Illinois Nursing Homes Archives

Report Claims It’s Tough to Determine Whether Community-Based Long-Term Care is Superior to Entering a Nursing Home in Illinois and Throughout the Nation

A report recently published by the Agency for Healthcare Research and Quality (AHRQ) found that there is no evidence to support the often accepted idea that home or community-based long-term care is less expensive than or provides superior care over institutions such as skilled nursing facilities. Instead, study authors argue that community-based elder care solutions reportedly benefit consumers who prefer to avoid entering a long-term care facility. The AHRQ report defines long-term care as daily living, housing, and medical care over an extended time frame.

According to the AHRQ, the question of how to provide the best, most economical long-term care solutions for the nation’s aging population has become increasingly important as states continue to experience revenue shortfalls. Currently, about 1.4 million U.S. residents reportedly reside in a skilled nursing facility. Approximately 40 percent of all long-term care provided throughout the country is paid for by federal Medicaid insurance. In addition, an estimated 64 percent of the money spent on long-term care for Medicaid beneficiaries is paid to nursing homes. At this time, at least 11 million Americans require some type of long-term care to assist them in their daily lives and about 55 percent of those individuals are reportedly age 65 or over. In addition, the AHRQ estimates that at least two-thirds of individuals who are over age 65 will require long-term care assistance for at least two years before the end of their lifetime.

The costs associated with receiving institutional care allegedly often exceed those for community-based elder care solutions. Because of this, many states have prioritized community-based solutions. Between 1995 and 2009, Medicaid spending on community-based long-term care solutions reportedly doubled. The AHRQ report argues, however, that there is no evidence that community-based solutions provide superior care. Still, skilled nursing facility residents allegedly exhibit more physical and cognitive impairment than individuals who utilize assisted living or community-based solutions. Because of this, the study authors reportedly believe more research should be performed to determine the exact cause of the disparity.

Families in Illinois often turn to skilled nursing facilities when they are no longer able to care for their elderly or disabled loved ones. Although nursing homes can be the best option for some patients, many need therapies that nursing homes are unable or unwilling to provide. Unfortunately, abuse and neglect can result when patients enter nursing facilities that are not equipped to properly care for them.

The Illinois Nursing Home Care Act was established to protect the rights of senior citizens and other individuals who live in long-term care facilities throughout the state. Those rights include the right to be free from abuse or neglect, the right to privacy, and the right to various levels of self-determination. If you believe the rights of your elderly or disabled friend or family member were violated by a long-term care facility, you should discuss your concerns with a skilled nursing home abuse and neglect attorney.
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Late Medicaid Payments Allegedly Place Illinois Nursing Home Residents at Risk

by Dave Abels

There is reportedly a Medicaid payment backlog of approximately six months for nursing homes and other long-term care facilities operating in Illinois. The State of Illinois has purportedly opted to delay payments to facilities that care for the state’s elderly and disabled Medicaid recipients in an effort to manage budgetary concerns. Reimbursements from the federal Medicaid insurance program reportedly fund the care of about two-thirds of all nursing home patients and approximately 60 percent of all assisted living facility residents in the state. According to some, the practice not only shifts the financial burden for Medicaid recipients in Illinois to the facilities that care for them, but also serves to decrease a company’s incentive to employ an adequate number of direct care staff.

According to Wayne Smallwood, Executive Director for the Affordable Assisted Living Coalition, small facilities are hit hardest by the backlog due to less flexibility in their budgets. He said many such nursing homes are currently experiencing difficulty with meeting payroll as funds become depleted. Jerry Finis, CEO of Pathway Senior Living, stated larger companies also feel the crunch when Medicaid payments are not received. A lack of information from state officials reportedly makes it hard for skilled nursing facilities to plan for unexpected shortfalls. Judy Baar Topinka, Comptroller for the State of Illinois, said the backlog has grown by at least $2 billion over the course of the past year. In addition, Baar Topinka stated the late Medicaid reimbursements are likely to get worse in the coming months.

