reglab/statecodes huggingface dataset:
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.680 - Restraints

Current through Register Vol. 48, No. 28, July 12, 2024
a) The facility
				shall have written policies controlling the use of physical restraints
				including, but not limited to, leg restraints, arm restraints, hand mitts, soft
				ties or vests, wheelchair safety bars and lap trays, and all facility practices
				that meet the definition of a restraint, such as tucking in a sheet so tightly
				that a bed-bound resident cannot move; bed rails used to keep a resident from
				getting out of bed; chairs that prevent rising; or placing a resident who uses
				a wheelchair so close to a wall that the wall prevents the resident from
				rising. Adaptive equipment is not considered a physical restraint. Wrist bands
				or devices on clothing that trigger electronic alarms to warn staff that a
				resident is leaving a room do not, in and of themselves, restrict freedom of
				movement and should not be considered as physical restraints. The policies
				shall be followed in the operation of the facility and shall comply with the
				Act and this Part. These policies shall be developed by the medical advisory
				committee or the advisory physician with participation by nursing and
				administrative personnel.
b) No
				physical restraints with locks shall be used.
c) Physical restraints shall not be used on a
				resident for the purpose of discipline or convenience.
d) The use of chemical restraints is
				prohibited.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.682 - Nonemergency Use of Physical Restraints

Current through Register Vol. 48, No. 28, July 12, 2024
a) Physical restraints shall only be used
				when required to treat the resident's medical symptoms or as a therapeutic
				intervention, as ordered by a physician, and based on:
1) the assessment of the resident's
				capabilities and an evaluation and trial of less restrictive alternatives that
				could prove effective;
2) the
				assessment of a specific physical condition or medical treatment that requires
				the use of physical restraints, and how the use of physical restraints will
				assist the resident in reaching his or her highest practicable physical, mental
				or psychosocial well being;
3)
				consultation with appropriate health professionals, such as rehabilitation
				nurses and occupational or physical therapists, which indicates that the use of
				less restrictive measures or therapeutic interventions has proven ineffective;
				and
4) demonstration by the care
				planning process that using a physical restraint as a therapeutic intervention
				will promote the care and services necessary for the resident to attain or
				maintain the highest practicable physical, mental or psychosocial well being.
				(Section 2-106(c) of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.684 - Emergency Use of Physical Restraints

Current through Register Vol. 48, No. 28, July 12, 2024
a) If a resident needs emergency care,
				physical restraints may be used for brief periods to permit treatment to
				proceed unless the facility has notice that the resident has previously made a
				valid refusal of the treatment in question. (Section 2-106(c) of the
				Act)
b) For this Section only,
				"emergency care" means the unforeseen need for immediate treatment inside or
				outside the facility that is necessary to:
1)
				save the resident's life;
2)
				prevent the resident from doing serious mental or physical harm to
				himself/herself; or
3) prevent the
				resident from injuring another individual.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.690 - Incidents and Accidents

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				facility shall maintain a file of all written reports of each incident and
				accident affecting a resident that is not the expected outcome of a resident's
				condition or disease process. A descriptive summary of each incident or
				accident affecting a resident shall also be recorded in the progress notes or
				nurse's notes of that resident.
b)
				The facility shall notify the Department of any serious incident or accident.
				For purposes of this Section, "serious" means any incident or accident that
				causes physical harm or injury to a resident.
c) The facility shall, by fax or phone,
				notify the Regional Office within 24 hours after each reportable incident or
				accident. If a reportable incident or accident results in the death of a
				resident, the facility shall, after contacting local law enforcement pursuant
				to Section
				300.695,
				notify the Regional Office by phone only. For the purposes of this Section,
				"notify the Regional Office by phone only" means talk with a Department
				representative who confirms over the phone that the requirement to notify the
				Regional Office by phone has been met. If the facility is unable to contact the
				Regional Office, it shall notify the Department's toll-free complaint registry
				hotline. The facility shall send a narrative summary of each reportable
				accident or incident to the Department within seven days after the
				occurrence.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.695 - Contacting Local Law Enforcement

Current through Register Vol. 48, No. 28, July 12, 2024
a) For the purpose of this Section, the
				following definitions shall apply:
1) "911" -
				an emergency answer and response system in which the caller need only dial
				9-1-1 on a telephone to obtain emergency services, including police, fire,
				medical ambulance and rescue.
2)
				Physical abuse - see Section
				300.30.
3) Sexual abuse - sexual penetration,
				intentional sexual touching or fondling, or sexual exploitation (i.e., use of
				an individual for another person's sexual gratification, arousal, advantage, or
				profit).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.696 - Infection Prevention and Control

