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Veterinarian License DefenseIn our previous post, we wrote about ways your clinic can cope with the changes caused by Covid-19. Here are some additional thoughts about understaffing and client satisfaction during the pandemic.

Question: How can my veterinary clinic navigate issues of understaffing caused by the Covid-19 Pandemic?

Understaffing in Veterinary care was a common issue prior to the pandemic. The pandemic only worsens this divide. Following CDC guidelines, an employee who is exposed to Covid-19 must quarantine until they receive their test results, and even if they are negative, the length of the quarantine is 7 days from the test. If it is positive, the quarantine period is at least 14-days, and they cannot return until they acquire a negative test. This can create large, unexpected gaps in staffing if even one employee is following quarantine protocol. This issue can become exacerbated if multiple employees were exposed and require quarantine. We recommend to have a plan and prepare for these possible scenarios. It will still be challenging, but you will be prepared for the unexpected.

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service of processUntil recently, Illinois courts disagreed on how to serve process on residents of Cook County. Some Appellate Courts interpreted the law to require court appointment of a private process server when serving a resident of Cook County. Other Appellate Courts held that the county where the lawsuit is filed is the controlling factor to determine whether appointment is necessary. Thus, if a lawsuit were filed in DuPage County against a resident of Cook County, then court appointment would not be necessary.

The Supreme Court of Illinois recently resolved this disagreement in Municipal Trust and Savings Bank v. Moriarty, 2021 IL 126290. Service of process in Illinois is controlled by Section 2-202 of the Code of Civil Procedure. Moriarty involved a plaintiff who filed suit in Kankakee County against a defendant residing in Cook County. The Supreme Court of Illinois held that Section 2-202 is concerned with where process is served on a defendant. Therefore, for a private detective to serve process on a defendant in Cook County, he or she must be specially appointed by the court.

The ruling sheds light on a murky area of the law. It also adds to the expense of lawsuits, requiring further diligence by both attorneys and process servers. Special attention should be given to the location of defendants and its impact on service of process requirements. 

Healthcare License DefenseOver a year into the Covid-19 Pandemic, there are still ongoing questions, concerns, and struggles faced by many industries. Veterinary care is certainly one of those industries affected, especially since Illinois deemed them as an Essential Service while most everything else was closed. We address commonly shared concerns and questions that have persisted throughout the pandemic:

Question: How can my veterinary clinic cope with the various changes caused by the Covid-19 Pandemic?

Things are uncertain, confusing, and wholly different. Established protocols that have been tried and true methods can no longer be followed in the same way; basic day-to-day office interaction is punctuated by strict social distancing and sanitary procedures to keep everyone safe; clients, who were once an office fixture, are commonly disallowed from attending the appointments. It can be difficult to adapt to these changes even after experiencing them for the past year. We recommend embracing the change and facing it head on, rather than comparing operations to the past. Fixating on the way things are different rather than how your clinic can expertly navigate the challenges of the Pandemic is one way to affect the morale of your staff and your clients.

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Medical License DefenseAll physicians work incredibly hard in their profession. However, not all physicians experience the same challenges within their fields. Now more than ever, gender issues are commonly discussed and acknowledged in health related professions.

Because of the intensive, long hours that physicians experience, there can be particular challenges when it comes to arranging and securing childcare or being able to take maternity leave when the time comes. Certainly, not all female physicians have or will have children in their professional careers; however, for those who do, it’s a hurdle one must navigate to both comfortably practice and also feel confident in their parenting ability. There is certainly the expectation that female physicians will somehow, with ease, juggle the intensity of their careers and be perfect mothers simultaneously. In reality, the stress of childcare, motherhood, and pregnancy, alongside the stress of long hours and unforgiving work can severely affect the physician. There have been cases of reported negligence stemming from exhaustion and extreme stress caused or exacerbated by the inability to balance these challenges; some female physicians also turn to other methods to help them through these challenging times, and it can result in substance abuse issues that could threaten their license. Acknowledging these challenges and providing solutions to put the female physician in a less precarious position is an important step that needs to be taken at many facilities.