In some cases, late Medicaid payments allegedly mean long-term care facilities are forced to delay payments for essential services such as utilities. According to Pat Comstock, Executive Director at Health Care Council of Illinois, a number of skilled nursing facilities have responded to delayed payments and the current 2.7 percent Illinois payment cut by declining to accept new residents who utilize Medicaid. Although Illinois reportedly pays a one percent interest penalty for late federal payments, the financial stress of the practice coupled with the need to increase direct care staff levels in order to comply with state law has reportedly placed many nursing homes at risk of closing.

Any skilled nursing facility in Illinois that receives federal Medicaid or Medicare funds is considered a certified nursing home. The majority of certified nursing homes that operate in Illinois are held to a high standard of care under both state and federal law. Despite that most nursing homes located in the state are certified, the Illinois Nursing Home Care Act does not require it. In addition, the Illinois Department of Public Health regulates the quality of care provided in all Illinois long-term care facilities regardless of the facility’s certified status.

The Illinois Nursing Home Care Act directed all skilled nursing facilities operating within the state to increase the number of direct care employees in order to sufficiently meet the needs of facility residents. Still, inadequate or poorly trained staff is a frequent cause of nursing home abuse or neglect. If your loved one suffered neglect or abuse as a result of inadequate staff levels, you are advised to speak with a quality lawyer to discuss your concerns.
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Study Suggests Nursing Homes that Successfully Coordinate With Other Medical Providers Reduce Hospitalization Rates

by Dave Abels

Medical care facility transitions for nursing home residents can often lead to a number of health complications. In fact, up to 20 percent of Medicare beneficiaries who enter a hospital are readmitted within 30 days. A study recently published in the Journal of the American Medical Association claims nursing homes and other long-term care facilities that collaborate with a patient’s other healthcare providers may have the ability to reduce repeat hospitalization rates. In a report entitled “Association Between Quality Improvement for Care Transitions in Communities and Rehospitalizations Among Medicare Beneficiaries,” researchers led by the non-profit corporation Colorado Foundation for Medical Care found that partnering between medical providers reduced rehospitalization rates by an average of almost six percent in the first 30 days following discharge. That number was reportedly almost three times the rate found when long-term care facilities attempted to reduce rehospitalization rates but failed to coordinate with community health care providers.

As part of the study, researchers analyzed data collected by 14 Centers for Medicare and Medicaid Services Quality Improvement Organizations (QIO) over a three-year-period. The QIOs purportedly focused on quality improvement efforts such as community organizing, coordinating evidence-based hospital discharges, providing technical assistance with regard to the implementation of best care practices, and monitoring. In 10 of the 14 communities that participated in the study, skilled nursing facilities also implemented the Interventions to Reduce Acute Care Transfers model for sharing relevant medical information. In addition to reducing rehospitalization rates, researchers found that collaboration saved each QIO community about $3 million in Medicare funds.

According to Dr. Jane Brock, lead study author and Chief Medical Officer at the Colorado Foundation for Medical Care, the research project successfully engaged entire communities in improving nursing home resident care. This was reportedly the first time researchers focused on successful health care intervention and monitoring. Dr. Brock stated the research demonstrates that community partnerships have the ability to improve medical care for nursing home residents.

Most nursing home and other long-term care facilities located in Illinois are under contract to receive Medicare and Medicaid funds. As a result, caregivers and administrators who are employed at such skilled nursing facilities must adhere to both state and federal laws. Although most nursing homes in Illinois provide satisfactory patient care, some cut costs and fail to employ a sufficient number of qualified staff. This research study suggests that providing quality resident care may actually reduce a facility’s expenses. If you believe a friend or loved one was abused or neglected while in the care of an Illinois long-term care facility, you should speak with a skilled attorney.
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Study Claims Disrespect is Number One Factor in Nursing Home Staff Turnover Rates in Illinois and Nationwide

by Dave Abels

Initial data collected by researchers from the University of Pittsburgh recently found that about 82 percent of certified nursing assistants (CNAs) surveyed enjoy their jobs. In addition, approximately 80 percent claim to be loyal to their workplace and a whopping 90 percent reportedly feel that what they do for a living makes the world a better place. Oddly, the very same workforce also has a surprisingly high turnover rate.

