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Never Sign An Arbitration Clause in Nursing Home Contracts

February 4, 2021/in Blog/by Yao Dinizulu

CHICAGO, IL – Nursing homes in Illinois often ask residents to sign an arbitration agreement as long as it is drafted in compliance with Illinois law. Some nursing homes practice forced arbitration by removing residents right to file a claim through the public court system in a formal, signed agreement. The American Bar Association (ABA) defines arbitration as “a private process where disputing parties agree that one or several individuals can make a decision about the dispute after receiving evidence and hearing arguments.”

Arbitration is similar to what happens in trial in terms of those who are involved will present their case along with evidence to an arbitrator; however, parties may not have to follow state or federal rules of presenting evidence. At the same time, arbitrators are not always required to apply the governing law.

The American Association for Justice (AAJ) collected five years of data on consumer and employment forced arbitration reported by the nation’s two largest arbitration providers: the American Arbitration Association (AAA) and Jams. The findings concluded were:

On average, only 382 consumer per year win a monetary forced arbitration.
There are more than 800 million arbitration clauses estimated to be in effect. The study found there are only 6,000 consumer arbitration claims filed each year.
Over the five years studied, consumers brought 6,012 claims valued around $3.7 billion in damages. They won monetary awards in only 131 cases.
Americans are more likely to be struck by lightning than they are to win a forced arbitration.
Over the span of the five-year study, only 16 nursing home arbitrations were reported to AAA. No residents won their case while nursing home corporations won four of the six they initiated.

How Americans Are Hurt By The Fine Print

Nursing homes facilities often try to sneak protections for themselves into Admission Agreements before residency even begins. The effects arbitration clauses have on residents can be determinantal. The AAJ mentions the effects residents endure by not reading arbitration clauses:

One-sided requirements: Most forced arbitration clauses require residents to waive their rights, while allowing nursing homes to sue in court.
High costs: In addition to hiring a lawyer, the resident or family has to often pay hefty fees just to initiate their case and pay their share of the arbitrator’s hourly charges. Forced arbitration clauses also allow the nursing home to choose the location, regardless of the inconvenience or costly travel for the resident.
Biased Decision-Makers: Nursing homes are repeat users of an arbitrator, meaning there is a disincentive for arbitrators to rule in favor of nursing homes.
Weak Civil Justice Safeguards: Forced arbitration clauses often have tight restrictions on the individual’s ability to argue his/her side of the case. For example, many arbitrators restrict the individual’s ability to obtain necessary evidence. It is also nearly impossible to appeal decisions by arbitrators. According to experts cited by the Washington Post, the amount of damages awarded, if any, has the potential to be less if the case were to be heard by an arbitrator as opposed to going to trial.
Secret Backroom Proceedings: Most forced arbitration clauses require that proceedings be kept confidential, even if the case raises important public health and safety issues.
Bounding: Parties are bound by the terms of the contract so wrongful death claims brought on behalf of a resident’s next of kin are not bound by the arbitration agreement.

Know What You’re Signing Before You Sign It

According to Illinois General Assembly, an arbitration agreement “may bar an action at law against any hospital or health care provider who is a party to the agreement on the grounds of respondeat superior for the negligence or other wrongful act of any employee reasonably alleged to have caused the injuries on which the claim is based.”

Under the Health Care Arbitration Act, it requires certain provisions to be included in arbitration agreements to make the information more conspicuous to signatories. Illinois contract requires that a person must possess sufficient mental capacity in order to sign a contract. This issue arises often in nursing home settings where a resident may not be mental competent due to dementia or Alzheimer’s. A resident or family member who does not feel confident that they have a firm understanding of what rights they’re waiving by signing the contract should seek advice from an experienced nursing home abuse and negligence attorney.