In addition to the very real challenges of childcare and motherhood, female physicians also experience discrimination based solely upon their gender. Sexism and biased attitudes toward women are still prevalent across most industries, and female physicians fall victim to this underlying (and sometimes overarching) current within their profession. Young male physicians are often lauded and highly regarded, or even seen as impressive, whereas young female physicians are often discredited and invalidated, with the assumption that they are too inexperienced and uneducated to properly care for patients and make the right medical decisions. This thread of negativity can place immense stress and pressure on the female physician and can destabilize their career, or even generate feelings of unworthiness and the want to leave to avoid further stress.

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Psychologist License DefenseOnce rare, online therapy is now commonplace. For many patients, the ease of meeting virtually has broadened accessibility and the willingness to meet more regularly. Similarly, many mental health professionals have found the recent surge of virtual appointments as a general benefit for both their patients and their own work. However, there is an underlying thread of challenges that most mental health professionals may not even realize exist.

There are many free programs available for virtual appointments. However, unbeknownst to its users, that particular program may not even be HIPAA-compliant. If the professional is audited or reported, their license could be suspended while investigation occurs, or a license could even be revoked for a HIPAA violation, even if unintended. Although there are free programs that comply with HIPAA, the mental health professional should also research and possibly invest in official licensed programs for mental health professionals. The patient will also have confidence that their appointments are safely occurring and that any sensitive information could not be recorded or stolen from them.

The mere nature of a virtual appointment can also be less than confidential. For some patients, they may not have regular access to a dedicated space in which to have the private appointment. This certainly prevents the patient from having basic privacy while engaging in private discussions, but they may not have another choice. There is also the possibility that the mental health professional may not have a dedicated home office due to lack of space, which can affect both patient confidentiality and invalidate the professional. The general informality of this setup can prevent the appointment from being useful to the patient and can be invalidating to the professional, who likely has a dedicated office space for in person meetings.

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Healthcare License DefenseWe have already written about the prevalence of understaffing in nursing. Undoubtedly, the Covid-19 Pandemic has severely exacerbated the existing understaffing issues. Now more than ever before, nurses are facing extremely challenging work environments with unforgiving and unrelenting conditions.

Already understaffed, facilities reaching critical capacities due to the Covid-19 Pandemic only further highlights these existing difficulties. Nurses who already struggle to provide care to a typical number of patients simply cannot manage an even larger number of patients. As much as patients are filling facilities with Covid-19, nurses are being exposed to the virus and many have fallen ill. With strict and long quarantine policies, a facility can be without multiple nurses at once. This can be devastating for facilities, especially those with minimal staff.

In many cases, nurses who test positive for Covid-19 are out of work for at least 14 days, and only return when they obtain a negative test result. For some people, despite having a negative test result and surpassing the quarantine period, their physical health remains affected by the virus. Scientists and doctors have barely scratched the surface of understanding the condition known as “Long Covid,” but the reality is that many nurses who tested positive continue to have symptoms long after their initial illness. These symptoms, which include fatigue, brain fog, heart palpitations, and lesions, can gravely affect the nurses’ ability to perform their work, if they are even able to physically be at work. This creates a perpetual cycle of understaffing and makes already-difficult work even more challenging.

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Medical License DefenseAcross facilities, whether they be public or private, the issue of understaffing is a critical issue within the field of nursing. Understaffing causes a variety of challenges that affect both the nurses and their patients. It is no fault of their own that facilities are understaffed, but nurses are the individuals on the frontlines who are most affected by these circumstances, and it has a ripple effect across their facilities.

There are many reasons that understaffing occurs. As otherwise qualified individuals apply to be nurses, they can face certain bureaucratic issues that delay their ability to receive their Nursing License. If prospective Nursing Licenses are on hold, this can cause a shortage in staffing while these individuals pursue the necessary routes to clear this hurdle and obtain their Licensing as they are qualified to do so. In a similar vein, a licensed Nurse can encounter difficulties with their established license, which can prevent them from practicing while they resolve those issues. This can lead to understaffing issues in the same vein as not having enough nurses in the first place. The demand for nurses always appears to be higher than the rate at which individuals can become licensed, which leads to perpetual understaffing. There simply are not enough people who are obtaining licenses (although they may be in the process of obtaining one, or are working to reinstate a license after an issue) to compensate for the demand of licensed Nurses in various facilities.

Nurses, even without understaffing issues, generally work very long hours and regularly work overtime. With the understaffing issues caused by various circumstances including those outlined above, the challenging nature of long hours and consistent overtime is greatly exacerbated. This creates burnout, which facilitates the cycle of understaffing. This is the unfortunate reality that many nurses face in their industry and there is little to no relief, plan, or solution to alleviate these issues.

