(A) Each long term care facility applicant shall submit a completed application form and such information as required by the Village Clerk. (See Appendix A.) The application shall contain the following information:
(1) The name and address of the applicant.
(2) The name and address of the facility for which a license is sought.
(3) A full and complete copy of the application for licensure filed with the Illinois Department of Public Health, including all attachments and required submittals.
(4) A copy of the license issued for the facility by the Illinois Department of Public Health.
(5) A census of current facility employees by number, experience and training.
(6) A census of current residents by age, diagnoses and treatment with psychoactive medications.
(7) Such other information as the village may deem necessary or prudent.
(B) All applications shall be accompanied by a current valid license issued by the Illinois Department of Public Health, any management agreements for the operation of the facility and copies of any Medicare/Medicaid certifications. A license fee shall be submitted in the amount of $500. To assure its application is continuously updated, current and correct, the applicant shall file a written supplement to its application within seven days of any of the following events:
(1) Any change in ownership, management or administrator.
(2) Any action by the State of Illinois which could result in the limitation, suspension, or revocation of its licensing.
(3) Any reduction by more than 5% in any portion of the applicant's employee census.
(4) Any change by more than 5% in any portion of the applicant's resident census.
(Ord. 2246, passed 12-5-05)