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Home My WebLink AboutORDINANCES-1976-073-O-76' 7/14/76, 8/12/76 9/22/76 73-0-76 9/24/76 . "jo AN ORDINANCE Amending Chapter 25 of the Code of the City of Evanston Regulating Long Term Care Facilities BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF EVANSTON, COOK COUNTY, ILLINOIS: SECTION 1: That Sections 25-35 to 25-47 inclusive of the Code of the City a of Evanston, 1957, as amended, be and are further amended to read as follows: 1125-35. Definitions. 1 'Conversion' shall mean adapting a building not currently in use as a home for the maintenance, care or nursing of persons who are ill, aged or physically infirm, into such a home. 'Nursing home (Skilled or Intermediate [Convalescent Home, Infirmary])' {� shall mean an establishment for three or more infirm persons, regardless of age, not related by blood or marriage. Such a home shall not contain equipment for or provide care for those cases for which hospitalizati.on is generally required. 'Phasing' shall mean changing a home for the maintenance, care or nursing of persons who are ill, aged or physically infirm from one level of service to another. 'Home for the Aged' shall mean an establishment providing living accomodati,ons and services principally to non -transient guests sixty (60) years of age or over. Accomodations may consist of maintenance, personal care, nursing or sheltered care beds. 'Sheltered Care Home' shall mean an establishment in which residents are not in need of skilled or intermediate nursing care, but are in need of assistance, supervision or oversight. A sheltered care home may not provide nursing services nor care for those cases for which hospitali- zation is generally required. ,•h. T,,....,.:..... :.^'w.. •w^os ,..,.,,, i ,ter .^ak°x � �'�., �, � , �=�`'�':1. ....e.'uti: �.:+',•-;,n=� .•y,'�;;..,.��,.•,,: ..ti,,'""u„'':.% •.r ;�„ s, �.,;• '��. + -,',�: ,,:,, �y, ..e�:•" v:ti.x..Y'Z;^.'t:`,Ca'`•`,i.,.;.r�+'.�":.d^` —«p�� ts:y:;,...-' ,k,'. ..^•c.+", ;r-•-.,a:.,�i ter' '�'`" ..,aw„��i '. i':�� ...� � �..p;',�..... •: r,.R'`'=':��-".. .+.y,:r �„ 1 a. ,lira y,•.,, �: ,�... :^�.,�h`. ,¢i3��,:..+. ..� �` .v� r'�" .^r..:�t. -�%.. . ^ `,,•`„ y„ '...;y.A �h:.�s,, vti ` ,� ... + "Yil" bra;' ' F° ,`b'i ��`': ar' �' .. �'�'r.v�». ..... ' '.F.� rn • 73-0-76 -2- 25-36. Adoption of Rules and Regulations. The licensing and regulations of homes for the maintenance, care or nursing of persons who are ill; aged or physically infirm, shall be in accordance with the Act approved by the People of the State of Illinois, July 17, 1945, as amended, October 28, 1975, and as heretofore or here- after amended. Pursuant to authority granted by the General Assembly and the Constitution of the State of Illinois, 1970, the City of Evanston adopts by reference the Minimum Standards Rules and Regulations for Classification and Licensure of Long Term Care Facilities by levels of care, and governing the Licensing of Skilled Nursing Facilities, Licensing of Intermediate Care Facilities and Sheltered Care Facilities promulgated under date of November 1, 1974, by the Director of Public • Health of the Department of Public Health of the State of Illinois and in effect on and after November 1, 1974, and a's may from time to time thereafter be amended. Violation of any of said Rules and Regulations as adopted by this ordinance -shall be considered a violation of the provisions of this ordinance, provided that: a. Any reference in said Rules and Regulations to 'Department' shall read as meaning the Evanston -North Shore Health Department. b. Any reference in said Rules and Regulations to the 'Director' shall mean the Public Health Director of the Evanston -North Shore Health Department. c. Any reference in said Rules and Regulations to the 'Fire Marshal' shall mean the Fire Marshal of the Evanston Fire Department. d. Filing for Public Inspection. Three copies of each of said Minimum Standards, Rules and Regulations, adopted by reference, shall • .{Ye.^ r-�tl _ _:.tY-.M' �,'~ u.4.:t"' ,� n� �., .. .. '.Y..tl�i ^,R.�J ai% .. Na. �!�',{�:� r'!^.^l�l'i t - ..YO.:..Wro'.L.. \q' �'�l� :�sY ,y .•"„'1riS'K�ihb � '":;n ^R '. d7. Y. .� P1„tR••;.�.•,;.4+1C � - a �wy4' :.✓'�:. �. �NC'; -0'�.7._'�r ,+'`�"AbA r��_'.L':'.. ti �q: •� .-:?!r.� � _ _ ��",,,.� , ""..1.TiYf5.•...}rhr."tn. ��: Jr.Gv, "�.l' .fin. . �'14'� .l �� •ka•..�.v?. ' i � Y ��'F? . ' �.r,.w .,),. '... ., _ ` "�e;R �� "A.:.r�. �� •S: l.. +:•�u 'S•w�..'ti..:' , y }. ys � .� � �„�,�. y, may.. ti-'..�.y�� 1.,.:1��,''-y.!. .��,,,,,�`�, ��°�., �'. �-. ..=� ar ��•��. �, . •'• •2�ri .t. � � �% ,'�i•,h r , .•mot, ...ryr� `C'� ._ .'y. � v R y � r�l rr �: i'�'�• ,:�•.s .�..":lR � .�jy .. •r . � �,.'+i N o ti J *�,,, .•.�'�.%'t".Oi% ', J' ti„• Y r .A'.-� 73-0-76 -3- • be filed in the office of the City Clerk and there kept available for public use, inspection and examination.for a period of at least 15 days prior to the adoption of this ordinance. At least one copy of each of the Minimum Standards, Rules and Regulations of the Department of Public Health of the.State of Illinois, shall be kept on file in the office of the Director for public inspection. 