CMS Final Rule on Forced Arbitration, July 2019

Forced arbitration practices change throughout administrations. In 2016, the Obama administration banned forced arbitration only to be turned over by the Centers for Medicare & Medicaid. Under the Final Rule published in July, long-term care facilities must comply with the following criteria:

Not require a resident or his/her representative sign an agreement for binding arbitration as a condition of admission to, or as a requirement to continue to receive care at a facility.
Ensure that the agreement is explained to a resident or his/her representative in a form, manner, and language that he/she must acknowledge that he/she understands the agreement.
Ensure that the agreement provides for the selection of a neutral arbitrator agreed upon by both parties and a venue that is convenient to both parties.
Ensure that the agreement does not contain any language that prohibits or discourages the resident or anyone else from communicating with federal, state, or local officials.
Retain copies of the signed agreement for binding arbitration and the arbitrator’s final decision for five years after the resolution of any dispute resolved through arbitration with residents. These documents must be available for inspection upon request by CMS or its designee.
Grant residents a 30-calendar day period during which they may rescind their agreement to arbitrate.

How the Dinizulu Law Group, Ltd. Can Help You

If you or a loved one has suffered injury or death due to a nursing homes negligence, you make seek compensation to hold wrongdoers accountable. Our attorneys have experience in interpreting nursing home agreements and know when our clients are being mistreated.

Our consultations are always free and confidential. Please call our office located in downtown Chicago, Illinois for a free consultation at (312) 384-1920 or visit our website for more information.

How Are Nursing Homes Different than Assisted Living Facilities?

December 2, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Many people often mistake nursing homes with living assisted facilities; however, the two offer two different levels of care. Assisted living facilities often provide personal care in a home-like, social setting and is generally for people who need extra monitoring or help. On the other hand, nursing homes are for people who are seriously ill and require around the clock care and monitoring.

According to the law in Illinois, assisted living facilities are described as “a home, building, or residence, or any place where sleeping accommodations are provided for at least three unrelated adults, in which at least 80% are 55 years of age or older, where the following is provided: services based on a social media where the resident’s unit is their home, mandatory services such as meals and laundry, and a physical environment that is a homelike setting,” (77 ILCS 295.200).

Long-term care facilities, like a nursing home, have a much higher level of care than a senior living home and different requirements under the law. According to Illinois law, a long-term care facility is “a private home, institution, building, or residence, or any other place, whether operated for profit or not, or a county home for the infirm and chronically ill,” (210 ILCS 45/1-113).

Care and Services Provided in Senior Housing

Assisted living facilities are generally for people who need help with activities of daily living. Assisted living is a more independent level of living. Someone who suffers from memory loss and who isn’t safe living alone is someone who would live in assisted living.

By contrast, residents in nursing homes require around the clock care and monitoring. Residents in nursing homes offer suffer with more complex health care conditions that require additional assistance of a skilled nurse or a physical or speech therapist. Nursing homes legal purpose is to provide residents with intensive health care and nursing care to people who suffer from chronic conditions, like dementia or Alzheimer’s.

Regulatory Differences Between a Nursing Home and Assisted Living in Illinois

Nursing homes in Illinois are licensed, regulated, and inspected and/or certified by a number of public and private agencies, including the Illinois Department of Public Health (IDPH) and the U.S. Department of Health and Human Services Centers for Medicare and Medicaid (CMS). The IDPH is responsible for ensuring all nursing homes in the state comply with mandatory state regulations. IDPH also ensures facilities accept Medicare and Medicaid payment for services rendered to program beneficiaries meet all federal regulations.

Nursing homes are inspected at least once every six to 15 months, according to IDPH. Nursing home inspections, whether standard or in response to a complaint, are conducted without giving notice to the facility.

Assisted living facilities are often loosely regulated. Regulations are set by individual state laws, which is different in every state, and are not monitored by state or local governments. Assisted living facilities also do not receive Medicare or Medicaid funding. Illinois’ state regulation of assisted living facilities include is they must be licensed by the Division of Assisted Living.

Though there are some differences in nursing homes and assisted living facilities, there are many obvious differences. Before deciding where to place your loved one, make sure to research both facilities before determining which is a right fit.

CMS Issues Memo Reaffirming Nursing Home Residents’ Right to Vote

October 22, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The Centers for Medicare & Medicaid Services (CMS) has issued a memo affirming the continued right that nursing home residents are allowed to exercise their right to vote. The memo recognizes limitations visitors have to enter facilities to assist residents in voting; however, nursing homes must still ensure residents are able to exercise their Constitutional right to vote.

