HB 4815

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Full Text of HB4815
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	HB4815 - 104th General Assembly
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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4815
Introduced , by Rep. Norine K. Hammond
SYNOPSIS AS INTRODUCED:
210 ILCS 9/15
210 ILCS 9/35
210 ILCS 9/70
210 ILCS 9/75
210 ILCS 9/91 new
210 ILCS 9/92
210 ILCS 9/135
Amends the Assisted Living and Shared Housing Act. Provides that the comprehensive assessment of a patient prior to the patient's admission to an establishment shall be completed by a physician or a nurse practitioner or physician assistant. In provisions concerning licensure of an establishment, changes education requirements for the full-time director of an establishment. Makes changes to the definition of "medication administration" in provisions concerning service requirements. Provides that a licensed health care professional may be employed (instead of 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, if the resident chooses to utilize the services of the licensed health care professional working within the scope of the professional's practice. Sets forth provisions concerning an emergency plan and disaster preparedness. Provides that incidents must be reported to the Department of Public Health within 24 hours after the incident or by the end of the next business day. Provides that staff in an establishment may be trained to assist in a nonemergency lift of a resident. Provides that repeated technical infractions by an establishment within a calendar year may result in a Type 3 violation.
LRB104 18031 BAB 31470 b
A BILL FOR
		HB4815		LRB104 18031 BAB 31470 b
1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Assisted Living and Shared Housing Act is
5amended by changing Sections 15, 35, 70, 75, 92, and 135 and by
6adding Section 91 as follows:
7    (210 ILCS 9/15)
8    Sec. 15. Assessment and service plan requirements. Prior
9to admission to any establishment covered by this Act, a
10comprehensive assessment that includes an evaluation of the
11prospective resident's physical, cognitive, and psychosocial
12condition shall be completed by a physician or a nurse 
13practitioner or physician assistant. At least annually, a
14comprehensive assessment shall be completed, and upon
15identification of a significant change in the resident's
16condition, including, but not limited to, a diagnosis of
17Alzheimer's disease or a related dementia, the resident shall
18be reassessed. The Department may by rule specify
19circumstances under which more frequent assessments of skin
20integrity and nutritional status shall be required. The
21comprehensive assessment shall be completed by a physician or 
22a nurse practitioner or physician assistant. Based on the
23assessment, the resident's interests and preferences,
		HB4815	- 2 -	LRB104 18031 BAB 31470 b
1dislikes, and any known triggers for behavior that endangers
2the resident or others, a written service plan shall be
3developed and mutually agreed upon by the provider, the
4resident, and the resident's representative, if any. The
5service plan, which shall be reviewed annually, or more often
6as the resident's condition, preferences, or service needs
7change, shall serve as a basis for the service delivery
8contract between the provider and the resident. The resident
9and the resident's representative, if any, shall, upon
10request, be given a copy of the most recent assessment; a
11supplemental assessment, if any, completed by the
12establishment; and a service plan. Based on the assessment,
13the service plan may provide for the disconnection or removal
14of any appliance.
15(Source: P.A. 104-191, eff. 1-1-26.)
16    (210 ILCS 9/35)
