77 Ill. Adm. Code 300.1232
Waiver of Registered Professional Nurse Staffing Requirements
Section
300.1232Â Waiver of Registered Professional Nurse Staffing Requirements
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)
d)
A
copy of each waiver application and each waiver granted or renewed
by the
Department
will be on file with the Department and available for public
inspection. The Director will annually review the file and recommend to the
Long-Term Care Facility Advisory Board any modification in this Part suggested
by the number and nature of waivers requested and granted and the difficulties
faced in compliance by similarly situated facilities.
(Section 3-303.1(d)
of the Act)
e)Â Â Â Â Â Â Â Â If
the Department grants a waiver to a facility under this Section,
the
facility shall
immediately
notify the following of the waiver
:
1)
The
Office of the State Long Term Care Ombudsman
;
2)
The
residents of the facility
;
3)
The
residents' guardians
;
4)
The
residents' representatives
(Section 3-303.1(c)(2) of the Act);
5)Â Â Â Â Â Â Â Â Individuals
seeking information from the facility prior to admission to the facility; and
6)Â Â Â Â Â Â Â Â The
Illinois Department of Healthcare and Family Services Bureau of Long-Term Care.
f)Â Â Â Â Â Â Â Â A
request for a waiver from the registered professional nurse staffing
requirements shall be made in writing to the Department, specifying the
following:
1)
A
detailed explanation of why 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
(Section 3-303.1(c) of the Act);
2)Â Â Â Â Â Â Â Â A
detailed description of the programs or services offered by the facility for
which the waiver is requested;
3)
A
detailed explanation of why the waiver will not endanger the health or safety
of residents of the facility
(Section 3-303.1(c) of the Act);
4)Â Â Â Â Â Â Â Â The
number of residents in the facility and the level of care they require, the
location and number of ambulatory and non-ambulatory residents, and residents'
decision making capacity; and
5)Â Â Â Â Â Â Â Â The
time period for which the waiver is requested.
g)Â Â Â Â Â Â Â Â The
Department may revoke a waiver granted to a facility if the facility fails to
comply with any of the requirements in the Act and this Section.
h)Â Â Â Â Â Â Â Â A
facility operating under an initial license shall not be eligible for a waiver
of registered professional nurse staffing requirements.
i)Â Â Â Â Â Â Â Â Â A
facility that has been subject to any of the following actions by the
Department in the three years prior to application shall not be eligible for a
waiver of registered professional nurse staffing requirements:
1)Â Â Â Â Â Â Â Â Issuance
of one or more Type "AA" violations if operated by the same owner at
the time of the waiver application;
2)Â Â Â Â Â Â Â Â Issuance
of two or more Type "A" violations if operated by the same owner at
the time of the waiver application; or
3)Â Â Â Â Â Â Â Â Issuance
of two consecutive annual or bi-annual certification surveys with substantiated
substandard quality of care deficiencies.
j)
No
waiver shall exceed the duration of the current license or, in the case of an
application for license renewal, the duration of the renewal period.
(Section 3-303.1(a) of the Act)Â For facilities with two-year licenses, no
waiver shall be granted for a period that exceeds one year. Waivers shall not
be transferable.
k)Â Â Â Â Â Â Â Â The
Department will post on its website a list of facilities with approved waivers
by no later than June 30 of each year.