25-37. License Required. a. It shall be unlawful for any person to conduct, maintain, operate or advertise any nursing home, sheltered care home, or home for aged as defined in this Ordinance without having first obtained a license therefor from the City of Evanston. Each license shall be applied for and obtained annually. Licenses for all long term care facilities operating under this Ordinance shall state the number of beds in'said facility licensed for each level of care as defined by the Minimum • Standards for Long Term Facilities, Rules and Regulations, State of Illinois. Said license shall be issued for a period not to exceed one year. Renewal license shall be applied for and obtained annually. b. The annual license fee shall be one hundred dollars ($100.00) plus twelve dollars ($12.00) per bed contained in such facility. c., Any license issued under the terms of this Ordinance shall be non- transferable. It shall be issued only to a specified individual, partner- ship, corporation or association, and shall be issued to specified location. 25-38. Application for License. a. Any person acting individually or jointly with other persons, who proposes to build, own, establish or operate a nursing home, home for the aged, or sheltered care home, shall submit a pre -application form • as furnished by the Department, accompanied by a fee payable to the City Collector of the City of Evanston in the amount of fifty dollars ($50.00). Said fee shall be non-refundable and shall be used to defray such costs as are incurred in investigating -the pre -application information. >� M",8., .+t' ..,:y!c:,r :'ti".:.'h.�:-,r^ "•'q;,ItJf n :,;y�i•_ ^ed.Ly.>' 'i. ":<:.��^`fii�r"5.� : ,�,—. �` ,i> a: ``i�" +\°' ,y,"+N' °$''C"'',•'r<�. �• ..t%:»".1` %a,.SnM,':� •;,+,� _.;,.: pr;' ,..^. r�"_r: Y',�;;9''�'y",,::y;'�+� , •:•w?,-�+�'�.++ �.�� r . y'A., «;. .r ;1� , ^•'•',• ..'j^;y� .r, ..,�.r,�,_y ` ..�•. � ..,�:a�,� .;+,r , : °4 ..ti,r;y.''•'+�,,`�'*� {,�� .`,: 2r ice, 'r w kW"*" ; '`'k'`J' ':.,n v Tnj;".�,a; ��c° ;�a � r^ �"��;; d`� ''Y✓:. .ter. �� ;sb>r . :,r {�i ap: ;"sir �-tF�,''ii�,:'�-,a„�i,•wv�' ,.fy.;;tr;J+"� '�'n, m.TC y 1'e P !�` r ,{t �:, e'•�. F' - ',.� `:Y.,',.. ` . yo • , �•�k. 't' `' 73-0-76 -4- In the case of new construction or the conversion of existing structures, said applicant shall also submit preliminary plans and speci- fications for the proposed home to the Department for approval. b. In addition to the .above, the applicant shall also submit a certi- ficate from the Department of Inspections and Permits stating that the building or, structure to be used as a nursing home, -home for the aged, or sheltered care home, complies with the requirements of the Building Code.and the Zoning Ordinance of the,City of Evanston, and that said building is located within an area in which a nursing home, sheltered care home, or home for the aged is permitted in accordance with the then applicable provisions of the.Zoning Ordinance. c. Upon acceptance of the pre -application form and approval of plans for the home by the City of Evanston' and the State of Illinois, the applicant may proceed to build the facility. Upon completion of the facility, and inspection by the personnel of Fire, Building and the State and Local Health Departments, a 'Statement of Approval' shall be issued by the Director to the applicant, notifying the applicant that his license is available for issue by the City Collector. A copy of the 'Statement of Approval' plus the 'annual license' shall be forwarded by the Director to the City Collector for issuance. 25-39. Inspection Required. No license to operate a nursing home, sheltered care home, or home for aged shall issue until an inspection of the facility shall have been conducted by the Department of Inspections and Permits, the Fire Depart- ment, and the Health Department, and certificates of approval shall have been delivered by the Director of Inspections and Permits and the Fire Marshal to the Public Health Director. • a. The Public Health Director shall determine that the applicant facility meets the provisions of this Ordinance. '*,'�.'ygry,^k»,'�fy5:�_.:;f... �...v' �:' Y:�';�1��.,,, �,�•� ,.•vs ..fi,��;M �•�f,,: v�''. ..a�.. ;�� :.a.._ `�. .Z, t. `.y r •� . .`�. < •4. -i � 'r... �,f:�v�: +.i^ .c,'...«: ., .r';w.� : �;.`oa�n y : C .. ti . !.�,;: � � :•��.^ ` ,;f�+y�f,` ;��,r..� '}.., ,e r�',r +.�� r:`.. .�a�.. •a,d„ ate. ��`^'e•,•,.:.. ."�z�'"':"��;.:+��.�"'R•:,yM+N.6'.:i,�~,_'�� J��,�,Y'. „�,¢ -,�^S 'i tr�� t k vv yl;.... r .•�.'.b� �/ r. 4 : r t' , r. ,�a..A ti;'.. ..lr „•.•A..i • 73-0-76 -5- b. The Director of Inspections and Permits shall determine that the building or structure occupied by the long term care facility complies with the applicable provisions of the Minimum Standards, Rules and Regulations for Long Term Care Facilities established and promulgated by the State of Illinois and the provisions of the Code.of the City of Evanston thereto pertaining. c. The Fire Marshal shall determine that building and premises comply with the minimum standards for fire prevention and protection established by the State of Illinois and the City of Evanston plus the Minimum Standards, Rules and Regulations for Long Term Care Facilities promulgated by the State of Illinois. 25-40. Renewal of License. No application for the annual renewal of a license will be granted unless authorized by the Department. Any license fee shall be submitted with the application on forms furnished by the Department. When a licensed nursing home, sheltered care home, or home for the aged is sold, leased, discontinued, moved to a new location, or the license has been revoked, the annual renewal license shall immediately become void and shall be returned to the Department. 