Section 690.10  Delegation of Authority

 

The Director of Labor or the Director's designated representative shall have the power and authority to enforce and administer the Illinois Nurse Agency Licensing Act.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.20  Definitions

 

In addition to those definitions found in Section 3 of the Act, the following definitions shall apply for the purposes of this Part:

 

"Act" means the Nurse Agency Licensing Act [225 ILCS 510].

 

"Applicant" means any nurse or certified nurse aide who interviews for employment, assignment, or referral to an Illinois health care facility by a nurse agency.

 

"Certified nurse aide" means an individual certified as defined in Section 3-206 of the Nursing Home Care Act [210 ILCS 45], Section 3-206 of the ID/DD Community Care Act [210 ILCS 47], or Section 3-206 of the MC/DD Act [210 ILCS 46].

 

"Covenant not to compete" means an agreement between a nurse agency and an employee that restricts the employee from performing the following:

 

any work for another employer for a specified period of time;

 

any work in a specified geographic area; or

 

any work for another employer that is similar to the work the employee performs for the employer that is a party to the agreement. 

 

"Department" means the Illinois Department of Labor.

 

"Director" means the Director of the Illinois Department of Labor or the Director's designated representative.

 

"Employee" means a nurse or certified nurse aide.

 

"Health care facility" is defined as in Section 3 of the Illinois Health Facilities Planning Act [20 ILCS 3960]. "Health care facility" also includes any facility licensed, certified, or approved by any State agency and subject to regulation under the Assisted Living and Shared Housing Act [210 ILCS 9] or the Illinois Public Aid Code [305 ILCS 5].

 

"Long-term basis" means the placement of a nurse or a certified nurse aide at a health care facility for an initial employment, assignment, or referral term of more than 24 continuous months by a nurse agency that incurs significant financial investment, to place the nurse or certified nurse aide at the health care facility, including one or more of the following expenses:

 

educational material expenses, if required;

 

expenses for credentialing, licensure, or certification; or

 

expenses for airline travel, lodging, meals, and ground transportation provided to a nurse or certified nurse aide.

 

"Long-term basis" does not include the placement of a nurse or a certified nurse aide at a health care facility for an initial employment, assignment, or referral term of an undefined duration.

 

"Manage" means to be in charge of the day-to-day operations of the nurse agency.

 

"Material amendment" means an amendment to any provision of a contract that is regulated or addressed by the Act or this Part, but does not include day-to-day changes in wage rates or bill rates relating to such changes.

 

"Nurse" means a registered nurse, a licensed practical nurse, an advanced practice registered nurse, or any individual licensed under the Nurse Practice Act [225 ILCS 65] and performing work pursuant to the Nurse Practice Act.

 

"Nurse agency" or "nurse staffing agency" means any individual, firm, corporation, partnership, other legal entity, or nurse registry, that employs, assigns, or refers nurses or certified nurse aides to a health care facility for a fee; or an entity that provides nurse or certified nurse aide staffing services.  The presence or absence of any single activity by an entity is not dispositive in the Department's analysis of whether the entity is a nurse agency under the Act and this Part. The term "nurse agency" does not include services provided by:

 

home health agencies licensed and operated under the Home Health, Home Services, and Home Nursing Agency Licensing Act [210 ILCS 55];

 

licensed or certified individuals who provide their own services as an employee of a health care facility;

 

a health care facility's coordination of non-salaried employees only in that health care facility; or

 

an entity or corporation that provides ancillary administrative support services for nurse agencies or nurse staffing agencies, such as payroll processing or contract negotiation, but which does not employ, assign, or refer nurses or certified nurse aides.

 

"Shift" means a period of consecutive hours during which a nurse or certified nurse aide performs work at a health care facility.

 

"Supervising nurse" means a registered nurse who is responsible for overseeing the assignment of nurses and certified nurse aides to a health care facility.

 

"Temporary basis" means an initial employment, assignment, or referral term of an undefined duration or a duration of 24 continuous months or less, exclusive of any extension.

 

"Transfer of ownership" means a sale or transfer of a majority interest in the ownership of a nurse agency.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.25  Illustrative Examples

 

The following examples provide guidance on whether an entity is acting as a nurse agency and is subject to the provisions of the Act and this Part. The examples are intended to illustrate some possible facts that the Department would consider relevant to this analysis and do not encompass all possible relevant facts or factual scenarios.

