An Illinois health care power of attorney, the IDPH Uniform POLST form and a signed residency agreement are the assisted living paperwork Cook County families are asked for at move-in.
By Chicago Senior Advisor Care Team · August 27, 2026
Almost every family touring assisted living in Cook County hits the same wall about a week before move-in. The community sends over a packet, and buried in it is a request for an Illinois health care power of attorney, a physician assessment, a signed residency agreement and, very often, a copy of the Illinois Department of Public Health Uniform POLST form. Families who have spent three months comparing buildings in Oak Park, Evanston and Beverly are suddenly being asked for legal and medical documents nobody mentioned on the tour. It is not a stalling tactic. Illinois licenses assisted living and shared housing establishments under the Assisted Living and Shared Housing Act (210 ILCS 9) and the rules at 77 Ill. Adm. Code 295, and those rules assume there is a clear answer to a simple question: if your mother cannot speak for herself at two in the morning, who does the community call, and what does that person have authority to decide? The paperwork exists to answer that question in advance rather than during a crisis.
The good news is that the list is short and the documents are standardized statewide. The Illinois statutory short form power of attorney for health care is a free, fill-in form written into the Illinois Power of Attorney Act (755 ILCS 45). The Uniform POLST form is published by IDPH and is the same form whether it is signed at Northwestern Memorial Hospital in Streeterville or at a physician office in Naperville. What trips families up is not difficulty; it is sequencing. These documents have to be signed while the person still has the capacity to sign them, and capacity is exactly what is slipping in most families who are shopping for assisted living. Get the paperwork done early and it takes an afternoon. Get to it late and the path runs through the Cook County Circuit Court probate division, which takes months and costs real money.
An Illinois health care power of attorney names an agent to make medical and care decisions when the person who signed it cannot make them personally. That authority is broad: it generally covers consenting to or refusing treatment, choosing physicians, accessing medical records, and agreeing to a move into an assisted living or shared housing establishment. For a Chicago family, that last item is the one that matters at move-in. A community in Lincoln Park or Skokie is signing a residency agreement that commits someone to thousands of dollars a month, and it needs to know the person signing has the authority to do it. Illinois publishes a statutory short form with plain-language notices attached, which is why so many hospital social workers at Rush University Medical Center and UI Health hand out the same packet.
Two practical details cause most of the do-overs. First, the form must be signed while the person still understands what they are signing, and a physician note in the chart confirming capacity is worth having if dementia has already been diagnosed. Second, Illinois has its own witnessing rules, and the witness generally cannot be the named agent, the attending physician, or someone who would benefit from the person's estate. Requirements have changed over the years and are easy to get subtly wrong, so confirm the current signing and witnessing requirements with an Illinois elder law attorney or the community's admissions director before the packet is due. This article is general information about the paperwork Illinois communities request, not legal advice, and a form that is technically defective is worse than no form at all because nobody discovers the defect until it is needed.
The second document in the packet is different in kind, and confusing the two is the single most common mistake Chicago families make. The IDPH Uniform POLST form, short for Practitioner Orders for Life-Sustaining Treatment, is not a legal appointment of anybody. It is an actual medical order signed by a practitioner, historically a physician and in current practice also an advanced practice registered nurse or physician assistant depending on the setting, together with the patient or the patient's legal representative. It records concrete instructions about cardiopulmonary resuscitation and the intensity of treatment desired, and because it is an order rather than a preference, Chicago Fire Department paramedics and emergency staff at Advocate Christ Medical Center in Oak Lawn or Loyola University Medical Center in Maywood can act on it immediately.
That is precisely why assisted living communities want a copy in the resident file and often want the original posted somewhere visible in the apartment, frequently on the refrigerator. If a resident in a Portage Park or Orland Park community collapses and 911 is called, staff have minutes, not hours, to produce the document. A POLST that lives in a safe deposit box does nothing. It is also worth knowing that a POLST is meant for people who are already seriously ill or frail, not for every healthy 78-year-old, and that it can be voided or revised as health changes. A health care power of attorney and a POLST are complements: the first says who decides, the second says what has already been decided and turns it into a standing order.
Plenty of families arrive at the move-in date with nothing signed, usually because a stroke or a rapid dementia decline outran the paperwork. Illinois anticipated this. The Health Care Surrogate Act (755 ILCS 40) establishes a priority order of surrogate decision-makers, typically beginning with a court-appointed guardian if one exists, then a spouse, then adult children, then parents and siblings. Surrogate authority is narrower than an agent's authority under a power of attorney and, for certain end-of-life decisions, it depends on an attending physician certifying a qualifying condition. It is a safety net, not a substitute, and adult children who disagree with one another can deadlock a surrogate decision in a way an appointed agent never would.
When surrogacy is not enough, or when financial decisions are also at stake, the remaining path is guardianship through the probate division of the Circuit Court of Cook County at the Richard J. Daley Center, with the equivalent divisions in DuPage, Lake, Will, Kane and McHenry counties for suburban families. Guardianship requires a physician report, a court petition, a guardian ad litem, and a hearing, and it commonly takes a couple of months and several thousand dollars in fees even when nobody contests it. Assisted living communities can sometimes hold an apartment during that process, and sometimes cannot. If a hospital discharge planner at Northwestern Medicine Central DuPage Hospital in Winfield tells you guardianship may be needed, treat that as the moment to call an elder law attorney rather than waiting to see whether it resolves itself.
Build the packet in this order. First, the Illinois health care power of attorney and, separately, a durable power of attorney for property, because the health care form does not authorize anyone to pay the rent. Second, the physician assessment or health evaluation the community requires, which normally has to be recent, typically within a set number of days of move-in. Third, a current medication list with prescribing physicians. Fourth, the IDPH Uniform POLST form if the resident's health warrants one. Fifth, the residency agreement itself, along with the community's written disclosure of its services, its rates, and its criteria for involuntary discharge. If the building operates an Alzheimer's Special Care Unit, Illinois also requires a separate written disclosure describing that unit's philosophy, staffing and services, and that disclosure is worth reading line by line rather than initialing.
Finally, do the benefits paperwork in parallel rather than afterward. If assisted living at $4,500 to $6,500 a month in the city, or higher along the North Shore in Evanston and Wilmette and across DuPage County, is not sustainable, the Supportive Living Program administered by Illinois Healthcare and Family Services is the Medicaid-funded alternative and requires a Determination of Need assessment plus a Medicaid financial review. If the plan is to stay home longer, the Community Care Program through the Illinois Department on Aging is the in-home track. AgeOptions serves suburban Cook County and the City of Chicago Area Agency on Aging within the Department of Family and Support Services serves the city; the statewide Senior HelpLine at 1-800-252-8966 will route you to the right one. Both assessments ask for many of the same documents, so assembling the packet once saves weeks.
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