reglab/statecodes huggingface dataset:
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.120 - Referenced Materials

Current through Register Vol. 48, No. 28, July 12, 2024
The following materials are referenced in this Part:
a) State of Illinois statutes:
1) Hospital Licensing Act [210 ILCS 85
			 ]
2) Ambulatory Surgical Treatment
			 Center Act [210 ILCS 5 ]
3)
			 University of Illinois Hospital Act [110 ILCS 330 ]
4) Criminal Code of 2012 [720 ILCS 5
			 ]
5) Code of Civil Procedure,
			 Article VIII, Part 21 [735 ILCS 5 /Art. VIII, Part 21]
6) Health Care Surrogate Act [755 ILCS 40
			 ]
7) Emancipation of Minors Act
			 [750 ILCS 30 ]
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.130 - Adverse Health Care Events

Current through Register Vol. 48, No. 28, July 12, 2024
The following are "adverse health care events" for the purposes
				of the Act and this Part:
a) Surgical
			 or Invasive Procedure Events. Events reportable under this subsection are:
1) Any surgery or other invasive procedure
			 performed on the wrong body part or site and that is not consistent with the
			 correct documented informed consent for that patient, excluding emergent
			 situations that occur in the course of surgery or other invasive procedure when
			 exigency precludes obtaining informed consents.
2) Surgery or other invasive procedure
			 performed on the wrong patient.
3)
			 The wrong surgical or other invasive procedure performed on a patient that is
			 not consistent with the correct documented informed consent for that
			 patient.
4) Unintended retention of
			 a foreign object in a patient after surgery or other invasive procedure,
			 including medical or surgical items intentionally placed by medical providers
			 that are unintentionally left in place. Unintended retention of a foreign
			 object excludes:
A) Objects present prior to
			 surgery or other invasive procedure that are intentionally left in
			 place;
B) Objects intentionally
			 implanted as part of a planned intervention; and
C) Objects not present prior to surgery or
			 other invasive procedure that are intentionally left in when the risk of
			 removal exceeds the risk of retention (such as micro-needles, broken
			 screws).
5)
			 Intraoperative or immediately postoperative or postprocedure death in an ASA
			 Class I patient, including all ASA Class I patient deaths in situations in
			 which anesthesia was administered, regardless of whether the planned surgical
			 procedure was performed.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.140 - Adverse Health Care Event Reporting System

Current through Register Vol. 48, No. 28, July 12, 2024
Reports of adverse health care events required. Each health
				care facility shall report to the Department the occurrence of any of the
				adverse health care events described in Section
				235.130
				of this Part no later than 30 days after discovery of the event. (Section
				10-15(a) of the Act) The reports required by the Act and this Part may be filed
				by electronic means. The electronic system shall have uniform reporting
				templates, automated report receipts, a user "save" feature and automatic
				reminders to report the 90-day Root Cause Analysis and Corrective Action Plan.
				Reports of adverse health care events shall include:
a) The name, address and Department-assigned
			 unique identifier of the health care facility making the report;
b) The name, title and contact information of
			 the person making the report;
c)
			 The exact location within the health care facility where the adverse health
			 care event occurred;
d) The date
			 and time that the adverse health care event occurred;
e) The date and time that any employee,
			 contractor or representative of the health care facility was notified of the
			 occurrence of the adverse health care event;
f) Gender and age (range) of the
			 patient;
g) Race or ethnicity of
			 the patient;
h) Language spoken by
			 patient; if the language was not English, was a translator present;
i) Date on which the patient was
			 admitted;
j) Admitting diagnosis
			 code of the patient;
k) Principal
			 procedure code of the patient if the event involved surgery;
l) Description of the adverse health care
			 event, including number and type of staff present at time of the
			 event;
m) Any immediate or
			 emergency remedial actions taken prior to filing the adverse health care event
			 report, including if the patient and/or the patient's family was informed of
			 the event; and
n) The outcome for
			 the patient from the adverse event.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.150 - Root Cause Analysis Findings and Corrective Action Plan

Current through Register Vol. 48, No. 28, July 12, 2024
a) Following the occurrence of an adverse
			 health care event, the health care facility must conduct a root cause analysis
			 of the event. Following the analysis, the health care facility must:
1) Implement a corrective action plan to
			 address the findings of the analysis; or
2) Report to the Department any reasons for
			 not taking corrective action.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.160 - Communication and Annual Report