Residents’ Rights include:

483.10(b) Exercise of Rights: The resident has the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States
483.10(b)(1): The facility must ensure that the resident can exercise his or her rights without interference, coercion, discrimination, or reprisal from the facility
483.10(b)(2): The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights as required under this subpart

A resident has the right to vote and must not be impeded in any way by the nursing home facility and its staff. Nursing homes should have a plan in place to ensure residents are able to exercise their right to vote, whether in-person, by mail, absentee, or other authorized process. Some states may have specific programs to enable nursing home residents to vote in which the facility should coordinate and engage with those programs. This may include:

Mobile Polling in residential facilities performed by a bipartisan team of workers; and/or
Assistance in registering to vote, requesting an absentee ballot, or completing a ballot from an agent of the Resident’s choosing, including family representative, LTC Ombudsmen or nursing home staff

If a resident is unable to cast their ballot in person, nursing homes must ensure residents have the right to receive and send their ballots via the U.S. Postal Service, or other authorized mechanism allowed by the State or locality.

CMS regulations specific to use of mail, which also apply to voting, for voting, include:

483.10(g)(7): The facility must protect and facilitate that resident’s right to communicate with individuals and entities within and external to the facility, including reasonable access to: (i) A telephone, including TTY and TDD services; (ii) The internet, to the extent available to the facility; and (iii) Stationery, postage, writing implements and the ability to send mail
483.10(h)(2) The facility must respect the residents right to personal privacy, including the right to privacy in his or her oral (that is, spoken), written, and electronic communications, including the right to send and promptly receive unopened mail and other letters, packages and other materials delivered to the facility for the resident, including those delivered through a means other than a postal service
- Promptly meaning the delivery of mail or other materials to the resident within 24 hours of delivery by the postal service, including a post office box, and delivery of outgoing mail to the postal service within 24 hours, except when there is no regularly scheduled postal delivery and pick-up service.

Additional information is available from the HHS Administration for Community Living related to voting rights and resources, as well as contact information for Long Term Care Ombudsmen can be found here.

How to Choose a Nursing Home in 2020

October 15, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Nearly 1.3 million residents live in nursing home facilities across the United States. Nursing homes should offer a safe place for your loved one who needs guided rehabilitation or a senior care facility their future residency. It’s normal to have questions and concerns about these facilities as a quarter of all residents will experience during their residency. The coronavirus pandemic has targeted the elderly nursing home population more than any other demographic.

When you begin to research, be sure to schedule a virtual tour of a facility. Ask to talk to the administrator and staff members and ask questions to learn about the nursing home’s staffing, training, environment, and infectious disease outbreaks.

Make sure to consider asking the following questions:

Facility Type:

Is the nursing home Medicare certified?
Is the nursing home Medicaid certified?
Are both the nursing home and current administrator licensed by my state?
Is rehabilitation care offered?
Does the nursing home offer specialized care, such as dementia?
Is there an arbitration agreement requested to be signed?
Will the nursing home create a care plan for my loved one?
Will the nursing home provide in writing to me their polices and procedures, services, charges, and fees before I move my love one into the facility?

Staffing:

Are you currently facing staffing challenges due to COVID-19?
Do staff wear masks and seem equipped with person protection equipment to protect against COVID?
How often is staff tested for COVID?
What is your staff to resident ratio?
Has there been a turnover in administration staff, such as the director of nurses, within the last year?
How long do nurses and aides spend with residents each day?
Do staff knock before entering a resident’s room?
Does the nursing home offer training and continued education for all staff?
How does the facility ensure they don’t hire staff members who have been found guilty of abuse, neglect, or mistreatment?

Safety, Infectious Disease & Care:

How are residents and staff screened for fevers and respiratory diseases?
What is your COVID outbreak history?
What is your COVID testing plan and response strategy?
Can residents still see their personal doctors?
Does the nursing home’s inspection report show the quality of care problems or other deficiencies?
Has the nursing home corrected all deficiencies?
Can I see the most recent health and fire inspection report?

Food:

Can the nursing home provide a special dietary need?
Do residents have a choice of food items at each meal?
Can residents eat when they want?
Does staff help residents eat and drink at mealtimes, if needed?

Residents Rooms:

Can residents have personal belongings in their room?
Does each resident have a storage space, such as a closet and drawers, in their room?
Does each resident’s room have a window in it?
Can a resident leave their room if showing signs of any illness? How do you minimize resident’s exposure to others who may be sick of tested positive for coronavirus?
Do residents have access to the internet, personal phone, television, and computer?