Current through Register Vol. 48, No. 28, July 12, 2024
a) A facility shall have an infection
				prevention and control program for the surveillance, investigation, prevention,
				and control of healthcare-associated infections and other infectious diseases.
				The program shall be under the management of the facility's infection
				preventionist who is qualified through education, training, experience, or
				certification in infection prevention and control.
b) Written policies and procedures for
				surveillance, investigation, prevention, and control of infectious agents and
				healthcare-associated infections in the facility shall be established and
				followed, including for the appropriate use of personal protective equipment as
				provided in the Centers for Disease Control and Prevention's Guideline for
				Isolation Precautions, Hospital Respiratory Protection Program Toolkit, and the
				Occupational Safety and Health Administration's Respiratory Protection
				Guidance. The policies and procedures must be consistent with and include the
				requirements of the Control of Communicable Diseases Code, and the Control of
				Sexually Transmissible Infections Code.
1) All
				staff shall be trained at least annually on basic infection prevention and
				control practices based on job responsibilities. Training records shall be
				maintained for three years. For the purposes of this Section, "staff" means
				those individuals who work in the facility on a regular (that is, at least once
				a week) basis, including individuals who may not be physically in the facility
				for a period of time due to illness, disability, or scheduled time off, but who
				are expected to return to work. This also includes individuals under contract
				or arrangement, including hospice and dialysis staff, physical therapists,
				occupational therapists, mental health professionals, or volunteers, who are in
				the facility on a regular basis.
2)
				Students enrolled in accredited health care training programs who are providing
				direct care during internships or clinical rotations must have completed
				infection prevention and control training prior to working in the facility. The
				facility shall ensure access to documentation of completed infection prevention
				and control training for all interns and students and provide a copy of this
				record upon request by the Department.
3) Facility activities shall be monitored on
				an ongoing basis by the Infection Preventionist to ensure adherence to all
				infection prevention and control policies and procedures.
4) Infection prevention and control policies
				and procedures shall be maintained in the facility and made available upon
				request to facility staff, the resident and the resident's family or resident's
				representative, the Department, the certified local health department, and the
				public.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.697 - Infection Preventionists

Current through Register Vol. 48, No. 28, July 12, 2024
A
facility shall designate a person or persons as
				  Infection Preventionists (IP) to develop and implement policies governing
				  control of infections and communicable diseases. The IPs shall be qualified
				  through education, training, experience, or certification or a combination of
				  such qualifications. The IP's qualifications shall be documented and shall be
				  made available for inspection by the Department.
(Section 2-213(d) of
				  the Act). The facility's infection prevention and control program as required
				  by Section
				  300.696(e)
				  shall be under the management of an IP.
a) IPs shall complete, or provide proof of
				completion of, initial infection control and prevention training, provided by
				CDC or equivalent training, covering topics listed in subsection (b)(1) to the
				facility, within 30 days after accepting an IP position. Documentation of
				required initial infection control and prevention training shall be maintained
				in the employee file.
b) Effective
				July 1, 2022, a qualified IP candidate shall:
1) Have completed at least 19 hours of
				training in infection prevention and control including, but not limited to,
				training in the following areas:
A) Principles
				of Standard Precautions
B)
				Principles of Transmission-Based Precautions
C) Prevention of Healthcare-Associated
				Infections
D) Hand
				Hygiene
E) Environmental Cleaning,
				Sterilization, Disinfection, and Asepsis
F) Environment of Care and Water
				Management
G) Employee/Occupational
				Health
H) Surveillance and
				Epidemiological Investigations
I)
				Antimicrobial Stewardship
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.699 - Electronic Monitoring

Current through Register Vol. 48, No. 28, July 12, 2024
A facility shall comply with Section 2-115 and subsections
				  3-318(a)(8) and (9) of the Act, with the Authorized Electronic Monitoring in
				  Long-Term Care Facilities Act, and with the Authorized Electronic Monitoring in
				  Long-Term Care Facilities Code.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart C - POLICIES › Section 300.700 - Testing for Legionella Bacteria

