Late Medicaid Payments Allegedly Place Illinois Nursing Home Residents at Risk

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.

If you believe your family member was abused or neglected while residing in a long-term care facility in Illinois, you should contact the hardworking attorneys at Abels & Annes, P.C. Our capable Chicago nursing home abuse and neglect lawyers are available 24 hours per day, seven days per week to help you protect the rights of your elderly or disabled loved ones. For a free consultation with a committed attorney, please give Abels & Annes, P.C. a call at (312) 475-9596 today.

More Blogs:

Federal Nursing Home Deficiency Reports Available Without Redactions for the First Time in Illinois and Nationwide, Illinois Nursing Home Abuse Lawyer Blog, January 24, 2013
Seniors in Illinois and Nationwide May Receive Inadequate Care from Private Medical Providers, Illinois Nursing Home Abuse Lawyer Blog, January 20, 2013
Additional Resources:

Deadbeat Illinois: Long-term care facilities struggling, by Kevin Haas, GateHouse News Service