Jonathan Rosenfeld's Nursing Homes Abuse Blog

Thankfully, We Now Have Many Laws To Protect The Elderly From Abuse In A Variety Of Settings. However, Laws Are Worthless, If The People For Whom They Are Intended To Help Are Unaware Of Them

Jonathan Rosenfeld — Mon, 08 Feb 2010 06:10:41 -0600

Over the last 20 years, federal and state legislatures have drafted many laws with the intention of protecting the most vulnerable members of our society-- they elderly. As the laws accumulate, it is important to know what laws apply to particular situations of abuse or mistreatment and how to properly apply them to particular situations.

What is elder abuse?

Elder abuse is the abuse, neglect, and financial exploitation of elderly persons. Older adults are particularly vulnerable to this type of abuse because of their isolation, illness, or fear. In the United States, an estimated 1 to 2 million Americans age 65 and older have suffered from abuse.

In Illinois, an estimated 76,000 persons over age 60 suffer from elder abuse, but only 10,000 elderly victims report this abuse to the Elder Abuse and Neglect Program each year. The 2008 Illinois Elder Abuse and Neglect Program Annual Report, Demographics reveals that of reported cases of abuse in Illinois in 2008: almost one in four victims are age 86 or older, the most common report received involved financial exploitation followed closely by emotional abuse, 77% of abusers were either the spouse, child, or other relative, and 70% of victims were female.

What is the Elder Abuse and Neglect Act?

The Elder Abuse and Neglect Act (320 ILCS 20/1 et seq.) is an Illinois law established to “design and manage a program of response and services for persons 60 years of age and older who have been, or area alleged to be, victims of abuse, neglect, financial exploitation, or self-neglect.” This program is administered by the Illinois Department on Aging and is coordinated locally through 45 provider agencies. The Program provides investigation, intervention, and follow-up services to victims of elder abuse.

The Elder Abuse and Neglect Program responds to the following types of abuse (320 ILCS 20/2(a)):

Physical abuse – inflicting physical pain or injury upon an older adult

Sexual abuse – touching, fondling, intercourse, or any other sexual activity with an older adult who is unable to understand, unwilling to consent, threatened, or physically forced

Emotional abuse – verbal assaults, treats of abuse, harassment, or intimidation

Confinement – restraining or isolating an older adult, other than for medical reasons

Passive neglect – caregiver’s failure to provide an older adult with life’s necessities (food, clothing, shelter, medical care)

Willful deprivation – willfully denying an older adult medication, medical care, shelter, food, therapeutic device, or other physical assistance which exposes that person to the risk of physical, mental, or emotional harm

Financial exploitation – misuse or withholding of an older adult’s resources by another, to the disadvantage of the elderly person, or the profit or advance of someone else

In order to encourage people to report elder abuse (call Elder Abuse Hotline at 1-866-800-1409), the Act provides that a person who reports suspected elder abuse in good faith or cooperates with an investigation will be granted immunity from criminal or civil liability or professional disciplinary action and their identify will not be disclosed without written permission or a court order. The Department on Aging, Office of Elder Rights started a campaign called Break the Silence (brochure) to increase public awareness of elder abuse.

Illinois law requires that persons delivering professional services to older adults (social services, adult care, law enforcement, education, medicine, state service to seniors, and social workers) report suspected abuse of older persons who are unable to report for themselves. This mandatory reporting requirement only applies if the reporter believes that the older person is not capable of reporting the abuse themselves. Any physician who willfully fails to report as required by the Act is referred to the Illinois State Medical Disciplinary Board. Any other mandated reporter required by the Act who willfully fails to report is guilty of a Class A misdemeanor.

The Department also encourages people to report suspected elder abuse even when not required. If the older person is a nursing home resident, reports are made to the Illinois Department of Public Health’s Nursing Home Hotline (1-800-252-4343).

Applicability of Elder Abuse & Neglect Laws to Nursing Homes and Group Homes

Nursing homes and group homes are intended to provide a safe and secure home for your family members when they are unable to live on their own or need special care and services. These facilities promise to take care of our loved ones with the care, respect, and safety that they deserve. However, many cases of elder abuse and neglect occur in these very facilities.

Illinois nursing homes are subject to federal and state laws including the Illinois Nursing Home Care Act (210 ILCS 45), which establishes minimum standards for the facility. The Illinois Department of Public Health (IDPH) is responsible for licensing nursing homes in order to ensure that they provide adequate and proper care for their residents. In addition, Illinois nursing home residents are guaranteed certain privileges according to the rights and protections afforded under State and Federal law (Resident’s Rights brochure).

When you enter a long-term care facility, you maintain the right to safety and good care, privacy, manage your own money, participate in your care, safety of your personal belongings, and keep living in your facility. It is important to remember that you do not lose your rights just because you enter a nursing home facility.

One of the most important rights you have is freedom from abuse, neglect, financial exploitation, and self-neglect. If a nursing home employee, medical worker, social services worker or other mandated reporter who is engaged in carrying out their professional duties suspects that a nursing home resident is being abused or neglected, they have the responsibility to report their suspicions to IDPH under the Elder Abuse and Neglect Act. Additionally, any person who suspects abuse or neglect may also voluntarily report their suspicions to IDPH.

IDPH is responsible for investigating allegations of abuse or neglect in long-term care facilities, including nursing home facilities. When a mandated reporter or any other person who suspects elder abuse reports an allegation to IDPH, an investigator responds to the complaint to ensure that the elderly person is not living in an abusive situation. An investigator will usually visit the facility in question and perform a face-to-face assessment with respect to a complaint report along with any casework and follow-up as required by Department protocols.

If you suspect that an older adult, age 60 or older, is being subjected to abuse, neglect, or exploitation, it is important to report your suspicions to the Illinois Department on Aging or the Illinois Department of Public Health if the person is a nursing home resident. Older adults, especially those with mental disabilities or illness, are particularly vulnerable to abuse and neglect. It is important to be vocal proponents of the safety and well-being of older adults to ensure that they receive adequate care and services while maintaining their rights.

Resources:

ILGA: Elder Abuse and Neglect Act
State of Illinois: Elder Abuse and Neglect Act and Related Laws
Illinois Department on Aging: Resident’s Rights Brochure
Senior Services Inc: Elder Abuse Intervention

Related Nursing Homes Abuse Blog Entries:

A Legal Victory For Nursing Home Residents. State Laws Can Supersede Federal Arbitration Act

Elder Abuse: Why Bruises Can Be Tell-Tale Signs Of Poor Care

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

Professor Devotes New Book To 'Oscar The Cat'-- The Feline With The Ability To Predict Death

Jonathan Rosenfeld — Sun, 07 Feb 2010 05:41:34 -0600

Talk about worthless news stories, here's a news-clip about a Brown University professor who will be releasing a new book devoted to.... a cat. Not just any alley cat, 'Oscar' allegedly has the ability to predict the impending death of nursing home patients. Oscar has apparently successfully predicted the impending death of more than 50 patients in a Rhode Island nursing home. Apparently, when Oscar cuddles up with you, your day may be numbered.

Lawsuit Alleges CNA At A Golen Living Center Sexually Abused Paralyzed Patient

Jonathan Rosenfeld — Fri, 05 Feb 2010 05:40:04 -0600

A recently filed lawsuit against Golden Living Centers in Merrillville, IN alleges that a CNA at the facility entered the room of a paralyzed stroke patient, took his clothes off and fondled the man against his will. The CNA identified as, Ismael Golden, also faces criminal charges related to the alleged sexual abuse. In addition to this incident, Mr. Golden is also accused of sexually assaulting another patient at the Indiana nursing home.

Read more about this case of alleged sexual abuse at a Golden Living Center here.

Lawsuit Claims That Nursing Home Failed To Intervene In Case Involving The Sexual Abuse Of A Patient

Nurse Charged With Rape Of Disabled Patient

In Wake Of Sexual Assault Of Elderly Woman, Chicago Nursing Home & Administrator Named In Civil Lawsuit

Update On Nursing Home Rape: Facility Made Errors In Investigation Of Incident

Golden Living Partners With Microsoft To Help Manage Patient Medical Records

Bankruptcy Laws Allow Owners Of Assisted Living Facility To Ignore $1.2M Judgment Against Them

Jonathan Rosenfeld — Thu, 04 Feb 2010 05:46:22 -0600

The $1.2 million judgment North Carolina Superior Court Judge, James Ammons handed down in a 2006 negligence trial will literally amount to nothing after the owners of the Countryside Villa run-for-cover under North Carolina's bankruptcy laws.

The large verdict against the assisted living facility was awarded to Joe Cooper, a Marine Corps Veteran, who suffered a concussion, respiratory failure that required a breathing tube and the loss of several teeth in a incident that occurred at the facility in 2003. In addition to the facilities responsibility for Mr. Cooper's injuries related to the specific episode, Judge Ammons also concluded that Countryside Villa's pattern of 'egregiously wrongful acts' further resulted in the aggravation of Mr. Coopers diabetes and other medical conditions.

North Carolina, like the majority of states, does not require the owners of nursing homes and assisted living facilities to carry liability insurance. In this case, and other similar cases, the judgment may attach to the owners of the facility individually, but the enforcement of the judgment remains difficult if-- if not downright impossible-- when the owner deliberately shields his or her personal assets by utilizing bankruptcy laws in their favor.

According to the owners bankruptcy petition, they were barely able to squeeze out a living with an annual income of $330,706 as their expenses ate into the majority of their take. According to Mr. Cooper's daughter, the doors to this assisted living facility remain open.

As a lawyer who represents people injured in long-term care facilities, I am continually frustrated by the lack of accountability on the part of the owners and operators. What continually impresses me is the sheer greed of many of these people. Rather than make the necessary improvements to their facilities and purchasing adequate insurance coverage to protect their patients, they make a conscious decision to squeeze every last penny of profit out of their facilities. Given the lack of civil enforcement, maybe its time to impose criminal penalties against operators who willfully endanger their patients?

Read more about this North Carolina assisted living facility here.

Who Benefits From Damage Caps In Nursing Home Lawsuits?

Appellate Court Orders Retrial In Nursing Home Negligence Case With $29.8M In Punitive Damages

Juries Sending A Message To Nursing Homes

Support Mandatory Nursing Home Insurance

Respite Care: A Welcome Break For Caregivers Or Exposing A Loved One To Unnecessary Harm?

Jonathan Rosenfeld — Wed, 03 Feb 2010 05:37:54 -0600

Respite Care means the intermittent and temporary care for frail or disabled adults on behalf of the primary caregiver in order to provide relief and support. It is an important aid for families who care for older family members so that they can run errands, work, take care of personal matter, or even give them some time off to relax. This allows you to care for family members without having to institutionalize them.

Caregiving requires large amounts of time, emotion, and money. It can be very stressful, which can lead to situations of abuse, neglect, financial exploitation, or even feelings of resentment. This is why having programs that offer respite care are so important to ensure that you give your family members the care they deserve while allowing you some time to yourself.

Respite care comes in many forms; it can be managed through national organizations such as The Arc, Easter Seals, and United Cerebral Palsy, provided by local organizations such as churches, schools, and non-profits, or even arranged with neighbors or people the family knows. The services provided depend on the provider, the needs of the family, and available funds. In addition, respite care can be planned or provide emergency relief to the caregiver.

In-home respite care means care provided by a trained paid worker providing short-term intermittent care, supervision, or companionship to the frail or disabled adult in the home while relieving the caregiver. In-Home respite care can consist of:

Home-based services
Sitter-companion services
Parent-trainer services

Out-of-Home respite can consist of:

Family Care Homes
Respite Family Day Care
Respite in Corporate Foster Home Settings
Residential Facilities
Parent Cooperative Model
Respitality Model
Hospital-Based
Camps

It is important that respite care workers receive proper training in order to provide quality care and assistance to your elderly or disabled family members. Elderly persons are at risk for abuse, neglect, and financial exploitation, which makes it even more important to take care when choosing respite care workers. You must have peace of mind when leaving your loved ones with a respite care worker, so you know that they are receiving

In Illinois, the Respite Program Act (320 ILCS 10) acknowledges the importance of respite care and helps provide affordable and appropriate in-home respite care services. The Director of the Illinois Department on Aging (IDOA) is in charge of administering a program of assistance to persons in need to deter the institutionalization of frail or disabled adults. The Act provides that respite care workers should be appropriately trained to provide in-home supervision and assistance to a frail or disabled adult.

As part of the 2000 National Family Caregiver Support Program, Illinois was given $4.7 million to develop the Caregiver Support Program, part of which is intended to lead family caregivers to respite care to enable them to be temporarily relieved from their caregiving responsibilities. There are Caregiver Resource Centers (Region 12 – City of Chicago) across the state which can help you located services. In 2009, the Illinois Department on Aging received a $200,000 federal grant to improve the state’s respite programs. Also in 2009, the IDOA implanted its three-year Lifespan Respite Project in collaboration with the Illinois Respite Coalition and other state and private organizations in order to improve respite care by establishing a statewide listing of respite services and train respite providers and volunteers.

Deciding whether or not to institutionalize a family member is a difficult and personal choice. If you do decide to offer care to an elderly or disabled family member in your home, there are respite care programs that can offer much needed relief and support.

As lawyers who frequently represent the elderly, I see many individuals mistreated or neglected in a respite-care-setting. The majority of the time we see an injury occurring in these situations, is probably due to an unfamiliarity between the temporary caregiver and the patient.

In order to make respite stays as easy on the facility and the individual, I suggest the following:

Visit the respite care facility on your own and with your loved one (if possible) before the respite visit
Make sure the facility regularly handles respite care stays
Try to be consistent with the facilities or individuals you use for respite care
Communicate your loved one's needs to the staff
Bring photos or other familiar keepsakes to the respite care facility
Don't hesitate to make a brief phone call to check in during the respite stay

Sources:

ILGA: Respite Program Act

DHHS: Respite Care

Illinois Department on Aging: Caregiver Support Program

Administration on Aging: Lifespan Respite Care Program

Elderly Woman Wanders From Her Convalescent Home To Her Death

Jonathan Rosenfeld — Tue, 02 Feb 2010 05:27:25 -0600

I'll never get accustomed to the fact that many elderly will suffer an injury or die due to the carelessness of people who are intended to care for them. It seems that every few weeks we hear about an elderly person who mysteriously goes missing from a facility and wanders to his or her death. Despite the frequency, it still outrages me when I hear about such completely preventable situations.

Most recently, I was saddened to hear about the death of 63-year-old Rosemary Nelson who was found dead along the shoulder of the road after wandering from a California convalescent home. Ms. Nelson's body was discovered three days after she was reported missing from the facility that was responsible for her care. A medical examiner concluded Ms. Nelson's death was due to 'exposure'

According to a report from Ms. Nelson's family, Ms. Nelson had a history of wandering from facilities and had gone missing from other board-and-care facilities in the past.

Of course its easy to come up with excuses why this elderly woman managed to wander from this skilled nursing facility, yet the reality most certainly remains that someone at the facility was not doing their job when this lady managed to leave undetected. As a society we must begin to demand that nursing homes begin to look after our elders the same way we expect nursery schools to look after out toddlers. Until we demand full accountability, we will likely continue to hear about elderly who wandered into a world they are ill equipped to handle.

Read more about this wandering episode involving a California Nursing Home here.

Related Nursing Homes Abuse Blog Entries:

Assisted Living Facility Lets Resident Walk Out The Door & Into Semi

Woman Dies From Hypothermia After Wandering From Assisted Living Facility

Chicago Nursing Home Lawyer, Jonathan Rosenfeld, Interviewed Regarding Preventing Patients From Wandering

What Can Nursing Homes Learn From Jails?

Nursing Home Operator And CNA's Named As Defendants In Civil Lawsuit After Sex Abuse Scandal

Jonathan Rosenfeld — Mon, 01 Feb 2010 05:50:20 -0600

After the well publicized abuse of elderly patients at the Good Samaritan Nursing Home in Minnesota, some of the patients who were victimized have filed a civil lawsuit against the nursing home and the individual nurses involved.

Prosecutors have already filed criminal charges against two young woman who tormented many of the Alzheimer's and dementia patients they were responsible for caring for. The criminal investigation revealed that these derelict CNA's were repeatedly abusing Good Samaritan patients over a six month period in 2008.

While employers are generally not responsible for the intentional acts of their employees, lawyers for the nursing home patients will argue that the abuse instituted by the nurses continued for such a long period that the nursing home knew or should have know of the abuse taking place at their facility.

Given the fact that many of the young women who were involved in this situation were 18-years-old, I find any argument by the nursing home operator that these women were acting on their own and did not require supervision laughable.

As a lawyer who has represented victims of sexual abuse, I find these "I didn't know" arguments made by employers heartless and insincere. I'll bet that if these young women were working a cash-register at this facility and were regularly taking money from the company coffers, the company would have stopped their conduct a lot quicker!

Read more about this nursing home lawsuit here.

Related Nursing Homes Abuse Blog Entries:

Girls Gone Wild In Minnesota Nursing Home

Nursing Home Abuse Charges Filed Against Teenage Workers

Forwarded Email From A Perfect Cause Re: Abuse At Albert Lea Nursing Home

Lawsuit Claims That Nursing Home Failed To Intervene In Case Involving The Sexual Abuse Of A Patient

60 Nursing Home Patients Sickened By Norovirus

Jonathan Rosenfeld — Sun, 31 Jan 2010 07:12:18 -0600

More than 60 patients at the Good Shepherd Nursing Home in Ohio have become ill after contracting norovirus. According to the Ohio Department of Health the norovirus outbreak occurred sometime around January 15th.

It is unclear what triggered this norovirus outbreak, but norovirus is highly contagious and can be spread through feces, vomit or food poisoning. In order to reduce episodes of norovirus, it is important to regularly wash hand and follow common sense sanitation guidelines.

Most people with norovirus initially have a bad stomach ache followed by nausea, vomiting or diarrhea. Norovirus in the elderly can be particularly problematic because many of the symptoms result in dehydration. By some accounts, norovirus claims the lives of more than 500 people each year.

Read more about this norovirus outbreak in an Ohio Nursing Home here.

Related Nursing Homes Abuse Blog Entries:

MRSA In Nursing Homes On The Rise Amongst Residents & Staff

Food Safety

Elderly Nursing Home Patients Are Particularly Susceptible To Illness Related To Contaminated Food

Medicare Standards Require Nursing Home Patients To Be Transported Safely

Jonathan Rosenfeld — Fri, 29 Jan 2010 06:40:17 -0600

Emergency medical and transportation services are a necessary component of a comprehensive medical care program. Ambulance services can be provided by: volunteer, municipal, private, independent and institutional providers. All providers must meet requirements set by State and local laws in order to ensure adequate services and safe transport.

According the U.S. Census Bureau, the population of people 65 and older is expected to double between 2000 and 2030. In the year 2020, there will be 10,000 people each day turning 65. As the population of people age 65 and older increases, there will be more people who require emergency medical and non-emergency transport services. Because many seniors have disabilities or limited mobility that make them particularly susceptable to injury during transport, it is important that companies strictly adhere the applicable standards of care.

Many seniors rely on medical transportation provided by nursing homes and private ambulance companies to get to vital services such as:

Physical therapy
Dialysis
Surgery
Doctors appointments

Some state legislatures, such as Illinois, have attempted to address the need for medical transportation in rural areas by passing legislation to increase the resources available for emergency and non-emergency transportation. The Illinois General Assembly (ILGA) passed the Regional Ambulance Services Law (55 ILCS 110) to improve the delivery of health care services in rural areas. This law allows regional ambulance systems the right to use private ambulance services to expand the regional ambulance services.

Private ambulances provide emergency medical and transport services. They transport patients from one hospital to another, to a nursing home, to another special-care center, from hospital to home, and they also answer emergency calls. In addition, some hospitals and nursing homes operate their own ambulances. Many private ambulances will deliver people to the hospital of their choice, unlike city ambulances which usually have to take people to a designated hospital, typically the nearest.

The only transportation service that Medicare (under Medicare Part B) pays for is ambulance services in severe medical situations such as life-threatening emergencies or when dealing with bedridden patients. However, Medicaid may pay for transportation services to get you to a medical appointment if you are eligible. In Chicago, the Chicago Department of Senior Service’s Transportation Program assists older adults who need medical transportation to receive life-sustaining treatments.

According to the Medicare Benefit Policy Manual, ambulances must be designed and equipped to respond to medical emergencies and transport patients in non-emergency situations. These ambulances must contain: a stretcher, linens, emergency medical supplies, oxygen equipment, other lifesaving emergency medical equipment and be equipped with: emergency warning lights, sirens, and telecommunications equipment.

Basic Life Support (BLS) ambulances must be staffed by at least two people, at least one of whom is certified as an emergency medical technician (EMT). Advance Life Support (ALS) vehicles must also be staffed by at least two people, one of whom is certified as an EMT-Intermediate or EMT-Paramedic. The ambulance must submit a statement and documentary evidence that the vehicle and crew meet all Medicare, State, and local requirements.

In order for Medicare to cover ambulance transport, the ambulance services must be “medically necessary and reasonable.” Ambulance transport is medically necessary when no other method of transportation could be used without endangering the health of the patient. This includes transport for patients who are bed-confined, which means that the patient is unable to get out of bed without assistance, unable to ambulate, and unable to sit in a chair or wheelchair. In addition, the medical transport must be to obtain or return from a Medicare covered service.

Furthermore, Medicare only covers ambulance transports to the nearest appropriate facility, as well as return transport. This means that you cannot always be transported to your personal physician or hospital of choice, if it is not the closest reasonable facility. Medicare covers transport to the following destinations: hospital, critical access hospital (CAH), skilled nursing facility (SNF), beneficiary’s home, and dialysis facility.

The Medicare Fee Schedule (FS) applies to app ambulance services including volunteer, municipal, private, independent and institutional providers. The FS equals a base rate for the level of service plus payment for mileage and applicable adjustment factors.