25-41. Denial, Refusal to Renew, Revocation of License. The City Manager may deny an application for a license, may refuse to renew or may revoke a license for violation of any of the provisions.of this ordinance or any rule, regulation or standard incorporated by reference under the provisions of this ordinance or any rule included.in this ordinance. An application for a license may be denied for any of the following reasons: (a) failure -to meet the minimum standards prescribed; (b) conviction of the applicant, or if the applicant is a firm, partnership or association, of any of,its members, or if a corpor- ation of any of its officers or directors', or of the person desig- nated to manage or supervise the home, of a felony or of two or '�Y. /.1 � :y � � � � •�; .: o ..._ .) • � �',5....; lye • 73-0-76 !M. more misdemeanors involving moral turpitude, or, in the case of the conviction of a misdemeanor by a court not of record, as shown by other evidence; or other satisfactory evidence that the moral character of the applicant or manager or supervisor of the home is not reputable; (c) personnel insufficient in number or unqualified by training or experience to properly care for the proposed number and type of residents; (d) insufficient financial or other resources to operate and con- duct the home in accordance with the requirements of this ordinance and.the minimum standards, rules and regulations promulgated there. - under. -A license may be revoked or renewal denied for any of the following reasons: (a) cruelty or indifference to the welfare of a resident; (b) misappropriation of the property of a resident; (c) conversion of the property of a resident; (d) violation of any of the provisions of this ordinance; (e) any ground upon which an application for a license may be denied. 25-42. Notice and Hearing. Investigation of an applicant or licensee shall be initiated by the Department upon the verified complaint in writing of any person setting forth facts which if proven would constitute grounds for denial of an application for a license.or'refusal to renew a license or revocation of a license. In addition, the Department may, upon its own motion, after evaluation of per- tinent facts, initiate an investigation of an applicant or licensee. Before denying an application or refusing to renew a license, or revoking a license, the Department shall notify the applicant in writing of a hearing to be held thereon. The notice shall specify the date, time and place of the hearing • 73-0-76 -7- which shall be held not less than ten days after the notice is mailed or delivered. The notice shall designate charges or reasons for its contem- plated action of denial, refusal to renew, or revocation. The notice may be served by delivery of the same personally to the applicant or licensee, or by mailing the same by registered mail to the address specified in the application, or, in the case of a licensee, to the address of the home designated in the license. The hearing shall be conducted by the City Manager or Director if so designated by the City Manager. Either may compel by subpoena or subpoena duces tecum, the attendance and testimony of witnesses and the production of books and papers, and administer oaths to witnesses. The hearing shall.be conducted at such place as designated by the Department. The City Manager or Director shall not be bound by common law or statutory rules of evidence or by technical or formal rules of procedure, but shall conduct hearings in such .manner as seems best calculated to result in substantial justice. When an application for a license has been denied, renewal has been refused, or a license has been revoked, the State Department of Public Health shall be notified. 25-43. Additional Requlations. The following regulations shall apply in addition to the standards . promulgated by the Department of Health, State of Illinois, and shall be deemed to be minimum standards licensed pursuant to the terms of this ordinance. a. Personnel 1. Nursing Personnel (a) Skilled Nursing Care Facility. Staffing requirements shall conform to the applicable provisions of the State and Federal Minimum Standards Rules and Regulations. � 'Q.v�`Y�d' ' _ ...`'il "�� ,,{,y` - 'Y.� '•1 •il ,. T.5 � �r ... 1 � _ .r . ;.. .�R Y, y. . 73-0-76 -8- (b) Intermediate Care Facilities. (1) In each Intermediate Care Facility there shall be a Director of Nurses, who shall be licensed as a registered nurse -in the State of Illi-nois, on duty 40 hours per week upon 5 days within any week, between the hours of 7:00 A.M. to 7:00 P.M. In addition thereto, there shall be an Assistant Director of Nurses, who shall be licensed as a registered nurse in the State of Illinois and who shall be on duty 40 hours per week between the hours of 7:00 A.M. and 7:00 P.M. for 5 days within any week and shall be on duty on those days upon which the Director of Nurses is not on duty. (2) In addition to the Director of Nurses (and where required by State Standards or Local Ordinance, an assistant Director of Nurses), there shall be, at least one Illinois Licensed Registered Nurse or one Illinois Licensed Practical. Nurse in charge of each 8 hour shift, regardless of size of facility. This person's duties shall be to provide professional super- vision and instruction to the non-professional staff. (3) There shall be coverage on days off for all licensed staff by Illinois Registered Nurses or Illinois Licensed Practical Nurses, on all shifts 7 days a week. (c) Nursing -Service Staff in Sheltered Care Facilities. (1) In facilities of 100 licensed beds or more there shall be a registered nurse licensed in the State of ,Illinois, or a practical nurse licensed in the State of Illinois on duty for.each 8 hour shift with coverage on days off. 