As part of a long-term study, researchers at the University’s Center for Health and Care Work surveyed 1,400 CNAs and other direct care workers in an effort to ascertain why employees choose to stay at or leave their jobs. The currently ongoing study was designed to last for a period of two years and direct care employees who participated in the initial survey will reportedly be interviewed again in a series of nine-month intervals. In the future, researchers hope to examine whether employees who resigned also changed industries.

Despite often low pay and difficult work, most CNAs who responded to the survey reported high levels of job satisfaction. Still, few opportunities for advancement, understaffing, inadequate continuing education, and a lack of mentorship reportedly contributed to direct care worker dissatisfaction. According to researchers, however, the number one reason CNAs and other direct care staff leave a care facility is a disrespectful management team. CNAs surveyed reportedly told researchers that they most often leave a particular job due to unrealistic expectations regarding the amount of daily work that can successfully be accomplished.

A high rate of direct care staff turnover can have a dramatic impact upon the quality of care nursing home residents in Illinois and throughout the nation receive. An inadequate number of CNAs or quickly and poorly trained workers can also have a significant effect on resident health and safety. Although the problems associated with low staff retention rates are allegedly recognized by most administrators and managers of skilled nursing facilities throughout the country, the University of Pittsburgh study illustrates that there may still be a long way to go before the issue can be fully addressed.

A stable workforce is an important indicator of quality elder care. Sadly, insufficient staffing levels are a common factor in nursing home abuse or neglect in Illinois and nationwide. The Illinois Nursing Home Care Act required nursing homes to increase the number of direct care hours provided to residents in order to adequately meet their needs. If your friend or loved one was harmed while residing in an Illinois skilled nursing facility, you should contact a qualified nursing home abuse and neglect lawyer to discuss your concerns.
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Illinois Ranks Third in Nation for Suspended Federal Payments Over Serious Nursing Home Violations

by Dave Abels

According to information recently compiled by non-profit corporation ProPublica, Illinois ranks third in the nation for suspended federal Medicare and Medicaid payments due to serious nursing home deficiencies. Over the last three years, federal skilled nursing facility payments were purportedly suspended nearly 100 times at 78 homes throughout the state. Normally, Medicare and Medicaid payments are only suspended when conditions at a long-term care facility require immediate improvement. In addition, Illinois reportedly ranked near the middle of states with regard to the number of serious deficiencies and fines issued per nursing home.

The Illinois Department of Public Health surveys and rates skilled nursing facilities at least once each year and when specific complaints are filed. Ratings of A to L are assigned to each nursing home based on facility conditions. An A assignment is the highest rating and an L assignment indicates the most severe level of deficiency. A J score reportedly indicates an isolated, immediate risk to a patient’s health or safety was found. Meanwhile, K indicates that such a condition exists as part of a pattern while an L means a state surveyor noted widespread and immediate risks to resident health and safety exist at a particular skilled nursing facility.

In the last three years, 144 of the 773 nursing homes throughout Illinois purportedly received at least one J, K, or L citation. Additionally, 199 nursing homes incurred $2.43 million in fines during the same time period. The largest fine was issued to a Chicago nursing home that allegedly committed 53 simultaneous violations. Federal payments were suspended twice over the last three years at one long-term care facility in Joliet. The same nursing home also reportedly received 82 deficiency citations and was ordered to address resident care deficiencies through a special focus program. According to a representative for the nursing home, all previously identified deficiencies were corrected and a new administrator and other staff members were hired. Still, a number of other nursing homes in Illinois have similar track records.

A statement from the Illinois Department of Public Health claims the state is committed to ensuring that skilled nursing facilities throughout Illinois meet both state and federal standards. The majority of nursing homes in Illinois are held to a high standard of care under both state and federal law. Although most skilled nursing facilities in the state are certified, the Illinois Nursing Home Care Act does not require it. A certified facility is one that is under contract to receive federal Medicare or Medicaid funds. The Illinois Department of Public Health regulates standards of care for all nursing homes in the state whether or not a facility receives federal funds.
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Illinois Nursing Home Advocates Concerned Residents May be Neglected as a Result of New Law

by Dave Abels

Recent legislation that included Illinois nursing home Medicaid rate cuts has reportedly angered resident advocates across the state. Although nursing home industry spokesperson Pat Comstock, Executive Director at the Health Care Council of Illinois, stated the recently signed Senate Bill 2840 will not affect the level of care required by sweeping nursing home legislation that was passed in 2010, others disagree. Wendy Meltzer, Director at Illinois Citizens for Better Care in Chicago, said the new law’s staffing level requirements are not only confusing, but will also be tough to enforce. According to Meltzer, many long-term care facility residents will likely suffer neglect as a result of the law.

