Section 1126.130 Definitions

Section 1126.130  Definitions

"Act"

means the Illinois Health Facilities Planning Act [20 ILCS 3960].

"Adverse Action" means a

disciplinary action taken by IDPH, federal Centers for Medicare and Medicaid

Services (CMMS), or any other State or federal agency against a person or

entity that owns and/or operates a licensed or Medicare or Medicaid certified

SMHRF in the State of Illinois. These actions include, but are not limited to,

a financial penalty, probation, revoked license, restricted license or the

inability to be licensed or relicensed  as set forth in SMHRA Section 4-109

and 77 Ill. Adm. Code 380.750.

"Agency"

or "IDPH" means the Illinois Department of Public Health.

"Applicant" means one or

more persons, as defined in the Act, who apply for a permit or exemption.  (See

77 Ill. Adm. Code 1130.220 to determine what parties must jointly apply for an

application.)

"Authorized

Representative" means a person who has authority to act on behalf of the

legal entity or person that is the applicant or permit holder. Authorized

representatives are, in the case of a:

corporation, any of its officers

or members of its board of directors;

limited liability company, any of

its managers or members (or the sole manager or member when two or more managers

or members do not exist);

partnership, any of its general

partners (or the sole general partner when two or more general partners do not

exist);

estate or trust, any of its

beneficiaries (or the sole beneficiary when two or more beneficiaries do not

exist); and

sole proprietor, the individual

who is the proprietor.

"Capital Expenditure"

means an expenditure made by or on behalf of

a SMHRF

(as such a facility

is defined in

the

Act)

that

, under generally accepted accounting

principles, is not properly chargeable as an expense of operation and

maintenance, or is made to obtain by lease or comparable arrangement any

facility or part thereof or any equipment for a facility or part, and

that

exceeds the capital expenditure minimum

means an expenditure made by or on behalf of

a SMHRF

(as such a facility

is defined in

the

Act)

that

, under generally accepted accounting

principles, is not properly chargeable as an expense of operation and

maintenance, or is made to obtain by lease or comparable arrangement any

facility or part thereof or any equipment for a facility or part, and

that

exceeds the capital expenditure minimum. For purposes of this

definition

,

the cost of any studies, surveys, designs, plans, working drawings,

specifications, and other activities essential to the acquisition, improvement,

expansion, or replacement of any plant or equipment with respect to which an

expenditure is made shall be included in determining if

the

expenditure

exceeds the capital expenditure minimum. Donations of equipment or facilities

to

a SMHRF that,

if acquired directly by

that

facility would be

subject to review under

the

Act shall be considered capital

expenditures, and a transfer of equipment or facilities for less than fair

market value shall be considered a capital expenditure if a transfer of the

equipment or facilities at fair market value would be subject to review.

[20 ILCS 3960/3]

"Capital Expenditure

Minimum" means the dollar amount or value that would require a permit for

capital projects and major medical equipment. Capital expenditure minimums are

annually adjusted to reflect the increase in construction costs due to

inflation under 77 Ill. Adm. Code 1130.310.

"CMMS"

means the federal Centers for Medicare and Medicaid Services.

"Chairman"

means the presiding officer of HFSRB.

"Change of Ownership"

means a change in the person who has operational control of an existing SMHRF

or

a change in the person who has ownership or control of

a SMHRF's

physical plant and capital assets.  A change of ownership is indicated by,

but

not limited to,

the following transactions: sale, transfer, acquisition,

leases, change of sponsorship or other means of transferring control

HFSRB.

"Change of Ownership"

means a change in the person who has operational control of an existing SMHRF

or

a change in the person who has ownership or control of

a SMHRF's

physical plant and capital assets.  A change of ownership is indicated by,

but

not limited to,

the following transactions: sale, transfer, acquisition,

leases, change of sponsorship or other means of transferring control.

[20

ILCS 3960/3]  Examples of change of ownership include:

a transfer of stock or assets

resulting in a person obtaining majority interest (i.e., over 50%) in the

person who is licensed or certified (if the facility is not subject to

licensure), or in the person who owns or controls the SMHRF's physical plant

and capital assets;

the issuance of a license by IDPH

to a person different from the current licensee;

a change in the membership or

sponsorship of a not-for-profit corporation;

a change of 50% or more of the

voting members of a not-for-profit corporation's board of directors, during any

consecutive 12 month period, that controls a SMHRF's operations, license,

certification (when the facility is not subject to licensing), or physical

plant and capital assets;

a change in the sponsorship or

control of the person who is licensed or certified (when the facility is not

subject to licensing) to operate, or who owns the physical plant and capital

assets of a governmental SMHRF; or

any other transaction that results

in a person obtaining control of a SMHRF's operations or physical plant and

capital assets, including leases.

