
action by the Department of Healthcare and Family Services
(formerly Department of Public Aid) with respect to the Title
XIX Medicaid recipient, shall hold a hearing at the resident's
facility not later than 10 days after a hearing request is
filed, and render a decision within 14 days after the filing of
the hearing request. The Department has continuing
jurisdiction over the transfer or discharge irrespective of
the timing of the hearing and decision. Once a request for a
hearing is filed, the Department shall hold a hearing unless
the request is withdrawn by the resident. If the request for a
hearing is withdrawn based upon a representation made by the
facility to the resident and the Department, including the
hearing officer, that a resident who has been denied
readmission will be readmitted, and the resident or resident
representative notifies the Department that the facility is
still denying readmission, failure to readmit is considered
failure to comply with a Department order to readmit pursuant
to Section 3-305.6, including the imposition of a daily fine
under Section 3-305.6.
(Source: P.A. 95-331, eff. 8-21-07.)
(210 ILCS 45/3-413) (from Ch. 111 1/2, par. 4153-413)
Sec. 3-413. If the Department determines that a transfer
or discharge is authorized under Section 3-401, the resident

SB3723 - 41 - LRB103 36302 CES 66400 b
shall not be required to leave the facility before the 34th day
following receipt of the notice required under Section 3-402,
or the 10th day following receipt of the Department's
decision, whichever is later, unless a condition which would
have allowed transfer or discharge in less than 30 21 days as
described under paragraphs (a) and (b) of Section 3-402
develops in the interim. The Department maintains jurisdiction
over the transfer or discharge irrespective of the timing of
the notice and discharge.
(Source: P.A. 81-223.)
(210 ILCS 45/3-413.1 new)
Sec. 3-413.1. Denial of transfer or discharge. If the
Department determines that a transfer or discharge is not
authorized under Section 3-401, then the Department shall
issue a written decision stating that the transfer or
discharge is denied. If the action of the facility giving rise
to the request for hearings is the facility's failure to
readmit the resident following hospitalization, other medical
leave of absence, or other absence, then the Department shall
order the immediate readmission of the resident to the
facility. The facility shall comply with the order
immediately. A surveyor shall make an on-site inspection of
the facility's compliance with the order unless the resident
or resident representative notifies the Department in writing
that there is compliance.
SB3723 - 42 - LRB103 36302 CES 66400 b
INDEX
Statutes amended in order of appearance