Illinois Nursing Home Cameras: 2027 Assisted Living Change

Last Updated: September 15, 2026

Starting January 1, 2027, Public Act 104-494 extends Illinois’ nursing home camera law to assisted living establishments. Since 2016 a nursing home resident may have a room camera after the consent steps. One limit applies: a home that houses residents with dementia may allow cameras only in rooms in a building or wing dedicated entirely to dementia care.

“Can I put a camera in my mother’s room?” In an Illinois nursing home the answer is yes when the law covers her room and its steps are followed. The first question is whether the home houses residents with dementia. If it does, the law allows a camera only in a room in a building or wing dedicated entirely to dementia care. The steps decide the rest: who signs, what the roommate can require, and what the facility has to do.

Illinois answered that question with a statute, the Authorized Electronic Monitoring in Long-Term Care Facilities Act, 210 ILCS 32/10, in force for nursing homes since January 1, 2016. It is often called the granny cam law. It gives the resident the right to a camera or an audio recorder in the resident’s own room and says who may consent when the resident cannot. It carries one limit for homes that house residents with dementia, explained below. What is coming: Public Act 104-494 takes effect January 1, 2027 and extends the same Act to assisted living establishments.

What the Illinois Law Allows

The law lets a resident of a covered long-term care facility install an electronic monitoring device in the resident’s own room to record video, audio, or both. Two things come first: the Act must reach the room (the dementia limit below), and its requirements must be met.

Key provisions include:

The resident, or the person the Act allows to consent for the resident, signs the Illinois Department of Public Health’s notification and consent form (210 ILCS 32/15).
If the resident has a roommate, the roommate, or the person allowed to consent for the roommate, signs the same form; the resident or the roommate may set conditions, including no audio.
Monitoring may begin only after the completed form has been given to the facility (210 ILCS 32/20).
The facility posts a sign at the building entrances and a sign at the door of the monitored room, and installs and maintains both (210 ILCS 32/30).
The resident pays for the device, its installation, upkeep and removal; the facility may not charge for the electricity it uses (210 ILCS 32/25).
A facility that houses residents with dementia may allow the devices only in rooms in a building, or a wing of a building, dedicated entirely to dementia care (210 ILCS 32/10(c)). In a home that houses residents with dementia and has no such building or wing, the Act’s permission for a room camera does not reach any resident’s room. That is true whether or not the resident has dementia. The Illinois Department of Public Health’s rule, 77 Ill. Adm. Code 389.110, repeats the limit.

If a resident lacks the capacity to consent, the resident’s court-appointed plenary guardian may consent. Without a guardian, the resident’s physician has to find that the resident cannot understand what monitoring means, and the resident must not have objected; then the Act names who may consent, in this order:

the agent named in the resident’s health care power of attorney;
the person the Nursing Home Care Act calls the resident’s representative;
the resident’s spouse;
the resident’s parent;
an adult child who has the other adult children’s written consent to decide;
an adult brother or sister who has the other siblings’ written consent.

Under the Nursing Home Care Act, 210 ILCS 45/3-318, a facility may not intentionally retaliate or discriminate against a resident for consenting to monitoring, and may not prevent the installation or use of a device once it has the completed notice and consent form.

Why This Law Matters

For years, families suspected that neglect or abuse was occurring behind closed doors but had little ability to confirm their concerns.

Electronic monitoring provides:

Transparency
Accountability
Peace of mind
Evidence when misconduct occurs

In cases across the country, cameras in residents’ rooms have captured physical abuse, rough handling, verbal intimidation, and prolonged neglect.

At the same time, monitoring can also confirm that staff members are providing attentive and compassionate care.

The goal is protection.

Important Legal Considerations

The Illinois law authorizes monitoring only in the rooms it reaches (the dementia limit above) and only when families comply with its procedural requirements.