 

a)         Example A:  A hospital contracts with Intermediary A for certain services. Per its contractual obligations, the hospital identifies its labor needs to Intermediary A. Intermediary A then engages several staffing agencies, including Staffing Agency, to source a pool of potential candidates for the hospital. Having received a pool of candidates from Staffing Agency, Intermediary A collects proof of the potential workers' credentials and background checks, consults with the hospital, and then provides the names of the selected workers to Staffing Agency for assignment to the hospital. Once workers are placed, Intermediary A tracks their hours worked. Then, Intermediary A bills the hospital according to their contractual agreement, and pays Staffing Agency according to their independent contractual agreement. Staffing Agency pays the workers for work performed at the hospital. Because Staffing Agency employs the nurses and participates in supplying them to Intermediary A's client (the hospital), the Staffing Agency and its contract with Intermediary A are subject to the Act and this Part. Intermediary A would not be subject to the Act.

 

b)         Example B:  Nurse Agency provides staffing services to several skilled care facilities. Nurse Agency identifies and recruits prospective nurses to provide to its skilled care facility clients, collects the prospective nurses' credentials, and conducts background checks. The skilled care facilities provide payment to Nurse Agency for nurses selected and placed at their facility. Nurse Agency separately contracts with Company B to provide Nurse Agency with payroll services. Company B tracks hours worked for the nurses placed by Nurse Agency and processes payments to the nurses on behalf of Nurse Agency.  Because Nurse Agency identifies and places temporary nursing labor to the skilled care facilities, Nurse Agency is covered by the Act and its contracts with the skilled care facilities are subject to the Act and this Part. Because Company B provides only payroll services and is not involved in the identification, assignment, or referral of nurses, Company B is not considered a nurse agency and its contract with Nurse Agency is not subject to the Act or this Part.

 

c)         Example C:  Nurse Agency B coordinates staffing for large long-term care facilities and is the exclusive provider to those facilities. Nurse Agency B recruits and identifies qualified certified nurse aides and employs them directly at these facilities. Nurse Agency B also contracts with Nurse Agencies C and D to identify nurse aides employed by Nurse Agencies C and D to provide supplemental nurse staffing to the facilities when necessary. The long-term care facilities provide payment to Nurse Agency B for all nurse aides referred through their agency. Nurse Agency B separately compensates Nurse Agencies C and D for those nurse aides that these agencies have identified and referred to Nurse Agency B for placement at the long-term care facilities. Because Nurse Agencies B, C, and D employ, assign, or refer temporary nursing labor at these long-term care facilities, they are subject to the Act.  However, Nurse Agency B is only a nurse agency subject to the Act with regard to its employment, assignment, and referral of its own employees.  It is not a Nurse Agency with regard to the certified nurse aides employed by Nurse Agencies C and D. As such, the contracts between the facilities and Nurse Agency B are subject to the reporting requirements of the Act and this Part, as are the contracts for the provision of supplemental staffing services between Nurse Agencies B and C, and between Nurse Agencies B and D.

 

d)         Example D:  Hospital E has a human resources department that recruits, interviews, and hires eligible health care workers, including nurses and certified nurse aides, to work as employees of Hospital E. Hospital E also contracts with a consultant who identifies and recruits nurses and certified nurse aides to become direct hire employees of Hospital E. These nurses and certified nurse aides are managed by fellow employees of Hospital E and are paid by Hospital E. Although Hospital E employs nurses and certified nurse aides, and its HR department verifies their credentials, and assigns them to certain departments within Hospital E, it is not acting as a nurse agency because it is not assigning them to work at a third-party health care facility for a fee. The contracted consultant, although it is earning a fee for recruitment, is not employing, assigning, or referring the nurses and certified nurse aides.

 

(Source:  Added at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.30  Licensure

 

a)         Regardless of whether its office is located within or outside Illinois, a nurse agency seeking to assign or refer nurses or certified nurse aides to health care facilities in Illinois shall not be established, operated, maintained, or advertised in the State of Illinois until such agency has been issued a license by the Department.

 

b)         A separate license must be issued for each location from which a nurse agency will be operated unless the nurse agency is owned and managed by the same individual, firm, corporation, partnership, or other legal entity. [225 ILCS 510/5]

 

c)         An agency that is licensed as a home health care agency must also be licensed as a nurse agency if it is referring or assigning nurses or certified nurse aides to health care facilities unless the referral or assignment is as a private duty nurse or certified nurse aide for the benefit of a particular individual with payment for the services made by, or on behalf of, that individual.

