HB3890 EnrolledLRB103 30120 CPF 56544 b HB3890 Enrolled LRB103 30120 CPF 56544 b
HB3890 Enrolled LRB103 30120 CPF 56544 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Hospital Licensing Act is amended by
5 changing Section 10.10 as follows:
6 (210 ILCS 85/10.10)
7 Sec. 10.10. Nurse Staffing by Patient Acuity.
8 (a) Findings. The Legislature finds and declares all of
9 the following:
10 (1) The State of Illinois has a substantial interest
11 in promoting quality care and improving the delivery of
12 health care services.
13 (2) Evidence-based studies have shown that the basic
14 principles of staffing in the acute care setting should be
15 based on the complexity of patients' care needs aligned
16 with available nursing skills to promote quality patient
17 care consistent with professional nursing standards.
18 (3) Compliance with this Section promotes an
19 organizational climate that values registered nurses'
20 input in meeting the health care needs of hospital
21 patients.
22 (b) Definitions. As used in this Section:
23 "Acuity model" means an assessment tool selected and
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1 implemented by a hospital, as recommended by a nursing care
2 committee, that assesses the complexity of patient care needs
3 requiring professional nursing care and skills and aligns
4 patient care needs and nursing skills consistent with
5 professional nursing standards.
6 "Department" means the Department of Public Health.
7 "Direct patient care" means care provided by a registered
8 professional nurse with direct responsibility to oversee or
9 carry out medical regimens or nursing care for one or more
10 patients.
11 "Nursing care committee" means a hospital-wide committee
12 or committees of nurses whose functions, in part or in whole,
13 contribute to the development, recommendation, and review of
14 the hospital's nurse staffing plan established pursuant to
15 subsection (d).
16 "Registered professional nurse" means a person licensed as
17 a Registered Nurse under the Nurse Practice Act.
18 "Written staffing plan for nursing care services" means a
19 written plan for the assignment of patient care nursing staff
20 based on multiple nurse and patient considerations that yield
21 minimum staffing levels for inpatient care units and the
22 adopted acuity model aligning patient care needs with nursing
23 skills required for quality patient care consistent with
24 professional nursing standards.
25 (c) Written staffing plan.
26 (1) Every hospital shall implement a written
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1 hospital-wide staffing plan, prepared by a nursing care
2 committee or committees, that provides for minimum direct
3 care professional registered nurse-to-patient staffing
4 needs for each inpatient care unit, including inpatient
5 emergency departments. If the staffing plan prepared by
6 the nursing care committee is not adopted by the hospital,
7 or if substantial changes are proposed to it, the chief
8 nursing officer shall either: (i) provide a written
9 explanation to the committee of the reasons the plan was
10 not adopted; or (ii) provide a written explanation of any
11 substantial changes made to the proposed plan prior to it
12 being adopted by the hospital. The written hospital-wide
13 staffing plan shall include, but need not be limited to,
14 the following considerations:
15 (A) The complexity of complete care, assessment on
16 patient admission, volume of patient admissions,
17 discharges and transfers, evaluation of the progress
18 of a patient's problems, ongoing physical assessments,
19 planning for a patient's discharge, assessment after a
20 change in patient condition, and assessment of the
21 need for patient referrals.
22 (B) The complexity of clinical professional
23 nursing judgment needed to design and implement a
24 patient's nursing care plan, the need for specialized
25 equipment and technology, the skill mix of other
26 personnel providing or supporting direct patient care,
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1 and involvement in quality improvement activities,
2 professional preparation, and experience.
3 (C) Patient acuity and the number of patients for
4 whom care is being provided.
5 (D) The ongoing assessments of a unit's patient
6 acuity levels and nursing staff needed shall be
7 routinely made by the unit nurse manager or his or her
8 designee.
9 (E) The identification of additional registered
10 nurses available for direct patient care when
11 patients' unexpected needs exceed the planned workload
12 for direct care staff.
13 (2) In order to provide staffing flexibility to meet
14 patient needs, every hospital shall identify an acuity
15 model for adjusting the staffing plan for each inpatient
16 care unit.
17 (2.5) Each hospital shall implement the staffing plan
18 and assign nursing personnel to each inpatient care unit,
19 including inpatient emergency departments, in accordance
20 with the staffing plan.
21 (A) A registered nurse may report to the nursing
22 care committee any variations where the nurse
23 personnel assignment in an inpatient care unit is not
24 in accordance with the adopted staffing plan and may
25 make a written report to the nursing care committee
26 based on the variations.
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1 (B) Shift-to-shift adjustments in staffing levels
2 required by the staffing plan may be made by the
3 appropriate hospital personnel overseeing inpatient
4 care operations. If a registered nurse in an inpatient
5 care unit objects to a shift-to-shift adjustment, the
6 registered nurse may submit a written report to the
7 nursing care committee.