Current through Register Vol. 48, No. 28, July 12, 2024
The Department will communicate with
health care
				facilities to maximize the use of the
adverse health care event
reporting system to improve health care quality.
(Section
				10-30(b) of the Act)
a) The Department
			 will collect and analyze data from adverse health care event reports
to
			 determine patterns of
system
failure in the health care system
			 and successful methods to correct these failures.
(Section 10-30(b) of
			 the Act)
b) The data collected will
			 be used to provide adverse health care event prevention recommendations to
			 Illinois health care facilities and to help to ensure a data base of adverse
			 health care event reports that will provide greater understanding of adverse
			 health care events and promote the reduction of risk for those
			 events.
c) The Department will
			 publish an annual report to increase general knowledge about adverse health
			 care events, their causes, and strategies for prevention. This report will be
			 made available to the public.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.170 - Enforcement

Current through Register Vol. 48, No. 28, July 12, 2024
a) A health care
			 facility that fails to comply with the requirements of the Act and this Part
			 shall be subject to enforcement action by the Department.
b)
After notice and opportunity for a
			 hearing, the
Department
may deny, suspend, or revoke a license
			 to open, conduct, operate, and maintain a hospital in any case in which
			 the
Department
finds that there has been a substantial failure
			 to comply with the provisions of
the Act or this Part. (Section 7(a)
			 of the Hospital Licensing Act)
c)
When the
Department
determines that
an
			 ambulatory surgical treatment center
has failed to comply with
the Act or this Part,
the Department may issue a notice of fine
			 assessment which shall specify the violations for which the fine is
			 assessed.
(Section 10(d) of the Ambulatory Surgical Treatment Center
			 Act) Fines will be assessed in accordance with Section 10(d) of the Ambulatory
			 Surgical Treatment Center Act. The Department will provide notice and
			 opportunity for hearing to the ambulatory surgical treatment center.
d) Hearings shall be conducted in accordance
			 with the Department's Rules of Practice and Procedure in Administrative
			 Hearings (77 Ill. Adm. Code 100).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 235 - ADVERSE HEALTH CARE EVENTS REPORTING CODE › Section 235.180 - Confidentiality

Current through Register Vol. 48, No. 28, July 12, 2024
Other than the annual report required under paragraph (4) of
				Section 10-35 of the Act, adverse health care event reports, findings of root
				cause analyses, and corrective action plans filed by a health care facility
				under the Act and records created or obtained by the Department in reviewing or
				investigating these reports, findings, and plans shall not be available to the
				public and shall not be discoverable or admissible in any civil, criminal, or
				administrative proceeding against a health care facility or health care
				professional. No report or Department disclosure under the Act or this Part may
				contain information identifying a patient, employee, or licensed professional.
				Notwithstanding any other provision of law, under no circumstances shall the
				Department disclose information obtained from a health care facility that is
				confidential under Part 21 of Article VIII of the Code of Civil Procedure.
				(Section 10-25 of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart A - GENERAL PROVISIONS › Section 240.10 - Authority, Scope and Purpose

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				This Part is promulgated pursuant to the authority granted the Department of
				Public Health in Sections 2-2(a), 2-2(b) 5-4, 5-5(d) and 5-8 of the Health
				Maintenance Organization Act (Ill. Rev. Stat. 1987, ch. 1111/2, pars. 1404(a),
				1404(b), 1412, 1413(d) and 1416) for the purpose of regulation and enhancement
				of Health Maintenance Organizations in Illinois. These regulations apply to
				certified Health Maintenance Organizations, as well as to applicants for an HMO
				Certificate of Authority, and are promulgated to carry out the Health
				Maintenance Organization Act and to facilitate the full and uniform
				implementation, enforcement and intent of the Act.
b) Pursuant to the Act the Illinois
				Department of Public Health and the Illinois Department of Insurance have joint
				responsibility for the regulation of Health Maintenance Organizations (HMOs) in
				Illinois. All applicants and certified programs are therefore bound by the
				Health Maintenance Organization rules of the Department of Insurance located at
				50 Ill. Adm. Code 6101 as well as this Part. No person shall establish or
				operate a Health Maintenance Organization without obtaining a Certificate of
				Authority from the Department of Insurance.
c) These regulations explain the requirements
				an HMO applicant must satisfy in order for the Department of Public Health to
				certify to the Department of Insurance that the applicant's proposed plan of
				operation meets the Department of Public Health requirements. Also included in
				this Part are the operational, recordkeeping and fee requirements applicable to
				HMOs.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart B - APPLICATION FOR HMO CERTIFICATE OF AUTHORITY › Section 240.30 - Submission of Application for HMO Certificate of Authority