"Charity Care"

means

care provided by

a SMHRF

for which the provider does not expect to

receive payment from the patient

/resident

or a third party payer

.

[20 ILCS 3960/3]

"Clinical Service Area"

means a department and/or service that is directly

related to the

diagnosis, treatment, or rehabilitation of persons receiving services from the SMHRF

l plant and

capital assets, including leases.

"Charity Care"

means

care provided by

a SMHRF

for which the provider does not expect to

receive payment from the patient

/resident

or a third party payer

.

[20 ILCS 3960/3]

"Clinical Service Area"

means a department and/or service that is directly

related to the

diagnosis, treatment, or rehabilitation of persons receiving services from the SMHRF.

A clinical service area's physical space shall include those components

required under the facility's licensure or Medicare and/or Medicaid

certification, and/or as outlined by documentation from the facility as to the

physical space required for appropriate clinical practice.

"Combined Service Area

Project" means a project that consists of both clinical service areas and

nonclinical service areas.

"Completion Date" or

"Project Completion Date" means the date established by the applicant

for the completion of the project, as stated in the CON permit application.

"Construction" or

"Modification"

means the establishment, erection, building,

alteration, reconstruction, modernization, improvement, extension,

discontinuation, change of ownership of or by a

SMHRF

, or the purchase

or acquisition by or through

a SMHRF

of equipment or service for diagnostic

or therapeutic purposes or for facility administration or operation or any

capital expenditure made by or on behalf of

a SMHRF

that

exceeds

the capital expenditure minimum; however, any capital expenditure made by or on

behalf of

a SMHRF

for the construction or modification of a facility

licensed under the Assisted Living and Shared Housing Act

[210 ILCS 9]

or

a conversion project undertaken in accordance with Section 30 of the Older

Adult Services Act

[320 ILCS 42]

shall be excluded from any obligations

under the Act.

[20 ILCS 3960/3]

"Contested Case" has the

meaning ascribed in Section 1-30 of the Illinois Administrative Procedure Act

[5 ILCS 100]

odification of a facility

licensed under the Assisted Living and Shared Housing Act

[210 ILCS 9]

or

a conversion project undertaken in accordance with Section 30 of the Older

Adult Services Act

[320 ILCS 42]

shall be excluded from any obligations

under the Act.

[20 ILCS 3960/3]

"Contested Case" has the

meaning ascribed in Section 1-30 of the Illinois Administrative Procedure Act

[5 ILCS 100].

"Control" means a person

possesses any of the following discretionary and nonministerial rights or powers:

In the case of an entity, the

ability to direct the management and policies of the entity, whether through

the voting of securities, corporate membership, contract or otherwise.

Examples of control include, without limitation:

holding 50% or more of the

outstanding voting securities of an issue;

in the case of an entity that has

no outstanding voting securities, having the right to 50% or more of the

profits or, in the event of dissolution, the right to 50% or more of the assets

of the entity;

having the power to appoint or

remove 50% or more of the governing board members of an entity;

having the power to require or

approve the use of funds or assets of the entity; or

having the power to approve, amend

or modify the entity's bylaws or other governance documents.

In the case of capital assets or

real property, the power to direct or cause the direction of the personal

property, real property or capital assets that are components of the project

(i.e., fixed equipment, mobile equipment, buildings and portions of

buildings).  Examples of control include, without limitation:

ownership of 50%

or more in the property or asset;

serving as lessee

or sublessee.

"Director"

means the Director of the Department of Public Health.

"Due Diligence" means to

take actions toward the completion of a project for which a permit has been

issued with that diligence and foresight that persons of ordinary prudence and

care commonly exercise under like circumstances

thout limitation:

ownership of 50%

or more in the property or asset;

serving as lessee

or sublessee.

"Director"

means the Director of the Department of Public Health.

"Due Diligence" means to

take actions toward the completion of a project for which a permit has been

issued with that diligence and foresight that persons of ordinary prudence and

care commonly exercise under like circumstances.  An accidental or unavoidable

cause that cannot be avoided by the exercise of due diligence is a cause that

reasonably prudent and careful persons, under like circumstances, do not and

would not ordinarily anticipate, and whose effects under similar circumstances

they do not and would not ordinarily avoid.