 

d)         An agency that is licensed as a private employment agency under the Private Employment Agency Act [225 ILCS 515] must also be licensed as a nurse agency if it refers nurses or certified nurse aides to health care facilities unless that referral is only for purposes of full-time employment by the health care facility.

 

e)         An agency that is registered under the Day and Temporary Labor Services Act must also be licensed as a nurse agency if the agency is in the business of assigning, referring, or employing nurses or certified nurse aides to health care facilities. 

 

f)         Application fees are non-refundable.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.40  Contents of Licensure Application

 

An application to operate a nurse agency shall be made on a form provided by the Department.  Upon receipt of an application, the Department may request additional information as necessary to determine whether to issue the license. The application shall contain but is not limited to the following:

 

a)         Business leadership

 

1)         The name, address, federal employer identification number, telephone number, and email address of the person seeking the license, including the trade or assumed name under which the person does business. If doing business under a trade or assumed name, the applicant shall include proof of compliance with the Assumed Business Name Act [805 ILCS 405].

 

2)         The name, address, federal employer identification number, telephone number, and email address of the registered agent for the place of business, including the position held by that person or entity with the person. Applications for registration renewal shall contain the name, address, federal employer identification number, email address, and telephone number of any new registered agent for the place of business, including the position held by that person or entity with the nurse agency;

 

b)         Business structure

 

1)         If the person seeking a license is a corporation or limited liability company: a copy of its articles of incorporation or organization, a copy of its current bylaws and the names and addresses of its officers and directors and the names and addresses of shareholders owning more than 5% of the corporation's stock or membership units shall be provided for an initial license.  Applications for license renewal shall contain any amendments to the articles of incorporation and bylaws.

 

2)         If the person seeking a license is a partnership: the names, business or personal addresses, and telephone numbers of all partners. Applications for registration renewal shall contain the names, business or personal addresses, and telephone numbers of all new partners.

 

3)         If the person seeking a license is a limited liability company: a copy of the articles of organization, the operating agreement, and the names and addresses of all organizers and members owning more than 5% of the membership;

 

c)         The names and addresses of all premises from which the nurse agency will provide services, including information on whether the location is a residential address;

 

d)         The name and address of the person under whose management or supervision the nurse agency will be operated;

 

e)         Description of business activity;

 

f)         A statement of whether the owner or operator has ever been convicted of a felony;

 

g)         The name of the supervising nurse or supervising nurses, if not the same person identified under (d), who is responsible for management or supervision of the nurse agency;

 

h)         A statement of financial solvency declaring:

 

1)         That the nurse agency or its owners have not been adjudged insolvent or bankrupt in a State or federal court;

 

2)         That a court proceeding to make a judgment of bankruptcy or insolvency with respect to the nurse agency or its owners is not pending in a State or federal court; and

 

3)         That the nurse agency agrees to inform the Director before any court proceeding that could make a judgment of insolvency or bankruptcy with respect to the nurse agency or its owners;

 

i)          A statement detailing the experience and qualifications of the owner or operator to operate a nurse agency;

 

j)          An attestation that the nurse agency is in compliance with State and federal laws relating to employee compensation, including but not limited to social security taxes, State and federal income taxes, workers' compensation, unemployment taxes, and State and federal overtime compensation laws;

 

k)         A certificate of insurance showing the nurse agency has professional liability insurance in the amounts of at least $1,000,000 per incident and $3,000,000 in aggregate;

 

l)          A certificate of insurance showing the nurse agency has workers' compensation insurance coverage for all nurses and certified nurse aides employed, assigned, or referred by the nurse agency to a health care facility;

 

m)        Copies of all currently effective contracts with health care facilities employing, assigning, or referring nurses or certified nurse aides to those health care facilities, including any effective material amendments or modifications, all of which are exempt from disclosure under Section 7.5(fff) of the Freedom of Information Act [5 ILCS 140]; [225 ILCS 510/5]

 

n)         Payment of an application fee made using the State Treasurer's E-Pay program or any successor program; and

 

o)         For a licensed nurse agency seeking a license renewal, a completed Shift Fulfillment Attestation Form detailing the total number of shifts contracted for, missed, and fulfilled in the 3 quarters preceding the application date in a format prescribed by the Department. [225 ILCS 510/7] This form can be found at https://labor.illinois.gov/laws-rules/fls/nurse-agency-licensing-act.html.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.50  Fee Schedule

 

a)         The application must be accompanied by a $1,000 fee and a $250 fee for each branch office or other location in Illinois from which the nurse agency operates.