The nursing home reform legislation was reportedly introduced as a result of a number of newspaper articles regarding dangerous conditions and inadequate staffing levels at skilled nursing facilities located throughout the state. Although resident advocacy groups allegedly agreed to determine what sort of care facility employees would be used to meet the requirements of the new law after the legislation was passed, disagreements arose once the matter was before the state legislature’s Joint Committee on Administrative Rules. In addition, despite that research purportedly demonstrates that 20 percent of nursing and personal care should be provided by registered nurses (RNs), the Health Care Council advocacy group allegedly disagreed. Instead of asking skilled nursing facilities to utilize federal matching funds to pay the estimated $105 million required to meet the suggested 20 percent RN resident care level, the Health Care Council reportedly argued that only 10 percent of patient care should be provided by RNs.

As part of recent state budget negotiations, the 10 percent RN care rule advocated for by the Health Care Council was adopted. Some believe the RN staffing level adopted is too low and disabled and senior residents throughout Illinois will suffer. Still, according to Comstock, many of the approximately 800 nursing homes in Illinois will be required to employ additional RNs as a result of the law. Resident advocates also argue that the way in which RN staffing levels will be tied to the overall nursing home reimbursement system may make it more difficult for inspectors to effectively determine whether a long-term care facility is adequately staffed. Meltzer conceded that RN staffing levels will increase under the law but she reportedly believes nursing home residents with dementia and other difficult to manage disorders are likely to suffer neglect.

Insufficient staffing levels are a frequent cause of nursing home abuse or neglect in Illinois and throughout the nation. The Illinois Nursing Home Care Act required long-term care facilities to increase staff numbers in an effort to fully meet the needs of all skilled nursing facility residents. The law required all nursing homes in Illinois to provide at least 2.5 hours of direct care staffing for every resident by July 1, 2010. In addition, elder and disabled care facilities operating in the state must provide 3.8 hours of direct care staffing for each patient by January 1, 2014.
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Newly Privatized Libertyville Nursing Home Receives 14 Citations from State Inspectors

by Dave Abels

Two recent state inspections noted 14 total deficiencies at a skilled nursing facility located in Libertyville. The deficiencies found at the recently privatized county facility included patient falls from both wheelchairs and beds, a lack of fall prevention measures, improper maintenance of medical equipment, assistance buttons placed in such a way it was impossible for residents to reach them, insufficient overnight staffing levels, inadequate staff training, poor sanitation, improper handling of patient medication, and other issues. In addition, Illinois Department of Health and Human Services inspectors also noted a number of elderly Winchester House residents were improperly prescribed anti-psychotic medications.

According to the Lake County nursing home’s Facility Administrator, Richard Curtis, each of the issues cited by state inspectors was remedied within four weeks of the annual license and certification survey completed in October. He said many of the problems noted at the facility were typical and Winchester House took the violations seriously. Curtis also added that three years ago, before the facility was privatized, the nursing home received 21 citations following a similar unannounced state inspection.

Currently, Winchester House provides long-term care to 177 residents and employs approximately 160 people. Three-fourths of facility employees are reportedly registered nurses. Last December, Health Dimensions Group took over management of the certified nursing home. Still, an advisory board that includes two members of the Lake County Board assists with facility oversight. According to Lake County Administrator Barry Burton, Health Dimensions Group violated only minor state requirements and is highly focused on cost containment measures.