"Entity" means any

corporation, company, partnership, joint venture, association, trust,

foundation, fund or other legally recognized organization, public body or

municipality.

"Establish" or

"Establishment"

means the construction of a

new

SMHRF

,

the licensing of unlicensed buildings or structures as a SMHRF, the

replacement

of an existing

SMHRF

on another site, or

the initiation of a

category of service

defined by the Board

.

[20 ILCS 3960/3]

"Estimated Project Cost"

or "Project Cost" means the sum of all costs, including the fair

market value of any equipment or other real property (whether acquired by

lease, donation or gift) necessary to complete a project, including:

preplanning

costs;

site survey and

soil investigation fees;

site preparation

costs;

off-site work;

construction

contracts and contingencies (including demolition);

capital equipment

included in construction contracts;

architectural and

engineering fees;

consultant and

other professional fees that are related to the project;

capital equipment

not in construction contracts;

bond issuance

expenses;

net interest

expense during construction; and

all other costs

that are to be capitalized

rk;

construction

contracts and contingencies (including demolition);

capital equipment

included in construction contracts;

architectural and

engineering fees;

consultant and

other professional fees that are related to the project;

capital equipment

not in construction contracts;

bond issuance

expenses;

net interest

expense during construction; and

all other costs

that are to be capitalized.

"Ex Parte Communication"

means a communication between a person who is not a State Board member or

employee that reflects on the substance of a

formally filed

State Board

proceeding and that takes place outside the record of the proceeding.

Communications regarding matters of procedure and practice, such as the format

of a pleading, number of copies required, manner of service, and status of

proceedings, are not considered ex parte communications.  Technical assistance

with respect to an application, not intended to influence any decision on the

application, may be provided by

State Board

employees to the applicant.

Once an application is filed and deemed complete, a written record of any

communication between staff and an applicant shall be prepared by staff and

made part of the public record, using a prescribed, standardized format, and

shall be included in the application file.

[20 ILCS 3960/4.2]

"Fair Market Value"

means the dollar value of a project or any component of a project that is

accomplished by lease, donation, gifts or any other means that would have been

required for purchase, construction or acquisition.

"Final Decision" or

"Final Administrative Decision" or "Final Determination"

means:

the decision by HFSRB to approve

or deny an application for permit.  Action taken by HFSRB to deny an

application for permit is subsequent to an administrative hearing or to the

waiver of an administrative hearing; or

the decision by

HFSRB on all matters other than the issuance of a permit

ion or acquisition.

"Final Decision" or

"Final Administrative Decision" or "Final Determination"

means:

the decision by HFSRB to approve

or deny an application for permit.  Action taken by HFSRB to deny an

application for permit is subsequent to an administrative hearing or to the

waiver of an administrative hearing; or

the decision by

HFSRB on all matters other than the issuance of a permit.

HFSRB NOTE:  The decision is final

at the close of business of the HFSRB meeting at which the action is taken.

"Final Realized Costs"

means all costs that are normally capitalized under generally accepted

accounting principles that have been incurred to complete a project for which a

permit or exemption was issued.  These costs include all expenditures and the

dollar or fair market value of any component of the project, whether acquired

through lease, donation or gift.

"Financial Commitment"

means the commitment of at least 33% of total funds assigned to cover total

project cost, which occurs by:

The actual

expenditure of 33% or more of the total project cost; or

The commitment to expend 33% or

more of the total project cost by signed contracts or other legal means.

"Financial Commitment

Date" means the date on which the permit holder expended or committed to

expend by contract or other legal means at least 33% of the total project cost.

"Hearing Officer" means

the person with authority to conduct public hearings and to take all necessary

steps to assure the proper completion of public hearings and to assure

compliance with requirements of the Act.  Responsibilities include: determining

the order and time allotment for public testimony; maintaining order; setting

and announcing new hearing dates, times and places, as necessary; determining

the conclusion of the hearing and assuring that all documents, exhibits and

other written materials presented or requested at the hearing are in the

hearing officer's custody; and preparing a report for submittal to HFSRB

lude: determining

the order and time allotment for public testimony; maintaining order; setting

and announcing new hearing dates, times and places, as necessary; determining

the conclusion of the hearing and assuring that all documents, exhibits and

other written materials presented or requested at the hearing are in the

hearing officer's custody; and preparing a report for submittal to HFSRB.

