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Illinois Senate Bill SB1465

Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1465 Compare Versions

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11 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1465 Introduced 1/31/2025, by Sen. Julie A. Morrison 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. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. Effective immediately. LRB104 08274 BAB 18324 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1465 Introduced 1/31/2025, by Sen. Julie A. Morrison 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. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. Effective immediately. LRB104 08274 BAB 18324 b LRB104 08274 BAB 18324 b A BILL FOR
22 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1465 Introduced 1/31/2025, by Sen. Julie A. Morrison 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
44 210 ILCS 45/3-202.05
55 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209
66 Amends the Nursing Home Care Act. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. 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 (10) infection preventionists;
3232 21 (11) minimum data set assessment nurses;
3333 22 (12) other social workers;
3434 23 (13) certified nursing assistant interns; and
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3838 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1465 Introduced 1/31/2025, by Sen. Julie A. Morrison 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
4040 210 ILCS 45/3-202.05
4141 210 ILCS 45/3-209 from Ch. 111 1/2, par. 4153-209
4242 Amends the Nursing Home Care Act. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. Effective immediately.
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7171 1 (14) medication aides.
7272 2 Except as otherwise provided by law, 100% of the hours
7373 3 worked by the staff listed in this subsection shall be counted
7474 4 toward the staff to resident ratio. The Department shall, by
7575 5 rule, allow certain facilities subject to 77 Ill. Adm. Code
7676 6 300.4000 and following (Subpart S) to utilize specialized
7777 7 clinical staff, as defined in rules, to count towards the
7878 8 staffing ratios.
7979 9 Within 120 days of June 14, 2012 (the effective date of
8080 10 Public Act 97-689), the Department shall promulgate rules
8181 11 specific to the staffing requirements for facilities federally
8282 12 defined as Institutions for Mental Disease. These rules shall
8383 13 recognize the unique nature of individuals with chronic mental
8484 14 health conditions, shall include minimum requirements for
8585 15 specialized clinical staff, including clinical social workers,
8686 16 psychiatrists, psychologists, and direct care staff set forth
8787 17 in paragraphs (4) through (6) and any other specialized staff
8888 18 which may be utilized and deemed necessary to count toward
8989 19 staffing ratios.
9090 20 Within 120 days of June 14, 2012 (the effective date of
9191 21 Public Act 97-689), the Department shall promulgate rules
9292 22 specific to the staffing requirements for facilities licensed
9393 23 under the Specialized Mental Health Rehabilitation Act of
9494 24 2013. These rules shall recognize the unique nature of
9595 25 individuals with chronic mental health conditions, shall
9696 26 include minimum requirements for specialized clinical staff,
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107107 1 including clinical social workers, psychiatrists,
108108 2 psychologists, and direct care staff set forth in paragraphs
109109 3 (4) through (6) and any other specialized staff which may be
110110 4 utilized and deemed necessary to count toward staffing ratios.
111111 5 (b) (Blank).
112112 6 (b-5) For purposes of the minimum staffing ratios in this
113113 7 Section, all residents shall be classified as requiring either
114114 8 skilled care or intermediate care.
115115 9 As used in this subsection:
116116 10 "Intermediate care" means basic nursing care and other
117117 11 restorative services under periodic medical direction.
118118 12 "Skilled care" means skilled nursing care, continuous
119119 13 skilled nursing observations, restorative nursing, and other
120120 14 services under professional direction with frequent medical
121121 15 supervision.
122122 16 (c) Facilities shall notify the Department within 60 days
123123 17 after July 29, 2010 (the effective date of Public Act
124124 18 96-1372), in a form and manner prescribed by the Department,
125125 19 of the staffing ratios in effect on July 29, 2010 (the
126126 20 effective date of Public Act 96-1372) for both intermediate
127127 21 and skilled care and the number of residents receiving each
128128 22 level of care.
129129 23 (d)(1) (Blank).
130130 24 (2) (Blank).
131131 25 (3) (Blank).
132132 26 (4) (Blank).
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143143 1 (5) Effective January 1, 2014, the minimum staffing ratios
144144 2 shall be increased to 3.8 hours of nursing and personal care
145145 3 each day for a resident needing skilled care and 2.5 hours of
146146 4 nursing and personal care each day for a resident needing
147147 5 intermediate care.
