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Illinois House Bill HB3171

Illinois 2025-2026 Regular Session

Illinois House Bill HB3171 Compare Versions

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11 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3171 Introduced , by Rep. Yolonda Morris SYNOPSIS AS INTRODUCED: 210 ILCS 45/3-202.05210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209 Amends the Nursing Home Care Act. In provisions concerning monetary penalties for noncompliance with minimum staffing standards, provides that monetary penalties shall be established based on a formula that calculates on a quarterly basis (instead of a daily basis). Provides that the monetary penalty may not be waived, except where there is no more than a 10% deviation from the staffing requirements, in which case the facility shall not receive a penalty. Makes changes regarding the notice that a facility that has received a notice of violation for a violation of the minimum staffing requirements shall display. Effective immediately. LRB104 08075 BAB 18121 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3171 Introduced , by Rep. Yolonda Morris SYNOPSIS AS INTRODUCED: 210 ILCS 45/3-202.05210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209 210 ILCS 45/3-202.05 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209 Amends the Nursing Home Care Act. In provisions concerning monetary penalties for noncompliance with minimum staffing standards, provides that monetary penalties shall be established based on a formula that calculates on a quarterly basis (instead of a daily basis). Provides that the monetary penalty may not be waived, except where there is no more than a 10% deviation from the staffing requirements, in which case the facility shall not receive a penalty. Makes changes regarding the notice that a facility that has received a notice of violation for a violation of the minimum staffing requirements shall display. Effective immediately. LRB104 08075 BAB 18121 b LRB104 08075 BAB 18121 b A BILL FOR
22 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3171 Introduced , by Rep. Yolonda Morris SYNOPSIS AS INTRODUCED:
33 210 ILCS 45/3-202.05210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209 210 ILCS 45/3-202.05 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209
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66 Amends the Nursing Home Care Act. In provisions concerning monetary penalties for noncompliance with minimum staffing standards, provides that monetary penalties shall be established based on a formula that calculates on a quarterly basis (instead of a daily basis). Provides that the monetary penalty may not be waived, except where there is no more than a 10% deviation from the staffing requirements, in which case the facility shall not receive a penalty. Makes changes regarding the notice that a facility that has received a notice of violation for a violation of the minimum staffing requirements shall display. Effective immediately.
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1212 1 AN ACT concerning regulation.
1313 2 Be it enacted by the People of the State of Illinois,
1414 3 represented in the General Assembly:
1515 4 Section 5. The Nursing Home Care Act is amended by
1616 5 changing Sections 3-202.05 and 3-209 as follows:
1717 6 (210 ILCS 45/3-202.05)
1818 7 Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
1919 8 thereafter.
2020 9 (a) For the purpose of computing staff to resident ratios,
2121 10 direct care staff shall include:
2222 11 (1) registered nurses;
2323 12 (2) licensed practical nurses;
2424 13 (3) certified nurse assistants;
2525 14 (4) psychiatric services rehabilitation aides;
2626 15 (5) rehabilitation and therapy aides;
2727 16 (6) psychiatric services rehabilitation coordinators;
2828 17 (7) assistant directors of nursing;
2929 18 (8) 50% of the Director of Nurses' time; and
3030 19 (9) 30% of the Social Services Directors' time.
3131 20 The Department shall, by rule, allow certain facilities
3232 21 subject to 77 Ill. Adm. Code 300.4000 and following (Subpart
3333 22 S) to utilize specialized clinical staff, as defined in rules,
3434 23 to count towards the staffing ratios.
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3838 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 HB3171 Introduced , by Rep. Yolonda Morris SYNOPSIS AS INTRODUCED:
3939 210 ILCS 45/3-202.05210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209 210 ILCS 45/3-202.05 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209
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4141 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209
4242 Amends the Nursing Home Care Act. In provisions concerning monetary penalties for noncompliance with minimum staffing standards, provides that monetary penalties shall be established based on a formula that calculates on a quarterly basis (instead of a daily basis). Provides that the monetary penalty may not be waived, except where there is no more than a 10% deviation from the staffing requirements, in which case the facility shall not receive a penalty. Makes changes regarding the notice that a facility that has received a notice of violation for a violation of the minimum staffing requirements shall display. Effective immediately.
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7171 1 Within 120 days of June 14, 2012 (the effective date of
7272 2 Public Act 97-689), the Department shall promulgate rules
7373 3 specific to the staffing requirements for facilities federally
7474 4 defined as Institutions for Mental Disease. These rules shall
7575 5 recognize the unique nature of individuals with chronic mental
7676 6 health conditions, shall include minimum requirements for
7777 7 specialized clinical staff, including clinical social workers,
7878 8 psychiatrists, psychologists, and direct care staff set forth
7979 9 in paragraphs (4) through (6) and any other specialized staff
8080 10 which may be utilized and deemed necessary to count toward
8181 11 staffing ratios.