 

b)         The fee shall be paid using the State Treasurer's E-Pay program or any successor program.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.55  Reporting Requirements

 

a)         Contracts. A nurse agency must comply with the following contract maintenance and reporting requirements:

 

1)         A nurse agency shall submit to the Department all contracts for the employment, assignment, or referral of nurses or certified nurse aides within seven calendar days of the effective date of the contract. This requirement includes contracts executed or materially amended or modified on or after July 1, 2022 that govern the procurement of staffing services for health care facilities. Contracts must be submitted electronically in PDF format through the Department's online portal provided on the Nurse Agency Licensing Act webpage:  https://labor.illinois.gov/laws-rules/fls/nurse-agency-licensing-act.html.

 

2)         All contracts must conspicuously identify the name of the nurse agency and the name of the health care facility to which nurses or certified nurse aides are employed, assigned, or referred pursuant to the contract. The contract must include the effective date and termination date of the contract; if the contract has no termination date, it must include a clear statement of the time period covered by the contract term, including any auto-renewal date, which shall be considered an effective date.  Contracts with auto-renewal provisions are deemed to begin a new contract term on the date of renewal.

 

3)         A nurse agency must maintain all contracts under this Section in accordance with the maintenance period requirements of Section 690.150(c).

 

b)         Invoices. All original invoices must be maintained by the nurse agency in accordance with the maintenance period requirements of Section 690.150(c), and copies of such invoices must be submitted to the Department upon request.

 

c)         Quarterly Labor Cost Report. Each nurse agency must report the following data on a quarterly basis, in the following manner.

 

1)         Reporting Schedule.

 

A)        Beginning on the effective date of this rulemaking, a nurse agency in operation on or before the effective date of this rulemaking must submit a quarterly report to the Department that covers all dates on which the nurse agency was in operation since the effective date of Public Act 102-946, July 1, 2022.

 

B)        A nurse agency that begins operations after the effective date of this rulemaking must submit its first quarterly report by the due date immediately following its first full quarter in operation; such report shall encompass data going back to the nurse agency's first day in operation. For example, a nurse agency that opens for business on February 20 shall report to the Department for the first time on June 15, with data covering February 20 through May 31.

 

C)        After a nurse agency submits its initial report, the nurse agency shall follow the below quarterly reporting schedule. If the due date falls on a weekend or holiday on which the offices of the Department are closed, the report shall be due on the next working day:

 

Reporting Period	Due Date
March 1-May 31	July 15
June 1-August 31	October 15
September 1-November 30	January 15
December 1-February 28	April 15

 

2)         Labor cost reports must be submitted electronically through the Department's online portal provided on the Nurse Agency Licensing Act webpage:  https://labor.illinois.gov/laws-rules/fls/nurse-agency-licensing-act.html. Reports must be submitted in .csv file format and organized according to the template provided by the Department on the portal.

 

3)         A nurse agency must submit a separate labor cost report for each health care facility with which the nurse agency has a current contract. Each report must identify the type of health care facility and must contain the following data regarding employees that have been assigned or referred to that health care facility, separated by employee category (i.e., registered nurse, licensed practical nurse, advanced practice registered nurse, and certified nurse aide):

 

A)        Amounts Charged to Facility:  the average amount charged to the health care facility for each individual employee category.

 

B)        Wages Paid to Employees:  the average base hourly rate paid by the nurse agency to employees in each individual employee category.

 

C)        Other Payments to Employees:  the average amount paid by the nurse agency to employees in each individual employee category exclusive of the base hourly rate, such as per diems, overtime compensation, expense reimbursements, mileage, lodging, bonuses, and wage differentials.

 

D)        Labor-Related Costs:  the average amount of labor-related costs paid by the nurse agency for each employee category, including payroll taxes, workers' compensation insurance, professional liability coverage, credentialing, and testing. [225 ILCS 510/14(h)]

 

d)         The fact that any agency contracts a third party to maintain any of these records does not alter the agency's reporting obligations under this Act.

 

(Source:  Added at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.60  Expiration and Renewal

 

a)         Each license shall be for a term of one year and shall expire one year from the date of issuance unless the Department revokes or suspends the license sooner or the nurse agency changes ownership.  A period of suspension does not extend the license for any period of time.