Current through Register Vol. 48, No. 28, July 12, 2024
a)
A facility shall develop a policy for testing its water supply for
				Legionella bacteria. The policy shall include the frequency with which testing
				is conducted. The policy and the results of any tests
and corrective
				actions taken
shall be made available to the Department upon
				request.
(Section 3-206.06 of the Act)
b) The policy shall be based on the ASHRAE
				Guideline "Managing the Risk of Legionellosis Associated with Building Water
				Systems" and the Centers for Disease Control and Prevention's" Toolkit for
				Controlling Legionella in Common Sources of Exposure". The policy shall
				include, at a minimum:
1) A procedure to
				conduct a facility risk assessment to identify potential Legionella and other
				waterborne pathogens in the facility water system;
2) A water management program that identifies
				specific testing protocols and acceptable ranges for control measures;
				and
3) A system to document the
				results of testing and corrective actions taken.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart D - PERSONNEL › Section 300.810 - General

Current through Register Vol. 48, No. 28, July 12, 2024
a) Sufficient staff
				in numbers and qualifications shall be on duty all hours of each day to provide
				services that meet the total needs of the residents. As a minimum, there shall
				be at least one staff member awake, dressed, and on duty at all times. (A,
				B)
b) The number and categories of
				personnel to be provided shall be based on the following:
1) Number of residents.
2) Amount and kind of personal care, nursing
				care, supervision, and program needed to meet the particular needs of the
				residents at all times.
3) Size,
				physical condition, and the layout of the building including proximity of
				service areas to the resident's rooms.
4) Medical orders.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart D - PERSONNEL › Section 300.820 - Categories of Personnel

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				facility shall provide an administrator as set forth in Subpart B.
				(B)
b) The facility shall provide a
				Resident Services Director who is assigned responsibility for the coordination
				and monitoring of the resident's overall plan of care. The director of nurses
				or an individual on the professional staff of the facility may fill this
				assignment to assure that residents' plans of care are individualized, written
				in terms of short and long-range goals, understandable and utilized; their
				needs are met through appropriate staff interventions and community resources;
				and residents are involved, whenever possible, in the preparation of their plan
				of care. (B,)
c) The facility shall
				provide activity personnel as set forth in Section
				300.1410(b).
				(B)
d) The facility shall provide dietary
				personnel as set forth in Sections
				300.2010
				and 300.2020.(B)
e) The facility
				shall designate a staff member(s) to provide social services to residents.
				(B)
f) The facility shall provide
				nursing personnel as set forth in Subpart F. (B)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart D - PERSONNEL › Section 300.830 - Consultation Services

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				facility shall have all arrangements for each consultant's services in a
				written agreement setting forth the services to be provided. These agreements
				shall be updated annually.
b) If
				the staff member designated to provide social services is not a social worker,
				the facility shall have an effective arrangement with a social worker to
				provide social service consultation. Skilled nursing facilities must provide a
				social worker to meet this requirement.
c) The facility shall have a written
				agreement for activity program consultation if required under Section
				300.1410(c).
d) Specific restorative services (physical
				therapy, occupational therapy, etc.) provided by the facility shall include
				consultation as set forth in Section
				300.1420(a).
e) The facility shall arrange for an advisory
				physician or medical advisory committee as set forth in Section
				300.1010.
f) The facility shall arrange for an advisory
				dentist and dental hygienist if desired, as set forth in Section
				300.1050.
g) The facility shall arrange for a
				consultant pharmacist as set forth in Section
				300.1610.
h) Skilled Nursing Facilities shall arrange
				for consultation from a health information management consultant as set forth
				in Section
				300.1860.
i) Facilities shall arrange for a dietary
				consultant as set forth in Section
				300.2010(b).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart D - PERSONNEL › Section 300.840 - Personnel Policies

Current through Register Vol. 48, No. 28, July 12, 2024
The personnel policies required in Section
				  300.650,
				  Section
				  300.651,
				  and other personnel policies established by the facility, shall be followed in
				  the operation of the facility.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart D - PERSONNEL › Section 300.850 - Employee Assistance Program

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				For the purposes of this Section, an "employee assistance program" is a program
				that supports individual physical and mental well-being and that is provided by
				the facility or through an insurance or employee benefits program offered by
				the facility. Employee assistance programs may include, but are not limited to,
				programs that offer professional counseling, stress management, mental wellness
				support, smoking cessation, and other support services.
b)
A facility shall ensure that
				nurses employed by the facility are aware of employee assistance programs or
				other like programs available for the physical and mental well-being of the
				employee
.
c)
The
				facility shall provide information on these programs, no less than at the time
				of employment and during any benefit open enrollment period, by an information
				form about the respective programs that a nurse
shall
sign
				during on boarding at the facility
, and upon request of the
				employee.
d)
The signed
				information form shall be added to the nurse's personnel file. The facility may
				provide this information to nurses electronically
. (Section 3-613 of
				the Act from PA 102-1007)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1010 - Medical Care Policies

