Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 240 - COMMUNITY CARE PROGRAM
Subpart P - PROVIDER PROCUREMENT
Section 240.1650 - Classification, Identification and Receipt of Provider Service Violations
Universal Citation: 89 IL Admin Code ยง 240.1650
Current through Register Vol. 48, No. 12, March 22, 2024
Failure to comply with the contract, proposal and Department rules shall be identified and classified by the Department.
a) In determining the classification assigned to each provider service violation, the Department shall consider the following:
1) the severity of the
violation;
2) the danger posed by
the violation to the health, safety or welfare of the participant, based upon
degree of participant impairment and availability of support sources;
3) the provider's efforts to correct
violations;
4) the volume and scope
of violations.
b) There are 3 classifications of violations: Type I, Type II and Type III.
1) Type I provider service violations are
participant-centered violations that pose an imminent risk to the health,
safety or welfare of the CCP participant, and represent situations in which
failure to correct the violation could result in the participant's potential
hospitalization or nursing facility placement. Type I violations shall receive
priority attention, requiring immediate (within 24 hours) correction to remove
the risk environment. Permanent correction must be achieved within 60 calendar
days.
2) Type II provider service
violations are participant-centered violations that pose a potentially serious
risk to the participant. These violations are to be corrected within 60
calendar days.
3) Type III provider
service violations are administrative violations that pose a very low risk to
the participant. The time frame for correction of Type III violations shall be
60 calendar days or as established in an approved work plan.
c) Provider service violations include, but are not limited to, violation of the following CCP rules:
1) adult day service standard
requirements(Section
240.1550
);
2) adult day service and in-home
provider staffing requirements(Sections
240.1530 and
240.1555
);
3) special services(Subpart
J);
4) provider administrative
minimum standards and responsibilities(Sections
240.1510,
240.1520,
240.1542,
240.1544
and
240.2020
);
5) service components(Sections
240.210,
240.230,
240.235,
240.237
and
240.270
);
6) adult day service and in-home
provider staff qualification and responsibilities(Sections
240.1535
and
240.1560
);
7) service provision
requirements (Subpart B and Section
240.915
);
8) emergency home response
equipment (Section
240.1541
);
9) AMD equipment(Section
240.1543
).
d) The Department will be in receipt of reported violations through the following methods:
1) Performance reviews of contracted provider
agencies(Section
240.1660
);
2) Service complaints/violations
that are reported directly to the Department or to the Senior HelpLine of the
Department or are referred to the Senior HelpLine by the Department/CCU or
service provider/other; and/or
3)
Reports from Department staff.
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