210 ILCS 45/3B-100: Definitions.

As used in this Article:

"Clinical support team" (CST) means non-universal team members who provide support services throughout the campus. The CST provides support to self-directed or self-managed work teams. The CST includes, but is not limited to, the Administrator, Director of Nursing, Assistant Director of Nursing, and Minimum Data Set nurse.

"Cottage style" or "cottage style facilities" means small, free-standing, self-contained homes that:

(1) Surround or are adjacent to a central administration unit.

(2) Provide up to 12 private residents' rooms that are shared only at the request of a resident to accommodate a spouse, partner, or family member. A spouse that does not meet medical criteria for nursing facility placement may reside in the room assigned to a spouse who is admitted to the facility and who meets medical criteria for admission. The facility may charge the spouse who does not meet medical criteria for room and board, as well as other services so long as the facility meets all requirements or cost reporting.

(3) Have a full, accessible private bathroom for each resident room that contains, at a minimum, a toilet, sink, and shower.

(4) Have the appearance of a residential dwelling for both the exterior and the interior.

(5) Have residents' rooms constructed around a central, communal, family-style open space that includes a hearth room, dining area, and residential-style kitchen. The central communal area shall contain a living area where residents and staff may socialize, dine, and prepare food together that, at a minimum, provides a living room seating area, a dining area large enough for a single table serving all residents in the home plus 2 staff members, and an open full kitchen. The communal area may include a gas fireplace with a fixed, "stay-cool" glass screen.

(6) Have all residents' room entrances visible from the central communal area.

(7) Each communal area may not exceed a ratio of one communal area to 12 resident rooms.

(8) Two cottages may share a centralized kitchen and laundry, but each may not exceed a ratio of one kitchen/laundry to 24 resident rooms.

(9) Contains residential-style design approach, scale, details, and materials throughout the home that are similar to the typical residential designs and finishes in the immediate surrounding community and does not contain or utilize commercial and institutional elements and products such as a nurse station, medication carts, hospital or office type fluorescent lighting, acoustical tile ceilings, institutional-style railings, room numbering, and labeling and signage that would not normally be found in a private home setting.

Where rules require specific institutional elements, every effort shall be made to provide the institutional elements in a manner consistent with what might be found in a new private home in the community (such as residential wall sconces used for required nurse call lights).

(10) Have outdoor space that:

(A) allows residents to ambulate, with or without assistive devices such as wheelchairs or walkers;

(B) signals staff wirelessly when someone enters the outdoor space from the cottage style home;

(C) is partially covered to protect from sun and elements under the covered area; and

(D) provides for outdoor activities.

(11) Utilize a wireless alert or call system. The system shall also include, for residents who have been care planned to be at risk for wandering or elopement, location bracelets that permit residents to signal for assistance and enable staff to locate residents. Wired call or alert systems and overhead paging are not permitted.

(12) Utilize a wireless communication and notification system for staff. The system shall provide a means for notification of staff both in the home and in other homes or other areas of the facility occupied by other staff.

(13) Contain ample natural light in each habitable space provided through exterior windows and other means, with window areas, exclusive of skylights and clerestories, being a minimum of 10% of the area of the room.

(14) Have built-in safety features (such as magnetic locks on cabinets with chemicals or knives) to allow all areas of the house, including the kitchen and any staff office, to be accessible to the residents during the majority of the day and night.

(15) Provide self-directed care for residents through the establishment of self-managed or self-directed work teams consisting of certified nursing assistants.

(16) Prepare and cook at least 80% of resident meals in the cottage style home. Nothing in this item (16) prohibits the consumption of foods that are:

(A) prepared outside the cottage style home by family, acquaintances, or social organizations such as churches;

(B) grown in or on the grounds of the cottage style home by residents or staff; or

(C) prepared by local retail eating establishments that are licensed or inspected based on local, State, or federal laws.

(17) Train all staff involved in the operation of the project in the philosophy, operations, and skills required to implement and maintain self-directed care, self-directed or self-managed work teams, a non-institutional approach to life and care in long-term care, appropriate safety and emergency skills, and other elements required for successful operations and outcomes of the project.

(18) Are designed to be fully accessible for persons with disabilities.

(19) Have overhead lift tracks that run from the bed into the bathroom in at least 30% of resident rooms.

(20) Have at least one lift motor for each cottage style home.

(21) Have separate slings for each resident in the facility who requires a lift.

(22) Are not connected to, or share, any area that would not typically be connected or shared between private homes in the surrounding community (such as a driveway).

(23) Provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychological well-being of the resident, in accordance with each resident's comprehensive resident care plan.

(24) Maintain a staffing plan compliant with the minimum direct care staffing ratios required by this Act, the Illinois Administrative Code, and any other applicable State or federal law.

(25) Maintain all professional licensure for staff and employees in accordance with applicable State laws, including, but not limited to, Department of Financial and Professional Regulation requirements.

(26) Comply with any applicable State and federal consent decrees.

(27) Obtain proof and documentation of federal approval by the Centers for Medicare and Medicaid Services.

"Home" means each discrete cottage style unit housing up to 12 private residents' rooms.

"Person-directed care" means a holistic model that takes into consideration each resident's physical, mental, and social needs in the development of a care and treatment plan and the delivery of services that is driven to the greatest extent possible by resident choice, as opposed to an institutional medical model that is schedule and task driven.

"Self-managed or self-directed work team" means the universal workers assigned to a specific cottage style home and who determine, plan, and manage day-to-day activities in the house with little or no direct supervision.

"Food safety" means a method of ensuring safe preparation and delivery of food for and to residents.

"Family-style dining" means residential-style dining, in which all food is placed in serving bowls, platters, and similar residential serving dishes on the table, residents and staff dine together, and residents are encouraged to serve themselves or serve themselves with help from staff.

"Universal or flexible worker" means a certified nursing assistant who has received additional training in the areas of dietary, housekeeping, activities, and laundry and is a member of the self-managed or self-directed work team.