For all the volumes of statutes on the books in the State of Illinois, there is a glowing vacancy when it comes to legislation to help protect our elders— and specifically nursing home patients. Call it a mere oversight if you wish, but much of the current legislation fails to address problems frequently encountered by individuals and families who have been abused or neglected in the states 1,000+ skilled nursing facilities.
Recognizing the litany of problems nursing home patients face when facilities go under-staffing, Illinois State Rep. Kelly Cassidy (D-Chicago) has introduced a new piece of legislation (HB 5668) to provide more guidance as to how skilled nursing facilities in Illinois need to be staffed.
Building upon existing states laws, Rep. Cassidy’s proposed legislation would promote the following issues:
1. Mandatory incident and violation reporting
Resident deaths, abuse, neglect or unusual incidents must be immediately reported to the Illinois Department of Public Health (IDPH), even if a resident does not die at the facility. Death reports must now include disclosure of medication errors or other incidents, and other violations must be reported to a resident’s next of kin or guardian.
Inspection violations must be disclosed to affected residents and their next of kin or guardian.
2. Requirements for treating mentally ill resident
Psychotropic medications can only be administered to objecting residents with a court order. Psychotropic medications may be administered to non-objecting residents incapable of giving informed consent.
IDPH may write rules on assignment of female residents to female-only units, which may be staffed only by female staff.
A psychiatric services rehabilitation coordinator (PSRC) must be available on call whenever there is no PSRC in the facility.
3. Resident advocacy
The Long-Term Care Ombudsman program will represent all long-term care facility residents, not just elderly residents, and increase staffing ratios so there is one ombudsman for every 3,500 licensed or approved beds served by the program by June 1, 2013, and one ombudsman for every 2,000 beds by June 1, 2014.
The state will make information clearly available to the public through electronic access to complete, near-current information on inspections and enforcement; information about facility staffing; and a database of the Consumer Choice Information Reports.
4. Consistent assignment
Staffing requirements will require that the same direct care staff stays assigned to the same residents, to the extent possible. There is an exemption if direct care staff request reassignment.
5. Mandatory liability insurance
All nursing facilities must maintain insurance against risks from neglect of a resident in an amount of at least $1 million per occurrence.
IDPH may deny a license application if the applicant does not have proof of liability insurance, and may suspend, revoke, or refuse to renew a license if the facility fails to maintain its liability insurance.
6. Certificate Of Need requirements
Nursing facility changes of ownership will now require a Certificate Of Need (CON) permit from the Health Facilities and Services Review Board.
A permit for change of ownership of a nursing facility with recent, serious violations will require a plan from the new owner detailing how the facility will remain in compliance. Facilities that do not follow such a plan will be subject to fines.
A nursing facility CON permit may be denied based on additional factors in operator history: insufficient staffing; repeated serious (AA) violations; failure to pay violations fines; termination of Medicare or Medicaid; lack of properly-credentialed administrator; or other “substantial failure” to follow licensing acts in the previous 5 years.
7. State Police training
Requires facility cooperation with State Police to train facility staff on preventing resident abuse and neglect.
8. Home Office Cost ReportsRequires the submission of home office cost reports to the state, by all “chain organization” facilities
Requires the public, online posting of several reports, including “home office cost report,” “facility cost report,” and “Consumer Choice report.”
9. Increased training
Increases training requirements for nursing homes, facilities for developmentally disabled, and Specialized Mental Health Rehabilitation facilities.
Increases minimum age and education requirement for Certified Nurse Assistants (CNAs) from 16 to 18 years, and from an 8th grade to a 10th grade education
As Chicago nursing home lawyers, we are grateful to see a lawmaker going to bat for nursing home patients across the state of Illinois. Sadly, the provisions of this bill are rarely considered by patients or their families until a nursing home injury or death has occurred. We will closely monitor Rep. Cassidy’s nursing home legislation as the bill proceeds though the revisionary process.
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