Oftentimes, ambulance transport of nursing home residents qualifies under Medicare coverage because the transport is medically necessary or the resident is confined to a bed. Medicare does not have a pre-authorization process for ambulance services to determine whether Medicare coverage may apply. Therefore, nursing home facilities must be familiar with Medicare requirements to ensure that a resident does not incur additional costs.

Regardless of the circumstances in which you utilize medical transport services, you have a right to be transported safely. If you believe that your injury is related to negligence during medical transport, we will use the applicable laws in your area to work for you. Put our experience representing people who have suffered an injury during medical transport to work for you today. Free consultations with experienced lawyers. (888) 424-5757

Thank you to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog entry.

Resources:

Illinois General Assembly: Regional Ambulance Services Law

Medicare: Transportation Services Overview

New York Times: Private Ambulances, When to Use Them

U.S. Department of Labor: Bureau of Labor Statistics: Emergency Medical Technicians and Paramedics

Medicare Benefit Policy Manual: Ch. 10 Ambulance Services

Improper Drug Dosage, Wrong Medication, Interactions With Other Drugs.... May Be The Result Of Pharmacutical Malpractice

Jonathan Rosenfeld — Thu, 28 Jan 2010 06:51:26 -0600

Prescription drugs are invaluable tools in the practice of medicine, used to treat numerous illnesses and diseases. However, prescription errors can result in serious injury and death. In the United States, about 1.5 million preventable adverse drug events occur every year.

Pharmaceutical malpractice can occur when a doctor prescribes the wrong medication or incorrect dose or when a pharmacist fills the wrong medication or dosage. The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) defines a medication error as:

"A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use."

These pharmaceutical errors can result in serious health complications including allergic reactions, organ damage caused by an overdose, infection, stroke, heart failure, and even death. Doctors and pharmacists must follow strict regulations in order to prevent mistakes. In Illinois, the Pharmacy Practice Act (225 ILCS 85) regulates the practice of pharmacy in Illinois.

Types of Pharmaceutical Errors

Adverse Drug Side Effects
Incorrectly Filling A Prescription
Incorrect Labeling
Incorrect Dosage
Drug Interactions
Incorrect instructions regarding usage

Drug Side Effects

Many prescription medications have serious side effects that should be considered before taking them. Some serious and common side effects include: allergic reactions, heart problems, liver and kidney failure, weight gain/loss, and psychological effects. The doctor prescribing your medication should consider the pros and cons of prescribing the medication as opposed to leaving the condition untreated or prescribing a different medication.

When considering whether to prescribe a drug with serious side effects, the doctor should consider your full medical history and information to determine whether you can handle the side effects. Also, when filling a prescription order, pharmacists have a duty to advise you about any side effects that might accompany the use of the prescription medication.

Incorrect Prescription

Medication errors can result when there is a miscommunication of drug orders. This can involve poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations. As many people know, doctor’s handwriting is often times little more than a scrawl or scribble.

Doctors must take reasonable care in correctly and accurately writing prescriptions. One way to reduce the chance of prescription errors is to use electronic prescriptions, removing the risk of errors associated with poor handwriting. However, mistakes can still occur when a doctor types in the wrong prescription order. Therefore, doctors should take extra care when prescribing medications to ensure that no transcribing errors have occurred.

Medication errors can also occur when doctors take incomplete patient information. For example, the doctor might not know about the patient’s allergies, any other medications the patient is taking, previous diagnoses, and lab results. Doctors perform best when fully informed about the patient’s history and information. Doctors should ensure that they have a patient’s complete and up to date information before prescribing medication, in order to cut down on medication errors.

Incorrect Labeling

Pharmacists must ensure that medications have correct labels before selling them to patients. Prescription medication labels should include the name of the drug it contains, the amount to be taken, the time of day to take the medication, and any warnings while taking the drug. When prescription medications are labeled incorrectly, you may end up taking the wrong drug, the wrong dose, the wrong time, or be unaware of warnings about what foods, beverages, or activities to avoid while taking the drug.

These mistakes can result in serious complications including liver or kidney damage or death or not receiving the full benefit of the drug’s intended purpose. Even when pharmacists include the correct information on the label, they should go over the recommended dosage, procedures, and warnings to ensure that you understand how to safely and correctly take the medication. This is especially important with older adults who may be unable to read the label.

Incorrect Dosage

Prescription medications have more serious dangers associated with them than over the counter (OTC) drugs. Therefore, it is important that pharmacists issue the correct drug (the one the doctor prescribed) at the correct dose. Errors in filling prescriptions can result from similar-looking pills, difficult to read physician handwriting, and rushed work at pharmacies. Pharmacists must exercise reasonable care when filling each and every prescription order to ensure that you receive the highest standard of care and avoid injury.

In Illinois, registered pharmacy technicians may, under the supervision of a pharmacist, assist in the dispensing process, offer counseling, and receive new verbal prescription orders (225 ILCS 85/9 – Registration as pharmacy technician). Depending on the pace of business at the pharmacy, these pharmacy technicians might not receive proper supervision to ensure the highest standard of care.

These mistakes can also cause serious medical complications, either because you take too much or too little of a drug or even taking the wrong drug. Many prescription medications treat serious illness and disease, and besides the risks associated with taking the wrong drug or the wrong dose, are the risks associated with not treating the illness or disease that prompted your doctor to give you a prescription in the first place.

Adverse Drug Interactions

Many people, especially older adults, take multiple prescription medications, which are commonly prescribed my multiple doctors. However, problems can occur because the doctors prescribing these medications might not know about the other drugs you are taking.

This can lead to serious complications stemming from drug interactions. Drug-drug interactions are not the only type of potentially dangerous drug interactions; there can also be drug interactions with foods, beverages, and dietary supplements.

There are three main types of drug interactions:

Drugs with food and beverages
Drugs with dietary supplements
Drugs with other drugs

Drug interactions can reduce the effectiveness of drugs, cause unexpected side effects, or increase the action of a particular drug. Drug interactions with food and beverages might result in delayed, decreased, or enhanced absorption of a medication. Dietary supplements can also cause a variety of drug interactions, and with fifty percent of American adults using dietary supplements (vitamins, minerals, amino acids, herbs or botanicals) on a regular basis, the risk of negative drug interactions is high.

For example, St. John’s Wort can reduce the concentration of medications in the blood; Vitamin E can increase anti-clotting activity and cause increased risk of bleeding when taken with blood-thinning medication; Ginseng can enhance the bleeding effects of aspirin and ibuprofen; and Ginkgo Biloba can decrease the effectiveness of anticonvulsant therapy. Drug-drug interactions can cause adverse drug reactions.

The rate of adverse drug reactions increases significantly when a patient is on four or more medications. This is especially worrisome because almost 40% of Americans receive prescriptions for four or more medications.

Because pharmacists fill prescriptions issued by multiple doctors, they are in the best position to catch potentially harmful drug interactions. However, some people use more than one pharmacy for their drug needs. Therefore, in order to avoid problems with drug interactions, you should use one pharmacy for all of your medications and keep a record of all prescription drugs, over the counter (OTC) drugs, and dietary supplements that you take.

Nursing home staff must take extra precautions when distributing new prescription medications to nursing home residents. Many nursing home residents are on multiple medications for a variety of physical and mental conditions that are best treated with prescription drugs. These residents might be under the supervision of multiple doctors, and it is the nursing home’s responsibility to ensure that the doctors are aware of all the resident’s medications and changes in condition in order to avoid serious medical complications.

Physician & Pharmacists Duty To Use Reasonable Care

Pharmacists and doctors have a duty to exercise reasonable care in prescribing and filling prescription drugs. When this duty is breached, serious injuries and even death can occur. Elderly adults are particularly susceptible to injuries stemming from pharmaceutical medication errors because many older adults take multiple medications. Furthermore, many older adults see multiple doctors for specialized care to treat specific injuries or illnesses.

The increased number of prescription drugs and multiple drug providers can increase the likelihood for a pharmaceutical error. Older adults are also less able to prevent pharmaceutical errors because they might be less able to read the labels and warnings, be less able to understand the medication labels, and might be unable to provide doctors with a complete list of medications or medical information. Many older adults, especially those in nursing homes, rely on other people to fulfill their prescription needs. Therefore, additional care and caution must be taken when prescribing medications to older adults, especially those who rely on nursing home staff for medications and activities of daily living.

If you or a member of your family has suffered injury because of a pharmaceutical error, you can bring a pharmaceutical malpractice or negligence action. In addition, if the worst occurs and the pharmaceutical malpractice results in the death of a loved one, you may also be entitled to bring a wrongful death action.

Speak to our experienced pharmaceutical error lawyers about your case for free today. Nationwide service. (888) 424-5757

Resources:

FDA: Avoiding Drug Interactions

National Coordinating Council for Medication Error Reporting and Prevention

Adverse Drug Event Reporting: The Roles of Consumers and Health-Care Professionals

Illinois General Assembly – 225 ILCS 85/9 Registration as pharmacy technician

PROFESSIONS AND OCCUPATIONS
(225 ILCS 85/) Pharmacy Practice Act.
(225 ILCS 85/1) (from Ch. 111, par. 4121)
(Section scheduled to be repealed on January 1, 2018)
Sec. 1. The Practice of Pharmacy in the State of Illinois is declared a professional practice affecting the public health, safety and welfare and is subject to regulation and control in the public interest. It is further declared to be a matter of public interest and concern that the practice of pharmacy, as defined in this Act, merit and receive the confidence of the public and that only qualified persons be permitted to practice pharmacy in the State of Illinois. This Act shall be liberally construed to carry out these objects and purposes.
(Source: P.A. 85‑796.)

(225 ILCS 85/2) (from Ch. 111, par. 4122)
(Section scheduled to be repealed on January 1, 2018)
Sec. 2. This Act shall be known as the Pharmacy Practice Act.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/2.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 2.5. References to Department or Director of Professional Regulation. References in this Act (i) to the Department of Professional Regulation are deemed, in appropriate contexts, to be references to the Department of Financial and Professional Regulation and (ii) to the Director of Professional Regulation are deemed, in appropriate contexts, to be references to the Secretary of Financial and Professional Regulation.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/3) (from Ch. 111, par. 4123)
(Text of Section from P.A. 96‑339)
(Section scheduled to be repealed on January 1, 2018)
Sec. 3. Definitions. For the purpose of this Act, except where otherwise limited therein:
(a) "Pharmacy" or "drugstore" means and includes every store, shop, pharmacy department, or other place where pharmacist care is provided by a pharmacist (1) where drugs, medicines, or poisons are dispensed, sold or offered for sale at retail, or displayed for sale at retail; or (2) where prescriptions of physicians, dentists, advanced practice nurses, physician assistants, veterinarians, podiatrists, or optometrists, within the limits of their licenses, are compounded, filled, or dispensed; or (3) which has upon it or displayed within it, or affixed to or used in connection with it, a sign bearing the word or words "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care", "Apothecary", "Drugstore", "Medicine Store", "Prescriptions", "Drugs", "Dispensary", "Medicines", or any word or words of similar or like import, either in the English language or any other language; or (4) where the characteristic prescription sign (Rx) or similar design is exhibited; or (5) any store, or shop, or other place with respect to which any of the above words, objects, signs or designs are used in any advertisement.
(b) "Drugs" means and includes (l) articles recognized in the official United States Pharmacopoeia/National Formulary (USP/NF), or any supplement thereto and being intended for and having for their main use the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals, as approved by the United States Food and Drug Administration, but does not include devices or their components, parts, or accessories; and (2) all other articles intended for and having for their main use the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals, as approved by the United States Food and Drug Administration, but does not include devices or their components, parts, or accessories; and (3) articles (other than food) having for their main use and intended to affect the structure or any function of the body of man or other animals; and (4) articles having for their main use and intended for use as a component or any articles specified in clause (l), (2) or (3); but does not include devices or their components, parts or accessories.
(c) "Medicines" means and includes all drugs intended for human or veterinary use approved by the United States Food and Drug Administration.
(d) "Practice of pharmacy" means (1) the interpretation and the provision of assistance in the monitoring, evaluation, and implementation of prescription drug orders; (2) the dispensing of prescription drug orders; (3) participation in drug and device selection; (4) drug administration limited to the administration of oral, topical, injectable, and inhalation as follows: in the context of patient education on the proper use or delivery of medications; vaccination of patients 14 years of age and older pursuant to a valid prescription or standing order, by a physician licensed to practice medicine in all its branches, upon completion of appropriate training, including how to address contraindications and adverse reactions set forth by rule, with notification to the patient's physician and appropriate record retention, or pursuant to hospital pharmacy and therapeutics committee policies and procedures; (5) drug regimen review; (6) drug or drug‑related research; (7) the provision of patient counseling; (8) the practice of telepharmacy; (9) the provision of those acts or services necessary to provide pharmacist care; (10) medication therapy management; and (11) the responsibility for compounding and labeling of drugs and devices (except labeling by a manufacturer, repackager, or distributor of non‑prescription drugs and commercially packaged legend drugs and devices), proper and safe storage of drugs and devices, and maintenance of required records. A pharmacist who performs any of the acts defined as the practice of pharmacy in this State must be actively licensed as a pharmacist under this Act.
(e) "Prescription" means and includes any written, oral, facsimile, or electronically transmitted order for drugs or medical devices, issued by a physician licensed to practice medicine in all its branches, dentist, veterinarian, or podiatrist, or optometrist, within the limits of their licenses, by a physician assistant in accordance with subsection (f) of Section 4, or by an advanced practice nurse in accordance with subsection (g) of Section 4, containing the following: (l) name of the patient; (2) date when prescription was issued; (3) name and strength of drug or description of the medical device prescribed; and (4) quantity, (5) directions for use, (6) prescriber's name, address and signature, and (7) DEA number where required, for controlled substances. DEA numbers shall not be required on inpatient drug orders.
(f) "Person" means and includes a natural person, copartnership, association, corporation, government entity, or any other legal entity.
(g) "Department" means the Department of Financial and Professional Regulation.
(h) "Board of Pharmacy" or "Board" means the State Board of Pharmacy of the Department of Financial and Professional Regulation.
(i) "Secretary" means the Secretary of Financial and Professional Regulation.
(j) "Drug product selection" means the interchange for a prescribed pharmaceutical product in accordance with Section 25 of this Act and Section 3.14 of the Illinois Food, Drug and Cosmetic Act.
(k) "Inpatient drug order" means an order issued by an authorized prescriber for a resident or patient of a facility licensed under the Nursing Home Care Act, the MR/DD Community Care Act, or the Hospital Licensing Act, or "An Act in relation to the founding and operation of the University of Illinois Hospital and the conduct of University of Illinois health care programs", approved July 3, 1931, as amended, or a facility which is operated by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities) or the Department of Corrections.
(k‑5) "Pharmacist" means an individual health care professional and provider currently licensed by this State to engage in the practice of pharmacy.
(l) "Pharmacist in charge" means the licensed pharmacist whose name appears on a pharmacy license and who is responsible for all aspects of the operation related to the practice of pharmacy.
(m) "Dispense" or "dispensing" means the interpretation, evaluation, and implementation of a prescription drug order, including the preparation and delivery of a drug or device to a patient or patient's agent in a suitable container appropriately labeled for subsequent administration to or use by a patient in accordance with applicable State and federal laws and regulations. "Dispense" or "dispensing" does not mean the physical delivery to a patient or a patient's representative in a home or institution by a designee of a pharmacist or by common carrier. "Dispense" or "dispensing" also does not mean the physical delivery of a drug or medical device to a patient or patient's representative by a pharmacist's designee within a pharmacy or drugstore while the pharmacist is on duty and the pharmacy is open.
(n) "Nonresident pharmacy" means a pharmacy that is located in a state, commonwealth, or territory of the United States, other than Illinois, that delivers, dispenses, or distributes, through the United States Postal Service, commercially acceptable parcel delivery service, or other common carrier, to Illinois residents, any substance which requires a prescription.
(o) "Compounding" means the preparation and mixing of components, excluding flavorings, (1) as the result of a prescriber's prescription drug order or initiative based on the prescriber‑patient‑pharmacist relationship in the course of professional practice or (2) for the purpose of, or incident to, research, teaching, or chemical analysis and not for sale or dispensing. "Compounding" includes the preparation of drugs or devices in anticipation of receiving prescription drug orders based on routine, regularly observed dispensing patterns. Commercially available products may be compounded for dispensing to individual patients only if all of the following conditions are met: (i) the commercial product is not reasonably available from normal distribution channels in a timely manner to meet the patient's needs and (ii) the prescribing practitioner has requested that the drug be compounded.
(p) (Blank).
(q) (Blank).
(r) "Patient counseling" means the communication between a pharmacist or a pharmacy intern under the supervision of a pharmacist and a patient or the patient's representative about the patient's medication or device for the purpose of optimizing proper use of prescription medications or devices. "Patient counseling" may include without limitation (1) obtaining a medication history; (2) acquiring a patient's allergies and health conditions; (3) facilitation of the patient's understanding of the intended use of the medication; (4) proper directions for use; (5) significant potential adverse events; (6) potential food‑drug interactions; and (7) the need to be compliant with the medication therapy. A pharmacy technician may only participate in the following aspects of patient counseling under the supervision of a pharmacist: (1) obtaining medication history; (2) providing the offer for counseling by a pharmacist or intern; and (3) acquiring a patient's allergies and health conditions.
(s) "Patient profiles" or "patient drug therapy record" means the obtaining, recording, and maintenance of patient prescription information, including prescriptions for controlled substances, and personal information.
(t) (Blank).
(u) "Medical device" means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component part or accessory, required under federal law to bear the label "Caution: Federal law requires dispensing by or on the order of a physician". A seller of goods and services who, only for the purpose of retail sales, compounds, sells, rents, or leases medical devices shall not, by reasons thereof, be required to be a licensed pharmacy.
(v) "Unique identifier" means an electronic signature, handwritten signature or initials, thumb print, or other acceptable biometric or electronic identification process as approved by the Department.
(w) "Current usual and customary retail price" means the price that a pharmacy charges to a non‑third‑party payor.
(x) "Automated pharmacy system" means a mechanical system located within the confines of the pharmacy or remote location that performs operations or activities, other than compounding or administration, relative to storage, packaging, dispensing, or distribution of medication, and which collects, controls, and maintains all transaction information.
(y) "Drug regimen review" means and includes the evaluation of prescription drug orders and patient records for (1) known allergies; (2) drug or potential therapy contraindications; (3) reasonable dose, duration of use, and route of administration, taking into consideration factors such as age, gender, and contraindications; (4) reasonable directions for use; (5) potential or actual adverse drug reactions; (6) drug‑drug interactions; (7) drug‑food interactions; (8) drug‑disease contraindications; (9) therapeutic duplication; (10) patient laboratory values when authorized and available; (11) proper utilization (including over or under utilization) and optimum therapeutic outcomes; and (12) abuse and misuse.
(z) "Electronic transmission prescription" means any prescription order for which a facsimile or electronic image of the order is electronically transmitted from a licensed prescriber to a pharmacy. "Electronic transmission prescription" includes both data and image prescriptions.
(aa) "Medication therapy management services" means a distinct service or group of services offered by licensed pharmacists, physicians licensed to practice medicine in all its branches, advanced practice nurses authorized in a written agreement with a physician licensed to practice medicine in all its branches, or physician assistants authorized in guidelines by a supervising physician that optimize therapeutic outcomes for individual patients through improved medication use. In a retail or other non‑hospital pharmacy, medication therapy management services shall consist of the evaluation of prescription drug orders and patient medication records to resolve conflicts with the following:
(1) known allergies;
(2) drug or potential therapy contraindications;
(3) reasonable dose, duration of use, and route of

administration, taking into consideration factors such as age, gender, and contraindications;
(4) reasonable directions for use;
(5) potential or actual adverse drug reactions;
(6) drug‑drug interactions;
(7) drug‑food interactions;
(8) drug‑disease contraindications;
(9) identification of therapeutic duplication;
(10) patient laboratory values when authorized and

available;
(11) proper utilization (including over or under

utilization) and optimum therapeutic outcomes; and
(12) drug abuse and misuse.
"Medication therapy management services" includes the

following:
(1) documenting the services delivered and

communicating the information provided to patients' prescribers within an appropriate time frame, not to exceed 48 hours;
(2) providing patient counseling designed to enhance

a patient's understanding and the appropriate use of his or her medications; and
(3) providing information, support services, and

resources designed to enhance a patient's adherence with his or her prescribed therapeutic regimens.
"Medication therapy management services" may also include

patient care functions authorized by a physician licensed to practice medicine in all its branches for his or her identified patient or groups of patients under specified conditions or limitations in a standing order from the physician.
"Medication therapy management services" in a licensed

hospital may also include the following:
(1) reviewing assessments of the patient's health

status; and
(2) following protocols of a hospital pharmacy and

therapeutics committee with respect to the fulfillment of medication orders.
(bb) "Pharmacist care" means the provision by a pharmacist of medication therapy management services, with or without the dispensing of drugs or devices, intended to achieve outcomes that improve patient health, quality of life, and comfort and enhance patient safety.
(cc) "Protected health information" means individually identifiable health information that, except as otherwise provided, is:
(1) transmitted by electronic media;
(2) maintained in any medium set forth in the

definition of "electronic media" in the federal Health Insurance Portability and Accountability Act; or
(3) transmitted or maintained in any other form

or medium.
"Protected health information" does not include individually

identifiable health information found in:
(1) education records covered by the federal

Family Educational Right and Privacy Act; or
(2) employment records held by a licensee in its

role as an employer.
(dd) "Standing order" means a specific order for a patient or group of patients issued by a physician licensed to practice medicine in all its branches in Illinois.
(ee) "Address of record" means the address recorded by the Department in the applicant's or licensee's application file or license file, as maintained by the Department's licensure maintenance unit.
(ff) "Home pharmacy" means the location of a pharmacy's primary operations.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑339, eff. 7‑1‑10.)