Current through Register Vol. 48, No. 28, July 12, 2024
The HMO application shall be submitted in triplicate (one
				  original and two copies) to the Department of Insurance in a loose-leaf
				  three-ring binder, indexed with the sections tabbed. The application
				  requirements pertaining to information required by the Department of Public
				  Health are described in Sections
				  240.40,
				  240.50,
				  and
				  240.60
				  of this Part.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart B - APPLICATION FOR HMO CERTIFICATE OF AUTHORITY › Section 240.50 - Provision of Care Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
The application for an HMO Certificate of Authority shall
				  contain the following information about the provision of health care services
				  by the HMO:
a) A copy of the evidence
				of coverage that will be issued to enrollees.
b) A description of the HMO's referral system
				that will be used when an enrollee is in need of a health care service covered
				by the HMO plan, but not available through the participating plan physicians.
				The referral mechanism shall require that the provider make any appointments,
				hospitalization, surgical procedures and any other health services available to
				enrollees within a medically appropriate timeframe. This policy shall not be
				construed so as to relieve an enrollee of any financial obligation incurred
				when that enrollee fails or refuses to utilize the HMO referral
				system.
c) A description of the
				medical record system of the HMO or HMO providers. The HMO and its providers
				shall meet the following medical record system requirements:
1) Clinical records shall be maintained on
				each enrollee who receives health care services through the HMO. The medical
				records system shall be organized to facilitate retrieval and compilation of
				medical records information necessary to provide continuity of care among
				various member and nonmember providers who are directly involved in the care of
				the enrollee.
2) There shall be a
				policy regarding the retention and retirement of enrollees' medical
				records.
3) There shall be a policy
				regarding confidentiality, security and release of enrollees' medical
				records.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart B - APPLICATION FOR HMO CERTIFICATE OF AUTHORITY › Section 240.60 - HMO Self-Evaluation Structure

Current through Register Vol. 48, No. 28, July 12, 2024
a) The application for an HMO Certificate of
				Authority shall contain a description of the actions that will be taken by the
				HMO to:
1) Monitor, on an ongoing basis, the
				quality, availability and accessibility of care delivered under the auspices of
				the HMO, and
2) Implement change,
				where necessary, based on problem identification, analysis and identification
				of corrective action.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart C - HMO OPERATING REQUIREMENTS › Section 240.80 - General Operating Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a) The HMO operations shall be consistent
				with the information provided to the Department in the application.
b) The HMO shall appoint a medical director
				prior to commencing operations. The medical director's credentials shall be
				submitted to the Department.
c) The
				HMO shall develop and implement a process which will enable the HMO to maintain
				current information regarding each provider site under contract with the HMO,
				including the following:
1) Attestation of
				the presence of valid certifications, registrations and licenses as required
				for physicians, nurses, and other ancillary and paramedic personnel who render
				care to enrollees at the provider site.
2) The hours the provider site is
				open,
3) The hours each physician
				is routinely available at the provider site,
4) The extent to which twenty-four (24) hour
				a day, seven (7) day a week coverage is provided through the provider
				site,
5) The number of HMO
				enrollees the provider site serves as well as the total number of patients
				served by the provider site.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart C - HMO OPERATING REQUIREMENTS › Section 240.90 - HMO Provider Site Medical Record Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a) The HMO shall require each provider to
				maintain an active record for each enrollee who receives health care services.
				This record shall be kept current, complete, legible and available to the
				medical and administrative staff of the HMO and to the Department's
				representatives.
b) The HMO shall
				require that each entry be indelibly added to the enrollee's record, dated and
				signed or initialed by the person making the entry. The HMO shall require each
				provider site to have a means of identifying the name and professional title of
				the individual who makes each entry.
c) The medical record for each enrollee who
				has had a routine, scheduled appointment with one of the HMO's primary care
				physicians shall include the following information:
1) identification,
2) patient history,
3) known past surgical procedures,
4) known past and current diagnoses and
				problems, and
5) known allergies
				and untoward reactions to drugs.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart C - HMO OPERATING REQUIREMENTS › Section 240.100 - Required Information and Reports