Hallways, Stairs, Common Areas, & Bathrooms:

What types of spaces do residents share?
How often are common areas cleaned and disinfected?
Are common areas, hallways, resident rooms, and doorways designed for wheelchair accessibility?
Are handrails appropriately placed in hallways and bathrooms?

Activities:

What types of activities are offered to residents, including those who are unable to leave their rooms, allowed to participate in?
Does the nursing home have outdoor areas for resident use?
When does the nursing home allow visitors? Are visits outside?
What disruptions has COVID-19 caused in group activities?

Use of Antipsychotic Drugs:

What percentage of residents who are diagnosed with dementia are prescribed antipsychotic medication?
Does the nursing home have specific policies and procedures related to the care of individuals with dementia?
What is the current rate of antipsychotic medication use within the facility?

Both state and federal laws protect the right of residents in nursing homes; however, each year nearly 5 million elders fall victim to abuse and neglect. Often times, negligence occurs because of understaffing and insufficiently trained to care for residents in long-term settings. When facilities do not comply with safety standards and employ adequate staff, residents may suffer from malnutrition, bedsores, dehydration, fatal falls, medication errors, come into contact with an infectious disease, or fall victim to abuse.

Resources for Nursing Home Abuse

The Centers for Medicare & Medicaid Services (CMS) has announced it is now easier for consumers to identify nursing homes and long-term facilities with instances of non-compliance related to abuse on their website. CMS is rolling out a warning icon strategy to highlight facilities that meet the following criteria:

Facilities cited for abuse where residents were found to be harms on the most recent standard survey, or on a complaint survey within the past 12 months;

Facilities cited for abuse where residents were found to be potentially harmed on the most standard survey or a complain survey within the past 12 months and on the previous standard survey or on a complain survey in the prior 12 months

The icon is designed a bright red “STOP” hand, which may negatively shift a provider’s overall federal quality rating, but the change is welcomed by elder abuse advocates after years of systematically being non-compliant with unexplained inconsistencies in quality measures. Consumers will now have access to more information about nursing facility’s history of abuse, neglect or exploitation citations when visiting the CMS’s Five-Star Quality Rating System through the Nursing Home Compare Website.

Contact Nursing Home Abuse and Neglect Attorneys in Illinois

If you suspect your loved one is being abused or neglected in a nursing home in Illinois, contact the attorney’s of Dinizulu Law Group, Ltd. Our attorney’s have extensive knowledge and resources in this area of law and offer a personalized service by working closely with clients throughout every step of the process. Call our office today for a free consultation at (312) 384-1920 or visit our website for more information.

CMS Clarifies Quality Reporting Rules After COVID Pause, Nursing Home Compare Frozen Until 2022

October 12, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The federal government waived several reporting requirements for nursing homes during the COVID-19 pandemic. Although they have been reinstated, the temporary pause will continue to have ripple effects on public data for years to come.

The Centers for Medicare & Medicaid Service (CMS) released an updated tip sheet explaining how the agency’s including data on the Nursing Home Compare website.

In March, CMS announced that the fourth quarter 2019 data for the Skilled Nursing Facility Quality Reporting Program (QRP) and the Value-Based Purchasing Program (SNF VBP) would be optional. This does not require submissions for the first and second quarters of 2020. The agency positioned the move as an emergency measure to allow health care providers to focus on the early days of the COVID-19 pandemic.

CMS Administrator Seema Verma stated the exceptions and extensions that were grant allows for CMS to support clinicians fighting coronavirus on the front lines.

The waived expired on July 1 with quality and Minimum Data Set (MDS) reporting resuming as usual. However, because of how much of CMS’s public data lags the present by several quarters, the pause will have a long-lasting ripple impact on Nursing Home Compare.

The missing data for quarter one and two of 2020 will impact what is displayed on the Nursing Home Compare too; however, CMS claims they have developed a strategy to accommodate these quarters of data.