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Real Estate Broker License DefenseThe current pandemic has noticeably altered the way most industries function. Prior to covid-19, Licensed Real Estate Brokers heavily relied on the ability to meet with possibly buyers/renters in person. Home tours were always in person, and open houses relied on the ability to invite many people into a small space to view the prospective house/condo/apartment prior to applying for it. The ability to meet in person has been heavily altered, and for a time especially toward the beginning of the pandemic, all in person meetings were effectively non-existent. Despite this, the show must go on, and Real Estate Brokers must make clever adjustments in order to reach their clientele and to navigate the housing market underneath these unprecedented terms.

One of the main differences and changes to the industry is the utilization of virtual tours. It was uncommon to organize a virtual tour for a possible buyer prior to covid-19, simply because it’s difficult for the person to gauge the space and to see the details as one would in-person. This type of tour might only occur for possible out-of-state individuals looking to move to this location. With the inability to avoid virtual tours, Real Estate Brokers have had to become adept at using technology to adequately and desirably show the space they are seeking to sell/rent out. There is also a different personal experience with virtual interaction rather than in person interaction, and the onus is certainly on the licensed professional to make the experience comfortable and easy for the interested party. This requires a distinct set of skills that the professional would have to quickly adapt to in order to continue to make money and generate happy clients.

The types of houses and amenities people are seeking out has also changed. With many individuals working from home for the foreseeable future, and some possibly permanently, having a space for a home office is absolutely vital. Because of the prevalence of working from home, individuals who would not normally seek quieter spaces are doing so, which can be a challenge for Real Estate Brokers who practice in places like Chicago. This certainly has encouraged and effectively required the professional to adapt to these particularities and to attempt to anticipate these particular needs from a prospective buyer/renter in the particular circumstances generated by the pandemic.

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Pharmacist License DefenseThe U.S. Federal Government has created a partnership with 21 pharmacy networks and partners to begin distribution of vaccines across the United States as a part of a program to broaden the average American citizens’ accessibility to vaccines. Prior to this program, most vaccines were distributed solely to healthcare workers, and then to the most essential frontline workers. Federally speaking, all citizens 16 or older now have access to the vaccine, but that does not mean that they are able to secure a vaccination appointment. Normalizing vaccination availability at pharmacies is just one way that our country is attempting to provide easy access to the Covid-19 Pandemic Vaccine.

By utilizing pharmacies, the federal government can provide vaccination access to most citizens, and most citizens will have multiple options to obtain a vaccine appointment through pharmacies in their neighborhood. It can be hard to travel to governmental mass sites, especially if there is limited access to public transportation or safe transportation in general due to the pandemic. The program bridges the otherwise insurmountable class, economic, and geographical difficulties many communities in America face. The communities who are most gravely affected by the pandemic can get an appointment with ease through this program.

The pandemic will not end, or even slow down, without widespread vaccine distribution. Up until recent weeks, most citizens found it impossible to find a vaccine appointment. If this program provides hundreds of thousands of appointments for the foreseeable future, this puts us closer to the ultimate goal of herd immunity and alleviates much of the horror experienced over the last year. In addition to providing accessibility to large amounts of people who normally would not have access to the vaccine, the vaccine is also completely free.

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Veterinary License DefenseThe veterinary field is highly varied and there are different types of certification and licensing that an individual interested in pursuing the field can obtain. One may choose a particular path dependent on needs, time, salary, and how they would like to put their certification or licensing to use. They also may be limited by their current education or funds. If you end up going the licensed path, we can assist in any matters that may arise.

Veterinary Assistants

If you are interested in pursuing a specialized veterinary route but do not want to commit to licensing or certification and their accompanying fees and time spent, then the Assistant path may be a route to research. Veterinary Assistants do not have any official licensing or certification, and only a high school education or GED is considered necessary to obtain the position. Assistants will often be the go-to person for most tasks in the veterinary office setting. The clinic must be kept sanitary, and assistants will maintain these standards. Besides the important task of clinic upkeep, assistants will help the vet or certified technicians in exams of patients. An assistant may be needed to restrain the animals, comfort them during procedures, and generally assist in any necessary aspect of the exam and appointment. This differs greatly from a general vet receptionist or kennel assistant, who are often unable to interact with animals. This path might be the right route for someone who wants to be involved in animal care, but does not want to/cannot obtain certification.