Current through Register Vol. 48, No. 28, July 12, 2024
a) The HMO shall maintain a membership file
				that identifies the name, date of enrollment, date of birth, sex, and address
				for each enrollee.
b) The following
				material changes to an Application for a Certificate of Authority shall be
				submitted to the Department:
1) Changes in
				medical group, hospital, skilled nursing home or other medically related
				agreements which may affect the availability and accessibility of health care
				services to enrollees shall be communicated in writing to the Department no
				later than thirty days after the execution of such changes or termination of
				such agreements.
2) Personnel
				changes in the Chief Administrative Officer or Medical Director positions shall
				be reported to the Department in writing upon the termination and commencement
				of such employment. A resume for the new appointees shall accompany each notice
				of appointment.
3) Termination of
				any benefit or service by the HMO shall be reported to the Department within 48
				hours by telephone and confirmed in writing within five working days.
4) Changes in the HMO's medical record,
				quality assessment and utilization review plans shall be submitted no later
				than thirty days after the adoption of the new plan.
5) Changes in the contracts concerning the
				information required in Section
				240.50(d)
				of this Part shall be filed with the Department at least thirty (30) days prior
				to entering into the revised Contracts.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart C - HMO OPERATING REQUIREMENTS › Section 240.110 - Department Interventions

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				Department of Public Health shall make an examination concerning the quality of
				health care services of any health maintenance organization and providers with
				whom such organization has contracts, agreements, or other arrangements,
				pursuant to its health care plan as often as he deems it necessary for the
				protection of the interest of the people of this state, but not less frequently
				than once every three years (Section 5-4 of the Act). In determining whether an
				examination is necessary, the Department shall consider whether health care
				services are being made available and accessible as evidenced by the following
				factors:
1) The number and nature of
				grievances received by the HMO,
2)
				The number of enrollees in the plan service area relative to the number
				participating health care providers in the plan service area,
3) The distribution of the enrollees and the
				providers throughout the plan service area,
4) The hours providers are available,
				and
5) The method by which after
				hours service is provided.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 240 - HEALTH MAINTENANCE ORGANIZATIONS CODE › Subpart C - HMO OPERATING REQUIREMENTS › Section 240.120 - Fees

Current through Register Vol. 48, No. 28, July 12, 2024
a) The expenses of
				examining Health Maintenance Organizations shall be assessed against the
				organization being examined. (Section 5-4 of the Act)
b) The annual fee for each health maintenance
				organization, which is based on the Department's estimate of cost for staff and
				other Department expenses to provide the examinations, shall be as follows:
1) A fixed annual fee of $1200,
				plus
2) An additional fee based on
				the individual HMO's enrollment in Illinois as follows:
A) For the first 50,000 enrollees, the HMO
				shall pay $.03 per enrollee,
B) For
				additional enrollees between 50,000 and 100,000, the HMO shall pay $.02 per
				enrollee, and
C) The HMO shall pay
				$.01 for each enrollee in excess of 100,000.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart A - GENERAL PROVISIONS › Section 245.10 - Purpose

Current through Register Vol. 48, No. 28, July 12, 2024
a) This Part has
				been adopted in accordance with Sections 6, 6.3 and 6.7 of the Home Health,
				Home Services and Home Nursing Agency Licensing Act (the Act) [210 ILCS 55/6,
				6.3 and 6.7].
b) Home health
				agencies licensed under the Act and this Part may be eligible for participation
				in the federal Medicare program under the rules of the federal Centers for
				Medicare and Medicaid Services (
				42 CFR 484.1
				through 484.40 ).
c)
Health
				care and support services are provided in the consumer's home by
three
basic types of agencies: home health care, home nursing care, and home
				support services. Each type of agency delivers a different type and scope of
				care or service.
(Section 1.01 of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart A - GENERAL PROVISIONS › Section 245.25 - Incorporated and Referenced Materials