8 (C) The nursing care committee shall develop a
9 process to examine and respond to written reports
10 submitted under subparagraphs (A) and (B) of this
11 paragraph (2.5), including the ability to determine if
12 a specific written report is resolved or should be
13 dismissed.
14 (3) The written staffing plan shall be posted, either
15 by physical or electronic means, in a conspicuous and
16 accessible location for both patients and direct care
17 staff, as required under the Hospital Report Card Act. A
18 copy of the written staffing plan shall be provided to any
19 member of the general public upon request.
20 (d) Nursing care committee.
21 (1) Every hospital shall have a nursing care committee
22 that meets at least 6 times per year. A hospital shall
23 appoint members of a committee whereby at least 55% of the
24 members are registered professional nurses providing
25 direct inpatient care, one of whom shall be selected
26 annually by the direct inpatient care nurses to serve as
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1 co-chair of the committee.
2 (2) (Blank).
3 (2.5) A nursing care committee shall prepare and
4 recommend to hospital administration the hospital's
5 written hospital-wide staffing plan. If the staffing plan
6 is not adopted by the hospital, the chief nursing officer
7 shall provide a written statement to the committee prior
8 to a staffing plan being adopted by the hospital that: (A)
9 explains the reasons the committee's proposed staffing
10 plan was not adopted; and (B) describes the changes to the
11 committee's proposed staffing or any alternative to the
12 committee's proposed staffing plan.
13 (3) A nursing care committee's or committees' written
14 staffing plan for the hospital shall be based on the
15 principles from the staffing components set forth in
16 subsection (c). In particular, a committee or committees
17 shall provide input and feedback on the following:
18 (A) Selection, implementation, and evaluation of
19 minimum staffing levels for inpatient care units.
20 (B) Selection, implementation, and evaluation of
21 an acuity model to provide staffing flexibility that
22 aligns changing patient acuity with nursing skills
23 required.
24 (C) Selection, implementation, and evaluation of a
25 written staffing plan incorporating the items
26 described in subdivisions (c)(1) and (c)(2) of this
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1 Section.
2 (D) Review the nurse staffing plans for all
3 inpatient areas and current acuity tools and measures
4 in use. The nursing care committee's review shall
5 consider:
6 (i) patient outcomes;
7 (ii) complaints regarding staffing, including
8 complaints about a delay in direct care nursing or
9 an absence of direct care nursing;
10 (iii) the number of hours of nursing care
11 provided through an inpatient hospital unit
12 compared with the number of inpatients served by
13 the hospital unit during a 24-hour period;
14 (iv) the aggregate hours of overtime worked by
15 the nursing staff;
16 (v) the extent to which actual nurse staffing
17 for each hospital inpatient unit differs from the
18 staffing specified by the staffing plan; and
19 (vi) any other matter or change to the
20 staffing plan determined by the committee to
21 ensure that the hospital is staffed to meet the
22 health care needs of patients.
23 (4) A nursing care committee must issue a written
24 report addressing the items described in subparagraphs (A)
25 through (D) of paragraph (3) semi-annually. A written copy
26 of this report shall be made available to direct inpatient
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1 care nurses by making available a paper copy of the
2 report, distributing it electronically, or posting it on
3 the hospital's website.
4 (5) A nursing care committee must issue a written
5 report at least annually to the hospital governing board
6 that addresses items including, but not limited to: the
7 items described in paragraph (3); changes made based on
8 committee recommendations and the impact of such changes;
9 and recommendations for future changes related to nurse
10 staffing.
11 (6) A nursing care committee must annually notify the
12 hospital nursing staff of the staff's rights under this
13 Section. The annual notice must provide a phone number and
14 an email address for staff to report noncompliance with
15 the nursing staff's rights as described in this Section.
16 The notice must be provided by email or by regular mail in
17 a manner that effectively facilitates receipt of the
18 notice. The Department shall monitor and enforce the
19 requirements of this paragraph (6).
20 (e) Nothing in this Section 10.10 shall be construed to
21 limit, alter, or modify any of the terms, conditions, or
22 provisions of a collective bargaining agreement entered into
23 by the hospital.
24 (f) No hospital may discipline, discharge, or take any
25 other adverse employment action against an employee solely
26 because the employee expresses a concern or complaint
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1 regarding an alleged violation of this Section or concerns
2 related to nurse staffing.
3 (g) Any employee of a hospital may file a complaint with
4 the Department regarding an alleged violation of this Section.
5 The Department must forward notification of the alleged
6 violation to the hospital in question within 10 business days
7 after the complaint is filed. Upon receiving a complaint of a
8 violation of this Section, the Department may take any action
9 authorized under Sections 7 or 9 of this Act.
10 (Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
11 102-813, eff. 5-13-22.)
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