 

b)         A nurse agency must apply for renewal at least 90 days prior to the expiration of the nurse agency's current license.  [225 ILCS 510/7]

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.70  Standards For Nurse Agency Operation

 

a)         Each nurse agency shall have at least one supervising nurse serving as manager or supervisor of all nurses and certified nurse aides at all times for the duration of its licensure.  [225 ILCS 510/14(b)]

 

b)         Each nurse agency shall develop and maintain written personnel policies and procedures with regard to its nurses and certified nurse aides.  These policies and procedures must be available for Department inspection upon request in each location from which a nurse agency operates, and must be submitted to the Department upon request.  These policies and procedures must include the following:

 

1)         An in-person or videoconference interview of selected nurses or certified nurse aides, performed or supervised by a nurse or other supervisor;

 

2)         Reference checks of selected nurses or certified nurse aides:

 

A)        Every nurse agency shall check at least two recent references and dates of employment listed on the application unless the nurse or certified nurse aide has not had two previous employers;

 

B)        Reference checks may be in writing, in person or by telephone. The nurse agency shall keep a written record of these reference checks in the personnel file for a period of two years;

 

3)         A nurse agency shall verify with the Department of Public Health or the Department of Financial and Professional Regulation (IDFPR), which may include using an IDFPR-approved third party verification resource, that selected nurses or certified nurse aides is certified or licensed in the State of Illinois as attested to on the employment application;

 

4)         An annual health examination to determine whether the nurse or certified nurse aide is free of communicable, contagious, or infectious diseases;

 

5)         An annual performance evaluation of each nurse or certified nurse aide; such evaluation must be maintained in the nurse's or certified nurse aide's personnel file for a period of three years;

 

6)         Required current CPR certification and vaccination records; and

 

7)         Orientation procedures.

 

c)         Background Checks

Prior to employing, assigning, or referring a certified nurse aide to a position at a health care employer or long-term care facility as defined in the Health Care Worker Background Check Act [225 ILCS 46], the nurse agency shall review the information provided on the Health Care Worker Registry to verify that the certified nurse aide is not ineligible for the position pursuant to Section 25 of the Health Care Worker Background Check Act. Records of such verification must be made available to the Department for inspection upon request.

 

d)         Covenants Not to Compete

 

1)         Temporary placements

 

A)        Nurse agencies shall not enter into covenants not to compete with nurses or certified nurse aides if the nurse agency is employing, assigning, or referring the employee to a health care facility on a temporary basis.

 

B)        If a nurse or certified nurse aide and a nurse agency entered into a covenant not to compete on or after July 1, 2022, then the covenant is illegal and void if the nurse or certified nurse aide is employed, assigned, referred by a nurse agency to a health care facility on a temporary basis.  [225 ILCS 510/14(g)]

 

2)         Long-term placements

 

A)        Nurse agencies may enter into covenants not to compete with nurses or certified nurse aides if the nurse agency is employing, assigning, or referring the employee to a health care facility on a long-term basis.  

 

B)        If a nurse or certified nurse aide and a nurse agency, on a long-term basis, entered into a covenant not to compete on or before December 31, 2027 and the covenant expires on or after January 1, 2028, the covenant shall remain in effect until its expiration date if the term of the covenant runs concurrently with the employment contract.  [225 ILCS 510/14(g-5)]

 

e)         Minimum Personnel Policy Training

Nurse agencies shall disclose to all employees, upon hire and prior to the effective date of any policy changes, information on the nurse agency's personnel policies and the requirements of the Act and this Part, including but not limited to the statutory restrictions on covenants not to compete and conversion fees, continuing education opportunities, and the responsibility to maintain an active health care license. Nurse agencies shall maintain records of such disclosures to each employee for the duration of that employee's employment and for at least three years after the employment ends.

 

f)         Responsibility for Compliance with Employment Requirements

For the purposes of the Act and this Part, nurses or certified nurse aides employed, assigned, or referred to a health care facility by a nurse agency shall be deemed to be employees of the nurse agency while working for the nurse agency or on nurse agency employment, assignment or referral.

 

g)         Termination Only For Cause

Nurses or certified nurse aides employed, assigned, or referred to a health care facility by a nurse agency may only be terminated by the nurse agency for cause. [225 ILCS 510.13]

 

h)         Responsibility for Compliance

A nurse agency must ensure each nurse or certified nurse aide the nurse agency employs, assigns, or refers meets all the requirements of the Act and this Part.