In Illinois, most nursing homes and other long-term care facilities receive Medicare and Medicaid funds. This means they are considered certified skilled nursing facilities. Doctors who treat residents at Illinois certified nursing homes must adhere to both state and federal laws and regulations. Too often, physicians and other nursing home caregivers choose to provide patients with inappropriate pharmaceutical drugs in order to compensate for understaffing. Because many elderly and disabled nursing home patients cannot advocate on their own behalf, any suspected over-medication or other resident abuse should always be discussed with an experienced lawyer.
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Lawsuit Filed Against Arlington Heights Nursing Home After Maggots Discovered in Resident’s Ear

by Dave Abels

The family of a 92-year-old Alzheimer’s patient recently filed a lawsuit against an Arlington Heights skilled nursing facility after the woman’s left ear required surgery as a result of becoming infested with maggots. The Lutheran Home for the Aged resident is reportedly unable to speak and the infestation was only discovered after she began tugging at her ear. Physicians at Northwest Community Hospital allegedly removed 57 maggots from the patient’s ear canal. Laboratory testing estimated the maggots were up to three days old at the time of removal.

According to the patient’s daughter, the elderly nursing home resident requires periodic ear flushing and other treatments as a result of a previous surgery. In addition, the resident’s ear was reportedly treated for wax build-up nine days before the maggot infestation was discovered. Her daughter said the woman’s doctor prescribed ear drops that were designed to be administered four times daily in order to treat the malady. According to the long-term care facility, the drops were administered on schedule and the last dose was placed in the woman’s ear the night before the maggots were discovered. Her daughter stated she now questions whether the nursing home resident’s medication was ever administered.

The elderly woman’s family filed a lawsuit against the Lutheran Home for the Aged seeking damages for negligence and emotional distress. Her daughter said although photos of the infestation were awful, listening to her mother scream while the maggots were removed was horrifying. Still, the nursing home’s administrator, Phillip Hemmer, maintains the facility’s staff did nothing wrong. According to Hemmer, a nursing assistant brought the infestation to the attention of a facility nurse who then notified the medical director at the nursing home. The medical director reportedly decided the patient should be examined by doctors at a local hospital. Hemmer said prior to this time, the maggots were too small to be seen by the naked eye.

Following the incident, the nursing home reportedly hired an insect exterminator to inspect the facility. According to facility administrators, no flies were found on the premises. Instead, the nursing home contends that a fly must have entered the 92-year-old’s ear canal and laid eggs while she was walking outside with a private caretaker. Although the Lutheran Home for the Aged claims the Illinois Department of Public Health failed to find any violations related to the woman’s case, state officials reportedly issued $1,100 in fines to the facility in November. The fines allegedly resulted from other complaints related to patient care. The woman’s family has since moved her to another long-term care facility.

The Illinois Elder Abuse and Neglect Act was created to respond to allegations of senior citizen abuse or neglect throughout our state. The Illinois Department of Public Health is tasked with investigating and responding to all reports of elder neglect or abuse that occur in a skilled nursing home or other long-term care setting. As was unfortunately the case in this instance, some nursing home residents are unable to report abuse or neglect by a caregiver. If you suspect a disabled or elderly nursing home patient is being neglected or otherwise mistreated, you should speak with a qualified nursing home abuse and neglect attorney.
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Study Finds Norovirus Outbreaks Place Nursing Home Residents at Increased Risk in Illinois and Nationwide

by Dave Abels

A recent study conducted by researchers at the University of Chicago’s Pritzker School of Medicine reportedly found that nursing home residents were much more likely to be hospitalized or die during a norovirus outbreak. The study, published in a recent issue of the Journal of the American Medical Association, compared patient hospitalization and death rates during confirmed outbreak periods versus non-outbreak periods between January 2009 and December 2010 at 308 certified skilled nursing homes in three states. The data used was reportedly collected from the National Outbreak Reporting System maintained by the nation’s Centers for Disease Control and Prevention. Additionally, nursing home resident deaths were verified through the federal Medicare Minimum Data Set.

According to the study, at least 1,000 gastroenteritis outbreaks are identified in nursing homes every year in the United States. In addition, norovirus is reportedly the suspected cause in 86 percent of confirmed outbreaks. Of the 407 norovirus outbreaks analyzed by researchers, a long-term care resident was hospitalized in 29 percent of cases and died during seven percent of the outbreaks. In addition, more than 2,500 hospitalizations and almost 1,100 nursing home resident deaths allegedly occurred during a confirmed norovirus outbreak during the time period examined by researchers.