(Text of Section from P.A. 96‑673)
(Section scheduled to be repealed on January 1, 2018)
Sec. 3. Definitions. For the purpose of this Act, except where otherwise limited therein:
(a) "Pharmacy" or "drugstore" means and includes every store, shop, pharmacy department, or other place where pharmacist care is provided by a pharmacist (1) where drugs, medicines, or poisons are dispensed, sold or offered for sale at retail, or displayed for sale at retail; or (2) where prescriptions of physicians, dentists, advanced practice nurses, physician assistants, veterinarians, podiatrists, or optometrists, within the limits of their licenses, are compounded, filled, or dispensed; or (3) which has upon it or displayed within it, or affixed to or used in connection with it, a sign bearing the word or words "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care", "Apothecary", "Drugstore", "Medicine Store", "Prescriptions", "Drugs", "Dispensary", "Medicines", or any word or words of similar or like import, either in the English language or any other language; or (4) where the characteristic prescription sign (Rx) or similar design is exhibited; or (5) any store, or shop, or other place with respect to which any of the above words, objects, signs or designs are used in any advertisement.
(b) "Drugs" means and includes (l) articles recognized in the official United States Pharmacopoeia/National Formulary (USP/NF), or any supplement thereto and being intended for and having for their main use the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals, as approved by the United States Food and Drug Administration, but does not include devices or their components, parts, or accessories; and (2) all other articles intended for and having for their main use the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals, as approved by the United States Food and Drug Administration, but does not include devices or their components, parts, or accessories; and (3) articles (other than food) having for their main use and intended to affect the structure or any function of the body of man or other animals; and (4) articles having for their main use and intended for use as a component or any articles specified in clause (l), (2) or (3); but does not include devices or their components, parts or accessories.
(c) "Medicines" means and includes all drugs intended for human or veterinary use approved by the United States Food and Drug Administration.
(d) "Practice of pharmacy" means (1) the interpretation and the provision of assistance in the monitoring, evaluation, and implementation of prescription drug orders; (2) the dispensing of prescription drug orders; (3) participation in drug and device selection; (4) drug administration limited to the administration of oral, topical, injectable, and inhalation as follows: in the context of patient education on the proper use or delivery of medications; vaccination of patients 14 years of age and older pursuant to a valid prescription or standing order, by a physician licensed to practice medicine in all its branches, upon completion of appropriate training, including how to address contraindications and adverse reactions set forth by rule, with notification to the patient's physician and appropriate record retention, or pursuant to hospital pharmacy and therapeutics committee policies and procedures; (5) drug regimen review; (6) drug or drug‑related research; (7) the provision of patient counseling; (8) the practice of telepharmacy; (9) the provision of those acts or services necessary to provide pharmacist care; (10) medication therapy management; and (11) the responsibility for compounding and labeling of drugs and devices (except labeling by a manufacturer, repackager, or distributor of non‑prescription drugs and commercially packaged legend drugs and devices), proper and safe storage of drugs and devices, and maintenance of required records. A pharmacist who performs any of the acts defined as the practice of pharmacy in this State must be actively licensed as a pharmacist under this Act.
(e) "Prescription" means and includes any written, oral, facsimile, or electronically transmitted order for drugs or medical devices, issued by a physician licensed to practice medicine in all its branches, dentist, veterinarian, or podiatrist, or optometrist, within the limits of their licenses, by a physician assistant in accordance with subsection (f) of Section 4, or by an advanced practice nurse in accordance with subsection (g) of Section 4, containing the following: (l) name of the patient; (2) date when prescription was issued; (3) name and strength of drug or description of the medical device prescribed; and (4) quantity, (5) directions for use, (6) prescriber's name, address and signature, and (7) DEA number where required, for controlled substances. DEA numbers shall not be required on inpatient drug orders.
(f) "Person" means and includes a natural person, copartnership, association, corporation, government entity, or any other legal entity.
(g) "Department" means the Department of Financial and Professional Regulation.
(h) "Board of Pharmacy" or "Board" means the State Board of Pharmacy of the Department of Financial and Professional Regulation.
(i) "Secretary" means the Secretary of Financial and Professional Regulation.
(j) "Drug product selection" means the interchange for a prescribed pharmaceutical product in accordance with Section 25 of this Act and Section 3.14 of the Illinois Food, Drug and Cosmetic Act.
(k) "Inpatient drug order" means an order issued by an authorized prescriber for a resident or patient of a facility licensed under the Nursing Home Care Act or the Hospital Licensing Act, or "An Act in relation to the founding and operation of the University of Illinois Hospital and the conduct of University of Illinois health care programs", approved July 3, 1931, as amended, or a facility which is operated by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities) or the Department of Corrections.
(k‑5) "Pharmacist" means an individual health care professional and provider currently licensed by this State to engage in the practice of pharmacy.
(l) "Pharmacist in charge" means the licensed pharmacist whose name appears on a pharmacy license and who is responsible for all aspects of the operation related to the practice of pharmacy.
(m) "Dispense" or "dispensing" means the interpretation, evaluation, and implementation of a prescription drug order, including the preparation and delivery of a drug or device to a patient or patient's agent in a suitable container appropriately labeled for subsequent administration to or use by a patient in accordance with applicable State and federal laws and regulations. "Dispense" or "dispensing" does not mean the physical delivery to a patient or a patient's representative in a home or institution by a designee of a pharmacist or by common carrier. "Dispense" or "dispensing" also does not mean the physical delivery of a drug or medical device to a patient or patient's representative by a pharmacist's designee within a pharmacy or drugstore while the pharmacist is on duty and the pharmacy is open.
(n) "Nonresident pharmacy" means a pharmacy that is located in a state, commonwealth, or territory of the United States, other than Illinois, that delivers, dispenses, or distributes, through the United States Postal Service, commercially acceptable parcel delivery service, or other common carrier, to Illinois residents, any substance which requires a prescription.
(o) "Compounding" means the preparation and mixing of components, excluding flavorings, (1) as the result of a prescriber's prescription drug order or initiative based on the prescriber‑patient‑pharmacist relationship in the course of professional practice or (2) for the purpose of, or incident to, research, teaching, or chemical analysis and not for sale or dispensing. "Compounding" includes the preparation of drugs or devices in anticipation of receiving prescription drug orders based on routine, regularly observed dispensing patterns. Commercially available products may be compounded for dispensing to individual patients only if all of the following conditions are met: (i) the commercial product is not reasonably available from normal distribution channels in a timely manner to meet the patient's needs and (ii) the prescribing practitioner has requested that the drug be compounded.
(p) (Blank).
(q) (Blank).
(r) "Patient counseling" means the communication between a pharmacist or a student pharmacist under the supervision of a pharmacist and a patient or the patient's representative about the patient's medication or device for the purpose of optimizing proper use of prescription medications or devices. "Patient counseling" may include without limitation (1) obtaining a medication history; (2) acquiring a patient's allergies and health conditions; (3) facilitation of the patient's understanding of the intended use of the medication; (4) proper directions for use; (5) significant potential adverse events; (6) potential food‑drug interactions; and (7) the need to be compliant with the medication therapy. A pharmacy technician may only participate in the following aspects of patient counseling under the supervision of a pharmacist: (1) obtaining medication history; (2) providing the offer for counseling by a pharmacist or student pharmacist; and (3) acquiring a patient's allergies and health conditions.
(s) "Patient profiles" or "patient drug therapy record" means the obtaining, recording, and maintenance of patient prescription information, including prescriptions for controlled substances, and personal information.
(t) (Blank).
(u) "Medical device" means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component part or accessory, required under federal law to bear the label "Caution: Federal law requires dispensing by or on the order of a physician". A seller of goods and services who, only for the purpose of retail sales, compounds, sells, rents, or leases medical devices shall not, by reasons thereof, be required to be a licensed pharmacy.
(v) "Unique identifier" means an electronic signature, handwritten signature or initials, thumb print, or other acceptable biometric or electronic identification process as approved by the Department.
(w) "Current usual and customary retail price" means the price that a pharmacy charges to a non‑third‑party payor.
(x) "Automated pharmacy system" means a mechanical system located within the confines of the pharmacy or remote location that performs operations or activities, other than compounding or administration, relative to storage, packaging, dispensing, or distribution of medication, and which collects, controls, and maintains all transaction information.
(y) "Drug regimen review" means and includes the evaluation of prescription drug orders and patient records for (1) known allergies; (2) drug or potential therapy contraindications; (3) reasonable dose, duration of use, and route of administration, taking into consideration factors such as age, gender, and contraindications; (4) reasonable directions for use; (5) potential or actual adverse drug reactions; (6) drug‑drug interactions; (7) drug‑food interactions; (8) drug‑disease contraindications; (9) therapeutic duplication; (10) patient laboratory values when authorized and available; (11) proper utilization (including over or under utilization) and optimum therapeutic outcomes; and (12) abuse and misuse.
(z) "Electronic transmission prescription" means any prescription order for which a facsimile or electronic image of the order is electronically transmitted from a licensed prescriber to a pharmacy. "Electronic transmission prescription" includes both data and image prescriptions.
(aa) "Medication therapy management services" means a distinct service or group of services offered by licensed pharmacists, physicians licensed to practice medicine in all its branches, advanced practice nurses authorized in a written agreement with a physician licensed to practice medicine in all its branches, or physician assistants authorized in guidelines by a supervising physician that optimize therapeutic outcomes for individual patients through improved medication use. In a retail or other non‑hospital pharmacy, medication therapy management services shall consist of the evaluation of prescription drug orders and patient medication records to resolve conflicts with the following:
(1) known allergies;
(2) drug or potential therapy contraindications;
(3) reasonable dose, duration of use, and route of

administration, taking into consideration factors such as age, gender, and contraindications;
(4) reasonable directions for use;
(5) potential or actual adverse drug reactions;
(6) drug‑drug interactions;
(7) drug‑food interactions;
(8) drug‑disease contraindications;
(9) identification of therapeutic duplication;
(10) patient laboratory values when authorized and

available;
(11) proper utilization (including over or under

utilization) and optimum therapeutic outcomes; and
(12) drug abuse and misuse.
"Medication therapy management services" includes the

following:
(1) documenting the services delivered and

communicating the information provided to patients' prescribers within an appropriate time frame, not to exceed 48 hours;
(2) providing patient counseling designed to enhance

a patient's understanding and the appropriate use of his or her medications; and
(3) providing information, support services, and

resources designed to enhance a patient's adherence with his or her prescribed therapeutic regimens.
"Medication therapy management services" may also include

patient care functions authorized by a physician licensed to practice medicine in all its branches for his or her identified patient or groups of patients under specified conditions or limitations in a standing order from the physician.
"Medication therapy management services" in a licensed

hospital may also include the following:
(1) reviewing assessments of the patient's health

status; and
(2) following protocols of a hospital pharmacy and

therapeutics committee with respect to the fulfillment of medication orders.
(bb) "Pharmacist care" means the provision by a pharmacist of medication therapy management services, with or without the dispensing of drugs or devices, intended to achieve outcomes that improve patient health, quality of life, and comfort and enhance patient safety.
(cc) "Protected health information" means individually identifiable health information that, except as otherwise provided, is:
(1) transmitted by electronic media;
(2) maintained in any medium set forth in the

definition of "electronic media" in the federal Health Insurance Portability and Accountability Act; or
(3) transmitted or maintained in any other form or

medium.
"Protected health information" does not include individually

identifiable health information found in:
(1) education records covered by the federal Family

Educational Right and Privacy Act; or
(2) employment records held by a licensee in its role

as an employer.
(dd) "Standing order" means a specific order for a patient or group of patients issued by a physician licensed to practice medicine in all its branches in Illinois.
(ee) "Address of record" means the address recorded by the Department in the applicant's or licensee's application file or license file, as maintained by the Department's licensure maintenance unit.
(ff) "Home pharmacy" means the location of a pharmacy's primary operations.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/4) (from Ch. 111, par. 4124)
(Section scheduled to be repealed on January 1, 2018)
Sec. 4. Exemptions. Nothing contained in any Section of this Act shall apply to, or in any manner interfere with:
(a) the lawful practice of any physician licensed to practice medicine in all of its branches, dentist, podiatrist, veterinarian, or therapeutically or diagnostically certified optometrist within the limits of his or her license, or prevent him or her from supplying to his or her bona fide patients such drugs, medicines, or poisons as may seem to him appropriate;
(b) the sale of compressed gases;
(c) the sale of patent or proprietary medicines and household remedies when sold in original and unbroken packages only, if such patent or proprietary medicines and household remedies be properly and adequately labeled as to content and usage and generally considered and accepted as harmless and nonpoisonous when used according to the directions on the label, and also do not contain opium or coca leaves, or any compound, salt or derivative thereof, or any drug which, according to the latest editions of the following authoritative pharmaceutical treatises and standards, namely, The United States Pharmacopoeia/National Formulary (USP/NF), the United States Dispensatory, and the Accepted Dental Remedies of the Council of Dental Therapeutics of the American Dental Association or any or either of them, in use on the effective date of this Act, or according to the existing provisions of the Federal Food, Drug, and Cosmetic Act and Regulations of the Department of Health and Human Services, Food and Drug Administration, promulgated thereunder now in effect, is designated, described or considered as a narcotic, hypnotic, habit forming, dangerous, or poisonous drug;
(d) the sale of poultry and livestock remedies in original and unbroken packages only, labeled for poultry and livestock medication;
(e) the sale of poisonous substances or mixture of poisonous substances, in unbroken packages, for nonmedicinal use in the arts or industries or for insecticide purposes; provided, they are properly and adequately labeled as to content and such nonmedicinal usage, in conformity with the provisions of all applicable federal, state and local laws and regulations promulgated thereunder now in effect relating thereto and governing the same, and those which are required under such applicable laws and regulations to be labeled with the word "Poison", are also labeled with the word "Poison" printed thereon in prominent type and the name of a readily obtainable antidote with directions for its administration;
(f) the delegation of limited prescriptive authority by a physician licensed to practice medicine in all its branches to a physician assistant under Section 7.5 of the Physician Assistant Practice Act of 1987. This delegated authority under Section 7.5 of the Physician Assistant Practice Act of 1987 may, but is not required to, include prescription of controlled substances, as defined in Article II of the Illinois Controlled Substances Act, in accordance with a written supervision agreement; and
(g) the delegation of prescriptive authority by a physician licensed to practice medicine in all its branches or a licensed podiatrist to an advanced practice nurse in accordance with a written collaborative agreement under Sections 65‑35 and 65‑40 of the Nurse Practice Act.
(Source: P.A. 95‑639, eff. 10‑5‑07; 96‑189, eff. 8‑10‑09; 96‑268, eff. 8‑11‑09.)

(225 ILCS 85/5) (from Ch. 111, par. 4125)
(Section scheduled to be repealed on January 1, 2018)
Sec. 5. Application of Act.
(a) It shall be unlawful for any person to engage in the practice of pharmacy in this State and it shall be unlawful for any employer to allow any person in his or her employ to engage in the practice of pharmacy in this State, unless such person who shall engage in the practice of pharmacy in this State shall be first authorized to do so under the provisions of this Act.
(b) Nothing contained in this Act shall be construed to invalidate any existing valid and unexpired certificate of registration, nor any existing rights or privileges thereunder, of any pharmacist, registered assistant pharmacist, local pharmacist, or registered pharmacy apprentice, in force on January 1, 1956 and issued under any prior Act of this State also in force on January 1, 1956. Every person holding such a certificate of registration shall have the authority to practice under this Act, but shall be subject to the same limitations and restrictions as were applicable to him or her in the Act under which his or her certificate of registration was issued. Each such certificate may be renewed as provided in Section 12.
(c) It shall be unlawful for any person to take, use or exhibit any word, object, sign or design described in subsection (a) of Section 3 in connection with any drug store, shop or other place or in any other manner to advertise or hold himself out as operating or conducting a drug store unless such drug store, shop, pharmacy department or other place shall be operated and conducted in compliance with the provisions of this Act.
(d) Nothing in this Act shall be construed to authorize a pharmacist to prescribe or perform medical diagnosis of human ailments or conditions.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/5.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 5.5. Unlicensed practice; violation; civil penalty.
(a) Any person who practices, offers to practice, attempts to practice, or holds oneself out to practice pharmacy without being licensed under this Act shall, in addition to any other penalty provided by law, pay a civil penalty to the Department in an amount not to exceed $5,000 for each offense as determined by the Department. The civil penalty shall be assessed by the Department after a hearing is held in accordance with the provisions set forth in this Act regarding the provision of a hearing for the discipline of a licensee.
(b) The Department has the authority and power to investigate any and all unlicensed activity.
(c) The civil penalty shall be paid within 60 days after the effective date of the order imposing the civil penalty. The order shall constitute a judgment and may be filed and execution had thereon in the same manner as any judgment from any court of record.
(Source: P.A. 89‑474, eff. 6‑18‑96.)

(225 ILCS 85/5.7)
(Section scheduled to be repealed on January 1, 2018)
Sec. 5.7. Advertising services. A licensee shall include in every advertisement for services regulated under this Act his or her title as it appears on the license or the initials authorized under this Act.
(Source: P.A. 91‑310, eff. 1‑1‑00.)

(225 ILCS 85/6) (from Ch. 111, par. 4126)
(Section scheduled to be repealed on January 1, 2018)
Sec. 6. Each individual seeking licensure as a registered pharmacist shall make application to the Department and shall provide evidence of the following:
1. that he or she is a United States citizen or legally admitted alien;
2. that he or she has not engaged in conduct or behavior determined to be grounds for discipline under this Act;
3. that he or she is a graduate of a first professional degree program in pharmacy of a university recognized and approved by the Department;
4. that he or she has successfully completed a program of practice experience under the direct supervision of a pharmacist in a pharmacy in this State, or in any other State; and
5. that he or she has passed an examination recommended by the Board of Pharmacy and authorized by the Department.
The Department shall issue a license as a registered pharmacist to any applicant who has qualified as aforesaid and who has filed the required applications and paid the required fees in connection therewith; and such registrant shall have the authority to practice the profession of pharmacy in this State.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/7) (from Ch. 111, par. 4127)
(Section scheduled to be repealed on January 1, 2018)
Sec. 7. Application; examination. Applications for original licenses shall be made to the Department in writing on forms prescribed by the Department and shall be accompanied by the required fee, which shall not be refundable. Any such application shall require such information as in the judgment of the Department will enable the Board and Department to pass on the qualifications of the applicant for a license.
The Department shall authorize examinations of applicants as pharmacists not less than 3 times per year at such times and places as it may determine. The examination of applicants shall be of a character to give a fair test of the qualifications of the applicant to practice pharmacy.
Applicants for examination as pharmacists shall be required to pay, either to the Department or the designated testing service, a fee covering the cost of providing the examination. Failure to appear for the examination on the scheduled date, at the time and place specified, after the applicant's application for examination has been received and acknowledged by the Department or the designated testing service, shall result in the forfeiture of the examination fee. The examination shall be developed and provided by the National Association of Boards of Pharmacy.
If an applicant neglects, fails or refuses to take an examination or fails to pass an examination for a license under this Act within 3 years after filing his application, the application is denied. However, such applicant may thereafter make a new application accompanied by the required fee and show evidence of meeting the requirements in force at the time of the new application.
The Department shall notify applicants taking the examination of their results within 7 weeks of the examination date. Further, the Department shall have the authority to immediately authorize such applicants who successfully pass the examination to engage in the practice of pharmacy.
An applicant shall have one year from the date of notification of successful completion of the examination to apply to the Department for a license. If an applicant fails to make such application within one year the applicant shall be required to again take and pass the examination.
An applicant who has graduated with a professional degree from a school of pharmacy located outside of the United States must do the following:
(1) obtain a Foreign Pharmacy Graduate Examination