 

i)          Dispatch Notice

 

1)         A nurse agency shall provide at the time of dispatch, to each nurse or certified nurse aide who is sent to work for a health care facility, a written notice that contains the following information:

 

A)        the name of the nurse or certified nurse aide;

 

B)        the name, address, and telephone number of the health care facility that the nurse or certified nurse aide is being dispatched to;

 

C)        the name and title of the health care facility employee to whom the nurse or certified nurse aide is expected to report;

 

D)        the rate of pay offered; and

 

E)        the hours that the nurse or certified nurse aide is expected to work.

 

2)         If a nurse or certified nurse aide is assigned to the same assignment for more than one day, the nurse agency is only required to provide the dispatch notice on the first day of the assignment and on any day that any of the terms listed on the dispatch notice are changed.

 

3)         An agency that is required to register under both the Illinois Day and Temporary Labor Services Act and the Nurse Agency Licensing Act, and provides a dispatch notice under the Illinois Day and Temporary Labor Services Act, is not required to provide a separate dispatch notice under this Section. 

 

j)          Wage Payment Notice

 

1)         At the time of payment of wages, a nurse agency shall provide the following information on the nurse or certified nurse aide's paycheck or pay stub, or on a form approved by the Department:

 

A)        the number of hours worked by the nurse or certified nurse aide at each health care facility each day during the pay period;

 

B)        the rate of payment for each hour worked, including any premium rate or bonus; and

 

C)        the total pay period earnings.

 

2)         An agency that is required to register under both the Illinois Day and Temporary Labor Services Act and the Nurse Agency Licensing Act, and provides a wage payment notice under the Illinois Day and Temporary Labor Services Act, is not required to provide a separate wage payment notice under this Section. 

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.80  Application for Employment, Assignment, or Referral

 

A nurse agency shall require each nurse or certified nurse aide applying for employment to complete an application.  Each application shall contain, but is not limited to, the following:

 

a)         Name and address of the nurse or certified nurse aide with verification of the nurse's or certified nurse aide's identity by means of a valid driver's license, state identification card, passport, or other appropriate government-issued photo identification;

 

b)         For nurses, written attestation that the nurse holds a license issued by the Illinois Department of Financial and Professional Regulation, including an attestation of the license held by the nurse and the nurse's licensure status;

 

c)         For certified nurse aides, written attestation that the certified nurse aide is certified by the Illinois Department of Public Health and that the certified nurse aide has been registered as having completed a course that has been certified by that agency;

 

d)         Dates employed, employer name, and contact information for the nurse's or certified nurse aide's most recent previous employment references, if applicable;

 

e)         An attestation completed within the last 24 months, stating that the nurse or certified nurse aide:

 

has completed a CPR training course provided by the American Red Cross or its equivalent.  The nurse's or certified nurse aide's date of CPR certification and the date of the certificate's expiration shall be indicated in writing on the application form, and the nurse or certified nurse aide shall maintain a copy of their current CPR certificate; and

 

f)         An attestation, completed within the last 12 months, stating that the nurse or certified nurse aide has completed a skill inventory and listed clinical areas of competence.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.90  Prerequisites for Employment, Assignment, or Referral

 

a)         Prior to employment, assignment, or referral of a nurse or certified nurse aide, a nurse agency shall verify:

 

1)         for a nurse, with the Illinois Department of Financial and Professional Regulation, which may include using an IDFPR-approved third party verification resource, that the nurse is licensed in the State of Illinois; and

 

2)         for a certified nurse aide, with the Illinois Department of Public Health that the certified nurse aide has completed all certification requirements and has been certified by the State of Illinois. (77 Ill. Adm. Code 395)

 

b)         No nurse agency shall employ, assign, or refer any nurse or certified nurse aide until the nurse agency has checked the nurse's or certified nurse aide's references.

 

c)         No nurse agency shall assign or refer a nurse or certified nurse aide to a health care facility unless the health care facility has disclosed the clinical area of skills required for job assignment.

 

d)         No nurse agency shall assign or refer a nurse or certified nurse aide who has not satisfied the application requirements in Section 690.80 or who is ineligible for the position as provided for in Section 690.70(d).

