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SB 1465

Virginia State Crime Commission; designating review panel, cases involving Mary Jane Burton, report.

2025 Regular Session Introduced by Ghazala Hashmi and 1 co-sponsor

Illinois nursing homes must count expanded direct-care staff toward ratios (100% of hours) and penalties now hit only when staffing falls 20% below minimum.

Acts of Assembly Chapter text (CHAP0430)
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Bill Summary · SB 1465

SB 1465 — Nursing Home Staffing Ratios (Illinois) — Summary

Short title / subject: Amendments to the Nursing Home Care Act to revise which staff count toward required staff-to-resident ratios and to change enforcement/penalty thresholds.

Jurisdiction & sponsor: Illinois (104th General Assembly). Introduced by Sen. Julie A. Morrison (SB1465). Companion: HB 1146.

Status / effective date: Introduced in 2025; bill text amends 210 ILCS 45 (Sections 3-202.05 and 3-209). The introduced synopsis indicates the bill is effective immediately.

Purpose / intent

To (1) broaden the categories of direct-care personnel whose hours may be included when calculating nursing home staff-to-resident ratios and (2) modify enforcement and penalty rules so that monetary penalties apply only for more substantial staffing shortfalls.

Key provisions / changes

  • Adds the following positions to the list of "direct care staff" counted when computing staff-to-resident ratios (amends 210 ILCS 45/3-202.05):

    • Infection preventionists
    • Minimum data set (MDS) assessment nurses
    • Other social workers
    • Certified nursing assistant (CNA) interns
    • Medication aides

  • Clarifies counting rule: except as otherwise provided by law, 100% of the hours worked by the newly listed staff (and other staff listed) shall be counted toward the facility’s staff-to-resident ratio.

  • Changes penalty/variance threshold:

    • No monetary penalties shall be imposed unless the variance between a facility’s reported staffing and the Department of Public Health’s computed minimum staffing requirement exceeds 20%.
    • Removes a prior statutory provision that prohibited waiver of a monetary penalty for noncompliance (i.e., permits waivers where applicable).

  • Reporting/notification changes:

    • For requirements related to reporting violations or corrective actions, the bill narrows triggers so that a facility must have a variance that exceeds 20% of the staffing requirement before certain reporting or penalty consequences apply.

  • Miscellaneous: The bill indicates other conforming and technical changes to Sections 3-202.05 and 3-209 of the Nursing Home Care Act; it directs the Department to use its payroll-based journal and census processes consistent with federal guidance to compute compliance (existing statutory structure retained where not amended).

Who is affected

  • Nursing home and long‑term care facility operators in Illinois (calculations of minimum staffing will potentially include additional staff categories, which may improve measured compliance for some facilities).
  • Direct‑care personnel included in the expanded list (their hours will now count fully toward ratios).
  • Illinois Department of Public Health (implements revised computation rules, oversight, and enforcement).
  • Residents and families (changes could affect interpreted staffing adequacy and how violations are enforced).

Potential impacts / considerations

  • Facilities that employ the newly included staff may find it easier to meet statutory staffing ratios on paper, reducing instances of measured noncompliance.
  • Raising the monetary‑penalty trigger to a >20% variance likely reduces fines for minor shortfalls but could reduce regulatory pressure to correct smaller deficits.
  • Counting 100% of hours for additional categories could alter staffing decisions (hiring or role deployment) without necessarily increasing direct hands‑on care by traditionally counted categories (RNs/LPNs/CNAs).
  • Implementation details (how titles map to payroll-based journal categories, rulemaking, and any exceptions) will matter for enforcement and are subject to Department procedures.

Procedural notes

  • Amends Illinois statutes (210 ILCS 45/3-202.05 and 3-209).
  • Companion bill: HB 1146.
  • Sponsors and committee assignments as reflected in bill file; stakeholders (providers, unions, public health advocates) may participate in rulemaking or administrative interpretations following enactment.

Compiled from official sources — confirm details with the bill’s official record.

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