Committee (FPGEC) Certificate;
(2) complete 1,200 hours of clinical training and

experience, as defined by rule, in the United States or its territories; and
(3) successfully complete the licensing requirements

set forth in Section 6 of this Act, as well as those adopted by the Department by rule.
The Department may employ consultants for the purpose of preparing and conducting examinations.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/7.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 7.5. Social Security Number or unique identifying number on license application. In addition to any other information required to be contained in the application, every application for an original, renewal, or restored license under this Act shall include the applicant's Social Security Number or other unique identifying number deemed appropriate by the Department.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/8) (from Ch. 111, par. 4128)
(Section scheduled to be repealed on January 1, 2018)
Sec. 8. Licensure by endorsement; emergency licensure. The Department may, in its discretion, license as a pharmacist, without examination, on payment of the required fee, an applicant who is so licensed under the laws of another U.S. jurisdiction or another country, if the requirements for licensure in the other jurisdiction in which the applicant was licensed, were, at the date of his or her licensure deemed by the Board to be substantially equivalent to the requirements then in force in this State.
A person holding an active, unencumbered license in good standing in another jurisdiction who applies for a license pursuant to Section 7 of this Act due to a natural disaster or catastrophic event in another jurisdiction may be temporarily authorized by the Secretary to practice pharmacy pending the issuance of the license. This temporary authorization shall expire upon issuance of the license or upon notification that the Department has denied licensure.
Upon a declared Executive Order due to an emergency caused by a natural or manmade disaster or any other exceptional situation that causes an extraordinary demand for pharmacist services, the Department may issue a pharmacist who holds a license to practice pharmacy in another state an emergency license to practice in this State.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/9) (from Ch. 111, par. 4129)
(Section scheduled to be repealed on January 1, 2018)
Sec. 9. Registration as pharmacy technician. Any person shall be entitled to registration as a registered pharmacy technician who is of the age of 16 or over, has not engaged in conduct or behavior determined to be grounds for discipline under this Act, is attending or has graduated from an accredited high school or comparable school or educational institution or received a GED, and has filed a written application for registration on a form to be prescribed and furnished by the Department for that purpose. The Department shall issue a certificate of registration as a registered pharmacy technician to any applicant who has qualified as aforesaid, and such registration shall be the sole authority required to assist licensed pharmacists in the practice of pharmacy, under the supervision of a licensed pharmacist. A registered pharmacy technician may, under the supervision of a pharmacist, assist in the practice of pharmacy and perform such functions as assisting in the dispensing process, offering counseling, receiving new verbal prescription orders, and having prescriber contact concerning prescription drug order clarification. A registered pharmacy technician may not engage in patient counseling, drug regimen review, or clinical conflict resolution.
Beginning on January 1, 2010, within 2 years after initial registration as a registered technician, a pharmacy technician must become certified by successfully passing the Pharmacy Technician Certification Board (PTCB) examination or another Board‑approved pharmacy technician examination and register as a certified pharmacy technician with the Department in order to continue to perform pharmacy technician's duties. This requirement does not apply to pharmacy technicians registered prior to January 1, 2008.
Any person registered as a pharmacy technician who is also enrolled in a first professional degree program in pharmacy in a school or college of pharmacy or a department of pharmacy of a university approved by the Department or has graduated from such a program within the last 18 months, shall be considered a "student pharmacist" and entitled to use the title "student pharmacist". A student pharmacist must meet all of the requirements for registration as a pharmacy technician set forth in this Section excluding the requirement of certification prior to the second registration renewal and pay the required pharmacy technician registration fees. A student pharmacist may, under the supervision of a pharmacist, assist in the practice of pharmacy and perform any and all functions delegated to him or her by the pharmacist.
Any person seeking licensure as a pharmacist who has graduated from a pharmacy program outside the United States must register as a pharmacy technician and shall be considered a "student pharmacist" and be entitled to use the title "student pharmacist" while completing the 1,200 clinical hours of training approved by the Board of Pharmacy described and for no more than 18 months after completion of these hours. These individuals are not required to become certified pharmacy technicians while completing their Board approved clinical training, but must become licensed as a pharmacist or become a certified pharmacy technician before the second pharmacy technician registration renewal following completion of the Board approved clinical training.
The Department shall not renew the pharmacy technician license of any person who has been registered as a "student pharmacist" and has dropped out of or been expelled from an ACPE accredited college of pharmacy, who has failed to complete his or her 1,200 hours of Board approved clinical training within 24 months or who has failed the pharmacist licensure examination 3 times and shall require these individuals to meet the requirements of and become registered a certified pharmacy technician.
The Department may take any action set forth in Section 30 of this Act with regard to registrations pursuant to this Section.
Any person who is enrolled in a non‑traditional Pharm.D. program at an ACPE accredited college of pharmacy and is a licensed pharmacist under the laws of another United States jurisdiction shall be permitted to engage in the program of practice experience required in the academic program by virtue of such license. Such person shall be exempt from the requirement of registration as a registered pharmacy technician while engaged in the program of practice experience required in the academic program.
An applicant for registration as a pharmacy technician may assist a pharmacist in the practice of pharmacy for a period of up to 60 days prior to the issuance of a certificate of registration if the applicant has submitted the required fee and an application for registration to the Department. The applicant shall keep a copy of the submitted application on the premises where the applicant is assisting in the practice of pharmacy. The Department shall forward confirmation of receipt of the application with start and expiration dates of practice pending registration.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/9.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 9.5. Certified pharmacy technician.
(a) An individual registered as a pharmacy technician under this Act may be registered as a certified pharmacy technician, if he or she meets all of the following requirements:
(1) He or she has submitted a written application in

the form and manner prescribed by the Department.
(2) He or she has attained the age of 18.
(3) He or she is of good moral character, as

determined by the Department.
(4) He or she has (i) graduated from pharmacy

technician training meeting the requirements set forth in subsection (a) of Section 17.1 of this Act or (ii) obtained documentation from the pharmacist‑in‑charge of the pharmacy where the applicant is employed verifying that he or she has successfully completed a training program and has successfully completed an objective assessment mechanism prepared in accordance with rules established by the Department.
(5) He or she has successfully passed an examination

accredited by the National Organization of Certifying Agencies, as approved and required by the Board.
(6) He or she has paid the required certification

fees.
(b) No pharmacist whose license has been denied, revoked,

suspended, or restricted for disciplinary purposes may be eligible to be registered as a certified pharmacy technician.
(c) The Department may, by rule, establish any additional

requirements for certification under this Section.
(d) A person who is not a registered pharmacy technician and meets the requirements of this Section may register as a certified pharmacy technician without first registering as a pharmacy technician.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/10) (from Ch. 111, par. 4130)
(Section scheduled to be repealed on January 1, 2018)
Sec. 10. State Board of Pharmacy. There is created in the Department the State Board of Pharmacy. It shall consist of 9 members, 7 of whom shall be licensed pharmacists. Each of those 7 members must be a licensed pharmacist in good standing in this State, a graduate of an accredited college of pharmacy or hold a Bachelor of Science degree in Pharmacy and have at least 5 years' practical experience in the practice of pharmacy subsequent to the date of his licensure as a licensed pharmacist in the State of Illinois. There shall be 2 public members, who shall be voting members, who shall not be licensed pharmacists in this State or any other state.
Each member shall be appointed by the Governor.
Members shall be appointed to 5 year terms. The Governor shall fill any vacancy for the remainder of the unexpired term. Partial terms over 3 years in length shall be considered full terms. A member may be reappointed for a successive term, but no member shall serve more than 2 full terms in his or her lifetime.
In making the appointment of members on the Board, the Governor shall give due consideration to recommendations by the members of the profession of pharmacy and by pharmacy organizations therein. The Governor shall notify the pharmacy organizations promptly of any vacancy of members on the Board and in appointing members shall give consideration to individuals engaged in all types and settings of pharmacy practice.
The Governor may remove any member of the Board for misconduct, incapacity or neglect of duty and he shall be the sole judge of the sufficiency of the cause for removal.
Each member of the Board shall be reimbursed for such actual and legitimate expenses as he may incur in going to and from the place of meeting and remaining thereat during sessions of the Board. In addition, each member of the Board may receive a per diem payment in an amount determined from time to time by the Director for attendance at meetings of the Board and conducting other official business of the Board.
The Board shall hold quarterly meetings at such times and places and upon notice as the Department may determine and as its business may require. A majority of the Board members currently appointed shall constitute a quorum. A vacancy in the membership of the Board shall not impair the right of a quorum to exercise all the rights and perform all the duties of the Board.
The Board shall exercise the rights, powers and duties which have been vested in the Board under this Act, and any other duties conferred upon the Board by law.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/11) (from Ch. 111, par. 4131)
(Section scheduled to be repealed on January 1, 2018)
Sec. 11. Duties of the Department. The Department shall exercise the powers and duties prescribed by the Civil Administrative Code of Illinois for the administration of Licensing Acts and shall exercise such other powers and duties necessary for effectuating the purpose of this Act. However, the following powers and duties shall be exercised only upon review of the Board of Pharmacy to take such action:
(a) Formulate such rules, not inconsistent with law and subject to the Illinois Administrative Procedure Act, as may be necessary to carry out the purposes and enforce the provisions of this Act. The Director may grant variances from any such rules as provided for in this Section;
(b) The suspension, revocation, placing on probationary status, reprimand, and refusing to issue or restore any license or certificate of registration issued under the provisions of this Act for the reasons set forth in Section 30 of this Act.
(c) The issuance, renewal, restoration or reissuance of any license or certificate which has been previously refused to be issued or renewed, or has been revoked, suspended or placed on probationary status.
The granting of variances from rules promulgated pursuant to this Section in individual cases where there is a finding that:
(1) the provision from which the variance is granted

is not statutorily mandated;
(2) no party will be injured by the granting of the

variance; and
(3) the rule from which the variance is granted

would, in the particular case, be unreasonable or unnecessarily burdensome.
The Director shall notify the State Board of Pharmacy of the granting of such variance and the reasons therefor, at the next meeting of the Board.
(d) The Secretary shall appoint a chief pharmacy coordinator and at least 2 deputy pharmacy coordinators, all of whom shall be registered pharmacists in good standing in this State, shall be graduates of an accredited college of pharmacy or hold, at a minimum, a bachelor of science degree in pharmacy, and shall have at least 5 years of experience in the practice of pharmacy immediately prior to his or her appointment. The chief pharmacy coordinator shall be the executive administrator and the chief enforcement officer of this Act. The deputy pharmacy coordinators shall report to the chief pharmacy coordinator. The Secretary shall assign at least one deputy pharmacy coordinator to a region composed of Cook County and such other counties as the Secretary may deem appropriate, and such deputy pharmacy coordinator shall have his or her primary office in Chicago. The Secretary shall assign at least one deputy pharmacy coordinator to a region composed of the balance of counties in the State, and such deputy pharmacy coordinator shall have his or her primary office in Springfield.
(e) The Secretary shall, in conformity with the Personnel Code, employ not less than 4 pharmacy investigators who shall report to the pharmacy coordinator or a deputy pharmacy coordinator. Each pharmacy investigator shall be a graduate of a 4‑year college or university and shall (i) have at least 2 years of investigative experience; (ii) have 2 years of responsible pharmacy experience; or (iii) be a licensed pharmacist. The Department shall also employ at least one attorney to prosecute violations of this Act and its rules. The Department may, in conformity with the Personnel Code, employ such clerical and other employees as are necessary to carry out the duties of the Board and Department.
The duly authorized pharmacy investigators of the Department shall have the right to enter and inspect, during business hours, any pharmacy or any other place in this State holding itself out to be a pharmacy where medicines, drugs or drug products, or proprietary medicines are sold, offered for sale, exposed for sale, or kept for sale.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/12) (from Ch. 111, par. 4132)
(Section scheduled to be repealed on January 1, 2018)
Sec. 12. Expiration of license; renewal. The expiration date and renewal period for each license and certificate of registration issued under this Act shall be set by rule.
As a condition for the renewal of a certificate of registration as a pharmacist, the registrant shall provide evidence to the Department of completion of a total of 30 hours of pharmacy continuing education during the 24 months preceding the expiration date of the certificate. Such continuing education shall be approved by the Accreditation Council on Pharmacy Education.
The Department shall establish by rule a means for the verification of completion of the continuing education required by this Section. This verification may be accomplished through audits of records maintained by registrants, by requiring the filing of continuing education certificates with the Department or a qualified organization selected by the Department to maintain such records or by other means established by the Department.
Rules developed under this Section may provide for a reasonable biennial fee, not to exceed $20, to fund the cost of such recordkeeping. The Department shall, by rule, further provide an orderly process for the reinstatement of licenses which have not been renewed due to the failure to meet the continuing education requirements of this Section. The requirements of continuing education may be waived, in whole or in part, in cases of extreme hardship as defined by rule of the Department. Such waivers shall be granted for not more than one of any 3 consecutive renewal periods.
Any pharmacist who has permitted his license to expire or who has had his license on inactive status may have his license restored by making application to the Department and filing proof acceptable to the Department of his fitness to have his license restored, and by paying the required restoration fee. The Department shall determine, by an evaluation program established by rule his fitness for restoration of his license and shall establish procedures and requirements for such restoration. However, any pharmacist who demonstrates that he has continuously maintained active practice in another jurisdiction pursuant to a license in good standing, and who has substantially complied with the continuing education requirements of this Section shall not be subject to further evaluation for purposes of this Section.
Any licensee who shall engage in the practice for which his or her license was issued while the license is expired or on inactive status shall be considered to be practicing without a license which, shall be grounds for discipline under Section 30 of this Act.
Any pharmacy operating on an expired license is engaged in the unlawful practice of pharmacy and is subject to discipline under Section 30 of this Act. A pharmacy whose license has been expired for one year or more may not have its license restored but must apply for a new license and meet all requirements for licensure. Any pharmacy whose license has been expired for less than one year may apply for restoration of its license and shall have its license restored.
However, any pharmacist whose license expired while he was (l) in Federal Service on active duty with the Armed Forces of the United States, or the State Militia called into service or training, or (2) in training or education under the supervision of the United States preliminary to induction into the military service, may have his license or certificate restored without paying any lapsed renewal fees, if within 2 years after honorable termination of such service, training or education he furnishes the Department with satisfactory evidence to the effect that he has been so engaged and that his service, training or education has been so terminated.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/13) (from Ch. 111, par. 4133)
(Section scheduled to be repealed on January 1, 2018)
Sec. 13. Inactive status. Any pharmacist or pharmacy technician who notifies the Department, in writing on forms prescribed by the Department, may elect to place his or her license on an inactive status and shall be excused from payment of renewal fees and completion of continuing education requirements until he or she notifies the Department in writing of his or her intent to restore his license.
Any pharmacist or pharmacist technician requesting restoration from inactive status shall be required to pay the current renewal fee and shall be required to restore his or her license or certificate, as provided by rule of the Department.
Any pharmacist or pharmacist technician whose license is in inactive status shall not practice in the State of Illinois.
A pharmacy license may not be placed on inactive status.
Continued practice on a license which has lapsed or been placed on inactive status shall be considered to be practicing without a license.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/14)
Sec. 14. (Repealed).
(Source: P.A. 94‑84, eff. 6‑28‑05. Repealed by P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/14.1)
(Section scheduled to be repealed on January 1, 2018)
Sec. 14.1. Structural and equipment requirements. The Department shall establish structural and equipment requirements for a pharmacy by rule.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/15) (from Ch. 111, par. 4135)
(Section scheduled to be repealed on January 1, 2018)
Sec. 15. Pharmacy requirements. It shall be unlawful for the owner of any pharmacy, as defined in this Act, to operate or conduct the same, or to allow the same to be operated or conducted, unless:
(a) It has a licensed pharmacist, authorized to practice pharmacy in this State under the provisions of this Act, on duty whenever the practice of pharmacy is conducted;
(b) Security provisions for all drugs and devices, as determined by rule of the Department, are provided during the absence from the licensed pharmacy of all licensed pharmacists. Maintenance of security provisions is the responsibility of the licensed pharmacist in charge; and
(c) The pharmacy is licensed under this Act to conduct the practice of pharmacy in any and all forms from the physical address of the pharmacy's primary inventory where U.S. mail is delivered. If a facility, company, or organization operates multiple pharmacies from multiple physical addresses, a separate pharmacy license is required for each different physical address.
(d) The Department may allow a pharmacy that is not located at the same location as its home pharmacy and at which pharmacy services are provided during an emergency situation, as defined by rule, to be operated as an emergency remote pharmacy. An emergency remote pharmacy operating under this subsection (d) shall operate under the license of the home pharmacy.
The Secretary may waive the requirement for a pharmacist to be on duty at all times for State facilities not treating human ailments. This waiver of the requirement remains in effect until it is rescinded by the Secretary and the Department provides written notice of the rescission to the State facility.
It shall be unlawful for any person, who is not a licensed pharmacy or health care facility, to purport to be such or to use in name, title, or sign designating, or in connection with that place of business, any of the words: "pharmacy", "pharmacist", "pharmacy department", "apothecary", "druggist", "drug", "drugs", "medicines", "medicine store", "drug sundries", "prescriptions filled", or any list of words indicating that drugs are compounded or sold to the lay public, or prescriptions are dispensed therein. Each day during which, or a part which, such representation is made or appears or such a sign is allowed to remain upon or in such a place of business shall constitute a separate offense under this Act.
The holder of any license or certificate of registration shall conspicuously display it in the pharmacy in which he is engaged in the practice of pharmacy. The pharmacist in charge shall conspicuously display his name in such pharmacy. The pharmacy license shall also be conspicuously displayed.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑219, eff. 8‑10‑09.)

(225 ILCS 85/15.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 15.5. Prescription information.
(a) Uncoordinated multiple controlled substances and drug seeking tendencies pose a significant threat to the health, safety, and welfare of patients. To address this threat, the General Assembly believes a physician who prescribes controlled substances should be provided with prescription information from pharmacies.
(b) Upon request, a pharmacist shall provide a physician licensed to practice medicine in all its branches who is prepared to prescribe or has prescribed a controlled substance for a patient with information from the patient's most recent patient profile, including information about any prescriptions for controlled substances.
(Source: P.A. 93‑571, eff. 8‑20‑03.)

(225 ILCS 85/16) (from Ch. 111, par. 4136)
(Section scheduled to be repealed on January 1, 2018)
Sec. 16. The Department shall require and provide for the licensure of every pharmacy doing business in this State. Such licensure shall expire 30 days after the pharmacist in charge dies or leaves the place where the pharmacy is licensed or after such pharmacist's license has been suspended or revoked.
In the event the designated pharmacist in charge dies or otherwise ceases to function in that capacity, or when the license of the pharmacist in charge has been suspended or revoked, the owner of the pharmacy shall be required to notify the Department, on forms provided by the Department, of the identity of the new pharmacist in charge.
It is the duty of every pharmacist in charge who ceases to function in that capacity to report to the Department within 30 days of the date on which he ceased such functions for such pharmacy. It is the duty of every owner of a pharmacy licensed under this Act to report to the Department within 30 days of the date on which the pharmacist in charge died or ceased to function in that capacity. Failure to provide such notification to the Department shall be grounds for disciplinary action.
No license shall be issued to any pharmacy unless such pharmacy has a pharmacist in charge and each such pharmacy license shall indicate on the face thereof the pharmacist in charge.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/16a) (from Ch. 111, par. 4136a)
(Section scheduled to be repealed on January 1, 2018)
Sec. 16a. (a) The Department shall establish rules and regulations, consistent with the provisions of this Act, governing nonresident pharmacies, including pharmacies providing services via the Internet, which sell, or offer for sale, drugs, medicines, or other pharmaceutical services in this State.
(b) The Department shall require and provide for an annual nonresident special pharmacy registration for all pharmacies located outside of this State that dispense medications for Illinois residents and mail, ship, or deliver prescription medications into this State. Nonresident special pharmacy registration shall be granted by the Department upon the disclosure and certification by a pharmacy:
(1) that it is licensed in the state in which the

dispensing facility is located and from which the drugs are dispensed;
(2) of the location, names, and titles of all

principal corporate officers and all pharmacists who are dispensing drugs to residents of this State;
(3) that it complies with all lawful directions and

requests for information from the board of pharmacy of each state in which it is licensed or registered, except that it shall respond directly to all communications from the Board or Department concerning any circumstances arising from the dispensing of drugs to residents of this State;
(4) that it maintains its records of drugs dispensed

to residents of this State so that the records are readily retrievable from the records of other drugs dispensed;
(5) that it cooperates with the Board or Department

in providing information to the board of pharmacy of the state in which it is licensed concerning matters related to the dispensing of drugs to residents of this State; and
(6) that during its regular hours of operation, but

not less than 6 days per week, for a minimum of 40 hours per week, a toll‑free telephone service is provided to facilitate communication between patients in this State and a pharmacist at the pharmacy who has access to the patients' records. The toll‑free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this State.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/16b)
(Section scheduled to be repealed on January 1, 2018)
Sec. 16b. Prescription pick up and drop off. Nothing contained in this Act shall prohibit a pharmacist or pharmacy, by means of its employee or by use of a common carrier or the U.S. mail, at the request of the patient, from picking up prescription orders from the prescriber or delivering prescription drugs to the patient or the patient's agent at the residence or place of employment of the person for whom the prescription was issued or at the hospital or medical care facility in which the patient is confined. Conversely, the patient or patient's agent may drop off prescriptions at a designated area.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/17) (from Ch. 111, par. 4137)
(Section scheduled to be repealed on January 1, 2018)
Sec. 17. Disposition of legend drugs on cessation of pharmacy operations.
(a) The pharmacist in charge of a pharmacy which has its pharmacy license revoked or otherwise ceases operation shall notify the Department and forward to the Department a copy of the closing inventory of controlled substances and a statement indicating the intended manner of disposition of all legend drugs and prescription files within 30 days of such revocation or cessation of operation.
(b) The Department shall approve the intended manner of disposition of all legend drugs prior to disposition of such drugs by the pharmacist in charge.
(1) The Department shall notify the pharmacist in

charge of approval of the manner of disposition of all legend drugs, or disapproval accompanied by reasons for such disapproval, within 30 days of receipt of the statement from the pharmacist in charge. In the event that the manner of disposition is not approved, the pharmacist in charge shall notify the Department of an alternative manner of disposition within 30 days of the receipt of disapproval.
(2) If disposition of all legend drugs does not

occur within 30 days after approval is received from the Department, or if no alternative method of disposition is submitted to the Department within 30 days of the Department's disapproval, the Director shall notify the pharmacist in charge by mail at the address of the closing pharmacy, of the Department's intent to confiscate all legend drugs. The Notice of Intent to Confiscate shall be the final administrative decision of the Department, as that term is defined in the Administrative Review Law, and the confiscation of all prescription drugs shall be effected.
(b‑5) In the event that the pharmacist in charge has died or is otherwise physically incompetent to perform the duties of this Section, the owner of a pharmacy that has its license revoked or otherwise ceases operation shall be required to fulfill the duties otherwise imposed upon the pharmacist in charge.
(c) The pharmacist in charge of a pharmacy which acquires prescription files from a pharmacy which ceases operation shall be responsible for the preservation of such acquired prescriptions for the remainder of the term that such prescriptions are required to be preserved by this Act.
(d) Failure to comply with this Section shall be grounds for denying an application or renewal application for a pharmacy license or for disciplinary action against a registration.
(e) Compliance with the provisions of the Illinois Controlled Substances Act concerning the disposition of controlled substances shall be deemed compliance with this Section with respect to legend drugs which are controlled substances.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/17.1)
(Section scheduled to be repealed on January 1, 2018)
Sec. 17.1. Pharmacy technician training.
(a) Beginning January 1, 2004, it shall be the joint responsibility of a pharmacy and its pharmacist in charge to have trained all of its pharmacy technicians or obtain proof of prior training in all of the following topics as they relate to the practice site:
(1) The duties and responsibilities of the