Enough providers were able to voluntarily report quarter four 2019 data to include that information in the October refresh, which will also unveil six new quality measures. These include:

Changes in skin integrity post-acute care: pressure ulcer/injury
Drug regiment review conducted with follow-up for identified issues
Application of IRF function outcome measure: change in self-care
Application of IRF functional outcome measure: change in mobility
Application of IRF functional outcome measure: discharge self-care score
Application of IRF functional outcome measure: discharge mobility score

October 2020 data will remain constant until public reporting resumes in January 2022, with the next normal Nursing Home Compare refresh which is scheduled for April 2022.

If CMS should change the methodology for calculating measures before January 2022, the agency will follow normal rulemaking procedures with notice and comment periods, according to Skilled Nursing News.

CMS acknowledged the resumption of data reporting requirements on July 1 may have created data mismatches. For example, a resident who does not have an admission record in the MDS because it occurred during the pause.

The agency stated they will make adjustments on their end to accommodate any records that may have missing admissions. The mismatched sets of records will not be counted or included in SNF data calculations for Nursing Home Compare.

Coronavirus Outbreak in Illinois Nursing Home Facility

March 24, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Officials of the Illinois Department of Public Health (IDPH) have reported at least 46 people, including residents and staff members, have tested positive for coronavirus at a DuPage county nursing home. This outbreak is the first in a long-term care facility in Illinois. Chicago’s WGN9 reported the first confirmed test of a Willowbrook resident by state health officials.

Within a matter of days, the virus spread to other members at Chateau Nursing and Rehabilitation Center of Willowbrook, a southwestern suburb of Chicago. Forty-six people, thirty-three residents and 13 staff members – have all tested positive for the virus. Other residents are now isolated in another area of the facility as officials expect additional positive tests to come back within the near future.

Mayor Frank Trilla, said, “this could have happened anywhere.”

There haven’t been any unusual incidents at this nursing home before the outbreak, though the mayor noted that nursing homes are regulated by the state and not local government.

Centers for Medicare & Medicaid Services (CMS) established a new set of rules for nursing home facilities beginning on March 13. The critical new measures were designed to reduce the spread of COVID-19. The new set of rules directs facilities to to significantly restrict visitors and nonessential personnel, as well as restrict communal activities inside nursing homes, with exceptions for compassionate care, such as an end-of-life situation. All group activities and communal dining are canceled and be implementing active screening of residents and health care personnel for fever and respiratory symptoms. The only exception is for certain care situations, such as end-of-life situations. The new measures are CMS’s latest action to protect America’s seniors, who are especially vulnerable to contracting COVID-19.

The First Outbreak at a Nursing Home Facility

According to the CDC, seniors with multiple health conditions are at the highest risk for complications. There have been reports of large numbers of cases spreading rapidly through nursing homes, such as the Life Care Center in Kirkland, Washington. The New York Times reported two thirds of residents, 55 employees, and 14 visitors have tested positive for COVID-19. Thirty five people have died, claiming 12 percent of staff and residents lives. These death totals make up nearly half of the coronavirus death toll in Washington. These numbers are expected to increase as tests become more available.

The Life Care Center stated, “Current residents and associates are being monitored closely, specifically for an elevated temperature, cough and/or shortness of breath.”

It’s not clear how the virus reached the facility; however, according to the New York Times the first reported case of coronavirus in the United States was from a man in nearby Snohomish County.

Officials of the Life Care Center, which operates more than 200 facilities in 28 states, are monitoring residents and workers closely.

The Outbreak Continues to Spread

Other than the outbreak in Kirkland, at least 15 others have died and dozens more have been infected at long-term care facilities across the nation. Major outbreaks include Willowbrook, Illinois with 46 infections, four deaths in at least two facilities in New Jersey, 13 infected in Little Rock Arkansas, and 11 infected in Troy, Ohio, with at least 30 more showing symptoms.

“Nursing homes would always have been ground zero, but given we already have a huge staff shortage, this will be magnified,” said, David Grabowski, a Harvard Medical School professor who has studied staffing storages in nursing homes. “It could be worse for today’s nursing home facilities than ever.”

The spread of COVID-19 in a nursing home can amplify when patients are transferred and when staff and visitors come and go. The CDC has said visitors and healthcare personnel are the most likely sources of introduction into long-term care facilities. In a recent report by CDC, the agency went on to say, “Limitations in effective infection control and prevention and staff members working in multiple facilities,” can contribute to an outbreak.