'In the event all three shifts are covered by a practical nurse, licensed in the State of Illinois, the facility shall have a.s a con- sultant an Illinois Licensed Registered nurse at least 16 hours. a month. l.n �i�`xi �f! f' 'A � � ... -l. \ k; � ,- � -µ.; 1� �. � -:\ v � ,S ,. 't r •. >S - �.'�k, v, t 1 ,_ ..a _, YAM .. .. wt',. � .. .�-•K' • 73-0-76 -9- (d) All medications administered to a resident in any facility shall be administered by a physician, registered nurse or prac- tical nurse licensed in the State of Illinois. When a resident's condition dictates, the physician may give permission in writing for the resident to administer medication himself, except when such resident requires skilled or greater care. (e) In all facilities there shall be additional ancillary per- sonnel to meet the total needs of the residents. (f) Nurses Aides and Orderlies employed by facilities licensed hereunder shall receive certification by the Health Department. Certification shall be contingent upon satisfactory completion of a course of training sponsored or approved by the Health Depart- ment. 2. Food Service Personnel. (a) All facilities shall have consultation from a dietary consult- ant who shall be a dietitian or nutritionist who meets the Ameri- can Dietetic Association's standards for qualification as a dietitian or who shall be a graduate from a university baccalaur- eate program with a major study in food and nutrition. The Dietary Consultant shall: (1) Schedule most consultation visits during active, week -day working hours for food service and administrative personnel; (2) Provide the service for a recommended duration of four or more continuous hours per visit; (3) Give the following minimum hours of consultation per month: 1 - 29 beds - as determined by Administrator, Consulting Dietitian, and Chief Nutritionist of the Health Department. 30 - 49 beds - 8 hours.per month 50 - 99 beds - 12 hours per month t �v �^:�;i��t, ,iir n�� .Vr� :a�� SY'n�, •. ';+•• � �., t '- .. t� 73-0-76 -10- 100 - 149 beds - 16 hours per month 150 - 199 beds - 20 hours per month 200 - 249 beds' - 24 hours per month 250 - 299 beds - 28 hours per month 300 and over beds-32 hours per month (b) The Director of Food Service shall be a graduate of a diete- tic training program approved by the American Dietetic Association or a State approved course that provided ninety (90) or more hours of class instruction in food service supervision and has had ex- perience as a food service supervisor in a health care institution with consultation from a dietitian, or has training and experience in food service supervision and management in a military service equivalent. Correspondence courses shall not be acceptable in lieu of classroom instruction. The requirements of this subsection b may be waived upon a determination by'the Chief Nutritionist of. the Health Department together with the facility's Administrator and Consulting Dieti- tian -that the Food Service Supervisor or Cook Manager of such facility is qualified by training, experience, and performance to fulfill the responsibilities of Director of Food Service. 3. Additional Professional Staff (a) All facilities shall engage the services of social workers and occupational therapists according to the following ratio of residents to hours of service: 0 - 49 resident beds - eight hours'a month 50 - 100 resident beds - sixteen hours a month 101 - 200 resident beds - forty-eight hours a month Over 200 resident beds - one full time social worker and one full time occupational therapist. (1) In determining the required level of services the hours indicated shall apply equally to each profession and shall require said hours of service for each profession. ♦R,v�., ��7 '��r ,.A�n "1`�lnti..��4' ;• w.4� '/'•?'i�..'•M •'iA«ir! ;_,��•i.��Y. 7.. w�y,r T.—in��Jl+lpr'. �s- '��•�;A��.w ..nJ. '." fir.. w+..�.. �. 0` , •.a* �.�n. aA1�Ti'✓:�_w� � r :� „fib � ,.,�:,,�, �.._ J`1 .'�y�sy!~: %�.. Y•r Ffb.•Nr"'f• ^{L� J W, r 1 U 73-0-76 (2) A social worker shall have a masters degree in social work, and be currently registered by the State of Illinois. The degree requirement herein provided may be waived by written application to the Health Department and Mental Health Board, upon a clear showing that the applicant has achieved an equivalent level of experience, training, and performance, when compared to written job criteria and guidelines developed by said Department and Board. (3) An occupational therapist shall be currently registered with the American Occupational Therapist Association. (b) Each facility shall.make available to its residents the ser- vices of a registered physical therapist currently licensed by the State of.Illinois who shall, under physician's order, spend such time within the facility as such orders may require. 4. Mental Health' Personnel. All facilities with residents evidencing mental problems as determined by their physician, or who care for mentally retarded residents, or residents discharged from psychiatric care within the last three years, shall meet the following staff requirements. (a) A psychiatrist licensed to practice in Illinois, shall be under formal contract by the facility, to provide services as determined by the utilization review committee. (b) A social worker with a masters degree and psychiatric train- ing and experience, currently licensed by the State of Illinois, shall be employed by the facility upon the ratio of residents in need of such service as defined in a.4 (supra), and hours herein- after set forth: 3 ..��,- :eq;�,� ..'K "', ^4{,v..:.,:. ^'r�Y, ;kw�d�„5 �~� .'�� n',`L"y,"•r.•: c w;j �: n�."y :-�;�`.. .:...yof X•'v, rvi.: t' :"'tv�: J�t.'�!;• - �r:r�. 4�.., ..iFr.