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				The following federal statutes are referenced in this Part:
Civil Rights Act of 1964 (42
				  USC 1981 et seq.)
b) The following federal regulations are
				incorporated by reference in this Part and apply only to Medicare certified
				agencies:
Department of Health and Human Services, Centers for Medicare
				  and Medicaid Services, Home Health Services (42 CFR 484, October 1,
				  2020).
c) The following
				guidelines of a federal agency are incorporated by reference in this Part:
Department of Health and Human Services, Centers for Disease
				  Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333:
1) General Best Practice Guidelines for
				Immunization: Best Practices Guidance of the Advisory Committee on Immunization
				Practices (May 4, 2021) available at
https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html
2) Guidelines for Hand Hygiene in Health-Care
				Settings (October 2002) available at
https://www.cdc.gov/mmwr/pdf/rr/rr5116.pdf
3) Infection Control in Healthcare Personnel:
				Infrastructure and Routine Practices for Occupational Infection Prevention and
				Control Services (October 25, 2019) available in two parts at
https://www.cdc.gov/infectioncontrol/pdf/guidelines/infection-control-HCP-H.pdf
and
https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/index.html
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.30 - Organization and Administration

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Governing Body - All Agencies
The agency shall have a governing body or a clearly defined
				  body with legal authority and responsibility for the conduct of the agency. For
				  the purposes of this Section, the governing body shall:
1) Have bylaws or the equivalent, which shall
				be reviewed annually and be revised as needed. They shall be made available to
				all members of the governing body. The bylaws or the equivalent shall specify
				the objectives of the agency;
2)
				Employ a qualified administrator for home health agencies;
3) Adopt and revise, as needed, policies and
				procedures for the operation and administration of the agency;
4) Meet to review the operation of the
				agency; and
5) Keep minutes of all
				meetings.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.40 - Staffing and Staff Responsibilities

Current through Register Vol. 48, No. 28, July 12, 2024
a) Home
				Health Administrator or Agency Manager. The administrator or agency manager
				shall have the following responsibilities:
1)
				Ensure that the agency is in compliance with all applicable federal, State and
				local laws;
2) Be familiar with the
				applicable rules of the Department and maintain them within the
				agency;
3) Familiarize all
				employees as well as providers through contractual purchase of services with
				the Act and the rules of the Department and make copies available for their
				use;
4) Ensure that reports and
				records as required by the Department are completed, maintained and
				submitted;
5) Maintain ongoing
				liaison with the governing body, staff members and the community;
6) Maintain a current organizational chart to
				show lines of authority down to the patient or client level;
7) Manage business affairs and the overall
				operation of the agency;
8)
				Maintain personnel records, administrative records and all policies and
				procedures of the agency;
9) Employ
				qualified personnel in accordance with job descriptions;
10) Provide orientation of new staff,
				regularly scheduled in-service education programs and opportunities for
				continuing education for the staff;
11) Designate in writing the qualified staff
				member to act in the absence of the administrator;
12) Provide and maintain an office with a
				working telephone that is staffed during the agency's business hours.
A) The office shall be adequately equipped
				for an efficient work environment.
B) The office shall be maintained to protect
				the confidentiality of patient and client records (physical or
				electronic).
C) The office shall
				provide a safe working environment that complies with local ordinances and
				regulations related to fire safety.
13) Adopt and enforce a written policy
				identifying the agency's operating hours and including, at a minimum,
				provisions that ensure clients and patients are provided information regarding
				the procedures for accessing care from the agency or another health care
				provider outside of the agency's operating hours.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.60 - Annual Financial Statement - Home Health Agencies

Current through Register Vol. 48, No. 28, July 12, 2024
a)
Each
home health agency
licensee shall file annually an attested financial statement on a form
				prescribed, prepared and furnished by the Department in conjunction with the
				Illinois Department of Healthcare and Family Services. The application shall
				contain such information as may be required by the Department and the Illinois
				Department of Healthcare and Family Services for the proper administration of
				the Act
and this Part
. An audited financial statement may be
				required of a particular facility, if the Director determines that additional
				information is needed.
(Section 11(a) of the Act)
b)
No public funds shall be expended
				for the services of a home health agency which has failed to file the financial
				statement required by this Section
. (Section 11(b) of the
				Act)
c)
No other State
				agency may require submission of financial data except as expressly authorized
				by law or as necessary to meet requirements of federal law or
				regulation.
(Section 11(d) of the Act)
d)
Information obtained under this
				Section shall be made available, upon request, by the Department only to any
				other State agency or legislative commission to which such information is
				necessary for investigations or to execute the intent of State or federal law
				or regulation.
(Section 11(d) of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.70 - Home Health Aide Training

