The Illinois General Assembly recently enacted HB 3392, which amends several provisions of the Illinois Assisted Living and Shared Housing Act (“Act”). The legislation imposes new assessment requirements, modifies qualifications for assisted living directors, updates medication administration provisions, revises dementia care requirements and strengthens enforcement authority for repeated compliance deficiencies. The law took effect immediately upon becoming law on July 24, 2026. HB 3392 continues Illinois’ recent efforts to modernize the Act, following 2025 reforms addressing resident rights, dementia care and reporting obligations, as well as 2026 legislation expanding the role of physician assistants and advanced practice registered nurses (“APRNs”) in resident assessments and dementia care oversight.
New Admission Assessment Requirements
HB 3392 eases pre-admission screening requirements, adding physician assistants and APRNs with experience in geriatric dementia care to complete the required pre-admission assessments for individuals seeking admission to assisted living and shared housing establishments. Existing law also requires annual reassessments and reassessments whenever there is a significant change in a resident’s condition, including a diagnosis of Alzheimer’s disease or a related dementia. Physician assistants and APRNs are also now permitted to perform these ongoing assessments. Previously, these pre-admission and ongoing assessments could only be completed by the resident’s physician.
Changes to Director Qualifications
The law expands the qualifications for assisted living directors. In addition to existing experience-based paths, a facility may now satisfy the licensure requirement if its full-time director holds a college degree in health administration or completes an approved program within six months of hire. The legislation also continues to require directors to participate in at least 20 hours of training every two years.
Medication Administration Clarifications
HB 3392 updates the Act’s medication administration provisions. The amendments recognize licensed health care professionals employed by an establishment as being authorized to administer certain medications, including insulin, vitamin B12 injections, oral medications, topical treatments, eye and ear drops, nitroglycerin patches and intramuscular injections.
Enhanced Dementia Care Requirements
HB 3392 makes significant revisions to dementia care programs. The Illinois Department of Public Health is directed to identify a validated dementia-specific assessment standard with inter-rater reliability for evaluating residents. Dementia assessments must be approved by a physician, a physician assistant with experience in geriatric dementia care or an APRN with experience in geriatric dementia care. The assessments must occur before admission, annually and whenever a change in condition is identified by specified individuals. Annual assessments and assessments completed due to a change in condition must be signed by a physician.
Increased Enforcement Risk for Repeat Deficiencies
While the Act already authorizes civil penalties for violations, HB 3392 adds a new enforcement provision stating that repeated technical infractions within a calendar year may result in a Type 3 violation. Under Illinois regulations, a Type 3 violation is an act or omission that causes a significant negative impact on the delivery of services to residents. A facility cited with a Type 3 violation may be required to participate in a consultative review with the Illinois Department of Public Health unless corrective action is taken within an agreed-upon timeframe. As a result, providers should pay close attention to recurring compliance issues that previously may have been viewed as isolated technical deficiencies.
Illinois Continues to Refine Its Assisted Living Regulatory Framework
HB 3392 is the latest in a series of recent amendments to the Act. In 2025, Illinois enacted several significant assisted living reforms addressing resident rights, dementia care and reporting obligations. Collectively, the 2025 and 2026 legislative changes reflect an ongoing effort by Illinois lawmakers and regulators to modernize the state’s assisted living framework.
- Expanded Resident Rights and Readmission Protections
The 2025 legislation requires facilities to notify residents and resident representatives when a significant change in condition affects the facility’s ability to meet the resident’s needs, requires notice to the Illinois Department of Public Health when a facility initiates an involuntary residency termination and expands appeal rights related to discharge decisions. The law also provides additional protections for residents returning from hospitalization or other medical absences and authorizes penalties when a provider improperly refuses a required readmission. Providers must also furnish residents with enhanced information regarding resident rights.
- Updated Dementia Assessment Standards
Illinois also amended its dementia care requirements in 2025 by moving away from reliance on a specified list of assessment tools. Instead, the legislation requires providers to utilize assessment tools approved or recommended by recognized Alzheimer’s disease and dementia care experts and to ensure those tools are reviewed and updated to reflect current clinical standards and best practices.
- New Incident Reporting Requirements
Another 2025 amendment created new incident and accident reporting requirements for assisted living and shared housing establishments. Providers must report incidents or accidents resulting in significant physical harm or injury to a resident, as well as situations requiring outside emergent medical treatment resulting from an incident or accident. The legislation clarifies that a resident’s health or medical decline alone is not a reportable incident.
Practical Takeaways for Providers
Assisted living and shared housing establishments in Illinois should review and, where necessary, update:
- Admission assessment policies and procedures;
- Dementia care program assessment protocols;
- Director qualification and onboarding standards;
- Medication administration policies; and
- Compliance monitoring programs designed to identify and correct repeat deficiencies.
If you have questions about how these changes may affect your organization, please contact:
- Brian Jent at (317) 977-1402 or bjent@hallrender.com;
- Ellie Tucker at (314) 228-7508 or etucker@hallrender.com;
- Sean Fahey at (317) 977-1472 or sfahey@hallrender.com;
- Robert Markette at (317) 977-1454 or rmarkette@hallrender.com;
- Todd Selby at (317) 977-1440 or tselby@hallrender.com; or
- Your primary Hall Render contact.
Hall Render blog posts and articles are intended for informational purposes only. For ethical reasons, Hall Render attorneys cannot—outside of an attorney-client relationship—answer specific questions that would be legal advice.
