Illinois first began requiring ALFs and SHEs to be licensed in 2001. To become and remain licensed, the state requires that these communities follow set regulations in how services are provided to the residents they serve.

Assisted Living Service Plan Requirements

To move into an ALF or SHE in Illinois, seniors first must undergo an assessment by a medical professional to determine if their level of needs is consistent with what an assisted living community can provide. In addition, assessments must be conducted yearly afterward to ensure that an assisted living environment is still appropriate.

Based on the initial assessment and continued checkups, all assisted living residents have a service plan that acts like a contract between them and the ALF or SHE. This service plan sets out the level of care needed for assistance with activities of daily living, the amount of access necessary to health care professionals and services, additional services such as medication reminders or administration and any known and negotiated risks.

The service plan agreement has to document both the services that are agreed upon and those that are refused by either the community or the resident. The service plan is designed by the resident or their legal representative or any other person they designate, an appropriately empowered person representing the community, and, if applicable, a nursing care or case manager.

Assisted Living Admission Requirements

To live in an ALF or SHE in Illinois, a prospective resident must be above the age of 65 or be between the ages of 22 and 64 and suffer from a physical disability. The resident cannot have a significant developmental or cognitive disability and must need only partial assistance with activities of daily living.

If a potential resident currently needs full nursing care, notably intravenous fluids, feedings or catheterization; are in need of total rehabilitation services or have stage 3 or 4 skin ulcers, they are also disqualified. Additionally, they cannot pose a threat to themselves or others and must be able to communicate their own needs clearly or have a close relative or representative living at the same community who can do so on their behalf.

Assisted Living Service Requirements

Illinois requires certain mandatory services be provided to all residents of ALFs and SHEs. In addition, these communities may also offer residents additional optional services, for which they may charge additional fees.

Mandatory services include:

• Providing at least three meals per day as dictated by individual dietary requirements
• Regular housekeeping services within each resident’s apartment as well as common areas
• Laundry services for personal garments as well as household linens
• Security that includes limited-access entrances and guard personnel as necessary
• Emergency communication devices that residents can use to signal needs to the building or emergency response personnel
• Assistance with the activities of daily living, such as feeding, dressing, hygiene and bathroom duties

Assisted Living Medicaid Policy

Prospective ALF and SHE residents may be able to obtain financial assistance through the Illinois Supportive Living Program (SLP), which is a Medicaid waiver. Eligible residents must qualify financially and be interested in living at a property that’s part of the SLP-approved list. SLP funding covers mandatory services except for room and board, which must be paid for individually by the resident. Of the residents’ other income sources, they must commit all but $90 per month to their own ALF or SHE costs.

Assisted Living Facility Requirements

Individual patient apartments in ALFs and SHEs must have a door that can lock, a telephone jack, a way to communicate an emergency with staff or response personnel, and a window or door that provides outside views. For communities that offer private apartments, residents must have a bed that is in good condition, adequate lighting, privacy covers for windows and storage space for belongings.

In an ALF, residents must have a private bathroom with all working fixtures and any assistive devices defined by the service plan contract. In addition, private apartments must provide space for small kitchen appliances.

Medication Management Regulations

The Illinois Administrative Code mandates that all medication administration must be undertaken by licensed health care professionals.

When medication management services are provided to residents, the community’s policies and procedures for handling medications must obtain approval by a qualified health care professional, such as a doctor, pharmacist or registered nurse. Unlicensed staff are not allowed to supervise self-administered medications unless under the direction of a licensed health-care professional.

All medications must be stored appropriately, labeled and administered according to an individual medication record established for each resident.

Staffing Requirements

An ALF or SHE in Illinois is required to have at least one staff member, at least 16 years of age, who is qualified in the administration of CPR on site at all time. In an ALF, an awake staff member must be available 24 hours per day. In a SHE, a staff member must always be present unless an emergency such as accompanying a resident to the hospital occurs.

There is no requirement for a nurse to be on staff, although most communities do provide nursing staff members. Staff members must be managed by an on-site manager in a SHE setting and by a manager who manages no more than three communities in an ALF setting.

Staff Training Requirements

When hired, ALFs and SHEs must provide an initial orientation to all employees on community philosophy, goals, policies and procedures, as well as expectations for respecting patient dignity and autonomy, confidentiality and hygiene. Within 30 days of being hired, additional orientation must occur to cover resident service plans and where they are stored, job responsibilities, emergency procedures and how to provide assistance with activities of daily living. All patient care staff and managers must undergo at least 8 hours of training every 12 months.

Background Checks for ALF and SHE Staff in Illinois

ALFs and SHEs in Illinois must hire employees in accordance with the Health Care Worker Background Check Act and Health Care Worker Background Check Code. Additionally, if a worker must be licensed, the community must verify their license with the Illinois Department of Professional Regulation. All potential hires must also be checked against the Nurse Aide Registry to ensure they have not been found guilty of abuse, neglect or misappropriation of property.

Requirements for Reporting Abuse

Whenever an ALF or SHE believes abuse has occurred, the person who committed that abuse must be removed immediately from the property and a report must be made to the Illinois Department of Public Health (IDPH) within 24 hours through the Assisted Living Complaint Registry. The facility must investigate within 14 days and then file a completed report with the IDPH.