148148 6 (e) Ninety days after June 14, 2012 (the effective date of
149149 7 Public Act 97-689), a minimum of 25% of nursing and personal
150150 8 care time shall be provided by licensed nurses, with at least
151151 9 10% of nursing and personal care time provided by registered
152152 10 nurses. These minimum requirements shall remain in effect
153153 11 until an acuity based registered nurse requirement is
154154 12 promulgated by rule concurrent with the adoption of the
155155 13 Resource Utilization Group classification-based payment
156156 14 methodology, as provided in Section 5-5.2 of the Illinois
157157 15 Public Aid Code. Registered nurses and licensed practical
158158 16 nurses employed by a facility in excess of these requirements
159159 17 may be used to satisfy the remaining 75% of the nursing and
160160 18 personal care time requirements. Notwithstanding this
161161 19 subsection, no staffing requirement in statute in effect on
162162 20 June 14, 2012 (the effective date of Public Act 97-689) shall
163163 21 be reduced on account of this subsection.
164164 22 (f) The Department shall submit proposed rules for
165165 23 adoption by January 1, 2020 establishing a system for
166166 24 determining compliance with minimum staffing set forth in this
167167 25 Section and the requirements of 77 Ill. Adm. Code 300.1230
168168 26 adjusted for any waivers granted under Section 3-303.1.
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179179 1 Compliance shall be determined quarterly by comparing the
180180 2 number of hours provided per resident per day using the
181181 3 Centers for Medicare and Medicaid Services' payroll-based
182182 4 journal and the facility's daily census, broken down by
183183 5 intermediate and skilled care as self-reported by the facility
184184 6 to the Department on a quarterly basis. The Department shall
185185 7 use the quarterly payroll-based journal and the self-reported
186186 8 census to calculate the number of hours provided per resident
187187 9 per day and compare this ratio to the minimum staffing
188188 10 standards required under this Section, as impacted by any
189189 11 waivers granted under Section 3-303.1. Discrepancies between
190190 12 job titles contained in this Section and the payroll-based
191191 13 journal shall be addressed by rule. The manner in which the
192192 14 Department requests payroll-based journal information to be
193193 15 submitted shall align with the federal Centers for Medicare
194194 16 and Medicaid Services' requirements that allow providers to
195195 17 submit the quarterly data in an aggregate manner.
196196 18 (g) Monetary penalties for non-compliance. The Department
197197 19 shall submit proposed rules for adoption by January 1, 2020
198198 20 establishing monetary penalties for facilities not in
199199 21 compliance with minimum staffing standards under this Section.
200200 22 Facilities shall be required to comply with the provisions of
201201 23 this subsection beginning January 1, 2025. No monetary penalty
202202 24 may be issued for noncompliance prior to the revised
203203 25 implementation date, which shall be January 1, 2025. If a
204204 26 facility is found to be noncompliant prior to the revised
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215215 1 implementation date, the Department shall provide a written
216216 2 notice identifying the staffing deficiencies and require the
217217 3 facility to provide a sufficiently detailed correction plan
218218 4 that describes proposed and completed actions the facility
219219 5 will take or has taken, including hiring actions, to address
220220 6 the facility's failure to meet the statutory minimum staffing
221221 7 levels. Monetary penalties shall be imposed beginning no later
222222 8 than July 1, 2025, based on data for the quarter beginning
223223 9 January 1, 2025 through March 31, 2025 and quarterly
224224 10 thereafter. Monetary penalties shall be established based on a
225225 11 formula that calculates on a daily basis the cost of wages and
226226 12 benefits for the missing staffing hours. All notices of
227227 13 noncompliance shall include the computations used to determine
228228 14 noncompliance and establishing the variance between minimum
229229 15 staffing ratios and the Department's computations. No monetary
230230 16 penalties shall be imposed unless the variance between a
231231 17 facility's minimum staffing ratios and the Department's
232232 18 computations exceeds 20%. The penalty for the first offense
233233 19 shall be 125% of the cost of wages and benefits for the missing
234234 20 staffing hours. The penalty shall increase to 150% of the cost
235235 21 of wages and benefits for the missing staffing hours for the
236236 22 second offense and 200% the cost of wages and benefits for the
237237 23 missing staffing hours for the third and all subsequent
238238 24 offenses. The penalty shall be imposed regardless of whether
239239 25 the facility has committed other violations of this Act during
240240 26 the same period that the staffing offense occurred. The
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251251 1 penalty may not be waived, but the Department shall have the
252252 2 discretion to determine the gravity of the violation in
253253 3 situations where there is no more than a 10% deviation from the
254254 4 staffing requirements and make appropriate adjustments to the
255255 5 penalty. The Department is granted discretion to waive the
256256 6 penalty when unforeseen circumstances have occurred that
257257 7 resulted in call-offs of scheduled staff. This provision shall
258258 8 be applied no more than 6 times per quarter. Nothing in this
259259 9 Section diminishes a facility's right to appeal the imposition
260260 10 of a monetary penalty. No facility may appeal a notice of
261261 11 noncompliance issued during the revised implementation period.