"HFSRB " or "State

Board" means the Illinois Health Facilities and Services Review Board.

"HFSRB Inventory" or

"Inventory" means the HFSRB Inventory of Health Care Facilities and

Services and Need Determinations, located at HFSRB's website (www.hfsrb.illinois.gov).

"IAPA"

means the Illinois Administrative Procedure Act [5 ILCS 100].

"Intent to Deny" means

the negative decision of HFSRB, following its initial consideration of an

application for permit that failed to receive the number of affirmative votes

required by the Act.

"Major

Construction Project" means:

Projects for

the construction of new buildings;

Additions to

existing facilities;

Modernization projects whose

cost is in excess of $1,000,000 or 10% of the facility's operating revenue,

whichever is less; and

such projects as

HFSRB

shall define and prescribe pursuant to

the

Act.

[20 ILCS 3960/5]

"Medicaid Certified" or

"Medicare Certified" or "Medicaid Certification" or

"Medicare Certification" means approval for a facility to receive

reimbursement under Title XVIII (Medicare) and/or XIX (Medicaid) of the Social

Security Act (42 USC 1395).

"Modification of an

Application" or "Modification" means any change to an

application during the review period (i.e., prior to a final HFSRB action)

dicaid Certified" or

"Medicare Certified" or "Medicaid Certification" or

"Medicare Certification" means approval for a facility to receive

reimbursement under Title XVIII (Medicare) and/or XIX (Medicaid) of the Social

Security Act (42 USC 1395).

"Modification of an

Application" or "Modification" means any change to an

application during the review period (i.e., prior to a final HFSRB action).

These changes include, but are not limited to:

changing the proposed project's

physical size or gross square feet;

the site within a planning area;

the operating entity when the

operating entity is not the applicant;

the number of proposed beds;

the categories of service to be

provided;

the cost;

the method of financing;

the proposed project completion

date;

the configuration of space within

the building; or

any change in the person who is

the applicant, including the addition or deletion of one or more persons as

co-applicants.

HFSRB NOTE:  A change of site to

a site outside the planning area originally identified in the application is

not considered a modification and invalidates the application.

"Newspaper of General

Circulation" means newspapers other than those intended to serve a

particular, defined population, such as the publications of professional and

trade associations.

"Newspaper of Limited

Circulation" means a newspaper intended to serve a particular or defined

population of a specific geographic area within a Metropolitan Statistical Area

such as a municipality, town, village, township or community area, but does not

include publications of professional and trade associations.

[20 ILCS

3960/8.5(a)]

"Non-Substantive

Projects" means projects that have been classified as non-substantive

under 77 Ill. Adm. Code 1110.40.  HFSRB will review a non-substantive project

within 60 days.

"Notification of HFSRB

Action" means the transmittal of HFSRB decisions to the applicant or

permit or exemption holder

t does not

include publications of professional and trade associations.

[20 ILCS

3960/8.5(a)]

"Non-Substantive

Projects" means projects that have been classified as non-substantive

under 77 Ill. Adm. Code 1110.40.  HFSRB will review a non-substantive project

within 60 days.

"Notification of HFSRB

Action" means the transmittal of HFSRB decisions to the applicant or

permit or exemption holder.  Notification shall be given to the applicant's or

permit holder's designated contact person, legal representative or chief

executive officer.

"Operational" means that

a permit holder is providing the services approved by HFSRB and, for a new

SMHRF, licensure or Medicare and/or Medicaid certification has been obtained

and residents/patients are utilizing the facility or equipment or are receiving

service.

"Permit" means

authorization to execute and complete a project related to a SMHRF, as reviewed

and approved by HFSRB

and as specified in the

Act.

"Person"

means any

one or more natural persons, legal entities, governmental bodies other than

federal, or any combination thereof.

[20 ILCS 3960/3]

"Proposal" or

"Project" means any proposed construction or modification of a long

term care facility or any proposed acquisition of equipment to be undertaken by

an applicant.

"Related

Person" means

any person that:

is at least 50% owned, directly

or indirectly, by either the

SMHRF

or a person owning, directly or

indirectly, at least 50% of the

SMHRF;

owns, directly or indirectly,

at least 50% of the

SMHRF [20 ILCS 3960/3];

is otherwise

controlled or managed by one or more SMHRFs;

controls or

manages the SMHRF; or

is otherwise, directly or

indirectly, under common management or control with one or more SMHRFs.

"Review Period" means

the time from the date an application for permit or exemption is deemed

complete until HFSRB

renders its final decision.