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each
				home health agency and home nursing agency shall ensure that all persons
				employed as home health aides or under any other title, whose duties are to
				assist with the personal, nursing or medical care and emotional comfort of the
				patients, and who are not otherwise licensed, certified or registered in
				accordance with Illinois law to render such care, comply with one of the
				following conditions:
1) Is approved on the
				Department's Health Care Worker Registry. (see Section
				245.72
				);
2) Meets training requirements
				by completion of a training program approved under the Long-Term Care
				Assistants and Aides Training Programs Code (see 77 Ill. Adm. Code 395);
				or
3) Meets equivalencies
				established in subsection (b).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.71 - Qualifications and Requirements for Home Services Workers

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each agency shall ensure and shall
				maintain documentation in the home services worker's employee file that all
				persons employed or providing services as an in-home services worker, and who
				are not otherwise licensed, certified or registered in accordance with Illinois
				law to render this care, comply with the following conditions:
1) Does not have a disqualifying background
				check under the requirements of the Health Care Worker Background Check Act
				without a waiver;
2) Has a copy of
				the person's Social Security card; and
3) Has a visa or proof of citizenship in
				compliance with federal requirements for employment.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.72 - Health Care Worker Background Check

Current through Register Vol. 48, No. 28, July 12, 2024
An agency shall comply with the Health Care Worker Background
				  Check Act [225 ILCS 46 ] and the Health Care Worker Background Check Code (77
				  Ill. Adm. Code 955).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart B - OPERATIONAL REQUIREMENTS › Section 245.75 - Infection Control

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each agency
				shall develop and implement policies and procedures for investigating,
				controlling and preventing infections. Placement agencies shall provide to
				in-home services workers the Centers for Disease Control and Prevention (CDC)
				publication "Guidelines for Hand Hygiene in Health-Care Settings".
b) Each agency shall adhere, at a minimum and
				as appropriate, to the guidelines of the CDC, United States Public Health
				Service, Department of Health and Human Services, as incorporated in Section
				245.25(c).
c) The home health agency shall maintain and
				document an infection control program to prevent and control infections and
				communicable diseases. Under that program, the agency shall:
1) Follow accepted standards of practice,
				including the use of standard precautions, to prevent the transmission of
				infections and communicable diseases;
2) Maintain a coordinated agency-wide program
				for the surveillance, identification, prevention, control and investigation of
				infectious and communicable disease that is an integral part of the agency's
				QAPI program; and
3) Provide
				infection control education to staff, patients and caregivers.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.90 - License Application

Current through Register Vol. 48, No. 28, July 12, 2024
a) Initial
				Application - All Agencies
1) Any person who
				desires to obtain a license to operate a home health, home nursing, home
				services, home nursing placement, or home service placement agency shall file a
				licensure application with the Department. Any person in interest, different
				from the licensee, who desires to conduct, maintain, or operate a home health,
				home nursing, home services, home nursing placement or home services placement
				agency shall also file an application for licensure with the
				Department.
2) The application
				shall be accompanied by a Certificate of Insurance documenting minimum
				liability coverage of $1 million per occurrence and $3 million in the
				aggregate.
3) Each initial
				application for licensure shall be on forms provided by the Department, and
				shall contain, at a minimum, the following information:
A)
Name, address, and location of the
				agency;
B) Ownership,
organization and governing structure of the agency;
C) The names and addresses of all persons who
				own at least 5% of the agency and the type of ownership of the agency (for
				example individual, partnership or corporation). In addition, corporation shall
				submit:
i) A list of the title, name and
				address of each of its corporate officers;
ii) A list of the name and address of each of
				its shareholders holding more than 5% of the shares; and
iii) Information for the applicant and its
				officers regarding any conviction of, or plea of guilty to, a felony, or two or
				more misdemeanors involving moral turpitude during the previous year;
D) A description of the services
				to be provided;
E) A list of the
				staff of the agency or a list of placement agency registry, including any
				applicable licensure, registration, or certification and any other
qualifications of the staff
of the agency;
F)
Sources of financing of
				services
and any other sources of income of the agency;
G) A description or map of the geographic
service area
in which services are provided by the
				agency;
H)
Charges for
				services
by types of services provided by the agency; and
I) For home health agencies, copies of any
affiliation agreements with other health care providers
.
				(Section 5(a) of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.95 - License Application Fee, Single or Multiple Licenses