17    Sec. 35. Issuance of license.
18    (a) Upon receipt and review of an application for a
19license and review of the applicant establishment, the
20Director may issue a license if he or she finds:
21        (1) that the individual applicant, or the corporation,
22    partnership, or other entity if the applicant is not an
23    individual, is a person responsible and suitable to
24    operate or to direct or participate in the operation of an
25    establishment by virtue of financial capacity, appropriate
		HB4815	- 3 -	LRB104 18031 BAB 31470 b
1    business or professional experience, a record of lawful
2    compliance with lawful orders of the Department and lack
3    of revocation of a license issued under this Act, the
4    Nursing Home Care Act, the Specialized Mental Health
5    Rehabilitation Act of 2013, the ID/DD Community Care Act,
6    or the MC/DD Act during the previous 5 years;
7        (2) that the establishment is under the supervision of
8    a full-time director who is at least 21 years of age and
9    has a high school diploma or equivalent plus either:
10            (A) 2 years of management experience or 2 years of
11        experience in positions of progressive responsibility
12        in health care, housing with services, or adult day
13        care or providing similar services to the elderly; [or]
14            (B) 2 years of management experience or 2 years of
15        experience in positions of progressive responsibility
16        in hospitality and training in health care and housing
17        with services management as defined by rule; or
18            (C) a college degree in health administration or 
19        the completion of an approved program within 6 months 
20        after hiring;
21        (3) that the establishment has staff sufficient in
22    number with qualifications, adequate skills, education,
23    and experience to meet the 24 hour scheduled and
24    unscheduled needs of residents and who participate in
25    ongoing training to serve the resident population;
26        (4) that all employees who are subject to the Health
		HB4815	- 4 -	LRB104 18031 BAB 31470 b
1    Care Worker Background Check Act meet the requirements of
2    that Act;
3        (5) that the applicant is in substantial compliance
4    with this Act and such other requirements for a license as
5    the Department by rule may establish under this Act;
6        (6) that the applicant pays all required fees;
7        (7) that the applicant has provided to the Department
8    an accurate disclosure document in accordance with the
9    Alzheimer's Disease and Related Dementias Special Care
10    Disclosure Act and in substantial compliance with Section
11    150 of this Act.
12    In addition to any other requirements set forth in this
13Act, as a condition of licensure under this Act, the director
14of an establishment must participate in at least 20 hours of
15training every 2 years to assist him or her in better meeting
16the needs of the residents of the establishment and managing
17the operation of the establishment.
18    Any license issued by the Director shall state the
19physical location of the establishment, the date the license
20was issued, and the expiration date. All licenses shall be
21valid for one year, except as provided in Sections 40 and 45.
22Each license shall be issued only for the premises and persons
23named in the application, and shall not be transferable or
24assignable.
25(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
		HB4815	- 5 -	LRB104 18031 BAB 31470 b
1    (210 ILCS 9/70)
2    Sec. 70. Service requirements. An establishment must
3provide all mandatory services and may provide optional
4services, including medication reminders, supervision of
5self-administered medication and medication administration as
6defined by this Section and nonmedical services defined by
7rule, whether provided directly by the establishment or by
8another entity arranged for by the establishment with the
9consent of the resident or the resident's representative.
10    For the purposes of this Section, "medication reminders"
11means reminding residents to take pre-dispensed,
12self-administered medication, observing the resident, and
13documenting whether or not the resident took the medication.
14    For the purposes of this Section, "supervision of
15self-administered medication" means assisting the resident
16with self-administered medication using any combination of the
17following: reminding residents to take medication, reading the
18medication label to residents, checking the self-administered
19medication dosage against the label of the medication,
20confirming that residents have obtained and are taking the
21dosage as prescribed, and documenting in writing that the
22resident has taken (or refused to take) the medication. If
23residents are physically unable to open the container, the
24container may be opened for them. Supervision of
25self-administered medication shall be under the direction of a
26licensed health care professional or, in the case of a
		HB4815	- 6 -	LRB104 18031 BAB 31470 b
1certified medication aide, under the supervision and
2delegation of a registered nurse as authorized by Section
350-75 of the Nurse Practice Act.
4    For the purposes of this Section, "medication
5administration" refers to a licensed health care professional
6employed by an establishment engaging in administering insulin
7and vitamin B-12 injections, oral medications, topical
8treatments, eye and ear drops, [or] nitroglycerin patches, and 
9intramuscular injections. A certified medication aide may
10administer medications under the supervision and delegation of
11a registered nurse as authorized by Section 50-75 of the Nurse
12Practice Act, except (i) Schedule II controlled substances as
13set forth in the Illinois Controlled Substances Act and (ii)
14any subcutaneous, intramuscular, intradermal, or intravenous
15medication.