technicians and pharmacists.
(2) Tasks and technical skills, policies, and

procedures.
(3) Compounding, packaging, labeling, and storage.
(4) Pharmaceutical and medical terminology.
(5) Record keeping requirements.
(6) The ability to perform and apply arithmetic

calculations.
(b) Within 6 months after initial employment or changing the duties and responsibilities of a pharmacy technician, it shall be the joint responsibility of the pharmacy and the pharmacist in charge to train the pharmacy technician or obtain proof of prior training in the areas listed in subsection (a) of this Section as they relate to the practice site or to document that the pharmacy technician is making appropriate progress.
(c) All pharmacies shall maintain an up‑to‑date training program describing the duties and responsibilities of a pharmacy technician.
(d) All pharmacies shall create and maintain retrievable records of training or proof of training as required in this Section.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/18) (from Ch. 111, par. 4138)
(Section scheduled to be repealed on January 1, 2018)
Sec. 18. Record retention. Except as provided in subsection (b), there shall be kept in every drugstore or pharmacy a suitable book, file, or electronic record keeping system in which shall be preserved for a period of not less than 5 years the original, or an exact, unalterable image, of every written prescription and the original transcript or copy of every verbal prescription filled, compounded, or dispensed, in such pharmacy; and such book or file of prescriptions shall at all reasonable times be open to inspection to the pharmacy coordinator and the duly authorized agents or employees of the Department.
Every prescription filled or refilled shall contain the unique identifiers of the persons authorized to practice pharmacy under the provision of this Act who fills or refills the prescription.
Records kept pursuant to this Section may be maintained in an alternative data retention system, such as a direct digital imaging system, provided that:
(1) the records maintained in the alternative data

retention system contain all of the information required in a manual record;
(2) the data processing system is capable of

producing a hard copy of the electronic record on the request of the Board, its representative, or other authorized local, State, or federal law enforcement or regulatory agency;
(3) the digital images are recorded and stored only

by means of a technology that does not allow subsequent revision or replacement of the images; and
(4) the prescriptions may be retained in written form

or recorded in a data processing system, provided that such order can be produced in printed form upon lawful request.
As used in this Section, "digital imaging system" means a system, including people, machines, methods of organization, and procedures, that provides input, storage, processing, communications, output, and control functions for digitized representations of original prescription records.
Inpatient drug orders may be maintained within an institution in a manner approved by the Department.
(Source: P.A. 94‑84, eff. 6‑28‑05; 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/19) (from Ch. 111, par. 4139)
(Section scheduled to be repealed on January 1, 2018)
Sec. 19. Nothing contained in this Act shall be construed to prohibit a pharmacist licensed in this State from filling or refilling a valid prescription for prescription drugs which is on file in a pharmacy licensed in any state and has been transferred from one pharmacy to another by any means, including by way of electronic data processing equipment upon the following conditions and exceptions:
(1) Prior to dispensing pursuant to any such prescription, the dispensing pharmacist shall:
(a) Advise the patient that the prescription on file

at such other pharmacy must be canceled before he or she will be able to fill or refill it.
(b) Determine that the prescription is valid and on

file at such other pharmacy and that such prescription may be filled or refilled, as requested, in accordance with the prescriber's intent expressed on such prescription.
(c) Notify the pharmacy where the prescription is on

file that the prescription must be canceled.
(d) Record in writing the prescription order, the

name of the pharmacy at which the prescription was on file, the prescription number, the name of the drug and the original amount dispensed, the date of original dispensing, and the number of remaining authorized refills.
(e) Obtain the consent of the prescriber to the

refilling of the prescription when the prescription, in the professional judgment of the dispensing pharmacist, so requires.
(2) Upon receipt of a request for prescription information set forth in subparagraph (d) of paragraph (1) of this Section, if the requested pharmacist is satisfied in his professional judgment that such request is valid and legal, the requested pharmacist shall:
(a) Provide such information accurately and

completely.
(b) Record electronically or, if in writing, on the

face of the prescription, the name of the requesting pharmacy and pharmacist and the date of request.
(c) Cancel the prescription on file by writing the

word "void" on its face or the electronic equivalent, if not in written format. No further prescription information shall be given or medication dispensed pursuant to such original prescription.
(3) In the event that, after the information set forth in subparagraph (d) of paragraph (1) of this Section has been provided, a prescription is not dispensed by the requesting pharmacist, then such pharmacist shall provide notice of this fact to the pharmacy from which such information was obtained; such notice shall then cancel the prescription in the same manner as set forth in subparagraph (c) of paragraph (2) of this Section.
(4) When filling or refilling a valid prescription on file in another state, the dispensing pharmacist shall be required to follow all the requirements of Illinois law which apply to the dispensing of prescription drugs. If anything in Illinois law prevents the filling or refilling of the original prescription it shall be unlawful to dispense pursuant to this Section.
(5) Prescriptions for drugs in Schedules III, IV, and V of the Illinois Controlled Substances Act may be transferred only once and may not be further transferred. However, pharmacies electronically sharing a real‑time, online database may transfer up to the maximum refills permitted by the law and the prescriber's authorization.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/20) (from Ch. 111, par. 4140)
(Section scheduled to be repealed on January 1, 2018)
Sec. 20. Two or more pharmacies may establish and use a common electronic file to maintain required dispensing information.
Pharmacies using such a common electronic file are not required to physically transfer prescriptions or information for dispensing purposes between or among pharmacies participating in the same common prescription file; provided, however any such common file must contain complete and adequate records of such prescription and refill dispensed as stated in Section 18.
The Department and Board may formulate such rules and regulations, not inconsistent with law, as may be necessary to carry out the purposes of and to enforce the provisions of this Section within the following exception: The Department and Board shall not impose greater requirements on either common electronic files or a hard copy record system.
Drugs shall in no event be dispensed more frequently or in larger amounts than the prescriber ordered without direct prescriber authorization by way of a new prescription order.
The dispensing by a pharmacist licensed in this State or another state of a prescription contained in a common database shall not constitute a transfer, provided that (i) all pharmacies involved in the transactions pursuant to which the prescription is dispensed and all pharmacists engaging in dispensing functions are properly licensed, permitted, or registered in this State or another jurisdiction, (ii) a policy and procedures manual that governs all participating pharmacies and pharmacists is available to the Department upon request and includes the procedure for maintaining appropriate records for regulatory oversight for tracking a prescription during each stage of the filling and dispensing process, and (iii) the pharmacists involved in filling and dispensing the prescription and counseling the patient are identified. A pharmacist shall be accountable only for the specific tasks performed.
Nothing in this Section shall prohibit a pharmacist who is exercising his or her professional judgment from dispensing additional quantities of medication up to the total number of dosage units authorized by the prescriber on the original prescription and any refills.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/21) (from Ch. 111, par. 4141)
Sec. 21. (Repealed).
(Source: Repealed by P.A. 88‑428.)

(225 ILCS 85/22) (from Ch. 111, par. 4142)
(Section scheduled to be repealed on January 1, 2018)
Sec. 22. Except only in the case of a drug, medicine or poison which is lawfully sold or dispensed, at retail, in the original and unbroken package of the manufacturer, packer, or distributor thereof, and which package bears the original label thereon showing the name and address of the manufacturer, packer, or distributor thereof, and the name of the drug, medicine, or poison therein contained, and the directions for its use, no person shall sell or dispense, at retail, any drug, medicine, or poison, without affixing to the box, bottle, vessel, or package containing the same, a label bearing the name of the article distinctly shown, and the directions for its use, with the name and address of the pharmacy wherein the same is sold or dispensed. However, in the case of a drug, medicine, or poison which is sold or dispensed pursuant to a prescription of a physician licensed to practice medicine in all of its branches, licensed dentist, licensed veterinarian, licensed podiatrist, or therapeutically or diagnostically certified optometrist authorized by law to prescribe drugs or medicines or poisons, the label affixed to the box, bottle, vessel, or package containing the same shall show: (a) the name and address of the pharmacy wherein the same is sold or dispensed; (b) the name or initials of the person, authorized to practice pharmacy under the provisions of this Act, selling or dispensing the same, (c) the date on which such prescription was filled; (d) the name of the patient; (e) the serial number of such prescription as filed in the prescription files; (f) the last name of the practitioner who prescribed such prescriptions; (g) the directions for use thereof as contained in such prescription; and (h) the proprietary name or names or the established name or names of the drugs, the dosage and quantity, except as otherwise authorized by regulation of the Department.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/22a)
(Section scheduled to be repealed on January 1, 2018)
Sec. 22a. Automated dispensing and storage systems. The Department shall establish rules governing the use of automated dispensing and storage systems.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/22b)
(Section scheduled to be repealed on January 1, 2018)
Sec. 22b. Automated pharmacy systems; remote dispensing.
(a) Automated pharmacy systems must have adequate security and procedures to comply with federal and State laws and regulations and maintain patient confidentiality, as defined by rule.
(b) Access to and dispensing from an automated pharmacy

system shall be limited to pharmacists or personnel who are designated in writing by the pharmacist‑in‑charge and have completed documented training concerning their duties associated with the automated pharmacy system.
(c) All drugs stored in relation to an automated pharmacy

system must be stored in compliance with this Act and the rules adopted under this Act, including the requirements for temperature, proper storage containers, handling of outdated drugs, prescription dispensing, and delivery.
(d) An automated pharmacy system operated from a remote site shall be under the continuous supervision of a home pharmacy pharmacist. To qualify as continuous supervision, the pharmacist is not required to be physically present at the site of the automated pharmacy system if the system is supervised electronically by a pharmacist, as defined by rule.
(e) Drugs may only be dispensed at a remote site through

an automated pharmacy system after receipt of an original prescription drug order by a pharmacist at the home pharmacy. A pharmacist at the home pharmacy must control all operations of the automated pharmacy system and approve the release of the initial dose of a prescription drug order. Refills from an approved prescription drug order may be removed from the automated medication system after this initial approval. Any change made in the prescription drug order shall require a new approval by a pharmacist to release the drug.
(f) If an automated pharmacy system uses removable cartridges or containers to store a drug, the stocking or restocking of the cartridges or containers may occur at a licensed wholesale drug distributor and be sent to the home pharmacy to be loaded after pharmacist verification by personnel designated by the pharmacist, provided that the individual cartridge or container is transported to the home pharmacy in a secure, tamper evident container. An automated pharmacy system must use a bar code verification or weight verification or electronic verification or similar process to ensure that the cartridge or container is accurately loaded into the automated pharmacy system. The pharmacist verifying the filling and labeling shall be responsible for ensuring that the cartridge or container is stocked or restocked correctly by personnel designated to load the cartridges or containers. An automated pharmacy system must use a bar code verification, electronic, or similar process, as defined by rule, to ensure that the proper medication is dispensed from the automated system. A record of each transaction with the automated pharmacy system must be maintained for 5 years. A prescription dispensed from an automated pharmacy system shall be deemed to have been approved by the pharmacist. No automated pharmacy system shall be operated prior to inspection and approval by the Department.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/23) (from Ch. 111, par. 4143)
(Section scheduled to be repealed on January 1, 2018)
Sec. 23. It is unlawful for a pharmacist or pharmacy to pay or promise to pay to any person who owns, operates, manages or is an employee of a hospital, nursing home or other health care facility or to any person authorized by law to prescribe drugs or to any entity in which a person authorized by law to prescribe drugs holds an interest, any rebate, refund, discount, commission or other valuable consideration for, on account of, or based upon income received or resulting from the sale or furnishing by any such pharmacy of drugs or devices, prescriptions or any other service to patients of the above specified persons, organizations or facilities.
This shall not be deemed to include rent or other remunerations paid to an individual, partnership, or corporation by a pharmacist or pharmacy for the lease, rental, or use of space, owned or controlled, by the individual, partnership or corporation.
(Source: P.A. 85‑796.)

(225 ILCS 85/24) (from Ch. 111, par. 4144)
(Section scheduled to be repealed on January 1, 2018)
Sec. 24. It shall be unlawful for any manufacturer or distributor of a prescription drug, or any person on behalf of such manufacturer or distributor, to distribute a prescription drug without charge or for less than its fair market value to any person directly or indirectly.
Nothing in this Section shall be construed to prohibit the distribution of a prescription drug:
(a) at a discount in accordance with the laws of the United States or the State of Illinois;
(b) to a person for use in an investigation conducted under Federal Food and Drug Administration regulations;
(c) to a patient by a pharmacist in response to a request written and signed by a medical practitioner which designates the quantity to be distributed;
(d) to a licensed medical practitioner in response to a request signed by the practitioner which designates the quantity to be distributed;
(e) to an agency of the federal government or to a state government or political subdivision for regulatory or enforcement purposes;
(f) in an emergency as determined by the laws of the United States or the State of Illinois; or
(g) to a bona fide charity authorized to possess and dispense prescription drugs.
(Source: P.A. 85‑796.)

(225 ILCS 85/25) (from Ch. 111, par. 4145)
(Section scheduled to be repealed on January 1, 2018)
Sec. 25. No person shall compound, or sell or offer for sale, or cause to be compounded, sold or offered for sale any medicine or preparation under or by a name recognized in the United States Pharmacopoeia National Formulary, for internal or external use, which differs from the standard of strength, quality or purity as determined by the test laid down in the United States Pharmacopoeia National Formulary official at the time of such compounding, sale or offering for sale. Nor shall any person compound, sell or offer for sale, or cause to be compounded, sold, or offered for sale, any drug, medicine, poison, chemical or pharmaceutical preparation, the strength or purity of which shall fall below the professed standard of strength or purity under which it is sold. Except as set forth in Section 26 of this Act, if the physician or other authorized prescriber, when transmitting an oral or written prescription, does not prohibit drug product selection, a different brand name or nonbrand name drug product of the same generic name may be dispensed by the pharmacist, provided that the selected drug has a unit price less than the drug product specified in the prescription. A generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration (FDA) shall be available for substitution in Illinois in accordance with this Act and the Illinois Food, Drug and Cosmetic Act, provided that each manufacturer submits to the Director of the Department of Public Health a notification containing product technical bioequivalence information as a prerequisite to product substitution when they have completed all required testing to support FDA product approval and, in any event, the information shall be submitted no later than 60 days prior to product substitution in the State. On the prescription forms of prescribers, shall be placed a signature line and the words "may not substitute". The prescriber, in his or her own handwriting, shall place a mark beside "may not substitute" to direct the pharmacist in the dispensing of the prescription. Preprinted or rubber stamped marks, or other deviations from the above prescription format shall not be permitted. The prescriber shall sign the form in his or her own handwriting to authorize the issuance of the prescription.
In every case in which a selection is made as permitted by the Illinois Food, Drug and Cosmetic Act, the pharmacist shall indicate on the pharmacy record of the filled prescription the name or other identification of the manufacturer of the drug which has been dispensed.
The selection of any drug product by a pharmacist shall not constitute evidence of negligence if the selected nonlegend drug product was of the same dosage form and each of its active ingredients did not vary by more than 1 percent from the active ingredients of the prescribed, brand name, nonlegend drug product. Failure of a prescribing physician to specify that drug product selection is prohibited does not constitute evidence of negligence unless that practitioner has reasonable cause to believe that the health condition of the patient for whom the physician is prescribing warrants the use of the brand name drug product and not another.
The Department is authorized to employ an analyst or chemist of recognized or approved standing whose duty it shall be to examine into any claimed adulteration, illegal substitution, improper selection, alteration, or other violation hereof, and report the result of his investigation, and if such report justify such action the Department shall cause the offender to be prosecuted.
(Source: P.A. 94‑936, eff. 6‑26‑06; 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/25.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 25.5. Centralized prescription filling.
(a) In this Section, "centralized prescription filling" means the filling of a prescription by one pharmacy upon request by another pharmacy to fill or refill the prescription. "Centralized prescription filling" includes the performance by one pharmacy for another pharmacy of other pharmacy duties such as drug utilization review, therapeutic drug utilization review, claims adjudication, and the obtaining of refill authorizations.
(b) A pharmacy licensed under this Act may perform centralized prescription filling for another pharmacy, provided that both pharmacies have the same owner or have a written contract specifying (i) the services to be provided by each pharmacy, (ii) the responsibilities of each pharmacy, and (iii) the manner in which the pharmacies shall comply with federal and State laws, rules, and regulations.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/25.10)
(Section scheduled to be repealed on January 1, 2018)
Sec. 25.10. Remote prescription processing.
(a) In this Section, "remote prescription processing"

means and includes the outsourcing of certain prescription functions to another pharmacy or licensed non‑resident pharmacy, including the dispensing of drugs. "Remote prescription processing" includes any of the following activities related to the dispensing process:
(1) Receiving, interpreting, evaluating, or

clarifying prescriptions.
(2) Entering prescription and patient data into a

data processing system.
(3) Transferring prescription information.
(4) Performing a drug regimen review.
(5) Obtaining refill or substitution authorizations

or otherwise communicating with the prescriber concerning a patient's prescription.
(6) Evaluating clinical data for prior authorization

for dispensing.
(7) Discussing therapeutic interventions with

prescribers.
(8) Providing drug information or counseling

concerning a patient's prescription to the patient or patient's agent, as defined in this Act.
(b) A pharmacy may engage in remote prescription processing under the following conditions:
(1) The pharmacies shall either have the same owner

or have a written contract describing the scope of services to be provided and the responsibilities and accountabilities of each pharmacy in compliance with all federal and State laws and regulations related to the practice of pharmacy.
(2) The pharmacies shall share a common electronic

file or have technology that allows sufficient information necessary to process a non‑dispensing function.
(3) The records may be maintained separately by each

pharmacy or in common electronic file shared by both pharmacies, provided that the system can produce a record at either location showing each processing task, the identity of the person performing each task, and the location where each task was performed.
(c) Nothing in this Section shall prohibit an individual

employee licensed as a pharmacist from accessing the employer pharmacy's database from a pharmacist's home or other remote location or home verification for the purpose of performing certain prescription processing functions, provided that the pharmacy establishes controls to protect the privacy and security of confidential records.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/25.15)
(Section scheduled to be repealed on January 1, 2018)
Sec. 25.15. Telepharmacy.
(a) In this Section, "telepharmacy" means the provision of pharmacist care by a pharmacist that is accomplished through the use of telecommunications or other technologies to patients or their agents who are at a distance and are located within the United States, and which follows all federal and State laws, rules, and regulations with regard to privacy and security.
(b) Any pharmacy engaged in the practice of telepharmacy must meet all of the following conditions:
(1) All events involving the contents of an automated

pharmacy system must be stored in a secure location and may be recorded electronically.
(2) An automated pharmacy or prescription dispensing

machine system may be used in conjunction with the pharmacy's practice of telepharmacy after inspection and approval by the Department.
(3) The pharmacist in charge shall:
(A) be responsible for the practice of

telepharmacy performed at a remote pharmacy, including the supervision of any prescription dispensing machine or automated medication system;
(B) ensure that the home pharmacy has sufficient

pharmacists on duty for the safe operation and supervision of all remote pharmacies;
(C) ensure, through the use of a video and

auditory communication system, that a certified pharmacy technician at the remote pharmacy has accurately and correctly prepared any prescription for dispensing according to the prescription;
(D) be responsible for the supervision and

training of certified pharmacy technicians at remote pharmacies who shall be subject to all rules and regulations; and
(E) ensure that patient counseling at the remote

pharmacy is performed by a pharmacist or student pharmacist.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/25.20)
(Section scheduled to be repealed on January 1, 2018)
Sec. 25.20. Electronic visual image prescriptions. If a pharmacy's computer system can capture an unalterable electronic visual image of the prescription drug order, the electronic image shall constitute the original prescription and a hard copy of the prescription drug order is not required. The computer system must be capable of maintaining, printing, and providing, upon a request by the Department, the Department's compliance officers, and other authorized agents, all of the prescription information required by State law and regulations of the Department within 72 hours of the request.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/26)
(Section scheduled to be repealed on January 1, 2018)
Sec. 26. Anti‑epileptic drug product selection prohibited.
(a) The General Assembly finds that this Section is necessary for the immediate preservation of the public peace, health, and safety.
(b) In this Section:
"Anti‑epileptic drug means (i) any drug prescribed for the treatment of epilepsy or (ii) a drug used to treat or prevent seizures.
"Epilepsy" means a neurological condition characterized by recurrent seizures.
"Seizure" means a brief disturbance in the electrical activity of the brain.
(c) When the prescribing physician has indicated on the original prescription "may not substitute", a pharmacist may not interchange an anti‑epileptic drug or formulation of an anti‑epileptic drug for the treatment of epilepsy without notification and the documented consent of the prescribing physician and the patient or the patient's parent, legal guardian, or spouse. This Section does not apply to medication orders issued for anti‑epileptic drugs for any in‑patient care in a licensed hospital.
(Source: P.A. 94‑936, eff. 6‑26‑06; 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/27) (from Ch. 111, par. 4147)
(Section scheduled to be repealed on January 1, 2018)
Sec. 27. Fees.
(a) The Department shall, by rule, provide for a schedule of fees to be paid for licenses and certificates. These fees shall be for the administration and enforcement of this Act, including without limitation original licensure and renewal and restoration of licensure. All fees are nonrefundable.
(b) Applicants for any examination as a pharmacist shall be required to pay, either to the Department or to the designated testing service, a fee covering the cost of determining an applicant's eligibility and providing the examination. Failure to appear for the examination on the scheduled date, at the time and place specified, after the applicant's application for examination has been received and acknowledged by the Department or the designated testing service, shall result in the forfeiture of the examination fee.
(c) Applicants for the preliminary diagnostic

examination shall be required to pay, either to the Department or to the designated testing service, a fee covering the cost of determining an applicant's eligibility and providing the examination. Failure to appear for the examination on the scheduled date, at the time and place specified, after the application for examination has been received and acknowledged by the Department or the designated testing service, shall result in the forfeiture of the examination fee.
(d) All fees, fines, or penalties received by the Department under this Act shall be deposited in the Illinois State Pharmacy Disciplinary Fund hereby created in the State Treasury and shall be used by the Department in the exercise of its powers and performance of its duties under this Act, including, but not limited to, the provision for evidence in pharmacy investigations.
Moneys in the Fund may be transferred to the Professions Indirect Cost Fund as authorized under Section 2105‑300 of the Department of Professional Regulation Law (20 ILCS 2105/2105‑300).
The moneys deposited in the Illinois State Pharmacy Disciplinary Fund shall be invested to earn interest which shall accrue to the Fund.
(e) From the money received for license renewal fees, $5 from each pharmacist fee, and $2.50 from each pharmacy technician fee, shall be set aside within the Illinois State Pharmacy Disciplinary Fund for the purpose of supporting a substance abuse program for pharmacists and pharmacy technicians.
(f) A pharmacy, manufacturer of controlled substances, or wholesale distributor of controlled substances that is licensed under this Act and owned and operated by the State is exempt from licensure, registration, renewal, and other fees required under this Act.
Pharmacists and pharmacy technicians working in facilities owned and operated by the State are not exempt from the payment of fees required by this Act and any rules adopted under this Act.
Nothing in this subsection (f) shall be construed to prohibit the Department from imposing any fine or other penalty allowed under this Act.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/28) (from Ch. 111, par. 4148)
(Section scheduled to be repealed on January 1, 2018)
Sec. 28. Returned checks; fines. Any person who delivers a check or other payment to the Department that is returned to the Department unpaid by the financial institution upon which it is drawn shall pay to the Department, in addition to the amount already owed to the Department, a fine of $50. The fines imposed by this Section are in addition to any other discipline provided under this Act for unlicensed practice or practice on a nonrenewed license. The Department shall notify the person that payment of fees and fines shall be paid to the Department by certified check or money order within 30 calendar days of the notification. If, after the expiration of 30 days from the date of the notification, the person has failed to submit the necessary remittance, the Department shall automatically terminate the license or certificate or deny the application, without hearing. If, after termination or denial, the person seeks a license or certificate, he or she shall apply to the Department for restoration or issuance of the license or certificate and pay all fees and fines due to the Department. The Department may establish a fee for the processing of an application for restoration of a license or certificate to pay all expenses of processing this application. The Director may waive the fines due under this Section in individual cases where the Director finds that the fines would be unreasonable or unnecessarily burdensome.
(Source: P.A. 92‑146, eff. 1‑1‑02.)

