Provider Notice issued 10/20/09

Revised Supportive Living Program Rules

Following are summaries of the main points of the rule revisions.  These summaries are intended for your convenience only; the rule should be consulted for specific requirements related to any particular topic.  The adopted rules, showing the changes (underlined and stricken), can be accessed in the Secretary of State's Web site at http://tinyurl.com/ychuw7t on page 11803.

Section 146.205, Definitions

• Expands definitions

Section 146.210, Structural Requirements

• Adds requirement for all shared apartment bedrooms to have a door,
• provides for common bathing room to be optional,
• provides that a public telephone may be placed anywhere in the facility, not just in a common area,
• adds hot water temperature range, including monthly checks and random sample of resident rooms, and
• adds language on how disposal of sharps must be handled.

Section 146.215, SLF Participation Requirements

• Clarifies that if a SLF charges a private pay rate higher than the Medicaid rate, the SLF must reserve at least 25% of its apartments for Medicaid-eligible residents.

Section 146.220, Resident Participation Requirements

• Requires three sex offender lists to be checked, including the national sex offender website, and
• adds that an SLF resident cannot participate in any other HCBS waiver program.

Section 146.230, Services

• Provides that assistance with medications must be available to all residents, not just those "physically impaired",
• clarifies the need for documentation relating to med administration and oversight,
• deletes exception for "therapeutic diets ordered by a physician" from requirement that the same menu options must be available to all residents,
• changes the length of time menus must be kept on file from four to six months,
• changes the requirement for length of time food purchase records must be maintained from 18 to six months,
• adds that transportation must be provided at no charge for group shopping and community or social activities,
• changes apartments to residents when calculating the number of 24-hour response staff needed,
• adds that at least one CNA must be on-site 24-hours,
• adds that the requirement for a secondary emergency call device may be met either by a device in each bedroom or a portable call device that can be worn by resident – each bathroom must still have a primary call device, and
• adds requirement that emergency call system have some type of immediate notification capability.

Section 146.235, Staffing

• Clarifies that licensed nurses or certified nursing assistants may not work in another part of building not certified as an SLF at the same time as on shift in the SLF,
• adds resident rights, financial exploitation and TB as a training subject,
• deletes negotiated risk as a training subject, and
• adds that names of CNAs must be checked against DPH's Health Care Worker Registry prior to employment.

Section 146.240, Resident Contract

• Adds requirement to include in resident contract the SLF's policy on temporary absence, food stamps and security deposits.

Section 146.245, Assessment and Service Plan and Quarterly Evaluation

• Adds that RAI must be completed for significant change in resident status, and
• adds requirement for monthly progress notes.

Section 146.250, Resident Rights

• Adds requirement for Department complaint hotline and ombudsman poster to be posted and HFS brochures to be available, and
• Deletes requirement for a "negotiated risk" agreement when a resident refuses a service or activity and replaces it with documenting refusal in the service plan with quarterly review.

Section 146.255, Discharge

• Clarifies the need for notice for an emergency discharge and
• deletes the need for written orders and medical justification from attending physician for an emergency discharge – SLF may consult with attending physician for additional support.

Section 146.265, Records and Reporting Requirements

• Adds "quarterly evaluation" to what needs to be developed and maintained in written records,
• adds documentation of TB test to be maintained in resident record,
• deletes requirement to retain annual performance evaluation in personnel record,
• adds requirement for completion of medication error and incident report, and
• deletes requirement for personnel report and subcontractor and manager report.

Section 146.270, Quality Assurance Plan

• Adds that the Department shall review the plan initially and annually thereafter.

Section 146.280, Non-Compliance Action (formerly Termination or Suspension of SLF Provider Agreement)

• Clarifies how non-compliance is handled for immediate jeopardy versus non-immediate jeopardy – allows for refute of findings.

146.295, Emergency Contingency Plan

• Deletes portion of definition of "emergency" – leaving only events as a result of mechanical failure or natural force, and making applicable changes throughout,
• adds that for power outages, plan should include how residents call for help, how resident safety is monitored, and how food spoilage is checked, 
• clarifies what the two drills per year should cover.
• Provides examples of types of events requiring notification to the Department (clarifies false alarms, as determined by the local fire department, are not included), and
• adds that names of residents involved in an emergency be included in notification to the Department and that a final report be submitted

146.305, Reporting of Abuse, Neglect and Financial Exploitation

• New section that addresses reporting of suspected abuse, neglect or financial exploitation of a resident.

146.310, Management of Resident Funds

• New section outlining an SLF's responsibility when managing resident funds.

The rule in its entirety without the revisions identified (not underlined or stricken) may be found at: www.slfillinois.com/rules.html

This SLF Informational Notice may be found online at: www.slfillinois.com/notice

Questions regarding this notice should be directed to the Healthcare and Family Services Bureau of Long Term Care at 217-524-0372.

Theresa A. Eagleson, Administrator
Division of Medical Programs