16    The Department shall specify by rule procedures for
17medication reminders, supervision of self-administered
18medication, and medication administration.
19    Nothing in this Act shall preclude a physician licensed
20under the Medical Practice Act of 1987 from providing services
21within the scope of his or her license to any resident.
22(Source: P.A. 103-886, eff. 8-9-24.)
23    (210 ILCS 9/75)
24    Sec. 75. Residency requirements.
25    (a) No individual shall be accepted for residency or
		HB4815	- 7 -	LRB104 18031 BAB 31470 b
1remain in residence if the establishment cannot provide or
2secure appropriate services, if the individual requires a
3level of service or type of service for which the
4establishment is not licensed or which the establishment does
5not provide, or if the establishment does not have the staff
6appropriate in numbers and with appropriate skill to provide
7such services.
8    (b) Only adults may be accepted for residency.
9    (c) A person shall not be accepted for residency if:
10        (1) the person poses a serious threat to himself or
11    herself or to others;
12        (2) the person is not able to communicate his or her
13    needs and no resident representative residing in the
14    establishment, and with a prior relationship to the
15    person, has been appointed to direct the provision of
16    services;
17        (3) the person requires total assistance with 2 or
18    more activities of daily living;
19        (4) the person requires the assistance of more than
20    one paid caregiver at any given time with an activity of
21    daily living;
22        (5) the person requires more than minimal assistance
23    in moving to a safe area in an emergency;
24        (6) the person has a severe mental illness, which for
25    the purposes of this Section means a condition that is
26    characterized by the presence of a major mental disorder
		HB4815	- 8 -	LRB104 18031 BAB 31470 b
1    as classified in the Diagnostic and Statistical Manual of
2    Mental Disorders, Fourth Edition (DSM-IV) (American
3    Psychiatric Association, 1994), where the individual is a
4    person with a substantial disability due to mental illness
5    in the areas of self-maintenance, social functioning,
6    activities of community living and work skills, and the
7    disability specified is expected to be present for a
8    period of not less than one year, but does not mean
9    Alzheimer's disease and other forms of dementia based on
10    organic or physical disorders;
11        (7) the person requires intravenous therapy or
12    intravenous feedings unless self-administered or
13    administered by a qualified, licensed health care
14    professional;
15        (8) the person requires gastrostomy feedings unless
16    self-administered or administered by a licensed health
17    care professional;
18        (9) the person requires insertion, sterile irrigation,
19    and replacement of catheter, except for routine
20    maintenance of urinary catheters, unless the catheter care
21    is self-administered or administered by a licensed health
22    care professional or a nurse in compliance with education,
23    certification, and training in catheter care or infection
24    control by the Centers for Disease Control and Prevention
25    with oversight from an infection preventionist or
26    infection control committee;
		HB4815	- 9 -	LRB104 18031 BAB 31470 b
1        (10) the person requires sterile wound care unless
2    care is self-administered or administered by a licensed
3    health care professional;
4        (11) (blank);
5        (12) the person is a diabetic requiring routine
6    insulin injections unless the injections are
7    self-administered or administered by a licensed health
8    care professional;
9        (13) the person requires treatment of stage 3 or stage
10    4 decubitus ulcers or exfoliative dermatitis;
11        (14) the person requires 5 or more skilled nursing
12    visits per week for conditions other than those listed in
13    items (13) and (15) of this subsection for a period of 3
14    consecutive weeks or more except when the course of
15    treatment is expected to extend beyond a 3-week period for
16    rehabilitative purposes and is certified as temporary by a
17    physician; or
18        (15) other reasons prescribed by the Department by
19    rule.
20    (d) A resident with a condition listed in items (1)
21through (15) of subsection (c) shall have his or her residency
22terminated.
