Illinois Expands Electronic Monitoring Rights to Assisted Living and Shared Housing

On June 26, Illinois Governor JB Pritzker signed House Bill 4517 into law, amending the Illinois Authorized Electronic Monitoring in Long-Term Care Facilities Act.

Previously, the Act afforded nursing home residents the right to use electronic monitoring devices in their rooms. Effective January 1, 2027, the Act’s right to record, consent, notice, reporting, and liability provisions will extend to assisted living residences (ALRs) — expanding the rights of approximately 28,600 ALR residents across the state. Senior living operators and managers should take note.

Overview of the Act

The Act defines “authorized electronic monitoring” as the placement and use of an electronic monitoring device by a resident in the resident’s room. Pursuant to the Act, a resident may install an electronic monitoring device, such as a camera or audio recorder, to broadcast or record activity in the resident’s room. The Act also permits a resident to impose conditions on monitoring — such as prohibiting audio-recording, denying facility access to recordings, or requiring devices to be turned off during private activities such as bathing. Roommates have the right to consent, or to not consent, to electronic monitoring.

Consent Provisions

A resident or the resident’s representative must consent to electronic monitoring on a notification and consent form prescribed by the Illinois Department of Public Health (IDPH). Before a resident’s representative consents on behalf of a resident, the resident must be asked in the presence of a facility employee whether the resident authorizes electronic monitoring. When asking a resident for their consent to be monitored, the resident’s representative must explain:

The type of monitoring device that would be installed.
Standard conditions that may be placed on the device’s use.
Who will have access to recordings.
The resident’s ability to refuse electronic monitoring.

A resident may object to electronic monitoring orally, visually, or through auxiliary aids. The resident’s response must be documented on the consent form and placed in the resident’s clinical file, and a copy must be provided to the resident and their representative. A facility may not access any recording created through authorized electronic monitoring without the written consent of the resident or their representative.

Before monitoring begins in a shared room, a resident must obtain written consent from their roommate, which the facility must document on a separate consent form. If a roommate moves into a shared unit where electronic monitoring is already implemented, and the roommate does not consent to monitoring, the facility must ensure the device is turned off. Additionally, the facility must make a reasonable attempt to accommodate the resident’s request for monitoring by offering to move either the resident or the roommate to another available room. If the facility does not have available units at the time of a resident’s request, the facility must reevaluate the request every two weeks until the resident’s request for monitoring can be fulfilled.

A resident or their roommate may withdraw consent at any time, and the facility must document consent withdrawal in the resident’s clinical record.

Signage Requirements

For nursing homes and other long-term care facilities (but not ALRs), facilities must post a sign at all building entrances accessible to visitors disclosing that “the rooms of some residents may be monitored electronically by or on behalf of the residents.” All covered facilities — including ALRs — must post a sign at the entrance of a monitored resident’s room disclosing that the room contains an electronic monitoring device.

Cost and Installation

The resident is responsible for the cost of authorized electronic monitoring. A resident who elects monitoring must pay the purchase, installation, maintenance, removal, and internet-service costs required for the device to operate. ALRs must make a reasonable attempt to accommodate installation needs, including by allowing access to telecommunications or equipment rooms, and bear the burden of proving that a requested accommodation is not reasonable. The device must be placed in a conspicuously visible location in the room, facilities may not charge residents for the electricity used by the device, and all installations and supporting services must comply with applicable National Fire Protection Association (NFPA) 101 Life Safety Code requirements.

Reports to IDPH

While the Act does not impose a specific retention schedule for resident-created recordings, because the device and recordings remain resident-controlled, facilities must retain notification and consent forms in residents’ clinical records. Each facility must annually report to IDPH the number of consent forms the facility receives. IDPH reports these aggregate totals to the Office of the Attorney General.

Dissemination of Recordings

There are limits on both facility access to recordings and downstream sharing. A covered facility, including an ALR, may not access any video or audio recording created through authorized electronic monitoring without the written consent of the resident or the person who consented on the resident’s behalf. Except as required under the Freedom of Information Act, a recording or copy of a recording may be disseminated only for the purpose of addressing concerns relating to the health, safety, or welfare of a resident or residents. The resident or consenting person must provide a copy of a recording to parties involved in a civil, criminal, or administrative proceeding upon request if the recording was made during the time period when the conduct at issue allegedly occurred.

Enforcement and Penalties

Under the Act, criminal penalties apply to any person who knowingly hampers, obstructs, tampers with, or destroys an electronic monitoring device or any recording without the resident’s or representative’s permission. However, a facility is not civilly or criminally liable for inadvertently disclosing a resident recording without prior authorization from the resident or their representative.

Key Takeaways

The Act does not become effective for assisted living establishments until January 1, 2027. Nonetheless, ALRs should begin preparing for the Act’s implementation. Accordingly, senior living operators should:

Identify covered communities and rooms. Determine which facilities are subject to the Act and which resident living spaces constitute a “room” under the statutory definition.
Update policies and procedures. Draft or revise electronic monitoring policies to incorporate the Act’s expanded scope, consent framework, signage obligations, and facility access restrictions.
Prepare roommate accommodation procedures. Establish a documented process for handling monitoring requests when a roommate does not consent, including offering to relocate either resident to an available unit.
Address cost and installation. Confirm that residents bear device, installation, maintenance, removal, and internet-service costs, while facilities coordinate reasonable installation accommodations and ensure NFPA 101 compliance.
Update signage. Procure compliant building-entrance signs (for nursing homes and long-term care facilities) and room-entrance signs (for all covered facilities, including ALRs), and establish procedures to install and maintain signage when monitoring is authorized.
Establish access and disclosure rules. Develop written procedures governing facility access to recordings, which requires the resident’s or representative’s written consent, permissible purposes for dissemination, and documentation of consent forms in clinical records.
Maintain records and reporting processes. Ensure completed forms are retained in clinical records, copies are provided as required, and annual IDPH reporting captures the number of electronic monitoring forms received.