(225 ILCS 85/29) (from Ch. 111, par. 4149)
(Section scheduled to be repealed on January 1, 2018)
Sec. 29. The Department shall maintain a roster of the names and addresses of all licensees and registrants and of all persons whose licenses or registrations have been suspended or revoked. This roster shall be available upon written request and payment of the required fee.
(Source: P.A. 85‑796.)

(225 ILCS 85/30) (from Ch. 111, par. 4150)
(Section scheduled to be repealed on January 1, 2018)
Sec. 30. Refusal, revocation, or suspension.
(a) The Department may refuse to issue or renew, or may revoke a license or registration, or may suspend, place on probation, fine, or take any disciplinary or non‑disciplinary action as the Department may deem proper, including fines not to exceed $10,000 for each violation, with regard to any licensee or registrant for any one or combination of the following causes:
1. Material misstatement in furnishing information

to the Department.
2. Violations of this Act, or the rules promulgated

hereunder.
3. Making any misrepresentation for the purpose of

obtaining licenses.
4. A pattern of conduct which demonstrates

incompetence or unfitness to practice.
5. Aiding or assisting another person in violating

any provision of this Act or rules.
6. Failing, within 60 days, to respond to a written

request made by the Department for information.
7. Engaging in unprofessional, dishonorable, or

unethical conduct of a character likely to deceive, defraud or harm the public.
8. Discipline by another U.S. jurisdiction or

foreign nation, if at least one of the grounds for the discipline is the same or substantially equivalent to those set forth herein.
9. Directly or indirectly giving to or receiving

from any person, firm, corporation, partnership or association any fee, commission, rebate or other form of compensation for any professional services not actually or personally rendered.
10. A finding by the Department that the licensee,

after having his license placed on probationary status has violated the terms of probation.
11. Selling or engaging in the sale of drug samples

provided at no cost by drug manufacturers.
12. Physical illness, including but not limited to,

deterioration through the aging process, or loss of motor skill which results in the inability to practice the profession with reasonable judgment, skill or safety.
13. A finding that licensure or registration has

been applied for or obtained by fraudulent means.
14. The applicant or licensee has been convicted in

state or federal court of or entered a plea of guilty, nolo contendere, or the equivalent in a state or federal court to any crime which is a felony or any misdemeanor related to the practice of pharmacy or which an essential element is dishonesty.
15. Habitual or excessive use or addiction to

alcohol, narcotics, stimulants or any other chemical agent or drug which results in the inability to practice with reasonable judgment, skill or safety.
16. Willfully making or filing false records or

reports in the practice of pharmacy, including, but not limited to false records to support claims against the medical assistance program of the Department of Healthcare and Family Services (formerly Department of Public Aid) under the Public Aid Code.
17. Gross and willful overcharging for professional

services including filing false statements for collection of fees for which services are not rendered, including, but not limited to, filing false statements for collection of monies for services not rendered from the medical assistance program of the Department of Healthcare and Family Services (formerly Department of Public Aid) under the Public Aid Code.
18. Dispensing prescription drugs without receiving

a written or oral prescription in violation of law.
19. Upon a finding of a substantial discrepancy in a

Department audit of a prescription drug, including controlled substances, as that term is defined in this Act or in the Illinois Controlled Substances Act.
20. Physical or mental illness or any other

impairment or disability, including without limitation deterioration through the aging process or loss of motor skills that results in the inability to practice with reasonable judgment, skill or safety, or mental incompetence, as declared by a court of competent jurisdiction.
21. Violation of the Health Care Worker

Self‑Referral Act.
22. Failing to sell or dispense any drug, medicine,

or poison in good faith. "Good faith", for the purposes of this Section, has the meaning ascribed to it in subsection (u) of Section 102 of the Illinois Controlled Substances Act. "Good faith", as used in this item (22), shall not be limited to the sale or dispensing of controlled substances, but shall apply to all prescription drugs.
23. Interfering with the professional judgment of a

pharmacist by any registrant under this Act, or his or her agents or employees.
24. Failing to report within 60 days to the

Department any adverse final action taken against a pharmacist, pharmacist technician, or certified pharmacist technician by another licensing jurisdiction in any other state or any territory of the United States or any foreign jurisdiction, any governmental agency, any law enforcement agency, or any court for acts or conduct similar to acts or conduct that would constitute grounds for discipline as defined in this Section.
25. Failing to comply with a subpoena issued in

accordance with Section 35.5 of this Act.
26. Disclosing protected health information in

violation of any State or federal law.
(b) The Department may refuse to issue or may suspend the license or registration of any person who fails to file a return, or to pay the tax, penalty or interest shown in a filed return, or to pay any final assessment of tax, penalty or interest, as required by any tax Act administered by the Illinois Department of Revenue, until such time as the requirements of any such tax Act are satisfied.
(c) The Department shall revoke the license or certificate of registration issued under the provisions of this Act or any prior Act of this State of any person who has been convicted a second time of committing any felony under the Illinois Controlled Substances Act, or who has been convicted a second time of committing a Class 1 felony under Sections 8A‑3 and 8A‑6 of the Illinois Public Aid Code. A person whose license or certificate of registration issued under the provisions of this Act or any prior Act of this State is revoked under this subsection (c) shall be prohibited from engaging in the practice of pharmacy in this State.
(d) Fines may be imposed in conjunction with other forms of disciplinary action, but shall not be the exclusive disposition of any disciplinary action arising out of conduct resulting in death or injury to a patient. Fines shall be paid within 60 days or as otherwise agreed to by the Department. Any funds collected from such fines shall be deposited in the Illinois State Pharmacy Disciplinary Fund.
(e) The entry of an order or judgment by any circuit court establishing that any person holding a license or certificate under this Act is a person in need of mental treatment operates as a suspension of that license. A licensee may resume his or her practice only upon the entry of an order of the Department based upon a finding by the Board that he or she has been determined to be recovered from mental illness by the court and upon the Board's recommendation that the licensee be permitted to resume his or her practice.
(f) The Department shall issue quarterly to the Board a status of all complaints related to the profession received by the Department.
(g) In enforcing this Section, the Board or the Department, upon a showing of a possible violation, may compel any licensee or applicant for licensure under this Act to submit to a mental or physical examination or both, as required by and at the expense of the Department. The examining physician, or multidisciplinary team involved in providing physical and mental examinations led by a physician consisting of one or a combination of licensed physicians, licensed clinical psychologists, licensed clinical social workers, licensed clinical professional counselors, and other professional and administrative staff, shall be those specifically designated by the Department. The Board or the Department may order the examining physician or any member of the multidisciplinary team to present testimony concerning this mental or physical examination of the licensee or applicant. No information, report, or other documents in any way related to the examination shall be excluded by reason of any common law or statutory privilege relating to communication between the licensee or applicant and the examining physician or any member of the multidisciplinary team. The individual to be examined may have, at his or her own expense, another physician of his or her choice present during all aspects of the examination. Failure of any individual to submit to a mental or physical examination when directed shall be grounds for suspension of his or her license until such time as the individual submits to the examination if the Board finds, after notice and hearing, that the refusal to submit to the examination was without reasonable cause. If the Board finds a pharmacist, certified pharmacy technician, or pharmacy technician unable to practice because of the reasons set forth in this Section, the Board shall require such pharmacist, certified pharmacy technician, or pharmacy technician to submit to care, counseling, or treatment by physicians or other appropriate health care providers approved or designated by the Board as a condition for continued, reinstated, or renewed licensure to practice. Any pharmacist, certified pharmacy technician, or pharmacy technician whose license was granted, continued, reinstated, renewed, disciplined, or supervised, subject to such terms, conditions, or restrictions, and who fails to comply with such terms, conditions, or restrictions or to complete a required program of care, counseling, or treatment, as determined by the chief pharmacy coordinator or a deputy pharmacy coordinator, shall be referred to the Secretary for a determination as to whether the licensee shall have his or her license suspended immediately, pending a hearing by the Board. In instances in which the Secretary immediately suspends a license under this subsection (g), a hearing upon such person's license must be convened by the Board within 15 days after such suspension and completed without appreciable delay. The Board shall have the authority to review the subject pharmacist's, certified pharmacy technician's, or pharmacy technician's record of treatment and counseling regarding the impairment.
(Source: P.A. 95‑331, eff. 8‑21‑07; 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/30.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 30.5. Suspension of license or certificate for failure to pay restitution. The Department, without further process or hearing, shall suspend the license or other authorization to practice of any person issued under this Act who has been certified by court order as not having paid restitution to a person under Section 8A‑3.5 of the Illinois Public Aid Code or under Section 46‑1 of the Criminal Code of 1961. A person whose license or other authorization to practice is suspended under this Section is prohibited from practicing until the restitution is made in full.
(Source: P.A. 94‑577, eff. 1‑1‑06.)

(225 ILCS 85/31) (from Ch. 111, par. 4151)
(Section scheduled to be repealed on January 1, 2018)
Sec. 31. The Department may refuse to issue a license to establish a new licensed pharmacy if an owner of the pharmacy applying for a license was an owner of a pharmacy that had its license revoked, unless the owner presents sufficient evidence indicating rehabilitation. Once a complaint has been filed by the Department against a pharmacy the Department may refuse to issue a license to establish a new licensed pharmacy, until such time as the Department issues a decision on the complaint, if an owner of the new pharmacy was also an owner of a pharmacy against which the complaint was filed. Neither an application for change of ownership nor for a change of location for any such pharmacy shall be acted on by the Department until such time as the Department issues a decision on the complaint. In the event that the pharmacy against which the complaint has been filed ceases to be licensed by the Department, for any reason, prior to the Department's decision on the complaint and an owner of that pharmacy applies for a license to establish a new pharmacy, the Department shall conduct a hearing on the complaint earlier filed, regardless of whether that pharmacy is presently licensed by the Department. If the conduct for which the complaint was originally filed would have been sufficient to result in a revocation of a license to operate a license pharmacy, then such conduct shall constitute sufficient grounds for denial of an application for a license.
For purposes of this Section "owner" means a sole proprietor, partner or a shareholder who owns in excess of 5 percent of the outstanding shares of a corporation, or the spouse or children of such sole proprietor, partner or shareholder. The provision of this Section shall not apply to any pharmacy owned by a corporation whose shares of stock are publicly traded on a national stock exchange.
(Source: P.A. 85‑796.)

(225 ILCS 85/32) (from Ch. 111, par. 4152)
(Section scheduled to be repealed on January 1, 2018)
Sec. 32. The Department shall render no final administrative decision relative to any application for a license or certificate of registration under this Act if the applicant for such license or certificate of registration is the subject of a pending disciplinary proceeding under this Act or another Act administered by the Department. For purposes of this Section "applicant" means an individual or sole proprietor, or an individual who is an officer, director or owner of a 5 percent or more beneficial interest of the applicant.
(Source: P.A. 85‑796.)

(225 ILCS 85/33) (from Ch. 111, par. 4153)
(Section scheduled to be repealed on January 1, 2018)
Sec. 33. The Director of the Department may, upon receipt of a written communication from the Secretary of Human Services, the Director of Healthcare and Family Services (formerly Director of Public Aid), or the Director of Public Health that continuation of practice of a person licensed or registered under this Act constitutes an immediate danger to the public, immediately suspend the license or registration of such person without a hearing. In instances in which the Director immediately suspends a license or registration under this Act, a hearing upon such person's license must be convened by the Board within 15 days after such suspension and completed without appreciable delay, such hearing held to determine whether to recommend to the Director that the person's license be revoked, suspended, placed on probationary status or reinstated, or such person be subject to other disciplinary action. In such hearing, the written communication and any other evidence submitted therewith may be introduced as evidence against such person; provided however, the person, or his counsel, shall have the opportunity to discredit or impeach such evidence and submit evidence rebutting same.
(Source: P.A. 95‑331, eff. 8‑21‑07.)

(225 ILCS 85/34) (from Ch. 111, par. 4154)
(Section scheduled to be repealed on January 1, 2018)
Sec. 34. The determination by a circuit court that a licensee is subject to involuntary admission or judicial admission as provided in the "Mental Health and Developmental Disabilities Code", approved September 5, 1978, as now or hereafter amended operates as an automatic suspension. Such suspension will end only upon a finding by a court that the patient is no longer subject to involuntary admission or judicial admission and issues an order so finding and discharging the patient; and upon the recommendation of the Board to the Director that the licensee be allowed to resume his practice.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.1) (from Ch. 111, par. 4155.1)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.1. (a) If any person violates the provision of this Act, the Director may, in the name of the People of the State of Illinois, through the Attorney General of the State of Illinois, or the State's Attorney of any county in which the action is brought, petition, for an order enjoining such violation or for an order enforcing compliance with this Act. Upon the filing of a verified petition in such court, the court may issue a temporary restraining order, without notice or bond, and may preliminarily and permanently enjoin such violation, and if it is established that such person has violated or is violating the injunction, the Court may punish the offender for contempt of court. Proceedings under this Section shall be in addition to, and not in lieu of, all other remedies and penalties provided by this Act.
(b) If any person shall practice as a pharmacist or hold himself out as a pharmacist or operate a pharmacy or drugstore, including a nonresident pharmacy under Section 16a, without being licensed under the provisions of this Act, then any licensed pharmacist, any interested party or any person injured thereby may, in addition to the Director, petition for relief as provided in subsection (a) of this Section.
Whoever knowingly practices or offers to practice in this State without being appropriately licensed or registered under this Act shall be guilty of a Class A misdemeanor and for each subsequent conviction, shall be guilty of a Class 4 felony.
(c) Whenever in the opinion of the Department any person not licensed in good standing under this Act violates any provision of this Act, the Department may issue a rule to show cause why an order to cease and desist should not be entered against him. The rule shall clearly set forth the grounds relied upon by the Department and shall provide a period of 7 days from the date of the rule to file an answer to the satisfaction of the Department. Failure to answer to the satisfaction of the Department shall cause an order to cease and desist to be issued forthwith.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.2) (from Ch. 111, par. 4155.2)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.2. The Department's pharmacy investigators may investigate the actions of any applicant or of any person or persons holding or claiming to hold a license or registration. The Department shall, before suspending, revoking, placing on probationary status, or taking any other disciplinary action as the Department may deem proper with regard to any license or certificate, at least 30 days prior to the date set for the hearing, notify the accused in writing of any charges made and the time and place for a hearing of the charges before the Board, direct him or her to file his or her written answer thereto to the Board under oath within 20 days after the service on him or her of such notice and inform him or her that if he or she fails to file such answer default will be taken against him or her and his or her license or certificate may be suspended, revoked, placed on probationary status, or have other disciplinary action, including limiting the scope, nature or extent of his or her practice, provided for herein. Such written notice may be served by personal delivery or certified or registered mail to the respondent at his or her address of record . At the time and place fixed in the notice, the Board shall proceed to hear the charges and the parties or their counsel shall be accorded ample opportunity to present such statements, testimony, evidence and argument as may be pertinent to the charges or to the defense thereto. Such hearing may be continued from time to time. In case the accused person, after receiving notice, fails to file an answer, his or her license or certificate may in the discretion of the Director, having received first the recommendation of the Board, be suspended, revoked, placed on probationary status, or the Director may take whatever disciplinary action as he or she may deem proper as provided herein, including limiting the scope, nature, or extent of said person's practice, without a hearing, if the act or acts charged constitute sufficient grounds for such action under this Act.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.3) (from Ch. 111, par. 4155.3)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.3. The Department, at its expense, shall preserve a record of all proceedings at the formal hearing of any case involving the refusal to issue, renew or discipline of a license. The notice of hearing, complaint and all other documents in the nature of pleadings and written motions filed in the proceedings, the transcript of testimony, the report of the Board or hearing officer, and orders of the Department shall be the record of such proceeding.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.4) (from Ch. 111, par. 4155.4)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.4. Any circuit court may, upon application of the Department or its designee or of the applicant or licensee against whom proceedings upon Section 35.2 of this Act are pending, enter an order requiring the attendance of witnesses and their testimony, and the production of documents, papers, files, books and records in connection with any hearing or investigation. The court may compel obedience to its order by proceedings for contempt.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.5) (from Ch. 111, par. 4155.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.5. The Department shall have power to subpoena and bring before it any person in this State and to take testimony, either orally or by deposition or both, with the same fees and mileage and in the same manner as prescribed by law in judicial proceedings in civil cases in circuit courts of this State. The Department may subpoena and compel the production of documents, papers, files, books, and records in connection with any hearing or investigation.
The Director, and any member of the Board, shall each have power to administer oaths to witnesses at any hearing which the Department is authorized to conduct under this Act, and any other oaths required or authorized to be administered by the Department hereunder.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.6) (from Ch. 111, par. 4155.6)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.6. At the conclusion of the hearing, the Board shall present to the Director a written report of its findings of fact, conclusions of law, and recommendations. The report shall contain a finding whether or not the accused person violated this Act or failed to comply with the conditions required in this Act. The Board shall specify the nature of the violation or failure to comply, and shall make its recommendations to the Director.
The report of findings of fact, conclusions of law, and recommendations of the Board shall be the basis for the Department's order or refusal or for the granting of a license or registration. The finding is not admissible in evidence against the person in a criminal prosecution brought for the violation of this Act, but the hearing and finding are not a bar to a criminal prosecution brought for the violation of this Act.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.7) (from Ch. 111, par. 4155.7)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.7. Notwithstanding the provisions of Section 35.6 of this Act, the Director shall have the authority to appoint any attorney duly licensed to practice law in the State of Illinois to serve as the hearing officer in any action before the Board for refusal to issue, renew, or discipline of a license or certificate. The Director shall notify the Board of any such appointment. The hearing officer shall have full authority to conduct the hearing. There shall be present at least one member of the Board at any such hearing. The hearing officer shall report his findings of fact, conclusions of law and recommendations to the Board and the Director. The Board shall have 60 days from receipt of the report to review the report of the hearing officer and present their findings of fact, conclusions of law, and recommendations to the Director. If the Board fails to present its report within the 60 day period, the respondent may request in writing a direct appeal to the Secretary, in which case the Secretary shall, within 7 calendar days after the request, issue an order directing the Board to issue its findings of fact, conclusions of law, and recommendations to the Secretary within 30 calendar days after such order. If the Board fails to issue its findings of fact, conclusions of law, and recommendations within that time frame to the Secretary after the entry of such order, the Secretary shall, within 30 calendar days thereafter, issue an order based upon the report of the hearing officer and the record of the proceedings or issue an order remanding the matter back to the hearing officer for additional proceedings in accordance with the order. If (i) a direct appeal is requested, (ii) the Board fails to issue its findings of fact, conclusions of law, and recommendations within the 30‑day mandate from the Secretary or the Secretary fails to order the Board to do so, and (iii) the Secretary fails to issue an order within 30 calendar days thereafter, then the hearing officer's report is deemed accepted and a final decision of the Secretary. Notwithstanding any other provision of this Section, if the Secretary, upon review, determines that substantial justice has not been done in the revocation, suspension, or refusal to issue or renew a license or other disciplinary action taken as the result of the entry of the hearing officer's report, the Secretary may order a rehearing by the same or other examiners. If the Secretary disagrees with the recommendation of the Board or the hearing officer, the Secretary may issue an order in contravention of the recommendation.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.8) (from Ch. 111, par. 4155.8)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.8. In any case involving the refusal to issue, renew or discipline of a license or registration, a copy of the Board's report shall be served upon the respondent by the Department, either personally or as provided in this Act for the service of the notice of hearing. Within 20 days after such service, the respondent may present to the Department a motion in writing for a rehearing, which motion shall specify the particular grounds therefor. If no motion for rehearing is filed, then upon the expiration of the time specified for filing such a motion, or if a motion for rehearing is denied, then upon such denial the Director may enter an order in accordance with recommendations of the Board except as provided in Section 35.6 or 35.7 of this Act. If the respondent shall order from the reporting service, and pay for a transcript of the record within the time for filing a motion for rehearing, the 20 day period within which such a motion may be filed shall commence upon the delivery of the transcript to the respondent.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.9) (from Ch. 111, par. 4155.9)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.9. Whenever the Director is satisfied that substantial justice has not been done in the revocation, suspension or refusal to issue or renew a license or registration, the Director may order a rehearing by the same hearing officer and Board.
(Source: P.A. 88‑428.)