23    (e) Residency shall be terminated when services available
24to the resident in the establishment are no longer adequate to
25meet the needs of the resident. The establishment shall notify
26the resident and the resident's representative, if any, when
		HB4815	- 10 -	LRB104 18031 BAB 31470 b
1there is a significant change in the resident's condition that
2affects the establishment's ability to meet the resident's
3needs. The requirements of subsection (c) of Section 80 shall
4then apply. This provision shall not be interpreted as
5limiting the authority of the Department to require the
6residency termination of individuals.
7    (f) Subsection (d) of this Section shall not apply to
8terminally ill residents who receive or would qualify for
9hospice care and such care is coordinated by a hospice program
10licensed under the Hospice Program Licensing Act or other
11licensed health care professional employed by a licensed home
12health agency and the establishment and all parties agree to
13the continued residency.
14    (g) Items (3), (4), (5), and (9) of subsection (c) shall
15not apply to a quadriplegic, paraplegic, or individual with
16neuro-muscular diseases, such as muscular dystrophy and
17multiple sclerosis, or other chronic diseases and conditions
18as defined by rule if the individual is able to communicate his
19or her needs and does not require assistance with complex
20medical problems, and the establishment is able to accommodate
21the individual's needs. The Department shall prescribe rules
22pursuant to this Section that address special safety and
23service needs of these individuals.
24    (h) For the purposes of items (7) through (10) of
25subsection (c), a licensed health care professional may [not] be
26employed by the owner or operator of the establishment, its
		HB4815	- 11 -	LRB104 18031 BAB 31470 b
1parent entity, or any other entity with ownership common to
2either the owner or operator of the establishment or parent
3entity, including, but not limited to, an affiliate of the
4owner or operator of the establishment, if the resident 
5chooses to utilize the services of the licensed health care 
6professional working within the scope of the professional's 
7practice. Nothing in this Section is meant to limit a
8resident's right to choose his or her health care provider.
9    (i) Subsection (h) is not applicable to residents admitted
10to an assisted living establishment under a life care contract
11as defined in the Life Care Facilities Act if the life care
12facility has both an assisted living establishment and a
13skilled nursing facility. A licensed health care professional
14providing health-related or supportive services at a life care
15assisted living or shared housing establishment must be
16employed by an entity licensed by the Department under the
17Nursing Home Care Act or the Home Health, Home Services, and
18Home Nursing Agency Licensing Act.
19(Source: P.A. 103-444, eff. 1-1-24; 103-844, eff. 7-1-25;
20104-191, eff. 1-1-26.)
21    (210 ILCS 9/91 new)
22    Sec. 91. Emergency plan; disaster preparedness drills.
23    (a) Each establishment shall have a written plan for 
24protection of all persons in the event of disasters, for 
25keeping persons in place, evacuating persons to areas of 
		HB4815	- 12 -	LRB104 18031 BAB 31470 b
1refuge, and evacuating persons from the building when 
2necessary. The plan shall address the physical and cognitive 
3needs of residents and include special staff response, 
4including the procedures needed to ensure the safety of any 
5resident. The plan shall be amended or revised whenever any 
6resident with unusual needs is admitted. The plan shall also:
7        (1) provide for the temporary relocation of residents 
8    for any disaster requiring relocation;
9        (2) provide for the movement of residents to safe 
10    locations within the establishment in the event of a 
11    tornado warning or severe thunderstorm warning issued by 
12    the National Weather Service;
13        (3) provide for the temporary relocation of residents 
14    any time the temperature in residents' bedrooms falls 
15    below 55 degrees Fahrenheit for 12 hours or more as a 
16    result of a mechanical problem or loss of power in the 
17    establishment;
18        (4) provide for the health, safety, welfare, and 
19    comfort of all residents when the heat index or apparent 
20    temperature, as established by the National Oceanic and 
21    Atmospheric Administration, inside the residents' living, 
22    dining, activities, or sleeping areas of the establishment 
23    exceeds a heat index or apparent temperature of 80 degrees 
24    Fahrenheit;
25        (5) address power outages; and
26        (6) include contingencies in the event of flooding, if 
		HB4815	- 13 -	LRB104 18031 BAB 31470 b
1    located on a flood plain.