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.100  Continuing Verifications

 

a)         The nurse agency shall review the disciplinary report published by the Illinois Department of Financial and Professional Regulation on a monthly basis to determine whether any nurse it employs, assigns or refers has had their license suspended or revoked.

 

b)         When a nurse is found to be on the disciplinary report, the nurse agency shall determine if the nurse's practice has been limited or conditioned.  It shall be the responsibility of the nurse agency to advise the health care facility in writing of the limitation or condition.

 

c)         The nurse agency shall review the Healthcare Worker Registry maintained by the Illinois Department of Public Health on a monthly basis to determine whether any certified nurse aide employed by the nurse agency is no longer eligible for employment.

 

d)         Prior to referral, the nurse agency shall verify, in writing, that a nurse continues to hold a valid, unencumbered license issued by the Illinois Department of Financial and Professional Regulation.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.110  Evaluation Forms

 

Nurse agencies must conduct an annual evaluation of each employee, which may be based in part upon information provided by health care facilities utilizing nurse agency personnel. [225 ILCS 510/14(a)(3)] Evaluations must be maintained for at least three years and provided to the Department upon request.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.120  Prohibition on Recruitment as a Condition of Employment

 

a)         No nurse agency shall require, as a condition of employment, assignment or referral, that any nurse or certified nurse aide recruit nurses or certified nurse aides for the nurse agency from among the permanent employees of the health care facility to which the nurse agency's nurses or certified nurse aides have been assigned or referred.

 

b)         Health care facilities are prohibited from requiring, as a condition of employment, that their employees recruit new employees from these nurse agency employees. [225 ILCS 510/40(f)]

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.130  Reporting Changes in Management and Stockholders

 

a)         Each nurse agency shall report in writing to the Department within 30 calendar days any changes in personnel who manage or supervise nurses or certified nurse aides. At no time shall a nurse agency be without at least one supervising nurse serving as manager or supervisor of all nurses and certified nurse aides.

 

b)         Each nurse agency that is a corporation or limited liability company shall report to the Department in writing within 30 calendar days any changes in the list of stockholders who own more than 5% of its stock or membership units.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.140  Transfer of Ownership

 

a)         Each nurse agency whose ownership is to be transferred shall report in writing to the Department the name of the transferee and the anticipated date of the transfer.

 

b)         The anticipated transferee shall apply for a license at least 45 calendar days before the anticipated date of the transfer.

 

c)         The Department may issue a license to a transferee to become effective on the date of the transfer, and the transferor's license will become void on the date the transferee's license becomes effective.  The transferor shall notify the Department in writing the day the transfer is effected.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.150  Inspections and Records

 

a)         The Director shall have the right to survey and inspect the facilities and records of any nurse agency as may be necessary in order to determine the status of the nurse agency's compliance with the Act and this Part.

 

b)         All records relating to a nurse's or certified nurse aide's employment, including all personnel records and records of assignment and referral, including required notices to nurses and certified nurse aides, shall be kept on the premises of the nurse agency and shall be open to inspection during regular business hours by the Department.

 

c)         A nurse agency must comply with the following record maintenance requirements:

 

1)         All contracts entered into or materially amended or modified on or after July 1, 2022 must be maintained for a minimum of three years after their expiration.

 

2)         Original invoices must be maintained for a minimum of three years.

 

3)         Nurse and certified nurse aide personnel records and evaluations must be maintained for a minimum of three years.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.160  Complaints and Investigations

 

a)         The Department shall accept complaints from any interested person regarding alleged violations of the Act or this Part by a nurse agency.  Complaints may be filed by any interested person on a form provided by the Department at https://labor.illinois.gov/laws-rules/fls/nurse-agency-licensing-act.html.  The Department shall review all complaints and determine whether a reasonable basis exists to initiate an investigation.  The Department may initiate an investigation, with or without having received a complaint, if the Director reasonably believes that a nurse agency may be in violation of the Act.

 

b)         The Department shall notify the applicant or licensee in writing of the investigation and may require that the nurse agency provide information in response to the Department's inquiry. Upon receipt of a notice of investigation, the nurse agency shall respond to the Department and provide comments, relevant information, or other evidence to support the nurse agency's response to the claim. The Department may issue subpoenas in the course of an investigation as provided for in Section 690.220.

 

c)         The Department will review the information provided by the parties to determine if a violation of the Act or this Part occurred.  If the Department determines that a violation has occurred, then the Department may suspend or revoke a license under Sections 690.180 and issue a fine under Section 690.210.