Current through Register Vol. 48, No. 28, July 12, 2024
a)
Applicants for multiple licenses
				under
the licensure
system
set forth in this Part
shall pay the higher of the licensure fees applicable.
(Section 4(d) of the Act)
b) A home
				nursing agency or a home services agency shall pay a licensure fee not to
				exceed $1500 annually. The fee is not refundable.
c) A home nursing placement agency or home
				services placement agency shall pay a licensure fee not to exceed $500
				annually. The fee is not refundable.
d) For a single home health agency license
				only, each initial and renewal application shall be accompanied by a
license fee of $25
. (Section 4(c) of the Act) The fee is not
				refundable.
e) An applicant for
				dual licenses as a home services agency and a home services placement agency,
				or a home nursing agency and a home nursing placement agency, shall operate
				each licensed agency as a separate entity to meet the requirements of the Act
				and this Part as an employer of workers and as a placement agency that places
				individuals.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.100 - Provisional License

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Provisional License for New Agencies
1) The
				Department shall
issue a provisional license
to a new agency
				provided that the application is in compliance with Section
				245.90. A new
				agency is an agency that meets either of the following circumstances:
A)
The applicant for licensure has
				not previously been licensed; or
B)
The agency is not in operation at
				the time the application is made
. (Section 4(a) of the Act).
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.110 - Inspections and Investigations

Current through Register Vol. 48, No. 28, July 12, 2024
a)
The Department will conduct such investigations and
				inspections
of licensed agencies and of persons suspected of operating
				an agency without a license
as it deems necessary to assess compliance
				with the Act
and this Part. (Section 9.01 of the Act)
b) Agencies shall facilitate any necessary
				visits by the Department's staff to patients or clients in their homes during
				the Department's investigations or inspections. The Department will obtain
consent from the patient
or client
prior to
				conducting
direct observation of patient care or the provision of home
				services in the home during an investigation or inspection
. (Section
				9.01 of the Act)
c)
Agencies shall make available to the Department all books, records,
				policies and procedures, or any other materials requested during the course of
				an investigation or inspection
. (Section 9.01 of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.115 - Complaints

Current through Register Vol. 48, No. 28, July 12, 2024
a) Complaints in
				regard to agencies licensed under the Act and this Part may be submitted either
				in writing, by telephone or by other electronic means to the IDPH Central
				Complaint Registry.
b) The
				Department will conduct an investigation of all complaints received. An
				appropriate investigation may include but is not limited to record reviews
				and/or telephone interviews, on-site surveys or a combination of
				methods.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.120 - Violations

Current through Register Vol. 48, No. 28, July 12, 2024
a) Notice of
				Violation
1)
When the Department
				determines that an agency is in violation of the Act
or this Part,
a notice of violation shall be served on the licensee
. The
				notice shall be served on the licensee personally or by certified mail.
				(Section 9.02 of the Act)
2)
Each notice of violation shall be in writing
and shall
				include:
A) A description of the
nature of the violation.
B) Citation of the
statutory
				provision or rule alleged to have been violated.
C) A statement that the agency must submit a
plan of correction as provided under Section 9.03
of the Act
				and subsection (b) of this Section.
D) A description of additional
action
				the Department may take under the Act, including adverse licensure action under
				Section 9
of the Act and Section
				245.130
				of this Part
or assessment of a penalty under Section 9.04
of
				the Act and Section
				245.140 of this
				Part.
E) A statement that
the licensee has a right to a hearing
to contest the
				violation, as provided in
Section 10
of the Act and Section
				245.150 of this Part,
				and a description of the procedure for requesting a hearing. (Section 9.02 of
				the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.130 - Adverse Licensure Actions

Current through Register Vol. 48, No. 28, July 12, 2024
a) Adverse
				licensure actions include the denial of an initial license application, denial
				of an application for license renewal, revocation of a license, suspension of a
				license, and the imposition of a penalty or fine.
b) Adverse licensure action shall be
				considered by the Department under the following conditions:
1) Failure of the agency to meet the
				standards prescribed by the Department in this Part.
2)
Satisfactory evidence that the
				moral character of the applicant or supervisor of the agency is not reputable.
				In determining moral character, the Department may take into consideration any
				convictions of the applicant or supervisor
for criminal offenses,
but such convictions shall not operate as a bar to licensing.
(Section 8(b) of the Act)
3)
Lack of personnel qualified by training and experience to properly
				perform the function of an agency
. This determination shall be based
				on the personnel requirements established in this Part. (Section 8(c) of the
				Act)
4)
Insufficient
				financial or other resources to operate and conduct a home health, home
				services or home nursing agency in accordance with the requirements of the Act
				and
this Part. (Section 8(d) of the Act)
5)
Refusal to make books, records,
				policies and procedures, or any other materials requested during the course of
				an investigation or inspection available to the Department.
(Section
				9.01 of the Act)
6)
Violation of any provision of the Act
or this Part. (Section
				9(a) of the Act)
7) Conduct or
				practice found by the Department to be detrimental to the health, safety or
				welfare of a patient or client.
8)
A final determination, that includes exhaustion of all available appeal
				and administrative review rights, of a violation of Section 1400 or 1400.2 of
				the Unemployment Insurance Act or Section 4(d) of the Workers' Compensation
				Act
. (Section 8(e) of the Act)
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.140 - Penalties and Fines