2    (b) Each establishment shall conduct at least 6 drills per 
3year on a bimonthly basis. At least 2 of the drills, involving 
4staff only, shall be conducted during the night when residents 
5are sleeping. All drills shall be held under varied conditions 
6to:
7        (1) ensure that all personnel on all shifts are 
8    trained to perform assigned tasks;
9        (2) ensure that all personnel on all shifts are 
10    familiar with the use of the firefighting equipment in the 
11    facility; and
12        (3) evaluate the effectiveness of disaster plans, 
13    procedures, and training.
14    Drills shall include residents, except at night when 
15residents are sleeping, establishment personnel, and other 
16persons in the establishment. Drills shall involve the actual 
17evacuation of residents to an assembly point specified in the 
18emergency plan, unless the community has a shelter-in-place 
19protocol approved by the local fire department and shall 
20provide residents with experience using various means of 
21escape. If an establishment has an evacuation capability 
22classification of impractical, those residents who cannot 
23meaningfully assist in their own evacuation or who have 
24special health problems shall not be required to participate 
25in the drill. If weather or other conditions present risk to 
26residents for actual evacuation of the entire building, the 
		HB4815	- 14 -	LRB104 18031 BAB 31470 b
1establishment shall conduct drills that involve evacuating to 
2designated sections or portions of the building. These drills 
3must simulate real evacuation conditions and ensure that, with 
4the personnel typically available, the entire building could 
5be evacuated if necessary.
6    As used in this subsection, "an evacuation capability of 
7impractical" means a situation where an establishment has a 
8high number of occupants with severe mobility limitations so 
9that a full evacuation within a reasonable time frame is 
10deemed nearly impossible.
11    Memory care units shall be deemed as impractical for 
12conducting drills, and residents shall be exempt. This 
13exemption does not apply to staff working in the memory care 
14unit.
15    (210 ILCS 9/92)
16    Sec. 92. Incident and accident reporting.
17    (a) Within 24 hours after the incident or by the end of the 
18next business day, an [An] establishment must report to the
19Department any incident or accident that results in
20significant physical harm or injury to a resident or any
21situation where a resident requires outside emergent medical
22treatment as a direct result of an incident or accident. A
23change in a resident's condition that is due to health or
24medical decline is not a reportable incident or accident.
25    (b) As used in this subsection, "nonemergency lift" means 
		HB4815	- 15 -	LRB104 18031 BAB 31470 b
1lifting a resident from the resident's current position to a 
2desired position. "Nonemergency lift" does not include an 
3incident or accident that results in significant physical harm 
4or injury to a resident or any situation where a resident 
5requires outside emergent medical treatment as a direct result 
6of an incident or accident. Staff in an establishment may be 
7trained to assist in a nonemergency lift of a resident.
8(Source: P.A. 104-209, eff. 1-1-26.)
9    (210 ILCS 9/135)
10    Sec. 135. Civil penalties.
11    (a) The Department may assess a civil penalty not to
12exceed $5,000 against any establishment subject to this Act
13for violations of this Act. Each day a violation continues
14shall be deemed a separate violation.
15    (b) Beginning 180 days after the adoption of rules under
16this Act, the Department may assess a civil penalty not to
17exceed $3,000 against any establishment subject to this Act
18for caring for a resident who exceeds the care needs defined in
19this Act. Each day a violation continues shall be deemed a
20separate violation.
21    (c) The Department is authorized to hold hearings in
22contested cases regarding appeals of the penalties assessed
23pursuant to this Section.
24    (d) Repeated technical infractions within a calendar year 
25may result in a Type 3 violation.
		HB4815	- 16 -	LRB104 18031 BAB 31470 b
1(Source: P.A. 91-656, eff. 1-1-01.)