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Home office cybersecurityMany professions were forced to abruptly shift to and adopt remote workspaces to be able to safely operate during the pandemic. Many physicians, real estate brokers, psychologists, and other licensed professionals who normally operated solely in person, have suddenly found themselves in a wholly foreign environment – likely their own spare room, interacting with clients and patients through a computer or phone. Certainly, many professionals have adapted to this method of practice over the last year, and some have even embraced it, or prefer it over pre-pandemic practices; however, a daunting oversight for many is the mere fact of cybersecurity. For many of these licensed professionals, client confidentiality and information protection, including HIPAA-aligned protocols, are legally required to operate. For a variety of reasons, including the necessity to suddenly shift to remote work, some professionals may not even realize that they are vulnerable to attack and that their patient/client information could be compromised at any moment.

For most of the licensed professionals listed above (and many who are not listed), patient/client confidentiality and privacy are an integral part of their practice. In addition to the requirement to follow HIPAA, it could also be the policy of the professional to contractually, and ethically, ensure confidentiality and privacy. Practicing from home greatly alters the ability to invoke the same standards that are possible in a private office space. A home office space may include visits from partners, children, roommates, or a variety of other possible visitors, and a closed door does not do much for privacy in the same way that a dedicated office space does. Licensed professionals must conscientiously think about the ways in which these conditions can affect the experience of their patient/client and agree upon a policy with those in their home office space to respect and follow client privacy policies.

Unless the home office was prepared in advance and made to mimic the kinds of resources available to the public office space, it is likely that the same types of cybersecurity programs are not in place. There have been reports of “smart” devices recording sound without the consent of the user, which could result in storage of private personal data, and criminals could access this information. Even though it is not the fault of the professional, it is ultimately their responsibility to protect their clientele through all routes possible.

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telehealth challengesAlthough telehealth/e-visits were legitimate options prior to the Covid-19 pandemic, most patients and professionals opted for in-person meetings. Since March 2020, the prevalence of telehealth appointments has skyrocketed, and in some places, it is the only option to get care from a medical professional. With this widespread adoption of a completely different way of seeing patients, there have certainly been challenges, and one that affects a variety of medical professionals.

Difficulty in Connecting with Patients

It’s an unavoidable fact that having a barrier of technology prevents the connections that normally occur in a professional-patient relationship. Treating and diagnosing a patient via phone or video removes the ability to physically connect, and for many, the “connection” that exists in telehealth appointments is superficial. It is also less personable and can feel like a negative, unfulfilling experience for all parties. Telehealth appointments are sometimes considered to be less valid because they are believed to rely on informed guesses rather than close physical examination of the possible medical issue. This does not apply for all appointments, certainly, but many patients wonder how a medical professional could diagnose a broken bone, for example, without examining it in person. This can make a patient less likely to schedule an appointment if they feel the care they receive is less valid through phone or video.

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benefits of telehealthAlthough telehealth/e-visits were legitimate options prior to the Covid-19 pandemic, most patients and professionals opted for in-person meetings. Since March 2020, the prevalence of telehealth appointments has skyrocketed, and in some places, it is the only option to get care from a medical professional. With this widespread adoption of a completely different way of seeing patients, although challenges have occurred, many medical professionals have noted pointed benefits to this adjustment.

Easier to attend

For some patients, it can be an impossible task to take time off work for a medical appointment. Similarly, for other patients, they do not have the ability to travel to an appointment or would have to plan far in advance to be able to secure transportation to a medical appointment. Having the ease of connecting via phone call or video entirely removes the stress and impossibility of having to coordinate a large chunk of time off work or a particular method of travel to attend the appointment. This not only benefits patients, but benefits medical professionals, too, who now are able to see more patients and care for patients who are normally unable to attend medical appointments.

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Illinois professional license defense attorneysOne tactic used by real estate brokers to advertise to consumers is through the use of “Coming Soon” signs, which advertise property that will be coming on the market. In order to appropriately use “Coming Soon” signs, you must have the appropriate authorization, as such signs serve as both notice of sale and an advertisement. Similarly to pocket listings, there are good reasons to use a “Coming Soon” listing: people may need to prepare their homes for sale or are waiting for their new homes to be completed. And also similarly to pocket listings, these listings create ambiguous ethical issues. 