- a.. ,,�:r-n' -gar,. , rw.:�•:v -�.{", r" ' v`r .v � :.a'.��+'^ hur+..-+•�Wr .•' ... ,,��'`'�r�,X .. _ '.,.b`� •,�.. ,, b -ate. n• .��:.'+ k"f>'' ��,: ;•.a;;.,r�.>..',�. !!...,�''f..a.46:-,'�„� ;•-,>.,,, �- <, ,'ems_ , ^:r•+a�'`. " '�:, si,, �•. - n �• ..�' . .. � r+• ,:. � a_;:: :,l"; M`',..�.,.: pI' .� �'•. . r . x. .., n�' o- - psi _ ^+..� •-k:^v.- ti _ .. . .r,,.,K ..N _ ., 'ter' �,l. � r". .. .Z--� �ti�wi �� r ' ,,t}'�' yil ;ter• 73-0-76 1 - 10 residents - hours to be determined by utilization review committee 11 - 25 residents - 5 hours per week 26 - 50 residents - 10 hours per week 51 - 75 residents - 20 hours per week 76 - 100 residents - 40 hours per week . 101 -.125 residents - 45 hours per week 126 - 150 residents - 50 hours per week r 151 - 175 residents - 60 hours per week 176 - 200 residents - 80 hours per week 200 or more residents repeat pattern l The psychiatric social worker's time shall be used fifty percent r.,� • for individual and group sessions.with the residents, and fifty percent of the time to be used for supportive services for the residents such as, but not limited to, family contacts, commu- nity resources linkages and staff training. b. Additional Required Programs 1. Restorative Programs: Each facility shall have an Illinois Department of Public Health approved Social Rehabilitation Pro- gram, an Illinois Department.of Public Health approved Rehabili- tation Nursing Program and an Illinois Department of Public Health approved Activities Program in excess of minimum standards according to appropriate licensed level of care. This shall be monitored by the Illinois Department of Public Health or the Evanston Health Department. 2. Work Programs: Any facility which permits residents to work within the facility in other than an approved work therapy program shall: (a) pay the minimum wage as may be from time to time estab- lished by State or Federal legislation. (b) record and maintain payroll records of such transaction available for inspection by the Health Department. 4 3. Utilization Review: There shall be established in each facility a Utilization Review Procedure, which shall be conducted by a Utilization Review Committee consisting of Physicians, Director of Nurses, Social Worker, Occupational Therapist,and/or Activities Director. Other Modalities such as Psychiatric, :� Pharmaceutical, and Dietary Services shall also be included Jkz' + V,1.d A, 1 ulif byoi 73-0-76 . -13- • as applicable. Itj shall be the responsibility of the Utilization Review Committee;to develop and oversee (a) The.treatment plan in operation (b) Drug therapy review (c) Referral needs and plans (d) Discharge plans Each resident shall be evaluated every ninety(90) days except residents requiring skilled nursing care, who shall be evaluated at intervals not greater than thirty (30) days for the first sixty (60) days and at intervals not greater than ninety days thereafter. Appropriate adjustments in the resident's care plan shall be instituted upon such evaluation. c. Additional Required Records 1. Admissions: A medical and social history of each resident . shall be compiled prior to admission to a long term care faci- lity, and filed with the patients' chart. 2. Contract: Each home shall enter into a written contract with each resident, and a copy of each executed contract shall be filed with the Health Department. Such contract shall.be executed at the time of admission or prior thereto, shall be verbally explained to the potential resident or his representa- tive prior to execution; and shall be completed, dated, and executed by the licensee or his legal representative, and by the appl',icant or his legal representative. No.limited, specific or general power'of attorney granted to .the licensee or his employees by the applicant or his representatives shall be a requirement for admission or continued residence; and if executed, shall be separately signed by the applicant or his representative, and shall • 3 } TR ry' ..fix.^ •w/4'i V�iK K�•- '�"y�<"MI: yH�W,\-•,. �PC.��.4'«-�("f��~::'\�` �'_-d?�i;i• a'•''M ;: �.l_.r ...�.. ��\� ��'}"L` --:T. •.��.�'il �°i� _ •.vy'.. .v.!Tr�i" J�.. p�:��par" `�`»� . �t �\. � ',rN'' ,�`�;•�.. �• :.� ".��'.�i, �_.:.� '`"`. �� ,�' • "f�'�7?:,�'�,>� �,..� ..I..y.,; ��"%n:,.�"•,S m. ,;�:.:.. �-p.: �': a�.. .yf':e`•�"'V=:.' .y;,`y�� a"v.a �'r -' i'�v t .;y r. 'd, L. • i • •ey:.•.. r ;s <A�`?�.� �:� �':'. }r ._ {�. `�:!'.«•' ,�,. i .cr. _..x r,yv �"4�.,� y;�a?Nr :;,�js �i' "k�,'t �' f�n..,.�'�• �."�� '." h^ .., � "'-�_rv. .. �',, �. -tby .,,aa,e ,,°;..' ✓ v:: :l+. _ � .'.,. ,err° ._ - � .,rt.Y+piL�VW1i,+,4 R.�:l:N'••-5.. .114S+a.tw'Ytvi N..`..l�IF'YI4JiYiw'M`f ..,•..r t.tW»•A.' 73-0-76 -14- • be attached to the contract on file with the Evanston Health Depart- ment. If no power of attorney has been granted, the contract must. so indicate. A duplicate original of the executed resident contract shall be provided to the resident and a copy of the executed contract shall be provided to any relative or agency responsible for or contributing to.payment. The contract shall set forth the following.information: (a) The services to be provided -by the facility, including.a statement of the minimum services required by the city, e.g., three full meals, medical treatment -at the facility, maximum number.of persons per room, activities and recreational faci- lities, and such -other services as are to be provided. (b) The basic monthly cost of such services and subsequent re- visions, the method and dates upon which payment is to be re- ceived by the licensee, and the period covered by said payments, and rates to be paid for optional services not included in the basic rate. Subsequent rate changes shall be on file with the Health Department. (c) Conditions.for modification of the contract, which shall indicate at least thirty (30) days prior written notice of basic rate changes. (d) Conditions under which refunds shall be made, which shall include but not be limited to the following: (1) in the event a resident shall experience a significant temporary or permanent change of physical or mental health which would -require treatment and residence in a facility for which he has not contracted, the contract may be. 4 . . 