8282 12 Within 120 days of June 14, 2012 (the effective date of
8383 13 Public Act 97-689), the Department shall promulgate rules
8484 14 specific to the staffing requirements for facilities licensed
8585 15 under the Specialized Mental Health Rehabilitation Act of
8686 16 2013. These rules shall recognize the unique nature of
8787 17 individuals with chronic mental health conditions, shall
8888 18 include minimum requirements for specialized clinical staff,
8989 19 including clinical social workers, psychiatrists,
9090 20 psychologists, and direct care staff set forth in paragraphs
9191 21 (4) through (6) and any other specialized staff which may be
9292 22 utilized and deemed necessary to count toward staffing ratios.
9393 23 (b) (Blank).
9494 24 (b-5) For purposes of the minimum staffing ratios in this
9595 25 Section, all residents shall be classified as requiring either
9696 26 skilled care or intermediate care.
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107107 1 As used in this subsection:
108108 2 "Intermediate care" means basic nursing care and other
109109 3 restorative services under periodic medical direction.
110110 4 "Skilled care" means skilled nursing care, continuous
111111 5 skilled nursing observations, restorative nursing, and other
112112 6 services under professional direction with frequent medical
113113 7 supervision.
114114 8 (c) Facilities shall notify the Department within 60 days
115115 9 after July 29, 2010 (the effective date of Public Act
116116 10 96-1372), in a form and manner prescribed by the Department,
117117 11 of the staffing ratios in effect on July 29, 2010 (the
118118 12 effective date of Public Act 96-1372) for both intermediate
119119 13 and skilled care and the number of residents receiving each
120120 14 level of care.
121121 15 (d)(1) (Blank).
122122 16 (2) (Blank).
123123 17 (3) (Blank).
124124 18 (4) (Blank).
125125 19 (5) Effective January 1, 2014, the minimum staffing ratios
126126 20 shall be increased to 3.8 hours of nursing and personal care
127127 21 each day for a resident needing skilled care and 2.5 hours of
128128 22 nursing and personal care each day for a resident needing
129129 23 intermediate care.
130130 24 (e) Ninety days after June 14, 2012 (the effective date of
131131 25 Public Act 97-689), a minimum of 25% of nursing and personal
132132 26 care time shall be provided by licensed nurses, with at least
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143143 1 10% of nursing and personal care time provided by registered
144144 2 nurses. These minimum requirements shall remain in effect
145145 3 until an acuity based registered nurse requirement is
146146 4 promulgated by rule concurrent with the adoption of the
147147 5 Resource Utilization Group classification-based payment
148148 6 methodology, as provided in Section 5-5.2 of the Illinois
149149 7 Public Aid Code. Registered nurses and licensed practical
150150 8 nurses employed by a facility in excess of these requirements
151151 9 may be used to satisfy the remaining 75% of the nursing and
152152 10 personal care time requirements. Notwithstanding this
153153 11 subsection, no staffing requirement in statute in effect on
154154 12 June 14, 2012 (the effective date of Public Act 97-689) shall
155155 13 be reduced on account of this subsection.
156156 14 (f) The Department shall submit proposed rules for
157157 15 adoption by January 1, 2020 establishing a system for
158158 16 determining compliance with minimum staffing set forth in this
159159 17 Section and the requirements of 77 Ill. Adm. Code 300.1230
160160 18 adjusted for any waivers granted under Section 3-303.1.
161161 19 Compliance shall be determined quarterly by comparing the
162162 20 number of hours provided per resident per day using the
163163 21 Centers for Medicare and Medicaid Services' payroll-based
164164 22 journal and the facility's daily census, broken down by
165165 23 intermediate and skilled care as self-reported by the facility
166166 24 to the Department on a quarterly basis. The Department shall
167167 25 use the quarterly payroll-based journal and the self-reported
168168 26 census to calculate the number of hours provided per resident
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179179 1 per day and compare this ratio to the minimum staffing
180180 2 standards required under this Section, as impacted by any
181181 3 waivers granted under Section 3-303.1. Discrepancies between
182182 4 job titles contained in this Section and the payroll-based
183183 5 journal shall be addressed by rule. The manner in which the
184184 6 Department requests payroll-based journal information to be
185185 7 submitted shall align with the federal Centers for Medicare
186186 8 and Medicaid Services' requirements that allow providers to
187187 9 submit the quarterly data in an aggregate manner.
188188 10 (g) Monetary penalties for non-compliance. The Department
189189 11 shall submit proposed rules for adoption by January 1, 2020
190190 12 establishing monetary penalties for facilities not in
191191 13 compliance with minimum staffing standards under this Section.