(225 ILCS 85/35.10) (from Ch. 111, par. 4155.10)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.10. None of the disciplinary functions, powers and duties enumerated in this Act shall be exercised by the Department except upon the review of the Board.
In all instances, under this Act, in which the Board has rendered a recommendation to the Director with respect to a particular license or certificate, the Director shall, in the event that he or she disagrees with or takes action contrary to the recommendation of the Board, file with the Board his or her specific written reasons of disagreement with the Board.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.11)
Sec. 35.11. (Repealed).
(Source: P.A. 85‑796. Repealed by P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.12) (from Ch. 111, par. 4155.12)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.12. Notwithstanding the provisions herein concerning the conduct of hearings and recommendations for disciplinary actions, the Director shall have the authority to negotiate agreements with licensees and registrants resulting in disciplinary consent orders provided a Board member is present and the discipline is recommended by the Board member. Such consent orders may provide for any of the forms of discipline otherwise provided herein. Such consent orders shall provide that they were not entered into as a result of any coercion by the Department.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/35.13) (from Ch. 111, par. 4155.13)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.13. Order or certified copy; prima facie proof. An order or a certified copy thereof, over the seal of the Department and purporting to be signed by the Director, shall be prima facie proof that:
(a) the signature is the genuine signature of the

Director;
(b) the Director is duly appointed and qualified; and
(c) the Board and the members thereof are qualified

to act.
(Source: P.A. 91‑357, eff. 7‑29‑99.)

(225 ILCS 85/35.14) (from Ch. 111, par. 4155.14)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.14. At any time after the suspension or revocation of any certificate, the Department may restore it to the accused person without examination, upon the written recommendation of the Board.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.15) (from Ch. 111, par. 4155.15)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.15. Upon the revocation or suspension of any license or registration, the holder shall forthwith surrender the license(s) or registration(s) to the Department and if the licensee fails to do so, the Department shall have the right to seize the license(s) or certificate(s).
(Source: P.A. 85‑796.)

(225 ILCS 85/35.16) (from Ch. 111, par. 4155.16)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.16. The Secretary may temporarily suspend the license of a pharmacist or pharmacy, or the registration of a pharmacy technician or certified pharmacy technician, without a hearing, simultaneously with the institution of proceedings for a hearing provided for in Section 35.2 of this Act, if the Secretary finds that evidence in his possession indicates that a continuation in practice would constitute an imminent danger to the public. In the event that the Secretary suspends, temporarily, this license or registration without a hearing, a hearing by the Department must be held within 15 days after such suspension has occurred, and be concluded without appreciable delay.
(Source: P.A. 95‑689, eff. 10‑29‑07; 96‑673, eff. 1‑1‑10.)

(225 ILCS 85/35.17) (from Ch. 111, par. 4155.17)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.17. All final administrative decisions of the Department are subject to judicial review pursuant to the provisions of the "Administrative Review Law", as now or hereafter amended, and all rules adopted pursuant thereto. The term "administrative decision" is defined as in Section 3‑101 of the Code of Civil Procedure.
Proceedings for judicial review shall be commenced in the circuit court of the county in which the party applying for review resides; but if the party is not a resident of this State, the venue shall be in Sangamon County.
(Source: P.A. 85‑796.)

(225 ILCS 85/35.18) (from Ch. 111, par. 4155.18)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.18. Certification of record. The Department shall not be required to certify any record to the court or file any answer in court or otherwise appear in any court in a judicial review proceeding, unless there is filed in the court, with the complaint, a receipt from the Department acknowledging payment of the costs of furnishing and certifying the record. Failure on the part of the plaintiff to file a receipt in court shall be grounds for dismissal of the action.
(Source: P.A. 87‑1031.)

(225 ILCS 85/35.19) (from Ch. 111, par. 4155.19)
(Section scheduled to be repealed on January 1, 2018)
Sec. 35.19. Any person who is found to have violated any provision of this Act is guilty of a Class A misdemeanor. On conviction of a second or subsequent offense, the violator shall be guilty of a Class 4 felony. All criminal fines, monies, or other property collected or received by the Department under this Section or any other State or federal statute, including, but not limited to, property forfeited to the Department under Section 505 of The Illinois Controlled Substances Act, shall be deposited into the Illinois State Pharmacy Disciplinary Fund.
(Source: P.A. 95‑689, eff. 10‑29‑07.)

(225 ILCS 85/36) (from Ch. 111, par. 4156)
(Section scheduled to be repealed on January 1, 2018)
Sec. 36. Administrative Procedure Act. The Illinois Administrative Procedure Act is hereby expressly adopted and incorporated herein as if all of the provisions of that Act were included in this Act, except that the provision of subsection (d) of Section 10‑65 of the Illinois Administrative Procedure Act that provides that at hearings the licensee has the right to show compliance with all lawful requirements for retention, continuation or renewal of the license is specifically excluded. For the purpose of this Act the notice required under Section 10‑25 of the Administrative Procedure Act is deemed sufficient when mailed to the last known address of a party.
(Source: P.A. 88‑45.)

(225 ILCS 85/37) (from Ch. 111, par. 4157)
(Section scheduled to be repealed on January 1, 2018)
Sec. 37. In the event of a conflict between any provision of this Act and the Mental Health and Developmental Disabilities Confidentiality Act, the provisions of this Act shall govern.
(Source: P.A. 85‑796.)

(225 ILCS 85/38) (from Ch. 111, par. 4158)
(Section scheduled to be repealed on January 1, 2018)
Sec. 38. It is declared to be the public policy of this State, pursuant to paragraphs (h) and (i) of Section 6 of Article VII of the Illinois Constitution of 1970, that any power or function set forth in this Act to be exercised by the State is an exclusive State power or function. Such power or function shall not be exercised concurrently, either directly or indirectly, by any unit of local government, including home rule units, except as otherwise provided in this Act.
(Source: P.A. 85‑796.)

(225 ILCS 85/39) (from Ch. 111, par. 4159)
(Section scheduled to be repealed on January 1, 2018)
Sec. 39. All licenses and certificates of registration in effect on December 3l, 1987 and issued pursuant to the "Illinois Pharmacy Practice Act", approved August 23, 1963, as amended, are reinstated for the balance of the term for which last issued. All rules and regulations in effect on December 3l, 1987 and promulgated pursuant to the "Illinois Pharmacy Practice Act", approved August 23, 1963, as amended, shall remain in full force and effect on the effective date of this Act without being promulgated again by the Department, except to the extent any such rule or regulation is inconsistent with any provision of this Act. All disciplinary action, taken or pending, pursuant to the Illinois Pharmacy Practice Act, approved July 11, 1955, as amended, shall, for the actions taken remain in effect, and for the actions pending, shall be continued, on the effective date of this Act without having separate actions filed by the Department.
(Source: P.A. 85‑796.)

(225 ILCS 85/40)
(Section scheduled to be repealed on January 1, 2018)
Sec. 40. Severability clause. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes.
(Source: P.A. 90‑253, eff. 7‑29‑97.)

(225 ILCS 85/41)
(Section scheduled to be repealed on January 1, 2018)
Sec. 41. Current usual and customary retail price disclosure. Upon request, a pharmacy must disclose the current usual and customary retail price of any brand or generic prescription drug or medical device that the pharmacy offers for sale to the public. This disclosure requirement applies only to requests made in person or by telephone for the prices of no more than 10 prescription drugs or medical devices for which the person making the request has a prescription. Prices quoted are for informational purposes only and are valid only on the day of inquiry. The requests must specify the name, strength and quantity of the prescription drug.
(Source: P.A. 94‑459, eff. 1‑1‑06.)

Diabetic Ketoacidosis Is An Under-Appreciated Danger Facing Many Nursing Home Patients

Jonathan Rosenfeld — Wed, 27 Jan 2010 06:41:37 -0600

Diabetes is a serious illness affecting many nursing home residents. Diabetics face an increased risk for a variety of health problems and complications, including ketoacidosis. Diabetic ketoacidosis is a dangerous complication of diabetes that occurs when you don’t have enough insulin in your body. This serious complication is more common in people who have type 1 diabetes, rather than type 2 diabetes.

Diabetic ketoacidosis develops when you have too little insulin in your body, raising your blood sugar level. This causes your body to break down fat for energy, creating toxic acids known as ketones. If left untreated, this can cause you to lose consciousness and even result in death. Symptoms develop quickly and include:

Excessive thirst
Frequent urination
Nausea and vomiting
Abdominal pain
Loss of appetite
Weakness or fatigue
Shortness of breath
Fruity-scented breath
Confusion.

Doctors can test for high blood sugar level and high ketone level in your urine in order to confirm ketoacidosis.

Ketoacidosis is commonly triggered by an illness or a problem with insulin therapy. Elderly diabetic nursing home residents are more susceptible to infection and other illnesses, which in turn puts them at greater risk for developing ketoacidosis. However, the risk of ketoacidosis is highest if you are age 19 or younger and suffering from type 1 diabetes. Other possible triggers include: stress, physical or emotional trauma, high fever, surgery, heart attack, stroke, and alcohol or drug abuse.

Treatment of ketoacidosis is done with fluid replacement, electrolyte replacement, and insulin therapy. These very treatments that are used to correct ketoacidosis are also the source of most ketoacidosis complications. These complications include: low blood sugar (hypoglycemia), low potassium (hypokalemia), and swelling of the brain (cerebral edema).

The best way to prevent ketoacidosis is to properly manage your diabetes with healthy eating and physical activity as well as monitoring your blood sugar level to ensure that it remains within your target range.

Many nursing home residents rely on nursing home staff to properly monitor their blood sugar level and adjust insulin dosage as needed as well as provide healthy and well-balanced meals. Therefore, it is important that nursing homes develop care plans to provide adequate care and services to manage diabetic residents. Most diabetic complications develop faster in elderly diabetics with poor glycemic control.

Diabetes in the Elderly

Diabetes is a serious disease that can cause many complications for elderly diabetics. Ketoacidosis and other diabetic complications require that nursing home staff take special precautions to properly monitor diabetic residents and ensure that they receive necessary care and services to attain and maintain the highest quality of life possible.

If you worry that a nursing home facility is not providing adequate care to manage your diabetes, it is important that you take immediate action to get your diabetes under control and prevent medical problems and complications.

Resources:

Medicine Net: Ketoacidosis

Diabetes Disease: Ketoacidosis

Journal of Geriatric and Gerontology: Diabetes in the Elderly

Resident Grand Rounds: Diagnosis and Management of Diabetic Ketoacidosis in Adults

Nursing Homes Abuse Blog:

Nursing Homes Must Be Prepared To Handle Diabetic Patients

Never Event #3: Poorly Controlled Blood Sugar, Hyperglycemia & Hypoglycemia

Investigation Determines Serious Safety Violations At Sunrise Assisted Living Facilities That Threaten Patient Safety

Jonathan Rosenfeld — Tue, 26 Jan 2010 05:41:27 -0600

The Georgia Department of Human Resources has been busy investigating serious safety infractions at several Sunrise Senior Living facilities in the Atlanta, GA metro area. According to an investigation initiated by CBS Atlanta News, problems abound at this national chain of assisted living facilities.

CBS Atlanta News began to scrutinize patient care at Sunrise facilities after a scabies outbreak at Sunrise in Dunwoody. The television station's investigation further revealed:

Brighton Gardens of Dunwoody; Staff at Brighton Gardens were cited for failing to follow protocol for emergency situations after staff failed to implement CPR for an unresponsive patient who wished to be resuscitated. State authorities imposed a $1,000 per day fine against the facility until changes were made.

Sunrise of Decatur: Georgia investigators fined the facility $601 after they determined the facility failed to provide protective care and watchful oversight of a patient.

Brighton Gardens of Vinings; The assisted living facility was fined $300 for failing to provide individual residents with protective care and watchful oversight.

Although many assisted living facilities provide similar care as their nursing home counterparts, in many states they still remain loosely regulated. Hopefully, as more information regarding safety violations becomes public, there will be a demand for increased regulation and transparency.

Nursing Home Negligence Lawsuit Claims Sunrise Senior Living Failed To Supervise Resident During Field Trip

Assisted Living Fall Leads To Wrongful Death Lawsuit

Nursing Home Sued Following Death Of Resident In Fall

Caring For The Elderly Pays... Especially If You Own The Nursing Home

Are Nursing Homes Required To Have Certain Numbers Of Staff?

Jonathan Rosenfeld — Mon, 25 Jan 2010 06:40:46 -0600

"Are nursing homes required to have certain numbers of staff"

-Edward, Highland Park, IL

Illinois does not require a specific staff to patient ratio for Illinois nursing home facilities. The responsibility lies on each facility to determine the staffing needs to meet the needs of its residents. (Section 300.1230 – Staffing) The Administrative Code requires that a sufficient number of staff remain on duty for all hours of the day to provide services that meet the total needs of the residents. (Administrative Code Part 300 – Skilled Nursing and Intermediate Care Facilities Code)

Staffing is based on the needs of the residents and is determined by determining the number of hours of nursing time each resident needs on each shift of the day. This determination must be made separately for both licensed and unlicensed nursing personnel. The number and categories of personnel that should be provided is based on:

Number of residents
Amount and kind of care required to meet the needs of all residents at all times
Size, physical condition, and layout of building including proximity to resident rooms
Medical orders (Section 300.1230 – Staffing)

The Skilled Nursing and Intermediate Care Facilities Code provides examples for how to compute staffing needs for a 100 bed Skilled Nursing Facility, based on the considerations listed above (see Resources below).

The facility must provide the necessary care and services to attain or maintain the highest level of physical, mental, and psychological well-being of the residents. (Section 300.1210 – General Requirements for Nursing and Personal Care)

Each facility must have a director of nursing services (DON) who is a registered nurse and is a full-time employee on duty a minimum of 36 hours, four days a week, with at least 50% of their hours scheduled between 7 A.M. and 7 P.M. In facilities with 100 or more occupied beds, there must also be an assistant director of nursing (ADON), on duty a minimum of 36 hours, four days a week. For all shifts, there must be a licensed nurse designated as being in charge of nursing services when neither the DON nor the ADON are on duty. The facility must also have a minimum of one staff member awake and ready at all times.

Resources:

Illinois Nursing Home Care Act

Administrative Code – Part 300 – Skilled Nursing and Intermediate Care Facilities Code

Section 300.1210 – General Requirements for Nursing and Personal Care

Section 300.1230 – Staffing – (p) – Example of Staffing Calculations

A) Total Minimum Hours of Care Needed

Level of Care	# of Residents		Total Hrs. Needed/Day Per Resident		Total Hrs. Needed/Day Per Facility
Skilled	25	[times]	2.5	=	62.5
General ICF	50	[times]	1.7	=	85.0
Light ICF	25	[times]	1.0	=	25.0
	Total hours needed				172.5

B) Minimum Total Hours Needed Per Shift

Shift	Total Hrs. Per Day			Minimum Percent	Total Hrs. Needed
7-3	172.5	[times]		45%	77.6
3-11	172.5	[times]		35%	60.4
11-7	172.5	[times]		20%	34.5
			100%		172.5

C) Licensed Nurse Coverage

Shift	Minimum Hrs. Per Shift		Minimum Percent	Minimum Nurse Hours Required
7-3	77.6	[times]	20%	15.5
3-11	60.4	[times]	20%	12.1
11-7	34.5	[times]	20%	6.9

D) Licensed Nurses Required

Shift	Minimum Nurse Hrs. Required		Hrs. Worked Per Shift		# of Nurses Needed
7-3	15.5	[divided by]	8	=	1.93 (2)
3-11	12.1	[divided by]	8	=	1.51 (1.5)
11-7	6.9	[divided by]	8	=	0.86 (1)

E) Nurse Aide/Orderly Coverage

Shift	Minimum Nurse Hrs. Required		Hrs. Worked Per Shift		# of Nurses Needed
7-3	77.6	[minus]	15.6	=	62.1
3-11	60.4	[minus]	12.1	=	48.3
11-7	34.5	[minus]	6.9	=	27.6

F) Nurse Aides/Orderlies Required

Related Nursing Homes Abuse Blog Entries:

Nurses Admit To Problems At Nursing Homes

High Staff Turnover Rates Plague Most Nursing Homes

A Recipe For Danger: Nursing Shortage Could Reach 1M By 2020

Under-staffing At Nursing Home Blamed For Pressure Ulcer, Infection & Subsequent Death

Jonathan Rosenfeld — Sun, 24 Jan 2010 06:01:45 -0600

The son of a deceased nursing home patient blames 'under-staffing' as the primary reason why his mother fell and subsequently developed pressure ulcers. Gary Brown filed a lawsuit against a county operated nursing home in Nebraska on behalf of his deceased mother's estate.

In addition to under-staffing, the lawsuit alleges the facility allowed his mother to develop pressure ulcers (also referred to as pressure sores, decubitus ulcers or bed sores) during her recovery from a fall at the facility. Despite the fact that the pressure ulcers progressed and became infected, the facility also allegedly failed to notify the woman's personal physician. Lastly, it is claimed that the pressure sores contributed to the patient's death.

Read more about this lawsuit due to development of pressure ulcers here.

Nursing Homes Obligation To Prevent Pressure Ulcers

Nursing homes must develop a customized program to prevent and monitor each resident's risk for developing pressure ulcers. Unfortunately, at facilities that are inadequately staffed, many of the preventative measures set forth in a care plan are not complied with.

Pressure ulcers may develop when a patient is left in one position for a long period of time. Consequently, many nursing home patients need to be 'turned' on a regular basis. Many facilities have charts to help staff keep track of the re-positioning schedule for each resident.

To minimize development of pressure ulcers, nursing home residents should be:

Cleaned regularly with mild soap and lukewarm water
Moisturized daily
Kept dry and clean-- especially kept free from urine and feces
Rotated on schedule to prevent the build up of pressure from one area of the body
Encouraged to get proper nutrition and hydration
Kept the bed elevation as low as possible- this reduces pressure on the sacrum and buttocks

Related Nursing Homes Abuse Blog Entries

Government Report Confirms Pressure Ulcers Harm All Nursing Home Residents; Regardless Of Race, Sex or Age

Nursing Home Visits. An Opportunity To Conduct Your Own Inspection.

In For Rehab. Out With Bedsores.

Hidden Camera Catches Nursing Home Worker Abusing Paralyzed Stroke Patient

Jonathan Rosenfeld — Sat, 23 Jan 2010 07:02:10 -0600

First-degree felony abuse charges have been filed against a nurses aide at Castle Pines Retirement Home in Lufkin, TX. The aide identified as Johnetta Dashaw Phillips, was responsible for caring for a patient who was left paralyzed from a stroke and suffers from dementia.

Despite earlier complaints of abuse by the patient's husband to administrators at Castle Pines, the facility claimed it was unable to take any action because the disabled wife was unable to identify her abuser.

Consequently, the husband set up a hidden video camera in his wife's room. The camera recorded two incidents of abuse:

In June, the video revealed Phillips striking the woman three times to get her out of her wheelchair and then throwing her into her bed
In July, the video revealed Phillips using a doll to hit the wife in the chest

Even when confronted with the video, Phillips claimed she was acting in self-defense. Currently, Phillips is in the Angelina County Jail, unable to satisfy the $100,000 bail. Read more about this incident involving a Texas nursing home here.

Related Nursing Homes Abuse Blog Entries:

Just Do It. Photograph Everything

What Steps Should I Take Before Meeting With A Nursing Home Lawyer?

Hidden Camera Reveals Caretaker Abuse By Nursing Home Worker

Video: New York Nursing Home Worker Caught On Tape

Family Claims Assisted Living Facilities Neglect Resulted In Death Of Mentally Disabled Woman

Jonathan Rosenfeld — Fri, 22 Jan 2010 06:10:55 -0600

The family of a 51-year-old woman with cerebral palsy has brought a lawsuit against the assisted living facility where she was a patient. The lawsuit alleges that Country Crossing Assisted Living Facility failed to properly care for the mentally disabled woman during the course of her four year stay and intentionally hid her physical condition from her family.

The lawsuit alleges that the assisted living facilities neglect resulted in severe malnourishment and advanced pressure sores. Quoting a nurse who used to work at the facility, the lawsuit further alleges that the facility failed to train new employees and keep records related to the patients medical treatment.

A Georgia jury will soon decide if the allegations of poor care are indeed true as the case is set to go to trial in the Walker County Courthouse. Read more about this lawsuit against an assisted living facility here.

My take on this lawsuit:

As a personal injury lawyer who is involved in many cases involving claims against nursing homes and assisted living facilities, I imagine that this assisted living facility will claim that the woman's family failed to properly look after her. While this claim may seem cold-hearted (and it is), jurors typically have a difficult time awarding money to an estranged family.