“Coming Soon” listings inform the widest possible audience that the house, while not ready to be seen, is for sale and will be ready for viewings on a specific date. If a seller has not signed a listing contract, the house cannot go into the MLS. This means that a broker can show the house to their own list of potential buyers without consequences. It also means the house receives limited exposure, which could lead to less lucrative offers. Listing a home on the MLS is generally viewed as the best way to inform the vast majority of potential buyers of availability, and if a client seeks to sell their home for the greatest possible price, such interest may be jeopardized by the use of “Coming Soon” signs. This can place a broker in direct conflict with the ethical duty to promote and protect the best interests of the client.

While not an illegal way to sell a home, it does place the broker in a precarious position that skirts ethical and legal boundaries. Failure to be fully transparent about the pros and cons of using a “Coming Soon” listing to a client could result in perceived unethical conduct, putting the broker’s license at risk for disciplinary action being taken by the Illinois Department of Financial and Professional Regulation. If you find yourself facing potential disciplinary action, Williams & Nickl has successfully defended the licenses of hundreds of real estate brokers before the IDFPR.

Illinois medical license defense attorneysHow many patients can healthcare providers treat while maintaining adequate care? Some patients would be surprised to learn that their physician might see up to 2,500 patients a year—visits during which the physician has to deliver all recommended preventive, chronic, and acute care services required. Nurse staffing has faced this problem as well, with short-staffing at hospitals leading to rising nurse-to-patient ratios. How can these healthcare providers sufficiently handle such clinic loads while providing adequate care?

For physicians, the answer heavily relies on effective delegation of workload. In a 2012 study by the University of California at San Francisco’s Center for Excellence in Primary Care, if a primary care physician does everything on their own, from screening, counseling, immunization, drug prescription, chronic care, and treatment of acute conditions, the physician could only accommodate a maximum panel of 983 patients.

Of these tasks, the time physicians spend on preventative services could be delegated to non-clinician care-team members. Those hours spent managing common chronic conditions could be delegated to other hospital personnel, such as nurses and medical assistants. In appropriately delegating these tasks, it allows a doctor more time to appropriately treat the greatest number of patients while ensuring proper care and treatment.

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Illinois real estate broker license defense attorneysA pocket listing refers to any property a real estate broker holds a signed contract with but does not advertise on a multiple listing system (“MLS”). While pocket listings have a somewhat negative reputation, there are many reasons why a broker and seller might prefer this method to the traditional listing: the property might not be ready to show, the seller might be subject to a listing agreement to only show to qualified buyers, or brokers strategically use pocket listings to increase an aura of exclusivity related to the home. While these are legitimate reasons, brokers would take care to exercise caution when using pocket listings to avoid any perceived unethical conduct.

If you choose to do a pocket listing, it must be in the best interests of the client. Realtors are ethically required to promote and protect their clients, which means a motivation to undertake pocket listings solely because it could result in a higher commission will raise red flags. In recommending a pocket listing to a client, the broker must thoroughly discuss the pros and cons with the seller and ensure the seller understands the benefits that are being waived by not showing the property on the MLS. By not listing on the MLS, the broker decreases marketing opportunities to reach a larger audience of potential buyers, and what is probably most relevant to the seller, may not bring in the highest possible price for the property. Because a broker is both legally and ethically required to act with the seller’s best interest in mind, a seller seeking the most money with the best terms must be fully informed before pursuing a pocket listing.

Pocket listings are not illegal, but they are viewed as an ethically grey area in the real estate business. In deciding to undertake a pocket listing, a broker must take extra steps to ensure the client’s best interests are being met. If a client ultimately feels like the broker did not receive ethical and adequate representation, a broker could face disciplinary action against their license by the Illinois Department of Financial and Professional Regulation. Williams & Nickl has considerable experience representing real estate brokers and defending their licenses before the IDFPR. If any troubles arise, please contact us for efficient and effective representation.