192192 14 Facilities shall be required to comply with the provisions of
193193 15 this subsection beginning January 1, 2025. No monetary penalty
194194 16 may be issued for noncompliance prior to the revised
195195 17 implementation date, which shall be January 1, 2025. If a
196196 18 facility is found to be noncompliant prior to the revised
197197 19 implementation date, the Department shall provide a written
198198 20 notice identifying the staffing deficiencies and require the
199199 21 facility to provide a sufficiently detailed correction plan
200200 22 that describes proposed and completed actions the facility
201201 23 will take or has taken, including hiring actions, to address
202202 24 the facility's failure to meet the statutory minimum staffing
203203 25 levels. Monetary penalties shall be imposed beginning no later
204204 26 than July 1, 2025, based on data for the quarter beginning
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215215 1 January 1, 2025 through March 31, 2025 and quarterly
216216 2 thereafter. Monetary penalties shall be established based on a
217217 3 formula that calculates on a quarterly daily basis the cost of
218218 4 wages and benefits for the missing staffing hours. All notices
219219 5 of noncompliance shall include the computations used to
220220 6 determine noncompliance and establishing the variance between
221221 7 minimum staffing ratios and the Department's computations. The
222222 8 penalty for the first offense shall be 125% of the cost of
223223 9 wages and benefits for the missing staffing hours. The penalty
224224 10 shall increase to 150% of the cost of wages and benefits for
225225 11 the missing staffing hours for the second offense and 200% the
226226 12 cost of wages and benefits for the missing staffing hours for
227227 13 the third and all subsequent offenses. The penalty shall be
228228 14 imposed regardless of whether the facility has committed other
229229 15 violations of this Act during the same period that the
230230 16 staffing offense occurred. The penalty may not be waived,
231231 17 except but the Department shall have the discretion to
232232 18 determine the gravity of the violation in situations where
233233 19 there is no more than a 10% deviation from the staffing
234234 20 requirements, in which case the facility shall not receive a
235235 21 penalty and make appropriate adjustments to the penalty. The
236236 22 Department shall is granted discretion to waive the penalty
237237 23 when unforeseen circumstances have occurred that resulted in
238238 24 call-offs of scheduled staff. This provision shall be applied
239239 25 no more than 6 times per quarter. Nothing in this Section
240240 26 diminishes a facility's right to appeal the imposition of a
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251251 1 monetary penalty. No facility may appeal a notice of
252252 2 noncompliance issued during the revised implementation period.
253253 3 (Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
254254 4 102-1118, eff. 1-18-23.)
255255 5 (210 ILCS 45/3-209) (from Ch. 111 1/2, par. 4153-209)
256256 6 Sec. 3-209. Required posting of information.
257257 7 (a) Every facility shall conspicuously post for display in
258258 8 an area of its offices accessible to residents, employees, and
259259 9 visitors the following:
260260 10 (1) Its current license;
261261 11 (2) A description, provided by the Department, of
262262 12 complaint procedures established under this Act and the
263263 13 name, address, and telephone number of a person authorized
264264 14 by the Department to receive complaints;
265265 15 (3) A copy of any order pertaining to the facility
266266 16 issued by the Department or a court;
267267 17 (4) A list of the material available for public
268268 18 inspection under Section 3-210;
269269 19 (5) Phone numbers and websites for rights protection
270270 20 services must be posted in common areas and at the main
271271 21 entrance and provided upon entry and at the request of
272272 22 residents or the resident's representative in accordance
273273 23 with 42 CFR 483.10(j)(4); and
274274 24 (6) The statement "The Illinois Long-Term Care
275275 25 Ombudsman Program is a free resident advocacy service
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286286 1 available to the public.".
287287 2 In accordance with F574 of the State Operations Manual for
288288 3 Long-Term Care Facilities, the administrator shall post for
289289 4 all residents and at the main entrance the name, address, and
290290 5 telephone number of the appropriate State governmental office
291291 6 where complaints may be lodged in language the resident can
292292 7 understand, which must include notice of the grievance
293293 8 procedure of the facility or program as well as addresses and
294294 9 phone numbers for the Office of Health Care Regulation and the
295295 10 Long-Term Care Ombudsman Program and a website showing the
296296 11 information of a facility's ownership. The facility shall
297297 12 include a link to the Long-Term Care Ombudsman Program's
298298 13 website on the home page of the facility's website.
299299 14 (b) A facility that has received a notice of violation for
300300 15 a violation of the minimum staffing requirements under Section
301301 16 3-202.05 shall display, during the calendar quarter in which
302302 17 the facility is notified of the violation period of time the
303303 18 facility is out of compliance, a notice stating in Calibri
304304 19 (body) font and 26-point type in black letters on an 8.5 by 11
305305 20 inch white paper the following:
306306 21 "Notice Dated: ...................
307307 22 This facility did does not currently meet the minimum staffing
308308 23 ratios required by law for [insert applicable quarter]. Posted
309309 24 at the direction of the Illinois Department of Public
310310 25 Health.".
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321321 1 The notice must be posted, at a minimum, at all publicly used
322322 2 exterior entryways into the facility, inside the main entrance
323323 3 lobby, and next to any registration desk for easily accessible
324324 4 viewing. The notice must also be posted on the main page of the
325325 5 facility's website. The Department shall have the discretion
326326 6 to determine the gravity of any violation and, taking into
327327 7 account mitigating and aggravating circumstances and facts,
328328 8 may reduce the requirement of, and amount of time for, posting
329329 9 the notice. Facilities shall not be required to post for the
330330 10 violation if they are within the 10% deviation, as provided in
331331 11 Section 3-202.05 of this Act.
332332 12 (Source: P.A. 101-10, eff. 6-5-19; 102-1080, eff. 1-1-23.)
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