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Advisory Physician or Medical Advisory Committee
1) There shall be an advisory physician, or a
				medical advisory committee composed of physicians, who shall be responsible for
				advising the administrator on the overall medical management of the residents
				and the staff of the facility. If the facility employs a house physician, he
				may be the advisory physician. (B)
2) Additional for Skilled Nursing Facilities.
				There shall be a medical advisory committee composed of two (2) or more
				physicians who shall be responsible for advising the administrator on the
				overall medical management of the residents and the staff in the facility. If
				the facility employs a house physician, the house physician may be one member
				of this committee.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1020 - Communicable Disease Policies

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				The facility shall comply with the Control of Communicable Diseases Code (77
				Ill. Adm. Code 690).
b) A resident
				who is suspected of or diagnosed as having any communicable, contagious or
				infectious disease, as defined in the Control of Communicable Diseases Code,
				shall be placed in isolation, if required, in accordance with the Control of
				Communicable Diseases Code. If the facility believes that it cannot provide the
				necessary infection control measures, it must initiate an involuntary transfer
				and discharge pursuant to Article III, Part 4 of the Act and Section
				300.620
				of this Part. In determining whether a transfer or discharge is necessary, the
				burden of proof rests on the facility.
c) All illnesses required to be reported
				under the Control of Communicable Diseases Code and Control of Sexually
				Transmissible Diseases Code (77 Ill. Adm. Code 693) shall be reported
				immediately to the local health department and to the Department. The facility
				shall furnish all pertinent information relating to such occurrences. In
				addition, the facility shall inform the Department of all incidents of scabies
				and other skin infestations.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1025 - Tuberculin Skin Test Procedures

Current through Register Vol. 48, No. 28, July 12, 2024
Tuberculin skin tests for employees and residents shall be
				  conducted in accordance with the Control of Tuberculosis Code (77 Ill. Adm.
				  Code 696).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1030 - Medical Emergencies

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				advisory physician or medical advisory committee shall develop policies and
				procedures to be followed during the various medical emergencies that may occur
				from time to time in long-term care facilities. These medical emergencies
				include, but are not limited to, such things as:
1) Pulmonary emergencies (for example, airway
				obstruction, foreign body aspiration, and acute respiratory distress, failure,
				or arrest).
2) Cardiac emergencies
				(for example, ischemic pain, cardiac failure, or cardiac arrest).
3) Traumatic injuries (for example,
				fractures, burns, and lacerations).
4) Toxicologic emergencies (for example,
				untoward drug reactions and overdoses).
5) Other medical emergencies (for example,
				convulsions and shock). (A, B)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1035 - Life-Sustaining Treatments

Current through Register Vol. 48, No. 28, July 12, 2024
a) Every
				facility shall respect the residents' right to make decisions relating to their
				own medical treatment, including the right to accept, reject, or limit
				life-sustaining treatment. Every facility shall establish a policy concerning
				the implementation of such rights. Included within this policy shall be:
1) implementation of Living Wills or Powers
				of Attorney for Health Care in accordance with the Living Will Act (Ill. Rev.
				Stat. 1991, ch. 1101/2, pars. 701 et seq.) [755 ILCS 35 ] and the Powers of
				Attorney for Health Care Law (Ill. Rev. Stat. 1991, ch. 1101/2, pars. 804-1 et
				seq.) [755 ILCS 45 ];
2) the
				implementation of physician orders limiting resuscitation such as those
				commonly referred to as "do-not-resuscitate" orders. This policy may only
				prescribe the format, method of documentation and duration of any physician
				orders limiting resuscitation. Any orders under this policy shall be honored by
				the facility. (Section 2-104.2 of the Act);
3) procedures for providing life-sustaining
				treatments available to residents at the facility;
4) procedures detailing staff's
				responsibility with respect to the provision of life-sustaining treatment when
				a resident has chosen to accept, reject or limit life-sustaining treatment, or
				when a resident has failed or has not yet been given the opportunity to make
				these choices;
5) procedures for
				educating both direct and indirect care staff in the application of those
				specific provisions of the policy for which they are responsible.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1040 - Care and Treatment of Sexual Assault Survivors