Litigation issues aside, I strongly believe that patients receive superior care when their family actively participates in their care and visits on a regular basis. Like it or not, staff notice a families presence and tend to provide more care to the patients with an active group of visitors.

Related Nursing Homes Abuse Blog Entries:

Despite Their Avoidability, Bed Sores Continue To Plague Nursing Home & Hospital Patients In All Demographics

Grim Details Emerge Regarding Malnutrition In Kentucky Nursing Home

Wrongful Death

Mentally Disabled Patients Are Easy Targets For Abuse In Institutional Settings

Jonathan Rosenfeld — Thu, 21 Jan 2010 05:45:29 -0600

People who suffer from mental impairments are particularly vulnerable to abuse and exploitation including physical abuse, sexual abuse, neglect, and financial exploitation.

A mental impairment is any mental or psychological disorder, such as mental retardation, organic brain syndrome (diseases that cause decreased mental functions), emotional or mental illness, and specific learning disabilities.

Caregiving can be very stressful because caring for a person with a mental impairment can require a lot of time, work, and money. Sometimes this stress can cause caregivers to provide inadequate care or even abuse the mentally impaired person. This can put the mentally impaired at increased risk for neglect and abuse compared with other nursing home patients.

In 2001, President Bush established the President’s New Freedom Commission on Mental Health. The Commission’s Interim Report to the President, it declared that “the mental health delivery system is fragmented and in disarray” and described the lack of care for older adults with mental illnesses. The Final Report contains an entire chapter on older adults and mental health. The Report states that “a substantial proportion of the population 55 and older – almost 20 percent of this age group – experience specific mental disorders that are not part of ‘normal’ aging.”

There are several laws and programs in place to protect this vulnerable population of people who suffer from mental impairments in order to ensure that their rights are protected and they receive the best quality of care possible.

The Americans with Disabilities Act (“ADA”) is in place to ensure that people with disabilities have legal protection against discrimination in the workplace, housing, and residential settings, public programs, and telecommunications. According to the ADA, you have a disability if you have at least one of the following:

A physical or mental impairment that substantially limits one or more major life activities
A record of such an impairment
You are regarded as having such an impairment

In Illinois, there are several laws and programs in place to help protect people with disabilities. These include:

The Illinois Guardianship & Advocacy Commission
The Domestic Abuse Project
Illinois Domestic Violence Act
Illinois Criminal Code

The Illinois Guardianship and Advocacy Commission protects the rights and promotes the welfare of people with disabilities. There are three divisions: Office of the State Guardian (“OSG”), the Legal Advocacy Service (“LAS”), and the Human Rights Authority (“HRA”). The OSG is appointed by the courts as a guardian for persons with disabilities as a last resort, when no other guardian is available. The LAS represents people with disabilities and hearings to enforce their rights. Lastly, the HRA investigates alleged rights violations by providers against people with disabilities.

The Domestic Abuse Program is administered by the Illinois Department of Human Services-Office of Rehabilitation Services (“ORS”). It provides a telephone number for people to report alleged or suspected abuse, neglect, or exploitation of an adult with disabilities. The program then investigates the reports and provides assistance to the abused person.

The Illinois Domestic Violence Act (750 ILCS 60) protects adults with disabilities from abuse, neglect, or exploitation from a family member, household member, personal assistant, or any other person who has assumed responsibility to provide care. A judge can enter an Order of Protection (“OOP”) if they determine that abuse, neglect, or exploitation has occurred in order to prevent further abuse and provide compensation or other remedies.

The Illinois Criminal Code (720 ILCS 5) provides criminal penalties for offenses including neglect, financial exploitation, assault, battery, sexual abuse, and home repair fraud. If certain crimes are committed against persons with disabilities, more severe penalties may be imposed (examples include: 720 ILCS 5/9-1(b)(17) murder of a person with a disability; 720 ILCS 5/11-9.5 Sexual Misconduct with a person with a disability; 720 ILCS 5/12-7.1 Hate Crime; 720 ILCS 5/12-19 Abuse and Criminal Neglect of a Long Term Care Facility Resident; 720 ILCS 5/12-21 Criminal abuse or neglect of an elderly person or person with a disability; 720 ILCS 5/16-1.3 Financial exploitation of an elderly person or a person with a disability). The Code also includes laws which make certain actions against persons with disabilities a crime, where those same actions when committed against persons without disabilities are not considered a crime.

In addition, each State has a protection and advocacy agency that receives funding from the federal Center for Mental Health Services (“CMS”) (Protection and Advocacy for Individuals with Mental Illness Program (“PAIMI”)) in order to protect and advocate for the rights of people with mental illness and to investigate reports of abuse and neglect in facilities that care for and treat mental illnesses. In Illinois, this program is Equip for Equality. This program has its own Abuse Investigation Unit whose purpose is to prevent the abuse, neglect, and deaths of individuals with disabilities receiving services in any setting including community-based facilities and programs, nursing homes, hospitals, and state-run mental health and developmental disability facilities in Illinois.

In Illinois, residents of long-term care facilities have the right to continue living in the facility (210 ILCS 45/3-401; 42 CFR 483.12). Involuntary discharge can only occur if:

Your medical needs cannot be met by the facility
Your health has improved so that you no longer require the facility’s services
Your physical health or safety is at risk
The safety of others is at risk if you remain
You have not paid or are late paying the facility’s bill
The facility closes

If a facility requests that a resident be discharged, it must provide written notice to the resident or the resident’s representative. Then, you still have the right to meet with the facility to discuss the discharge and appeal the discharge to the Illinois Department of Public Health. Therefore, a facility cannot discharge a person simply because of a mental impairment.

Mental Retardation (Developmental Disability)

An intellectual disability (or developmental disability) is a condition which causes substantial mental impairment attributable to mental retardation or a condition similar to mental retardation. People with intellectual disabilities display a significantly below-average score on a test of mental ability or intelligence and face limitations in areas of daily life. Mental retardation can result from a number of conditions including Down Syndrome (extra copy of Chromosome 21) and Fragile X Syndrome (the most common form of inherited mental retardation).

Most developmental disabilities have no cure, but therapy can help treat symptoms. If you are a caregiver for someone who has mental retardation, you may be performing the following activities for that person: bathing, dressing, feeding, cooking, shopping, paying bills, running errands, giving medicine, and providing company and emotional support.

In Illinois, the Mental Health and Developmental Disabilities Code ensures that people with developmental disabilities receive adequate and humane care in the least restrictive setting. The Code governs the procedure for the admission, transfer, and discharge of people with developmental disabilities from “developmental disability facilities” (licensed or operated by or under contract with the State of Illinois) to ensure that people with developmental disabilities receive appropriate care in the least restrictive environment.

A “developmental disability” is defined as a condition which causes a substantial impairment and which is attributable to mental retardation (intelligence quotient (IQ) of 70 or below), cerebral palsy, epilepsy, autism, or any other condition which results in impairment similar to that caused by mental retardation. These developmental disabilities must originate before the age of 18 and be expected to continue indefinitely.

People with mental retardation should not be cared for in facilities designed to care for people with mental illness. When a person is admitted into a mental health facility, the facility must evaluate the person for mental retardation. If the person has severe mental retardation, they must be transferred to a developmental disability facility within 72 hours unless they also have a mental illness and the mental health facility can provide appropriate mental health treatment and habilitation services.

A common source of abuse is the use of restraints in inappropriate situations. People with developmental disabilities have the right to be free of restraints unless used as a therapeutic measure to prevent the person from causing physical harm to themselves or physical abuse to others. In addition, restraints require the written order of a physician, psychologist, social worker or registered nurse, unless there is an emergency requiring the immediate use of restraints.

Oftentimes, facilities use restraints on persons with developmental disabilities so they are more manageable and require less work. Developmental disability facilities and other health facilities are often understaffed, which leads staff members to resort to unnecessarily severe measures, such as restraints, to control patients. However, this constitutes abuse, unless the restraints are medically necessary.

Financial exploitation is sadly another common source of abuse when dealing with people with mental retardation. A recipient of developmental disability services has the right to possess and use their personal belongings, unless necessary to protect the resident and others from harm. In addition, a recipient of services may use his money as he chooses. More often than should be allowed, people financially exploit these vulnerable adults, who lack the mental capacity to make well-informed decisions. The Illinois Criminal Code includes a provision for the financial exploitation of an elderly person or a person with a disability (720 ILCS 5/16-1.3).

Organic Brain Syndrome

Organic Brain Syndrome (“OBS”) is a general term that refers to diseases that cause decreased mental function. Symptoms include agitation, confusion, dementia (long-term loss of brain function; Alzheimer’s disease is the most common type of dementia), and delirium (severe, short-term loss of brain function). OBS is very common in the elderly, but it is not a part of the normal aging process. Alzheimer’s disease affects about 5% of people between the ages of 65 and 74 and nearly 50% of people over the age 85. Doctors do not fully understand the cause of Alzheimer’s, but it appears to be a combination of genetic, lifestyle, and environmental factors.

Many disorders are associated with OBS including: brain injury caused by trauma, breathing conditions, cardiovascular disorders, degenerative disorders, drug and alcohol-related conditions, infections, and other medical disorders. Treatment of OBS depends on the disorder, but it mostly consists of supportive care to assist the person in areas where brain function is lost. Some disorders cause aggressive behavior which can be treated with medications.

Mentally disabled nursing home residents might be unaware of abuse or unable to report abuse because of cognitive impairment. Also, residents with moderate or severe dementia may be unable to give an accurate description of abuse or neglect.

Mental Illness

Mental illness is a mental or emotional disorder which substantially impairs a person’s cognitive, emotional, and/or behavioral functioning. Common mental illnesses include depression, bipolar disorder, and schizophrenia.

Illinois has the highest number of mentally ill adults under age 65 living in nursing homes. This is in part because Illinois only has 1,480 public hospital beds for mentally ill patients since the state shut down seven state-run mental hospitals since 1980. Under federal law, nursing homes may only admit mentally ill patients if the state has determined that the person needs the high level of care the nursing home can provide. Governor Pat Quinn formed the Illinois Nursing Home Safety Task Force to improve Illinois’ nursing home system and ensure the safety of residents. The task force will address the welfare of mentally ill nursing home residents after a series of assaults, rapes, and murders by mentally ill residents.

The Illinois Department of Health and Human Services’ Division of Mental Health offers services ranging from intensive in-patient hospitalization to outpatient care backed by supportive housing and employment programs. The goal of the Division is to ensure that Illinois residents have access to publicly funded mental health services.

A study by researchers Brown University found that in the United States, nursing home admission rates for people with mental illness varied between the States. These variations in services and how they are admitted may result in longer-than-average stays for those individuals with mental illnesses (46% of people with mental illnesses remained in the nursing home facility 90 days after admission compared to only 24% of people who did not have a mental illness). The study suggests that this might be because Medicaid pays nursing homes a higher rate for people with mental illness who have minimal physical problems, which might provide an incentive for nursing homes to admit these patients. It also suggests that patients with mental illnesses lack a safety net, which may explain why many of them become long term care residents.

Another report from the Agency for Healthcare Research and Quality revealed that nursing home residents are likely to diagnose and treat depression. However, disparities were found in both depression diagnosis and treatment, which may indicate that certain groups of nursing home residents are not receiving the care they need. Furthermore, nursing homes usually treated depression with antidepressants rather than psychotherapy, which the study suggested might be because antidepressants are cheaper.

Learning Disabilities

Learning disabilities also put a person at risk for abuse and exploitation depending on the severity of the disability. Older adults suffering from learning disabilities might not be able to read, fully understand conversation, or have difficulty speaking and expressing their thoughts.

Learning disability (“LD”) is a term that describes specific kinds of learning problems (trouble learning and using certain skills). Oftentimes, the skills most affected are: reading, writing, listening, speaking, reasoning, and doing math. Learning disabilities are life-long disabilities and there is no cure. As many as 1 in 5 people in the United States have a learning disability, but they vary from person to person.

The federal Individuals with Disabilities Education Act (“IDEA”) defines learning disability as “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia." Learning disabilities do not include “learning problems that are primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage." (34 Code of Federal Regulations §300)

Cases of abuse, neglect, and exploitation of people with mental impairments are all too frequent despite the myriad of programs in place to protect people who suffer from mental impairments. If a family member has suffered from abuse or exploitation at the hands of a caregiver, facility, or hospital, you have legal options to seek a remedy appropriate for your case. Mental health facilities and caregivers owe a duty of care to the mentally impaired, and when this duty is breached, the person hurt by this neglect might be entitled to damages.

For two generations we have advocated on behalf of the mentally disabled who are victims of abuse. Our experience in these these cases allows us to represent the mentally disabled as compassionately and effectively as possible. We would honor the opportunity to speak to you regarding a friend or loved one who was mistreated in a: group home, mental institution, assisted living facility or any communal living arrangement. All consultations are kept in the strictest confidence. (888) 424-5757

Many thanks to Heather Keil, J.D. for her thorough research in these areas.

Resources:

Centers for Disease Control and Prevention: Intellectual Disability

Mayo Clinic: Mental Illness

Illinois General Assembly: 405 ILCS Mental Health and Developmental Disabilities Code

Illinois Department of Health and Human Services: Division of Mental Health

Illinois General Assembly: 720 ILCS 5 Criminal Code

Illinois Guardianship and Advocacy Commission

U.S. Surgeon General: Mental Health Report: Chapter 5 – Older Adults and Mental Healt h

Report Shows: Hispanic Nursing Home Patients Are Living In Inferior Facilities

Jonathan Rosenfeld — Wed, 20 Jan 2010 06:18:02 -0600

A new study published in Health Affairs concluded Hispanics are more likely to live in bad nursing homes than other demographics. After analyzing data from predominately Hispanic vs. non-Hispanic nursing homes, the studies leader Mary Fennell, a professor of sociology and community health at Brown University, believes the data conclusively demonstrates that Hispanics live in inferior nursing homes.

Amongst the studies findings:

4.5 million elderly Hispanics require nursing home care in 2010
From 2000 - 2005, the percentage of Hispanic nursing home patients increased from 5% to 6.4% of the total nursing home population
Most of the Hispanic patients in nursing homes had already endured prior hospitalizations and require high-level care

One of the reasons the study suggests for the increase in Hispanic nursing home patients is that many of the predominately female care-givers now work outside of the home.

Whatever the underlying reason for the increase in Hispanic nursing home patients, I strongly believe that all nursing home patients are entitled to the best care that is feasible.

As a personal injury lawyer in Chicago, I unfortunately see many minorities flocking to inferior nursing homes because they are conveniently located within the confines of their neighborhood. Consequently, I always suggest that families should select a facility based on the quality of the services they provide over the convenience of its location.

Read more about this study of Hispanic nursing home patients here.

Nursing Homes With Higher Percentage Of Hispanic Residents Have Higher Rate Of Bed Sores

Blacks Receive Inferior Care At Most Nursing Homes

Attorney General Lays Out Guidelines For Selection Of Nursing Homes & Assisted Living Facilities

Elderly Nursing Home Patients Are Paticularly Susceptible To Illness Related To Contaminated Food

Jonathan Rosenfeld — Tue, 19 Jan 2010 06:36:52 -0600

Older adults are particularly susceptible to food poisoning because as you get older, your immune system does not respond as quickly and as effectively to infectious organisms as when you were younger. In addition, many nursing home residents already have weakened immune systems due to age, illness, and disease, and their bodies cannot handle the added onslaught caused by food poisoning.

For example, dehydration, which is a common and serious complication of food poisoning, is also a risk factor for the development of pressure sores, which can present a serious risk to nursing home residents. Therefore, nursing homes should take extra precautions to ensure that food is served in a safe, timely, and proper manner so as to prevent contamination.

Food poisoning (also known as food-borne illness) occurs when you consume contaminated food or beverages. Food can be contaminated by bacteria, viruses, parasites, or their toxins. In the United States, there are an estimated 76 million cases of foodborne disease each year.

The CDC estimates that foodborne diseases cause 325,000 hospitalizations and 5,000 deaths each year. Depending on the source of contamination, symptoms may vary. Oftentimes, people think they have the “stomach flu.” However, most types of food poisoning cause the following symptoms:

Nausea
Vomiting
Watery diarrhea
Abdominal pain
Stomach cramps
Loss of appetite
Fatigue
Fever

These symptoms can start as soon as just hours after eating the contaminated food or days later. Illness usually lasts from 1-10 days. Treatment for food poisoning is usually done with fluid replacement and control of nausea and vomiting. In serious cases, hospitalization might be necessary.

Food can be contaminated by bacteria, viruses, parasites, or their toxins. This contamination can occur at any point in the food production (growing, harvesting, processing, storing, shipping, and preparing). The most common cause of food poisoning is cross-contamination (the transfer of harmful organisms from one surface to another.

Some common contaminants include: Campylobacter, Clostridium perfiringens, Escherichia coli (E. coli), Giardia lamblia, Hepatitis A, Listeria, Norovirus, Rotavirus, Salmonella, Shigella, Staphylococcus aureus, Vibrio vulnificus, and Botulism.

Salmonella and Campylobacter are bacteria that commonly cause food poisoning. They are normally found in warm-blooded animals such as cattle, poultry, and swine. The bacteria may be present in raw meat, poultry, eggs, or unpasteurized dairy products. Another common bacterial contamination is Clostridium perfringens, which may be present in raw meat, poultry, eggs, or unpasteurized dairy products as well as in vegetables and crops that come in contact with soil.

Staphylococci, bacteria that are naturally found on human skin and in the nose and throat, can also cause food poisoning when handling food. E. coli (Escherichia coli) is found in the intestines of healthy cattle and can cause infection when people eat undercooked beef or unpasteurized milk. Shellfish and other foods that may have been exposed to sewage-contaminated water can transmit viral diseases such as Hepatitis A. Finally, Botulism is a rare but deadly form of food poisoning caused by Clostridium botulinum, which is found in improperly canned foods.

Food poisoning can be easily prevented through the following steps:

Wash your hands, utensils, and food surfaces often
Keep raw foods separate from ready-to-eat foods
Cook foods at a safe temperature
Refrigerate or freeze perishable foods promptly
Defrost safely
Throw it out when in doubt

Older adults should avoid the following because they have weakened immune systems:

Raw or rare meat and poultry
Raw or undercooked fish or shellfish
Raw or undercooked eggs
Raw sprouts
Unpasteurized juices and ciders
Soft cheeses, blue-veined cheese, and unpasteurized cheese
Refrigerated pates and meat spreads
Uncooked hot dogs, luncheon meats, and deli meats

Nursing home residents rely completely on nursing home staff to provide safe and nutritious food. When nursing homes fail to take adequate precautions, serious consequences, such as food poisoning, can occur.

If your loved one suffered an injury or death related to food poisoning at a nursing home, hospital or assisted living facility, learn your legal rights today. Our team of injury lawyers remain committed to maximizing all aspects of recovery. (888) 424-5757 Anytime. Anywhere.

Resources:

The University of Chicago Medical Center: Food Poisoning

Marler Blog

Mayo Clinic: Food Poisoning

CDC: Foodborne Illness

New York Times Health Guide: Food Poisoning

"Home Care Nursing" Doesn't Mean "No Care Nursing"

Jonathan Rosenfeld — Mon, 18 Jan 2010 05:32:02 -0600

As the number of older adults increases, families are faced with the question of where their parents and grandparents will receive the best care.

The answer for many families is to keep their family members at home. Many older adults who live at home require home health services, home nursing services, and in-home support services in order to maintain a high quality of life.

Although home care nursing affords seniors more flexibility, the lack of a structured setting makes them particularly susceptible to elder abuse, neglect, and financial exploitation-- especially at the hands of unqualified or dangerous in-home caregivers.

About 7.5 million individuals receive long-term care at home because of an acute illness, long-term health condition, permanent disability, or terminal illness according to the American Association for Long-Term Care Insurance. This is significantly more than the 1.5 million individuals in nursing homes and 1.1 million individuals in assisted living facilities who receive similar care for the same types of conditions.

In order to protect individuals who receive health services at home, some states such Illinois, have passed laws to protect seniors who receive care in their homes. Illinois' Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55) ensures that people who receive home health services, home nursing services and in-home support services at their residence are granted consumer protection and quality care. The Act establishes and enforces standards for services and care.

In addition, all home nursing agencies must be licensed by the Illinois Department of Public Health as one or more of the following entities: home health, home nursing, and home services agencies. One requirement for licensure is compliance with the requirements of the Health Care Worker Background Check Act (225 ILCS 46), which helps protect frail and disabled citizens through a criminal background check of health care workers. A licensee of an agency that violates of the Home Health Licensing Act may be subject to penalties or fines of $100 per day starting on the date of the violation and ending on the date the violation is corrected.

No doubt about it, legislation applicable to home nursing certainly provides a foundation for patient safety. Nonetheless, as the demand for home nursing continues to grow, many companies that provide home nursing care will cut corners with respect to screening and training their workers in order to satisfy the demand.

If your loved one has suffered an injury or abuse at the hands of a home care worker, you should immediately report the situation to law enforcement. Many of these tragic situations give rise to civil lawsuits against these home care agencies. As always, you can talk candidly with our lawyers about your legal options for free. Only if we are successful recovering money on your behalf, will we accept a fee. (888) 424-5757

Sources:

Illinois General Assembly: 210 ILCS 55 Home Health, Home Services, and Home Nursing Agency Licensing Act

Illinois General Assembly: Administrative Code, Part 245 Home Health, Home Services and Home Nursing Agency Code

Illinois General Assembly: 210 ILCS 46 Health Care Worker Background Check Act

Medical News Today: New Study Reports Three Times More People Receiving Health Care Support at Home Rather Than in Nursing Homes or Assisted-Living Facilities