The norovirus outbreaks analyzed by researchers lasted an average of 13 days. Although hospitalizations reportedly increased during the first two weeks of an outbreak, resident deaths spiked during the initial week. After two weeks, the study authors found that hospitalization and death rates returned to previous levels. Interestingly, the study reports that skilled nursing facilities with a higher proportion of daily registered nurse hours per resident did not exhibit an increase in resident deaths during a norovirus outbreak. Unfortunately, the ratio of daily registered nurse hours did not appear to have an effect on resident hospitalization rates during such an outbreak. Study authors concluded that infection control strategies and other measures designed to prevent the spread of illness should be implemented at all long-term care facilities in an effort to protect the health and well-being of the approximately 3.3 million nursing home residents nationwide.

Because residents normally live in close proximity to one another, communicable diseases often spread easily in nursing homes. Long-term care facility employees are required to take precautionary measures to control the spread of disease in Illinois nursing homes. Proper sanitation is vital to the health of nursing home residents in Illinois and elsewhere. Unfortunately, many nursing home workers fail to use simple sanitation techniques such as washing their hands between each patient. This simple omission constitutes negligence on the part of skilled nursing facility staff. In addition, all nursing home facilities in Illinois are required to designate an infection prevention and control professional to develop and implement policies aimed at reducing and controlling both infections and communicable diseases. If your friend or family member died from a preventable disease he or she contracted as a result of nursing home caregiver negligence, you should speak with a nursing home abuse and neglect attorney as soon as possible.
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Former Caseyville Nurse Sentenced For Stealing Drugs From Nursing Home Residents

by Dave Abels

Last month, a former Illinois Licensed Practical Nurse (LPN) was sentenced to two years of probation in connection with filing fraudulent prescription claims with Medicaid. The 34-year-old woman allegedly kept hydrocodone pills for herself that were intended for residents at the Caseyville nursing home where she was employed. Additionally, the former LPN reportedly made false prescription requests for the drug between 2010 and January 2012. By stealing drugs from numerous residents, the woman allegedly caused at least 11 fraudulent claims to be submitted to the Illinois Medicaid Program.

The former nurse’s alleged criminal activity was investigated by the Caseyville Police Department, Illinois State Police Medicaid Fraud Control Bureau, and agents from the nation’s Department of Health and Human Services. In June, the woman pleaded guilty to one count of health care fraud. Although she received probation, the former LPN reportedly faced a maximum possible sentence of 10 years in prison in connection with the crime.

As this case demonstrates, the over-medication of elderly and disabled patients is not the only way prescription medication issues can lead to neglect or abuse in Illinois nursing homes and other long-term care facilities. Sadly, some misguided nursing home employees may choose to steal the necessary medications that were prescribed to your elderly or disabled loved ones. Because prescription drug abuse has exploded throughout the nation in recent years, senior citizens are increasingly being left without the pain medication they need. Such abuse is wholly unacceptable.

When aging loved ones are no longer able to care for themselves, many Illinois families turn to nursing home facilities for assistance. Sadly, nursing home negligence can cause numerous injuries to long-term care facility patients. Neglected elderly and disabled nursing home residents may exhibit broken bones, bedsores, cuts and bruises, or even premature death. In addition, nursing home patients may be subjected to verbal abuse or denied access to necessities such as water, food, and prescription medications. No matter the type of mistreatment, all suspected cases of nursing home abuse or neglect in Illinois and nationwide should be taken seriously and reported.

The Illinois Elder Abuse and Neglect Act was enacted in an effort to respond to senior citizen abuse throughout the state. The Illinois Department of Public Health is tasked with investigating and responding to all reports regarding elder neglect or abuse in a nursing home or other long-term care setting. Law enforcement, healthcare, and social service professionals are also required to notify the Illinois Department of Health whenever they suspect a senior citizen who is unable to self report has been victimized by a caregiver.
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