Current through Register Vol. 48, No. 28, July 12, 2024
a) For the purposes of this Section, the
				following definitions shall apply:
1)
				Ambulance Provider - an individual or entity that owns and operates a business
				or service using ambulances or emergency medical services vehicles to transport
				emergency patients.
2) Sexual
				Assault - an act of nonconsensual sexual conduct or sexual penetration, as
				defined in Section 12-12 of the Criminal Code of 1961, including, without
				limitation, acts prohibited under Sections 12-13 through 12-16 of the Criminal
				Code of 1961.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart E - MEDICAL AND DENTAL CARE OF RESIDENTS › Section 300.1050 - Dental Standards

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each
				long-term care facility shall have a dental program which will provide for
				in-service education to residents and staff under direction of dental personnel
				including at a minimum the following: (B)
1)
				Information regarding nutrition and diet control measures which are dental
				health oriented.
2) Instruction in
				proper oral hygiene methods.
3)
				Instruction concerning the importance of maintenance of proper oral hygiene and
				where appropriate including family members (as in the case of residents leaving
				the long-term care facility).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart F - NURSING AND PERSONAL CARE › Section 300.1230 - Direct Care Staffing

Current through Register Vol. 48, No. 28, July 12, 2024
a)
For purposes of the minimum staffing ratios in Section 3-202.05 of the
				Act
and this Section,
all residents shall be classified as
				requiring either skilled care or intermediate care
. (Section
				3-202.05(b-5) of the Act)
b) For
				the purposes of this Section, the following definitions shall apply:
1) "Direct care" - the provision of nursing
				care or personal care as defined in Section
				300.330, therapies,
				and care provided by staff listed in subsection (i). Direct care staff are
				those individuals who, through interpersonal contact with residents or resident
				care management, provide care and services to allow residents to attain or
				maintain the highest practicable physical, mental and psychosocial well-being.
				Direct care staff does not include individuals whose primary duty is
				maintaining the physical environment of the facility (e.g.,
				housekeeping).
2)
"Skilled
				care" - skilled nursing care, continuous skilled nursing observations,
				restorative nursing, and other services under professional direction with
				frequent medical supervision
. (Section 3-202.05(b-5) of the Act)
				Skilled nursing services are either nursing or therapy care services, furnished
				pursuant to physician orders, that require the skills of a licensed nurse to
				treat, manage, and observe a resident's condition and evaluate a resident's
				care. The skilled nursing services may be provided by a CNA, under the
				supervision of a licensed nurse to ensure the safety of the patient and to
				achieve the medically desired result. A resident in a skilled nursing facility
				is classified as receiving skilled care if:
A) The resident is receiving care covered by
				Medicare under any arrangement allowed by Title XVIII of the Social Security
				Act;
B) The resident is receiving
				care that would be covered by Medicare, but the resident has exhausted his or
				her Medicare benefits; or
C) The
				resident is not Medicare eligible, but is receiving care that would be covered
				by Medicare if the resident were eligible.
3)
"Intermediate care" - basic
				nursing care and other restorative services under periodic medical
				direction
. (Section 3-202.05(b-5) of the Act) Services not classified
				as skilled care will be classified as intermediate care.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart F - NURSING AND PERSONAL CARE › Section 300.1231 - Calculation of Direct Care Staffing During Inspections, Surveys and Evaluations