Roommate consent decides whether monitoring can start. If the roommate says no, monitoring cannot start in that room. The facility then has to try to accommodate the resident, and it meets that duty by offering to move either resident to another shared room that is open at the time; if none is open, it must look again every two weeks. A private room chosen to make the camera possible is paid at the private room rate. A new roommate has to consent before recording resumes, and consent can be withdrawn at any time.

Audio is allowed under the Act. The Act’s definition of a monitoring device includes an audio recorder, and the resident or the roommate may make no audio a condition of consent. A recording made outside the Act’s consent process is where the Illinois eavesdropping law, 720 ILCS 5/14-2, applies.

Before installing any device, families should:

Ask the facility in writing whether it houses residents with dementia. If it does, ask whether the resident’s room is in a building or wing dedicated entirely to dementia care. If the home houses residents with dementia and has no such building or wing, the Act’s permission for a room camera does not reach the room (210 ILCS 32/10(c)). If the home has such a building or wing and the resident’s room is outside it, the Act’s permission does not reach that room either. As of 2026 we have found no Illinois court decision applying this subsection, so the statute’s words are the guide. Get the home’s answer in writing and keep it.
Get the Illinois Department of Public Health’s notification and consent form and work out who in the family may sign it.
Get the roommate’s signature on the same form, with any conditions written in.
Give the completed form to the facility before the camera goes in.
Place the device where it can plainly be seen; the Act requires a conspicuously visible spot in the room.
Confirm the facility has posted the entrance sign and the sign at the door.

Consulting with an attorney familiar with Illinois long-term care law can help avoid mistakes.

Cameras Are Not a Substitute for Legal Action

Electronic monitoring can reveal problems, but it does not fix systemic issues like chronic understaffing, poor training, or inadequate care planning.

If a loved one has already suffered serious harm, such as:

Advanced pressure ulcers
Unexplained fractures
Severe dehydration or malnutrition
Repeated falls
Signs of physical abuse

then installing a camera may not be enough.

In those situations, families should consider speaking with a nursing home neglect attorney immediately.

Protecting Vulnerable Residents

The Illinois monitoring law reflects a broader recognition: transparency protects residents.

Under the Act the facility knows the camera is there and posts the signs, so what happens in the room is on the record for the resident, or for the person who consented for her.

Peoria personal injury lawyer Robert Parker takes nursing home neglect and abuse claims and personally handles every case the firm accepts. If you are deciding whether to put a camera in a family member’s room, call before you buy it: 309-673-0069.

Need a lawyer? This article is part of our Peoria Nursing Home Injury Lawyer practice area. Call Parker & Parker at 309-673-0069 for a free consultation.

Frequently Asked Questions

What does the 2027 change to Illinois’ nursing home camera law do?

Public Act 104-494 takes effect January 1, 2027 and extends the Authorized Electronic Monitoring in Long-Term Care Facilities Act to assisted living establishments. Starting January 1, 2027, the same monitoring rules extend to assisted living establishments.

Who can sign the consent form for an Illinois nursing home resident who lacks capacity?

The resident’s court-appointed plenary guardian can. Without a guardian, the resident’s physician has to find that the resident cannot understand what monitoring means, and the resident must not have objected; then the Act’s order applies: the agent named in the resident’s health care power of attorney, the resident’s representative, spouse, parent, an adult child with the other adult children’s written consent, then an adult sibling with the other siblings’ written consent (210 ILCS 32/15).

What if the roommate refuses a camera in an Illinois nursing home?

Monitoring cannot start in that room. The facility has to try to find a solution, usually a room change: it offers to move either resident to another shared room that is open, looks again every two weeks if none is open, and a private room chosen for the camera is paid at the private room rate.

Is audio recording allowed in an Illinois nursing home room?

Yes, through the Act’s consent process. The resident or the roommate can make no audio a condition of consent on the form (210 ILCS 32/20). A recording made outside that process is where the Illinois eavesdropping law, 720 ILCS 5/14-2, applies.

Cameras in Illinois Nursing Home Rooms: The 2027 Change Reaches Assisted Living