ASSISTED LIVING-HOSPICE CARE

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB4056

Introduced 2/18/2026, by Sen. David Koehler

SYNOPSIS AS INTRODUCED:

210 ILCS 9/75

Amends the Assisted Living and Shared Housing Act. In provisions
concerning terminally ill residents who receive or would qualify for
hospice care, provides that establishments shall ensure that those
residents receive care from a licensed health care professional available
on-site 7 days per week, 24 hours per day to meet the medical, nursing, and
mental and psychosocial care needs of the resident.
LRB104 20045 BAB 33496 b

A BILL FOR

SB4056
LRB104 20045 BAB 33496 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Assisted Living and Shared Housing Act is
5
amended by changing Section 75 as follows:

6

(210 ILCS 9/75)
7

Sec. 75.
Residency requirements.
8

(a) No individual shall be accepted for residency or
9
remain in residence if the establishment cannot provide or
10
secure appropriate services, if the individual requires a
11
level of service or type of service for which the
12
establishment is not licensed or which the establishment does
13
not provide, or if the establishment does not have the staff
14
appropriate in numbers and with appropriate skill to provide
15
such services.
16

(b) Only adults may be accepted for residency.
17

(c) A person shall not be accepted for residency if:
18

(1) the person poses a serious threat to himself or
19

herself or to others;
20

(2) the person is not able to communicate his or her
21

needs and no resident representative residing in the
22

establishment, and with a prior relationship to the
23

person, has been appointed to direct the provision of

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LRB104 20045 BAB 33496 b
1

services;
2

(3) the person requires total assistance with 2 or
3

more activities of daily living;
4

(4) the person requires the assistance of more than
5

one paid caregiver at any given time with an activity of
6

daily living;
7

(5) the person requires more than minimal assistance
8

in moving to a safe area in an emergency;
9

(6) the person has a severe mental illness, which for
10

the purposes of this Section means a condition that is
11

characterized by the presence of a major mental disorder
12

as classified in the Diagnostic and Statistical Manual of
13

Mental Disorders, Fourth Edition (DSM-IV) (American
14

Psychiatric Association, 1994), where the individual is a
15

person with a substantial disability due to mental illness
16

in the areas of self-maintenance, social functioning,
17

activities of community living and work skills, and the
18

disability specified is expected to be present for a
19

period of not less than one year, but does not mean
20

Alzheimer's disease and other forms of dementia based on
21

organic or physical disorders;
22

(7) the person requires intravenous therapy or
23

intravenous feedings unless self-administered or
24

administered by a qualified, licensed health care
25

professional;
26

(8) the person requires gastrostomy feedings unless

SB4056
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LRB104 20045 BAB 33496 b
1

self-administered or administered by a licensed health
2

care professional;
3

(9) the person requires insertion, sterile irrigation,
4

and replacement of catheter, except for routine
5

maintenance of urinary catheters, unless the catheter care
6

is self-administered or administered by a licensed health
7

care professional or a nurse in compliance with education,
8

certification, and training in catheter care or infection
9

control by the Centers for Disease Control and Prevention
10

with oversight from an infection preventionist or
11

infection control committee;
12

(10) the person requires sterile wound care unless
13

care is self-administered or administered by a licensed
14

health care professional;
15

(11) (blank);
16

(12) the person is a diabetic requiring routine
17

insulin injections unless the injections are
18

self-administered or administered by a licensed health
19

care professional;
20

(13) the person requires treatment of stage 3 or stage
21

4 decubitus ulcers or exfoliative dermatitis;
22

(14) the person requires 5 or more skilled nursing
23

visits per week for conditions other than those listed in
24

items (13) and (15) of this subsection for a period of 3
25

consecutive weeks or more except when the course of
26

treatment is expected to extend beyond a 3-week period for

SB4056
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LRB104 20045 BAB 33496 b
1

rehabilitative purposes and is certified as temporary by a
2

physician; or
3

(15) other reasons prescribed by the Department by
4

rule.
5

(d) A resident with a condition listed in items (1)
6
through (15) of subsection (c) shall have his or her residency
7
terminated.
8

(e) Residency shall be terminated when services available
9
to the resident in the establishment are no longer adequate to
10
meet the needs of the resident. The establishment shall notify
11
the resident and the resident's representative, if any, when
12
there is a significant change in the resident's condition that
13
affects the establishment's ability to meet the resident's
14
needs. The requirements of subsection (c) of Section 80 shall
15
then apply. This provision shall not be interpreted as
16
limiting the authority of the Department to require the
17
residency termination of individuals.
18

(f) Subsection (d) of this Section shall not apply to
19
terminally ill residents who receive or would qualify for
20
hospice care and such care is coordinated by a hospice program
21
licensed under the Hospice Program Licensing Act or other
22
licensed health care professional employed by a licensed home
23
health agency and the establishment and all parties agree to
24
the continued residency.
Establishments shall ensure that
25
residents subject to this subsection receive care from a
26
licensed health care professional available on-site 7 days per

SB4056
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LRB104 20045 BAB 33496 b
1
week, 24 hours per day to meet the medical, nursing, and mental
2
and psychosocial care needs of the resident.

3

(g) Items (3), (4), (5), and (9) of subsection (c) shall
4
not apply to a quadriplegic, paraplegic, or individual with
5
neuro-muscular diseases, such as muscular dystrophy and
6
multiple sclerosis, or other chronic diseases and conditions
7
as defined by rule if the individual is able to communicate his
8
or her needs and does not require assistance with complex
9
medical problems, and the establishment is able to accommodate
10
the individual's needs. The Department shall prescribe rules
11
pursuant to this Section that address special safety and
12
service needs of these individuals.
13

(h) For the purposes of items (7) through (10) of
14
subsection (c), a licensed health care professional may not be
15
employed by the owner or operator of the establishment, its
16
parent entity, or any other entity with ownership common to
17
either the owner or operator of the establishment or parent
18
entity, including but not limited to an affiliate of the owner
19
or operator of the establishment. Nothing in this Section is
20
meant to limit a resident's right to choose his or her health
21
care provider.
22

(i) Subsection (h) is not applicable to residents admitted
23
to an assisted living establishment under a life care contract
24
as defined in the Life Care Facilities Act if the life care
25
facility has both an assisted living establishment and a
26
skilled nursing facility. A licensed health care professional

SB4056
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LRB104 20045 BAB 33496 b
1
providing health-related or supportive services at a life care
2
assisted living or shared housing establishment must be
3
employed by an entity licensed by the Department under the
4
Nursing Home Care Act or the Home Health, Home Services, and
5
Home Nursing Agency Licensing Act.
6
(Source: P.A. 103-444, eff. 1-1-24; 103-844, eff. 7-1-25;
7
104-191, eff. 1-1-26
.)

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