7r".'-_at!` s�.,. ,,M �" ty ' �'y —� »/'ay. +-n•-«• ,y "i'"- �ir�y, "i: ''TM';.Y.� �,, .r y,�... .•J."^�r�++�apl." ,µ _•�,`,'ae.4,: `��' :v�."�.^'; 'i�+y;,��' _ \ +w: ;Y'+v, rasa • r,..s:... �' 1. .:air • ` ; p;?._« � rr�r. ,+� �%4 y., w . ,,�..� ^ai4w. '.. ;<Lr,{; of i "sH,, �` �, yt„f:;. Rw ,ar . 'n�5a�•.*.. ,�'*' ^� � ';�^.'.. - �!..!-�,�ti:`. 1¢"., ,ea ,*�+','y�•a.'01 «ti a "-,+:•;'.,�s: ",;y.. ti nin`` �.+7•h''•� •rr:u.fa+".e''��r ...,.Si. ��.';4�:J+ � •:l+,. hru=.,^av`':*,,.�'y. Lri'. ^ � �,^�"'..f'�' •.,;rY��q. ,nG n,H«: ��5/i ✓�.., ••'o �:k; �:. 7',�,� 'Y•r^c`�'s, P�.,yo-� ,1 'i ,,:�' .+b: .e.° i. '" �kv�r;;�r•. r�e{��`'_' •0.1•'vy�'• _. .calf':+�::,�% ... J .• , .. _.r 73-0-76 -15- cancelled at the resident's request without advance notice. An accounting shall be rendered which shall prorate the charges for services rendered for which payment has not been received, or a rebate to the patient for moneys paid for unearned services. (2) in other cases, in order to qualify for refunds on ter- mination of the contract, the resident shall not be required to give more than seven (7) days written notice of such in- tent to terminate. A resident shall in no event forfeit more than seven (7) days charges for services. (e) The services afforded by such facility shall be provided without discrimination, affording equal treatment without regard to race, color, national origin, sex, ancestry or religion, ex- cept with a facility which is operated by a bona fide religious organization for the benefit of its own members. d. The following standards shall apply to all facilities: 1. All Long Term Care Facilities shall provide each resident with a functional bedside cabinet with a drawer. This requirement shall not affect the requirements to provide drawers in dressers for each resident. 2. In one of the pieces of furniture required, there shall be pro- vided a space which is capable of being secured by a locking device which is to be controlled by the resident to which said furniture is assigned. Provided however that where in the opinion of the at- tending physician such secured space would be contrary to the health or welfare of a resident, such requirement may be abrogated during such period of time when there exists a danger to the health or welfare of such a resident. tt � ti. - vFC..` t,:+"ry"<- � aa"C'"—��.r�,'to'y:';,... ry,..� ..' .. .,r, ••f^ri_ +� ;,:y., ..�h. in: .. F.,,.. r. N.�'•� ¢', ..�... h,.:�; ."ht'"�.J ",•,. ro"t;w ti'` � � _ .'`�°,�r' ��"`y.¢"'':: , ^y:' .. Y ;aar�•;y�.::.,:.; w., ri v"�a`y:y'-.. .,r.. . ,�:.� +"'.N- •��., t� w *,�:'' ♦. �r •r. ,i' ,''`:."`t'r'�� '� -.,4 yr �,.' n hu,K M�''.„ri. k....,,a;:. � ?''• �•'a�'t; Y �"1A..��H v`�.N`.�iT.y'`,ti...rr°,d:=••:j.'1a.`.t!^ r, %� el".'•:Y i• s,'j Y�'��, p r. �0i�c ; ..•, 4r� , , u.,.,. f t �P:. r.;yo .ta.� �.fn'°s•,•:: Py�. q(r ,try. .. M�� yT � Via, -ti aw ✓: .�`.r:'� � � Y",� ✓ 'i,,t,,,.. .. r • / � . • /�"�'�. `''^'- ��3..i� _ ,ta� n�,1^""�t J .. Ky„ ., ,- J' � `.M ~,... • `•;(� i ... vd ••Qi"'�,`' ~.a ti � . ... . , .. fi 73-0-76 -16- 3. Each room containing more than one resident shall be pro- vided with a number of functional privacy screens so as to • afford privacy to each resident therein. 4. Facilities shall allow residents access to their room at all times. 5. Each facility shall provide sedentary and recreational equipment, apparatus and supplies to meet the reasonable needs of the residents. a 6. Each facility shall distribute a handbook to each resident, his legal representative, and/or family which shall include the following: (a) a list.of all rights, responsibilities, and services of- fered by the facility; (b) a list of all rights and responsibilities of residents; (c) a current guide to all required costs for residence in the facility; (d) policies and procedures of the facility for handling complaints or grievances brought'by or on behalf of resi- dents, together with the name of the administrator/director, who shall resolve such matters, and the manner in which he may be contacted. (e) the phone number of the Evanston Hospital Crisis Inter- vention Center; (f) the address and phone number of the following agencies: (1) Illinois Department of Public Aid (2) Illinois Department of Public Health (3) Illinois Department of Mental Health (4) Evanston -North Shore Health Department (5) Evanston Mental Health Services Board (6) Cook County Legal Assistance Foundation, Inc. (7) Local Social Security Office (8) Evanston Commission on Aging. .r^v wZs •. � aS'.� .yy:. ,�.' Y^Z" 'A, ...:Y,•' '*� . n't; `. ry.. .. y�.�. �"y si'Ny .�'X; p`�.'1.i Y:`a•.^ ,�.y.; Y� Y• V•d�'�.''„� :;�:N:..':`�y�s... . }v 'y ..r'�• ^.;+ ,� � � i � ...� .e ; vyy l�+' kip^ :� �vw��w::'�L. . , •ti .. » .i t ,. •,{ • • . vI •'Xl'.S'. v .. •yam .� V�i'i.`1� � "''�Tr,�M" .,:-to".'''Y::."..Yron ��. 73-0-76 -17= (g) the procedure for leaving facility, including information on transfering Public Assistance, Social Security, SSI or other payments. 