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Calculation of direct care staffing during inspections, surveys and evaluations
				will be based on the finalized working schedule and daily census report totals
				for the two-week period preceding the first day of the inspection. The work
				schedule shall be determined as outlined in Section
				300.1230(k)
				and shall be provided upon request.
b) For certified facilities, copies of nurse
				staffing information required by
				42 CFR
				483.35(g) for the two-week
				period preceding the first day of the inspection shall be provided upon
				request.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart F - NURSING AND PERSONAL CARE › Section 300.1232 - Waiver of Registered Professional Nurse Staffing Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a)
Upon
				application by a facility, the Director may grant or renew a waiver, in whole
				or in part, of the registered professional nurse staffing requirements
				contained in Section 3-202.05(e) of the Act
and Section
				300.1230(c)
				of this Part,
considering the criteria in
Section
				300.320,
if the
				facility demonstrates to the Director's satisfaction that the facility is
				unable, despite diligent efforts, including offering wages at a competitive
				rate for registered professional nurses in the community, to employ the
				required number of registered professional nurses and that the waivers will not
				endanger the health or safety of residents of the facility.
b)
A facility in compliance with the
				terms of a waiver granted under Section 3-303.1(c) of the Act
and this
				Section
will not be subject to fines or penalties imposed by the
				Department for violating the registered professional nurse staffing
				requirements of Section 3-202.05(e) of the Act
and Section
				300.1230(c).
Nothing in the Act
or this Section
allows the Director
				to grant or renew a waiver of the minimum registered professional nurse
				staffing requirements provided in
				42 CFR
				483.35(b) to a facility that
				is Medicare-certified or to a facility that is both Medicare-certified and
				Medicaid-certified.
c)
Waivers granted under the Act
and this Section
will be
				reviewed quarterly by the Department, including requiring a demonstration by
				the facility that it has continued to make diligent efforts to employ the
				required number of registered professional nurses, and shall be revoked for
				noncompliance with any of the following requirements:
1)
For periods in which the number of
				registered professional nurses required by law is not in the facility, a
				physician or registered professional nurse shall respond immediately to a
				telephone call from the facility.
2)
The facility
to
notify the following of the waiver: the Office of the State Long Term
				Care Ombudsman, the residents of the facility, the residents' guardians, and
				the residents' representatives.
(Section 3-303.1(c) of the
				Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart F - NURSING AND PERSONAL CARE › Section 300.1233 - Quarterly Administrative Staffing Compliance Review

Current through Register Vol. 48, No. 28, July 12, 2024
a) The Department will determine compliance
quarterly by comparing the number of hours provided per resident per
				day using the Centers for Medicare and Medicaid Services' payroll-based journal
				(PBJ) and the facility's daily census.
(Section 3-202.05(f) of the
				Act) PBJ data that is utilized for compliance shall not be contested. For a
				crosswalk of job titles from Section
				300.1230(i)
				versus PBJ job titles, see Appendix B.
b) The quarterly deadlines for submitting PBJ
				data to the Department are as follows:
1) For
				the first fiscal quarter reporting period of October 1 through December 31,
				quarterly PBJ data is due to the Department on March 1.
2) For the second fiscal quarter reporting
				period of January 1 through March 31, quarterly PBJ data is due to the
				Department on June 1.
3) For the
				third fiscal quarter reporting period of April 1 through June 30, quarterly PBJ
				data is due to the Department on September 1.
4) For the fourth fiscal quarter reporting
				period of July 1 through September 30, quarterly PBJ data is due to the
				Department on December 1.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart F - NURSING AND PERSONAL CARE › Section 300.1240 - Additional Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
In addition to the staffing requirements, in Section
				  300.1230,
				  the following staffing requirements also apply to all Skilled Nursing
				  Facilities and Intermediate Care Facilities:
a) There shall be a licensed nurse designated
				as being in charge of nursing services on all shifts when neither the director
				of nursing or assistant director of nursing are on duty. If registered nurses
				and licensed practical nurses are on duty on the same shift, this person shall
				be a registered nurse. This person may be a charge nurse on one of the nursing
				units. (A, B)
b) There shall be at
				least one person awake, dressed and on duty at all times in each separate
				nursing unit. (A, B)
c) There shall
				be at least one registered nurse on duty seven days per week, 8 consecutive
				hours, in a skilled nursing facility. (A, B)
d) There shall be at least one registered
				nurse or licensed practical nurse on duty at all times in an intermediate care
				facility or a skilled nursing facility. (A, B)
e) There shall be at least one registered
				nurse or licensed practical nurse on duty on each floor housing residents in a
				skilled nursing facility. (A, B)
f)
				The need for licensed nurses on each nursing unit in a skilled nursing facility
				and each floor or nursing unit in an intermediate care facility will be
				determined on an individual case basis, dependent upon the individual
				situation. If such additional staffing is required, the Department will inform
				the facility in writing of the kind and amount of additional staff time
				required, and the reason why it is needed.
g) The need for an additional licensed nurse
				to serve as a "house supervisor" will be determined on an individual case
				basis. If the Department determines that there is a need for a registered nurse
				in a skilled nursing facility or a licensed practical nurse in an intermediate
				care facility on certain shifts whose sole duties will consist of supervising
				the nursing services of the facility, the Department shall notify the facility
				in writing when and why such a person is needed. This person shall not perform
				the duties of a charge nurse while serving as the "house supervisor".
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart G - RESIDENT CARE SERVICES › Section 300.1410 - Activity Program