Illinois business license defense attorneyRecently, the housing market has seen an increase in business due to low-interest rates and rising prices. With the increase in business comes more juggling of clients and listings. Because real estate brokers have a duty to act in the best interest of their clients, they are held to higher standards than most. To ensure your conduct is viewed as honest and ethical, keep these considerations in mind:

Advertising and Social Media

Under the NAR Code of Ethics and Standards of Practice, social media is treated as a form of marketing, despite the difficult task of separating the professional and the personal. Because of this, anything you post on a social media account, such as Facebook, Twitter, or Instagram, must be accurate to the best of your knowledge. Any descriptions you make about a property must be accurate, so you should avoid any exaggerations or misrepresentations. Remember to clearly disclose your agency status and professional affiliation. This can be achieved by including the name of your firm in any posts you make.

Proper Property Disclosures

One of the most prominent complaints made by customers relates to improper property disclosures. It is a legal and ethical requirement that real estate brokers disclose all known material facts about a property to interested clients and failure to disclose could land a broker in serious trouble. While you are not obligated to know about latent defects or matters outside the scope of your license, it would be smart to direct your client to an appropriate source. Be sure to disclose all important information affecting the desirability or value of the property being shown.

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Illinois real estate broker license defense attorneysDue to historically low-interest rates, the housing market has witnessed a boom in business. With this increase in business, it raises possible ethical considerations faced by real estate brokers as they strive to enjoy the strong market. What steps can you take to ensure you remain in good ethical standing?

Presentation of Multiple Offers

Because of the low interest rates and rising prices, it is not uncommon for multiple offers to be made. In handling such offers, it is important to take certain steps to ensure fair dealing. For any offers received, present them as quickly and objectively as possible. If any buyer or fellow broker asks for information regarding any of the offers you have received, remember that you can only disclose the existence of such offers, along with their source, with express approval provided by the seller. Additionally, if you have authorization via a signed agreement to act as the buyer’s representative, you have to make sure the buyer is aware that the seller does not have to treat any offer as confidential, unless required to do so by law, regulation, or agreement.

Prevent Unauthorized Access

In order to avoid violating any terms and conditions a seller has for viewing their property, it is important to be present when a client wants to look at a home and ensure the viewing occurs within the appropriate time window. Never provide a client with unnecessary access to the home, meaning the client should never have a key to the home, the combination of a lockbox, or use of a lockbox key.

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Illinois medical license defense attorneyIllinois is one of the most popular states for physicians, and depending on your credentials and practice history, the application process could take between 3-6 months. Here are some tips to avoid or minimize unnecessary frustration.

Ensure You Are Eligible

It sounds obvious, but ensuring you meet your board’s eligibility requirements can save time, money, and possibly an appearance before the Illinois Medical Board.

Complete the Application

There are paper and online versions of the application available; however, it is recommended you complete the online application to avoid any unnecessary delays. In either case, you will be required to mail in supporting documents. The application contains questions dealing with adverse or non-routine situations, and if you answer “yes” to any questions related to adverse actions, the Board will require you to provide a written explanation and verifying documentation. Keep in mind the application process requires a criminal background check, which often take 6-8 weeks for the Board to receive. Since your license cannot be issued until the results of a criminal background check have been received, do not delay in submitting it.

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Illinois real estate broker license defense attorneyAn ever-present war has been raging between Zillow and real estate brokers. Zillow believes it filled a gap where NAR failed to provide valuable services for online consumers. Real estate brokers believe Zillow steals listing information from MLS agreements, repackages the information, and then sells the information back to real estate agents who owned it in the first place.

In 2015, upon the merger of Zillow and Trulia into one big company, Zillow Group, the war between brokers and Zillow escalated. And now, the war seems to be entering an escalated phase once again. For several years, Zillow has worked to transition into a buying-and-selling entity, offering iBuying services through Zillow Offers, and mortgage, title, and escrow services through Zillow Home Loans. Taking things a step further, Zillow has now started its own licensed brokerage: Zillow Homes.

Starting in January 2021, Zillow Offers customers in Atlanta, Tucson, and Phoenix will be able to work directly with licensed employees of Zillow Homes. Zillow Homes plans to expand into additional markets later in 2021. Zillow Homes will be licensing existing Zillow employees under the entity, rather than recruiting agents from any other companies. With this move, Zillow will be free to pull directly from the MLS Internet Data Exchange, which it believes will allow Zillow to more efficiently serve mutual customers with MLS partners. Zillow has also announced plans to join local real estate associations, including NAR.

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