Current through Register Vol. 48, No. 28, July 12, 2024
a) Notice of
				Assessment of Penalties and Fines
1) When the
				Department determines that a penalty or fine is to be assessed under Section
				245.130
				of this Part, the Department shall
issue a notice of fine assessment
				which shall
contain the following information:
A) A specific description of
the
				violations for which the fine is levied.
(Section 9.04(b) of the
				Act)
B) The amount of the penalty
				or fine, based on consideration of the factors specified in Section 9.04(c) of
				the Act and Section
				245.130(c)
				of this Part.
The Department may impose a fine of up to $100 per day
				commencing on the date the violation was identified and ending on the date the
				violation is corrected, or action is taken by the Department to suspend, revoke
				or deny renewal of the license, whichever comes first.
(Section
				9.04(b) of the Act)
C) A
				description of the manner in which the licensee may appeal the assessment and
				the right of the licensee to a hearing under Section 10 of the Act and Section
				245.150 of this
				Part.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart C - LICENSURE PROCEDURES › Section 245.150 - Hearings

Current through Register Vol. 48, No. 28, July 12, 2024
a) Applicants for
				an agency license and licensees may appeal certain actions of the Department
				under the Act and this Part. Following receipt of an appeal or a request for a
				hearing from an applicant or licensee, the Department shall conduct a hearing
				to review the contested action.
b)
				Hearings conducted pursuant to the Act and this Part shall be conducted in
				accordance with the following:
1) Section 10
				of the Act.
2) The Illinois
				Administrative Procedure Act .
3)
				The rules of the Department titled Rules of Practice and Procedure in
				Administrative Hearings.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart D - CLIENT/PATIENT SERVICES › Section 245.200 - Services - Home Health

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each home
				health agency shall provide skilled nursing service and at least one other home
				health service on a part-time or intermittent basis. The agency staff shall
				directly provide basic skilled nursing service. The agency staff may provide
				other home health services directly or through a contractual purchase of
				services. Additional skilled specialty nursing services and use of additional
				nursing staff to meet changes in caseload may be provided by contract. All
				services shall be provided in accordance with the orders of the patient's
				health care professional, under a plan of treatment established by the health
				care professional, and under the supervision of agency staff.
b) The agency shall state in writing what
				services will be provided directly and what services will be provided under
				contractual arrangements.
c)
				Services provided under contractual arrangements shall be through a written
				agreement that includes, but is not limited to, the following:
1) A detailed description of the services to
				be provided;
2) Provision for
				adherence to all applicable agency policies and personnel requirements,
				including requirements for initial health evaluations and employee health
				policies;
3) Designation of full
				responsibility for agency control over contracted services;
4) Procedures for submitting clinical and
				progress notes;
5) Charges for
				contracted services;
6) Statement
				of responsibility of liability and insurance coverage;
7) Period of time in effect;
8) Date and signatures of appropriate
				authorities; and
9) Provision for
				termination of services.
Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart D - CLIENT/PATIENT SERVICES › Section 245.205 - Services - Home Nursing Agencies

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Each home nursing agency shall provide skilled nursing services and may provide
				home health aide services under the supervision of the registered nurse. Home
				nursing services may be provided directly by agency staff or through a
				contractual purchase of services. All services shall be provided:
1) In accordance with the client's health
				care professional, or under a plan of treatment established by the health care
				professional; and
2) Under the
				supervision of agency staff, by a health care professional. If the agency
				manager is the designated nursing supervisor, the agency shall also have
				another nurse on staff to provide the direct skilled nursing care.