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				facility shall provide an ongoing program of activities to meet the interests
				and preferences and the physical, mental and psychosocial well-being of each
				resident, in accordance with the resident's comprehensive assessment. The
				activities shall be coordinated with other services and programs to make use of
				both community and facility resources and to benefit the residents.
b) Activity personnel shall be provided to
				meet the needs of the residents and the program. Activity staff time each week
				shall total not less than 45 minutes multiplied by the number of residents in
				the facility. This time shall be spent in providing activity programming as
				well as planning and directing the program. The time spent in the performance
				of other duties not related to the activity program shall not be counted as
				part of the required activity staff time.
1)
				In a facility whose residents participate in regularly scheduled therapeutic
				programs outside the facility, such as school, employment or sheltered
				workshop, the minimum hours per week of activity staff time may be reduced. The
				reduction shall be calculated by multiplying the number of residents in the
				facility who participate in such programs by the percentage of the day that
				these residents spend in such programs.
2) Activity personnel working under the
				direction of the activity director shall have a minimum of 10 hours of
				in-service training per calendar or employment year, directly related to
				recreation/activities. In-service training may be provided by qualified
				facility staff and/or consultants, or may be obtained from college or
				university courses, seminars and/or workshops, educational offerings through
				professional organizations, similar educational offerings or any combination
				thereof.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart G - RESIDENT CARE SERVICES › Section 300.1420 - Specialized Rehabilitation Services

Current through Register Vol. 48, No. 28, July 12, 2024
If physical therapy, occupational therapy, speech therapy or
				  any other specialized rehabilitative service is offered, it shall be provided
				  by, or supervised by, a qualified professional in that specialty and upon the
				  written order of the physician. (B)
a)
				In addition to the provision of direct services, any such qualified
				professional personnel shall be used as consultants to the total restorative
				program and shall assist with resident evaluation, resident care planning, and
				in-service education.
b)
				Appropriate records shall be maintained by these personnel. Direct service to
				individual residents shall be documented on the individual clinical record as
				set forth in Section
				300.1810(c).
				A summary of program consultation and recommendations as set forth in Section
				300.1810(h)
				 shall be documented.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart G - RESIDENT CARE SERVICES › Section 300.1430 - Work Programs

Current through Register Vol. 48, No. 28, July 12, 2024
a) Work
				programs for individual residents in facilities shall be allowed only if they
				are oriented toward resident adjustment and therapeutic benefits and if they
				are approved in writing by the Department. Such programs should be a rarity in
				skilled nursing facilities.
b)
				Permission for each such program shall be secured from the Department. Each
				program shall be presented in writing indicating such things as objectives,
				possible work assignment, duties, policies governing the program, agency
				involvement (where appropriate), and supervision.
c) Residents involved in such programs shall
				meet all requirements of the Department for persons functioning in these
				positions.
d) Residents shall not
				be used to replace employed staff. (B)
e) Appropriate records shall be maintained
				for each resident functioning in these programs. These shall show
				appropriateness of the program for the individual, resident's response to the
				program and any other pertinent observations and shall become a part of the
				resident's record. (See Section
				300.1810(c).)
f) All such programs shall be in full
				compliance with all applicable regulations of both the State and Federal
				Departments of Labor. Any program found by the Department not to be in
				compliance with State and Federal Departments of Labor regulations shall be
				terminated immediately.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart G - RESIDENT CARE SERVICES › Section 300.1440 - Volunteer Program

Current through Register Vol. 48, No. 28, July 12, 2024
a) If the
				facility has a volunteer or auxiliary program, a facility staff person shall
				direct the program. Community groups such as Boy and Girl Scouts, church groups
				and civic organizations that may occasionally present programs, activities, or
				entertainment in the facility shall not be considered volunteers for the
				purposes of this Section.
b)
				Volunteers shall complete a standard orientation program, in accordance with
				their facility responsibilities and with the facility's policies and procedures
				governing the volunteer program. The orientation shall include, but not be
				limited to:
1) Residents' rights;
2) Confidentiality;
3) Disaster preparedness (i.e., fire,
				tornado);
4) Emergency response
				procedures;
5) Safety
				procedures/precautions;
6)
				Infection control; and
7) Body
				mechanics.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart G - RESIDENT CARE SERVICES › Section 300.1450 - Language Assistance Services