"Site" means the

physical location of a proposed project and is identified by address or legal

property description

Fs;

controls or

manages the SMHRF; or

is otherwise, directly or

indirectly, under common management or control with one or more SMHRFs.

"Review Period" means

the time from the date an application for permit or exemption is deemed

complete until HFSRB

renders its final decision.

"Site" means the

physical location of a proposed project and is identified by address or legal

property description.

"SMHRA" means the

Specialized Mental Health Rehabilitation Act of 2013 [210 ILCS 49]

"SMHRF"

means Specialized Mental Health Rehabilitation Facility.

"Square Feet" or

"SF" or "Square Footage" means a unit of measure of

physical service areas or buildings considered by HFSRB.

Departmental Gross Square Feet

(DGSF) means the designation of physical areas for departments and services.

It consists of the entirety of space dedicated to the use of that department or

service, including walls, shafts and circulation.

Building Gross Square Feet (BGSF)

means the designation of physical area of an entire building.  It includes all

exterior walls and space within those walls.

"Substantially Changes the

Scope or Changes the Functional Operation of the Facility" means:

the addition of a

category of service;

a change of a material

representation made by the applicant in an application for permit or exemption

subsequent to receipt of a permit that is relied upon by HFSRB in making its

decision.  Material representations are those that provide a factual basis for

issuance of a permit and include:

withdrawal or nonparticipation in

the Medicare and/or Medicaid programs;

charge information;

other representations made to

HFSRB

as stipulated or agreed upon in the public

record and specified in the application or the permit approval letter.

"Substantive Projects"

means types of projects that are defined in the Act and classified as

substantive

al basis for

issuance of a permit and include:

withdrawal or nonparticipation in

the Medicare and/or Medicaid programs;

charge information;

other representations made to

HFSRB

as stipulated or agreed upon in the public

record and specified in the application or the permit approval letter.

"Substantive Projects"

means types of projects that are defined in the Act and classified as

substantive.

Substantive projects shall include no more than the following:

Projects to construct a new or

replacement facility located on a new site or a replacement facility located on

the same site as the original facility and the costs of the replacement

facility exceed the capital expenditure minimum;

Projects proposing a new

service or discontinuation of a service, which shall be reviewed by the Board

within 60 days;

Projects proposing a change in

the bed capacity of

a SMHRF

by an increase in the total number of beds

or by a redistribution of beds among various categories of service or by a

relocation of beds from one facility to another by more than 20 beds or more

than 10% of total bed capacity, as defined by HFSRB, whichever is less, over a

2 year period.

[20 ILCS 3960/12]

"Technical Assistance"

means help provided by an employee of HFSRB to a person, SMHRF or the State

Board, and is not considered ex parte communication as defined in Section 4.2

of the Act.  Technical assistance may be provided to any person regarding

pre-application conferences, the filing of an application, or other request to

HFSRB provided that the communication is

not intended to influence any

decision on the application.

Technical assistance may be provided for the

benefit of HFSRB to clarify issues relevant to an application or other business

of HFSRB.  The assistance may be in the form of written correspondences,

conversations, site visits, meetings, and/or consultations with independent

experts

r request to

HFSRB provided that the communication is

not intended to influence any

decision on the application.

Technical assistance may be provided for the

benefit of HFSRB to clarify issues relevant to an application or other business

of HFSRB.  The assistance may be in the form of written correspondences,

conversations, site visits, meetings, and/or consultations with independent

experts.

Once an application or exemption is filed and deemed complete, a

written record of any communication between staff and an applicant shall be

prepared by staff and made part of the public record, using a prescribed,

standardized format, and shall be included in the application file

, within

10 business days after the assistance is provided

.

[20 ILCS 3960/4.2]

"Temporary Suspension of

Facility or Category of Service" means a facility that has ceased

operation or that has ceased to provide a category of service (see 77 Ill. Adm.

Code 1100.220 for category of service definition) for a period not to exceed

one year, due to unanticipated or unforeseen circumstances (such as the loss of

appropriate staff or a natural or unnatural disaster).  The time period may be

extended upon finding that the resumption of facility operation or category of

service has proceeded with due diligence and HFSRB approval of the

requested extension.  The facility administrator shall file notice to HFSRB of

a temporary suspension of service, in compliance with the requirements

described in Section 1130.240(d).

"Underserved" means a

planning area in Illinois that does not have another Specialized Mental Health

Rehabilitation Facility.