Understanding the Responsibilities of Illinois Nursing Homes

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As you assess the care that your loved one is receiving in a nursing home, you should pay attention to whether the facility’s staff, administrators and owners are living up to their legally mandated duties under state and federal laws. In addition to ensuring that a resident’s rights are respected – please see our section on “Understanding the Rights of Illinois Nursing Home Residents” – a nursing home must specifically:

1. Ensure that no resident is harmed by any intentional or negligent act or omission. If a resident is harmed, whether it is by a staff member or fellow resident, the nursing home can and should be held liable.
2. Establish a written plan to protect residents’ rights and carry out its responsibilities as required by law. The home must provide an explanation of the resident’s rights in writing to the resident at the time of admission or within two days after admission.
3. Inform staff members of resident’s rights and their responsibilities. The home has a legal duty to ensure that all of its staff members understand these rights and responsibilities. Again, if a nursing home resident suffers harm due to a violation of his or her rights, the facility owner and licensee can be held liable for damages.
4. Establish a complaint process. The nursing home’s policies and procedures for investigating and resolving resident complaints must be “clear and unambiguous” and available for inspection by any person.
5. Develop and implement a comprehensive care plan for each resident. The plan must be developed with the participation of the resident and his or her guardian. It must include measureable objections and timetables to meet the resident’s medical, nursing, mental and psychosocial needs and “allow the resident to attain or maintain the highest practicable level of independent functioning.”
6. Provide adequate staffing levels. In particular, under an Illinois law that was enacted in 2010, the facility must provide 3.8 hours of direct care staffing for every skilled care resident and 2.5 hours of direct care staffing for intermediate residents. The home can only admit that number of residents for which it is licensed.
7. Implement enhanced resident pre-screening procedures and background checks. The goal is to identify any potentially dangerous individuals.
8. Keep out or remove potentially dangerous persons. If administrators find that a person’s presence in the facility would be “injurious to the health and safety of a resident or would threaten the security of the property of a resident or the facility,” the person may be refused access. Any employee who is found to be perpetrator of abuse must be immediately barred from the facility. If a fellow resident is found to be the perpetrator of abuse, the resident must be evaluated and moved.
9. Immediately notify the resident’s next of kin, representative and doctor of the resident’s death. Those parties should also receive immediate notice if the resident’s death appears to be imminent.
10. Report violations as required by law. Under Illinois law, it is mandatory for certain professionals to report suspected abuse or neglect, including any doctors, registered nurses or staff members at a nursing home.

Who Holds Nursing Homes to Their Responsibilities?

The Illinois Department of Public Health (IDPH) is the state agency that is in charge of ensuring that the state’s nursing homes comply with state laws. The agency conducts more than 1,300 on-site inspections, or surveys, and responds to more than 6,000 complaints each year.

Many inspections and complaints result in disciplinary actions against a nursing home. According to the IDPH’s quarterly violation reports, which are available online, the agency initiated more than 2,000 disciplinary actions between 2010 and 2014:

Source: Illinois Department of Public Health

These violations fall into the following categories (from most to least serious in terms of the conduct involved and resulting sanctions and fines imposed):

• Type AA – When a condition or occurrence at a nursing home has caused the death of a resident due
• Type A – When a condition or incident could lead or has led to physical harm and a substantial probability of death, mental or physical harm
• Type B – When an incident that would likely cause mental or physical harm to a resident has occurred
• Type C – When a less serious incident has occurred that would not cause immediate physical or mental harm but could lead to the probability of such harm occurring.

In addition to ensuring that nursing homes comply with the Illinois regulations, the IDPH works with the U.S. Department of Health and Human Services for Medicare and Medicaid Services (CMS) to ensure that facilities that participate in Medicare or Medicaid meet their responsibilities under the Nursing Home Reform Act of 1987. A nursing home’s violation of federal regulations, or a “deficiency,” can lead to sanctions and fines as well.

Unfortunately, data from the Nursing Home Compare website indicates that numerous facilities throughout Illinois fail to meet their responsibilities. Between February 2012 and May 2015, more than 30,000 deficiencies were reported in Illinois nursing homes.

Source: Nursing Home Compare