7. . Each facility shall designate an area wherein any resident may meet and consult in private with persons of his choosing on matters of business. e. In addition to standards, conditions and regulations imposed, all facilities hereafter constructed, or existing structures which are hereafter converted to use as a long term care facility, and all additions to existing facilities shall be so constructed as to: 1. Provide all corridors with six (6) tempered fresh air changes per hour at a rate of two (2) cubic feet per minute per square foot. 2. Provide all laundry, storage and counting rooms with four • (4) changes of fresh air and exhaust per hour at the rate of one and one-half (1-112) cubic feet per minute per square foot, unless said rooms are vented directly outside by proper operable windows. 3. Provide twenty-five (25) square feet of outside space per bed. _ 4. Provide.a maximum total of one hundred (100) beds for a sheltered care facility, and a maximum total of one hundred fifty (150) beds for any combination of skilled or intermediate or sheltered care facility. No facility, whether new or exist- ing; shall be constructed, converted or altered,'to create or Y expand its facilities to house more than 150 resident beds in a single free standing structure. f. The following standards shall apply to all facilities hereafter constructed or converted, and to additions to existing buildings. 0 ' :�--- .'^i: ��_ qY�: •y:-a'a: ..t._�...� �io�" .,,� :_3r^Y,, '`,r; .. �„ :�._ __ -x. ;:C—,.. _ ... '4 y"y�.i +�q�, dwH;. .� �'v .�«,. K ry\Y';. ,y.:,'.r,� wad hk.%4 1: avi'..: .:r', ^•''\ "y�.v.!,�� y' �l �'aC: T'`; � '�`..F;� . ' `�...; w, �� .f^ "y �Y.. 1 \ �h'�_,: ��... R �,,.. "\.'.Y :. ,jI fn� » � .�5a •� /.N"'\c�' �H ,'! -- � 1J. v'4 b�. � �..0 �. ""\,v'�•,'.�'i; e�✓M �xa•yt y.r': •>r�^•,;t _ ..NA'=�),, ",:Jti "Jd.* .fi " *, C ,3j '.°•u � �M1°.+2'.�''�.,'' q ':>ac,:+,'..v �:r, h+i.V :^ta^d,::.. ..�i;'«}�,;• -, �, +� �,'`41,.''-,�y � .. :,,... ,�•y :�:.,,t •�'a. •yam•<'• r, •�.,, �..' 4:.. �o.. •`�'"� ��a4+*'��+:.n.h V,+.�a.+•{`�• s � 'Y .� i� ^�t.�.:� ^•�^�.ti-f' :.i."'; 'y!r •rt!waE�„•�Y'��wN„''",7',. . . Y� e.: e;.«,�+ ^�.�: �= `x RY 1'd^ , fv.. r �^ . b. ,y .n''^i+ i •�� ^,.r ..a!^v,.-w, ..� ti ^', k��,"'I�•",�� ... "' �., �' f .- ,'•�(f � `'f��'��. Rr•,,, ,iR ,� ✓.� �� 73-0-76 -18- l.. Residents' living space shall meet the following standards: • (a) Two Hundred Twenty -Five (225) square feet of .floor area per bed shall be -provided. This two hundred twenty-five (225) square feet of living space shall include no less than one hundred twenty (120) square feet of bed space per single bed- room, one hundred (100) square feet of bed space per resident per multiple bedroom and seventy-five (75) square feet of recreational and dining space per resident. (b) All long term care facilities shall: provide each resi- dent with a functional closet or wardrobe with a floor area of no less than four (4) square feet. This area is in addition to above requirements. 2. There shall be one lavatory and one water closet for each bedroom except that one such facility directly accessible from each of two rooms may serve both, provided.there are not more • than four residents in the two rooms. In addition, there shall ' be one water closet for each twenty (20) residents accessible from the corridor. Where this results in four units or more, they are to be placed in two separate rooms, one for each sex. ,s Each such room shall contain a lavatory. Each resident's pri- vacy shall be preserved. 3. There shall be one bathtub or shower for each six resident beds on each floor, with direct access thereto from the resi- dent's room, or from the common hallway. g. The following standards shall apply to only those affected areas in existing facilities which shall be phased into any altered level of care. 1. Bathroom fixtures shall be provided in the following mimi- mum numbers: i • (a) one lavatory and one water closet for each ten resident 3 beds. � �;�''..k;.; �.�� .��,'1` :..,+p�ii'JI,,:,yi?'t.�. .r.. "�Yv `�,��n�.:`a,. '°�'^M.,� 'a, �_a?'�!r,}"` ,o'+i'i ."�iy"".��u :'O?�^� ,•.j„-r`:..�.,..9, ',f�. .�,5,' .'�._.."%�a __ ,r.. _ •'Fr.,,:�.m�•mr�; ris`>..`.°�°„�D-�,� y�'..eP;�t,,,:w°a"'!'r.:. ,,.,N,�r;.:�,�; ?�„r.«' .R�,,,�t� :�: ,. �'w:.,.:?'�?'��:.'.y�. .,;��;�,. ^;,�«.':"' y.. .:.yv ..Y �r'•mw.'�C' :�'4., ,•q,ra. cr'.'�w�:.� ti.;'n' N'•...`�"{. t.�'?'a-"'. :.;,t�'i.. � 4. ,`ri. ,, Y^ . -n,' 3. 5.. N,u ' •y'v • 'r. fG, « �«�M '.'� /:. • : t .A a. � .. •."�V� � ..,;r�Wd.,y:,.; *:,. � l"<w �+;M'i': "•� v"�•i ' ..�.. J�.!.,n.r' •, � �, +O�J �.,�' ' �•@,,,� apl�r•�.4 .'�°'4�?'f,�>��:e: �.vc •.".•�•y ^� .r^•. ��... r.+�- _a''� •�'. �.. ~., Y. 'X.�. .. ..:.i��.•.r .. ruvJ•.`YFr :-er.v.R• ��k_5.. ,_e j;•",. 4`�•�' .+''�' ... .,I�'�. r„•;i,.m•�^w+, 73-0-76 -19- (b) one bathtub or shower for each fifteen resident beds. . 