 

d)         The Department may dismiss for lack of cause or assess penalties in accordance with Section 690.210.

 

e)         The names of persons who file complaints under this Section are considered confidential and are exempt from disclosure under section 7(1)(b) of the Freedom of Information Act [5 ILCS 140].

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.170  Denial of Initial License or License Renewal

 

A license application may be denied for any of, but not limited to, the following reasons:

 

a)         failure to comply with the minimum standards set forth by the Act or Section 690.70;

 

b)         a felony conviction of the owner or operator of the nurse agency;

 

c)         failure to provide an accurate statement of financial solvency (see Section 690.40(g));

 

d)         failure to establish personnel policies and procedures as required by the Act and this Part;

 

e)         failure to complete the application in full;

 

f)         submission of false or misleading information to the Department;

 

g)         for any violations of provisions of the Act or of this Part, if the applicant has previously held a license under this Act; or

 

h)         for refusal to comply with enforcement provisions of the Act or this Part, such as refusal to pay a fine, if the applicant has previously held a license under this Act.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.180  Suspension or Revocation of License

 

a)         A license shall be suspended or revoked for any of the following reasons:

 

1)         for any of the reasons for which a license may be denied as listed in Section 690.170;

 

2)         for violations of provisions of the Act or of this Part;

 

3)         for willful non-payment of a fine; or

 

4)         for any conduct or practice found, after an administrative hearing to be detrimental to the public's right to high quality health care.

 

b)         The Department may not suspend or revoke a license without appropriate notice and hearing pursuant to Section 690.190 and 56 Ill. Adm. Code 120. [225 ILCS 510/9]

 

c)         When determining whether to suspend or revoke a nurse agency's license, the Director shall consider the factors found in Section 690.200.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.190  Hearings

 

a)         Before denying any application or refusing to renew a license, revoking or suspending a license, or imposing a fine, the Department shall notify the applicant or licensee in writing by certified mail, or by email to an email address previously designated by the party for the purpose of receiving communications under the Act, setting forth the particular reason for the proposed action and fixing a date at which time the applicant or licensee shall be given an opportunity for a hearing.

 

b)         Hearings conducted under this Part are formal in nature and subject to the Departmental hearing rules at 56 Ill. Adm. Code 120.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.200  Considerations in Reaching a Decision

 

In determining whether to revoke, suspend, deny an application for, or refuse to renew a license subsequent to a violation, the Director shall consider:

 

a)         Whether the violation constitutes a technical error;

 

b)         The seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation, including probability that death or serious physical or mental harm to any person will result or has resulted, the severity of the actual or potential harm, and the extent to which the provisions of the applicable statutes or regulations were violated;

 

c)         Whether the violation could pose any direct or potential harm to a patient in a health care facility or to an employee of the nurse agency;

 

d)         Whether the nurse agency has taken steps to correct the noted violation;

 

e)         Whether the same violation or similar violations relating to the same conditions or occurrences have been documented and the nurse agency has allowed the condition or occurrence to continue or to recur;

 

f)         The economic harm to the employee caused by the violation;

 

g)         The history of previous violations;

 

h)         The action necessary to deter a future violation; and

 

i)          Any other matter that justice may require.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.210  Fines

 

a)         The Director shall impose a fine of $500 for submission of false, misleading information.

 

b)         The Director shall impose a fine of $10,000 for violation of any other provision of the Act or this Part.

 

c)         A fine may be imposed in addition to a suspension, a revocation, or refusal to renew a license.

 

d)         Fines imposed under the Act or this Part shall be paid via the State Treasurer's E-Pay program or any successor program and shall be payable to the Department for the purposes of enforcing the Act.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.220  Subpoena

 

The Director shall, upon the Director's own motion or on the written request of any party to a proceeding, issue subpoenas requiring the attendance of and the giving of testimony by witnesses and subpoenas duces tecum requiring the production of books, papers, records, or memoranda.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.230  Determination

 

Any determination based on investigation by the Illinois Department of Labor shall be considered a contested case subject to the Illinois Administrative Procedure Act [5 ILCS 100] and the final decision shall be in writing.

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)

 

Section 690.240  Administrative Review

 

A final decision under Section 690.230 may be reviewed under the Administrative Review Law [735 ILCS 5/Art.III].

 

(Source:  Amended at 49 Ill. Reg. 6180, effective April 25, 2025)