262262 12 (Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
263263 13 102-1118, eff. 1-18-23.)
264264 14 (210 ILCS 45/3-209) (from Ch. 111 1/2, par. 4153-209)
265265 15 Sec. 3-209. Required posting of information.
266266 16 (a) Every facility shall conspicuously post for display in
267267 17 an area of its offices accessible to residents, employees, and
268268 18 visitors the following:
269269 19 (1) Its current license;
270270 20 (2) A description, provided by the Department, of
271271 21 complaint procedures established under this Act and the
272272 22 name, address, and telephone number of a person authorized
273273 23 by the Department to receive complaints;
274274 24 (3) A copy of any order pertaining to the facility
275275 25 issued by the Department or a court;
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286286 1 (4) A list of the material available for public
287287 2 inspection under Section 3-210;
288288 3 (5) Phone numbers and websites for rights protection
289289 4 services must be posted in common areas and at the main
290290 5 entrance and provided upon entry and at the request of
291291 6 residents or the resident's representative in accordance
292292 7 with 42 CFR 483.10(j)(4); and
293293 8 (6) The statement "The Illinois Long-Term Care
294294 9 Ombudsman Program is a free resident advocacy service
295295 10 available to the public.".
296296 11 In accordance with F574 of the State Operations Manual for
297297 12 Long-Term Care Facilities, the administrator shall post for
298298 13 all residents and at the main entrance the name, address, and
299299 14 telephone number of the appropriate State governmental office
300300 15 where complaints may be lodged in language the resident can
301301 16 understand, which must include notice of the grievance
302302 17 procedure of the facility or program as well as addresses and
303303 18 phone numbers for the Office of Health Care Regulation and the
304304 19 Long-Term Care Ombudsman Program and a website showing the
305305 20 information of a facility's ownership. The facility shall
306306 21 include a link to the Long-Term Care Ombudsman Program's
307307 22 website on the home page of the facility's website.
308308 23 (b) A facility that has received a notice of violation for
309309 24 a violation with a variance that exceeds 20% of the minimum
310310 25 staffing requirements under Section 3-202.05 shall display,
311311 26 during the period of time the facility is out of compliance, a
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322322 1 notice stating in Calibri (body) font and 26-point type in
323323 2 black letters on an 8.5 by 11 inch white paper the following:
324324 3 "Notice Dated: ...................
325325 4 Last quarter, this This facility did not does not currently
326326 5 meet the minimum staffing ratios required by law. Posted at
327327 6 the direction of the Illinois Department of Public Health.".
328328 7 The notice must be posted, at a minimum, at all publicly used
329329 8 exterior entryways into the facility, inside the main entrance
330330 9 lobby, and next to any registration desk for easily accessible
331331 10 viewing. The notice must also be posted on the main page of the
332332 11 facility's website. The Department shall have the discretion
333333 12 to determine the gravity of any violation and, taking into
334334 13 account mitigating and aggravating circumstances and facts,
335335 14 may reduce the requirement of, and amount of time for, posting
336336 15 the notice.
337337 16 (Source: P.A. 101-10, eff. 6-5-19; 102-1080, eff. 1-1-23.)
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