2. Bedrooms: (a) Each single bedroom for a resident shall have at least one hundred twenty (120) square feet of floor area, not in- cluding any space taken up by closets. (b) Each multiple bedroom used for residents shall have at least ninety (90) square feet of floor area, not including space taken up by closets, for each resident's. bed. 3. The combined living room, dining room and activity area, shall be approximately fifty (50) square feet per resident bed. 25-44. Appeals. Any person seeking relief from the provisions of this Ordinance shall submit to the Director, in writing, a detailed explanation of the nature of the relief sought and why compliance with the terms of this Ordinance would create practical difficulties and unnecessary hardships to the ap- plicant. The Director, together with the Director of the Mental Health Service Board shall consider any such appeal. The.Director shall within fifteen days of receipt of such appeal set a,time and place for a public hearing thereon and shall render their decision promptly after such hearing. Notice by certified mail of such hearing shall be given the applicant set- ting forth the nature of the request and shall also be posted ina promi- nent location of the app°licant facility and not less than 15 days nor more than 30 days prior to the date for the public hearing shall be published in a newspaper of general circulation in Evanston. All testimony at the hearing shall be taken under oath and all persons desiring an opportunity to be heard on said application shall be*given an opportunity to be heard. The Director shall render his decision in writing and, if relief is granted, shall make specific findings showing wherein the applicant would suffer practical difficulty or particular hardship in complying with this Ordinance. The decision shall promptly be submitted to the City Council and the Human Services Committee of the Council may review, amend and reverse such decision but shall not rehear the evidence. .:"ram"y `� � i �±""�� ,;,�;`.�y{y�4�,�.,;�. •1'. ';ac,'. ,j�y%'i:. "9':"� •,,�,=t >�:=�i''°r,' �' ; r:�;,,,,:'' r•,.:z;,"?'.., '�� '"..,.,v;-.,.�., ;.M»•-' - ri -�-r,. — . R ,r;,. U. ,�i, ,*` `{v ^\,,-s.+y,. •. ,: j`4'^ LN. � R.y.`1 ti , Y:• �'`` •''•�:'.'�rv!yt ..... ., . r �,,, � •. � .. .«�� ,�;M n b4.FS.t'rr �� ,w«�.�-?j �.r,4 ry,C4. .K{P .,; yi•. t rw•��J"�,F?.,a+.•,Yq r i;��r,•�' «\-.•. � vuy.: •+a'?r• :N•.: '�,:�,r ,J :. ..7,; :: .",.'�;?r�.�' �al.y6:.A J, �r 1",, .'.. `i. o Ifi- q.�.� `�>. ?mac `-� �.: I�'�yr'-J?'_.- ,,'F�,.-• `.",'ir. .m�.Nx •-_il•�`d• ..•7y.+y�„�w�.^+e, ..�,.. : nY.w � � r. w.� I � ,. �•A+ N.., i.� /�d' ' .�'� ♦ ^ D .� r .. '; .yI'a , . .; .w :,,. ,F,. `.r 73-0-76 -20- 25-45. Provisional License Pending Appeal. An applicant for renewal of its annual license who has filed an appeal with the Director, shall be issued a provisional license pending appeal. Such license shall be issued for a period not to exceed ninety (90) days, shall specify the requirements appealed from, and shall merge with the annual license upon approval of the appeal by the City Council. In the event the City Council denies the appeal the provisional license shall lapse. 25-46. Severabili.ty. If any part or parts of this ordinance shall for any reason be held to be invalid, such decision shall not affect the validity of the remaining portions hereof. 25-47. Penalty for Violation. Any person who shall violate any provisions of this ordinance shall be guilty of a misdemeanor, punishable by a fine of not less than twenty- five ($25.00), nor more than five hundred dollars ($500.00). Each day a violation continues shall be deemed a separate offense. In addition there- to, such persons may be enjoined from continuing such violations." SECTION 2: Ordinance 89-0-70 and all ordinances or portions of ordinances in conflict herewith are hereby repealed. SECTION 3: This ordinance shall be in full force and effect from and after its passage, approval and publication in the manner provided by law, and shall be applicable to the facilities licensed hereunder upon application for renewal of existing licenses for the next licensing period after the passage thereof. - r^�'-^a'r'w��'••x.:»1:ryH��S..,l'!i:•w�y .. �'C•.. ,�Y+;. ti� `�•'.�an'4•.�"t.r, �"?'.'yi:uo..Fy: ''"»......' • �u "`"'P +. w _,•'k°• nay±w^;• ^ r .jy_ _. ;.`Y. _ _. :.�.«... �.. } ..., fr y`.,N- Na"�-"'yb�.lr�4,... �.+�"`.,�' �'`^' .,�ry ^v-s %_.0 ""'t,: 1:. •`i _ ^ Y',4 .. �r'c, ,�.,,w.., 3'�""l. >."'gK'^Y+c? FC .R".: ...e? . . ' ♦- .�!" '•� ..y.� �,,. L, ».;'err 1.. _ 1 ;��'�' �',� .•'�.'fv.+'^lrn'..:. .�,.,,,;.... W' '' y�'�"'✓ , ..'�` '�',,: ^•r'F 'A �... i ` .'`�� '� , ..,:.r: y" :�:' ` ^�-'..'%' .m �.` _ *'!a%A .. r: 1`;"�':• ' '• "Ai�^'�l^'f,��.Hr � r /V.>+ 1". `� •ti � .{; W�:11� � A. •>1 n�„� ,,.;. . .. - Win,. _ •� .. .., ,.,.'n.,,",- i.d •��; .' �..+.'air^t�'.•��•'. _�D�� .v.+ejro. ��.n�. � t .;`Nw> V .. {�•..�`'...•„ w ..: _ •• �r •. �w'� .. lk'' •t..''f...,. ��rr • 73-A-76 Introduced r7 V C. to S T— 1976 Adopted Q 1976 Af rA�TEST: C p Y ►. II�W �`-� �l ►C�Q'w1✓ City Clerk Approved as to form: Corporation Counsel r . �u�1,tSthCD; (�c'�aefR � It )97� i t --- �r� t' •' � ��",Che'�t, S7�1 i' A- R ,v i 't V� 1 �� a�fe i„, �; i '��,�.�a� 1..`•�.,'$:,+ �`',.:x �,�'+. ;.'t�p�� '�,�r + •T E +`r -Z.J } .`x�� ! i - .t,�f ,� � d- • }.J, .q t„ -,R^t ., � t �q? '�fi -i.• .�. .e� ' 7s •"<', tt • �� ' �.�,, r{3; qj_ •�..._ !+:�.: k";, $n�: .diM1 iM1:ie..: �JJ'' 8�' `•fir t+�;?4.'��st'dt>«.'e+=:. ,.W,�ia.a -•� Zt. ': .-. .• .. _" C w, y�;.'R` .�*� _ +'L�i'F,';"!a�t.<Y '•?: ` .="P"L`r w. �'"";;.`� �`+,`." L."�.'vt.S�.w. 3!rra? -+. - X > �.•vy'';F;w,:.lhAx,i+�' :Svrie,•i�yh1"4 Y�.1 �?'!.r,',•�:d"�.';,�•c :;�r.:=,v�'�'vJ-�� 'wir /do-: C': .i... .:;•,�„j._.t.,�� b.R ',rim `�"'., "'�i�'x.y ;..5 •w/";,e„4w r <•_+ �1{W r°`; s• �b. "'•k .�,; `.'�"':r4 r+? }'" r%. ` .�?�. �, �,Y<` .��_. 'S''\< :_,.�r..a ,';:ti,3.c _ v"�.,; � r �n ,A:.• , A��,�•pr "C1^" `ny, i. ':l�a - ,ri.�"Yr("�„rr m. .9A �'; a°:r•�:'��',�'"��'� 7•"'�lG!s +►.'��f�: i+ _'kb. "�"�f,{; ,C;ic ',f< � Y,'' •.,,� �.<•^�� p ";'.:y.�';H:..titi�.,,. �-��`. ��'k' •, . ai a� �-r4r`>'�< .,�!'+.'�i vM r<..%� t'eM� :r xi, y i• .k17'' � Y, �,.E�tl'.4(G•'' V •,Z+ (�Fj �� +, �� ,,,�yy'� - "^ .+.G .r ..iw �'�'�;,:..a 4.sK+'• ...� s' a' .. -'''" a;�di,` .. ,��'�••3',�{; • .�-,,d,,,,r •! '�•J<` +.•"yr,• }�» ;,•e .:.$ •'ins.d "+S+hy. 'g- �..