Current through Register Vol. 48, No. 28, July 12, 2024
A facility shall provide language assistance services in
				  accordance with the Language Assistance Services Act and the Language
				  Assistance Services Code.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart H - MEDICATIONS › Section 300.1610 - Medication Policies and Procedures

Current through Register Vol. 48, No. 28, July 12, 2024
a) Development of Medication Policies
1) Every facility shall adopt written
				policies and procedures for properly and promptly obtaining, dispensing,
				administering, returning, and disposing of drugs and medications. These
				policies and procedures shall be consistent with the Act and this Part and
				shall be followed by the facility. These policies and procedures shall be in
				compliance with all applicable federal, State and local laws.
2) Medication policies and procedures shall
				be developed with the advice of a pharmaceutical advisory committee that
				includes at least one licensed pharmacist, one physician, the administrator and
				the director of nursing. This committee shall meet at least
				quarterly.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart H - MEDICATIONS › Section 300.1620 - Compliance with Licensed Prescriber's Orders

Current through Register Vol. 48, No. 28, July 12, 2024
a) All medications shall be given only upon
				the written, facsimile, or electronic order of a licensed prescriber. The
				facsimile or electronic order of a licensed prescriber shall be authenticated
				by the licensed prescriber within 10 calendar days, in accordance with Section
				300.1810.
				All orders shall have the handwritten signature (or unique identifier) of the
				licensed prescriber. (Rubber stamp signatures are not acceptable.) These
				medications shall be administered as ordered by the licensed prescriber and at
				the designated time.
b) Telephone
				orders may be taken by a registered nurse, licensed practical nurse or licensed
				pharmacist. All telephone orders shall be immediately written on the resident's
				clinical record or a telephone order form and signed by the nurse or pharmacist
				taking the order. These orders shall be countersigned by the licensed
				prescriber within 10 calendar days.
c) Review of medication orders: The staff
				pharmacist or consultant pharmacist shall review the medical record, including
				licensed prescribers' orders and laboratory test results, at least monthly and,
				based on their clinical experience and judgment, and Section 300. Appendix F,
				determine if there are irregularities that may cause potential adverse
				reactions, allergies, contraindications, medication errors, or ineffectiveness.
				This review shall be documented in the clinical record. Portions of this review
				may be done outside the facility. Any irregularities noted shall be reported to
				the attending physician, the advisory physician, the director of nursing and
				the administrator, and shall be acted upon.
d) A medication order not specifically
				limiting the time or number of doses shall be automatically stopped in
				accordance with written policies approved by the pharmaceutical advisory
				committee.
e) The resident's
				licensed prescriber shall be notified of medications about to be stopped so
				that the licensed prescriber may promptly renew such orders to avoid
				interruption of the resident's therapeutic regimen.
f) The licensed prescriber shall approve the
				release of any medications to the resident, or person responsible for the
				resident's care, at the time of discharge or when the resident is going to be
				temporarily out of the facility at medication time. Disposition of the
				medications shall be noted in the resident's clinical record.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart H - MEDICATIONS › Section 300.1630 - Administration of Medication

Current through Register Vol. 48, No. 28, July 12, 2024
a) All
				medications shall be administered only by personnel who are licensed to
				administer medications, in accordance with their respective licensing
				requirements. Licensed practical nurses shall have successfully completed a
				course in pharmacology or have at least one year's full-time supervised
				experience in administering medications in a health care setting if their
				duties include administering medications to residents.
1) Medications shall be administered as soon
				as possible after doses are prepared at the facility and shall be administered
				by the same person who prepared the doses for administration, except under
				single unit dose packaged distribution systems.
2) Each dose administered shall be properly
				recorded in the clinical record by the person who administered the dose. (See
				Section
				300.1810.)
3) Self-administration of medication shall be
				permitted only upon the written order of the licensed prescriber.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 300 - SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE › Subpart H - MEDICATIONS › Section 300.1640 - Labeling and Storage of Medications

Current through Register Vol. 48, No. 28, July 12, 2024
a) All medications for all residents shall be
				properly labeled and stored at, or near, the nurses' station, in a locked
				cabinet, a locked medication room, or one or more locked mobile medication
				carts of satisfactory design for such storage. (See subsections (f) and (g) of
				this Section.)
1) These cabinets, rooms, and
				carts shall be well lighted and of sufficient size to permit storage without
				crowding.
2) All mobile medication
				carts shall be under the visual control of the responsible nurse at all times
				when not stored safely and securely.