How to Keep Residents Safe

The CDC has made additional recommendations for nursing homes as they work to keep residents safe, including:

Nursing homes should put alcohol-based hand sanitizer with 60-95 percent alcohol in every resident room – both inside and outside the room if possible – and in every common area
Sinks should be well-stocked with soap and paper towels for hand washing
Tissues and facemasks must be available for people who are coughing
Hospital grade disinfectants must be available to allow for frequent cleaning of high-touch surfaces and shared resident equipment

More information on a full list of CDC’s guidance for nursing homes safety can be found here.

Counties in Illinois with Confirmed COVID-19 Cases:

Adams
Christian
Champaign
Clinton
Cook
Cumberland
DeKalb
DuPage
Kane
Kankakee
Kendall
Lake
LaSalle
Madison
McHenry
McLean
Peoria
Sangamon
St. Clair
Washington
Whiteside
Will
Williamson
Winnebago
Woodford

Any nursing home with residents suspected of having COVID-19 should contact their local health department immediately. To remain updated on long-term care and nursing home updates, please visit the CMS website.

Negligence Related to Coronavirus

If a loved one has sustained a serious infectious disease complication or missed a medical treatment provided by a nursing home or the understaffing in facility, we can help you. Please reach out to Dinizulu Law Group, a Chicago-based law firm with extensive experience in nursing home negligence. For a free consultation, please call (312) 384-1920.

Better Oversight in Needed in Nursing Homes to Protect Residents

December 16, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – The Centers for Medicare and Medicaid Services (CMS) is responsible for ensuring nursing homes nationwide meet the federal quality standard of care, including residents be free from abuse. CMS has a contract with state agencies that allow citations on nursing homes for any incidents of abuse.

What GAO Found

In June 2019, the U.S. Government Accountability Office (GAO) report found that from 2013 to 2017, nursing home abuse citations more than doubled, increasing from 430 reports in 2013 to 875 in 2017 and the largest increase in severe cases. There are gaps in the oversight that make it difficult to protect residents from the abuse occurring within nursing home facilities.

Specifically, the main concerns by GAO include:

Information on abuse and perpetrator types is not readily available. CMS’s database does not allow the type of abuse or perpetrator to be identified by the agency. Specifically, CMS does not require state agencies to record abuse or perpetrator type, and even when recorded, it cannot be easily analyzed by CMS. GAO suggested that CMS require state agencies to submit data on abuse, perpetrator types, and HHS concurred.
Facility reported incidents lack key information. Federal law requires nursing homes to self-report allegations of abuse and covered individuals to report reasonable suspicions of crimes against residents. CMS has not provided any guidance to nursing homes on what information should be included in facility-reported incidents, which contributes a lack of information to state agencies and delays in on-going investigations.
Gaps exist in the CMS process for state agency referrals to law enforcement. There are gaps in CMS’s process for reporting incidents to law enforcement officials. These gaps may limit or delay CMS’s ability to ensure that nursing homes meet federal requirements to ensure residents are free from abuse. GAO identified issues relating to:
1. Referring abuse to law enforcement in a timely manner,
2. Tracking abuse referrals,
3. Defining what it means to substantiate an allegation of abuse,
4. And sharing information with law enforcement.

Recommendations by GAO for Executive Action

The administrator of CMS should require that abuse and perpetrator type be submitted in CMS’s databases for deficiency, complaint, and facility-reported incident data where CMS can systematically assess trends in these data.
The administrator of CMS should develop and guide – using a standardized form – to all state agencies on the information nursing homes and covered individuals should include on facility-reported incidents.
The administrator of CMS should require state agencies to immediately refer complaints to law enforcement if they have reasonable suspicion that a crime against a resident has been committed when the complaint was received.
The administrator of CMS should conduct oversight of state agencies to ensure referrals of complaints, survey’s, and incidents within a reasonable suspicion be referred to law enforcement in a timely manner.
The administrator of CMS should develop guidance for state agencies clarifying allegations verified by evidence should be substantiated and reported to law enforcement and state registries in cases where federal deficiency may not be appropriate.
The administrator of CMS should provide guidance on what information needs to be contained in the referral of abuse allegations to law enforcement.

Why GAO Conducted this Study

Nationwide, nearly 1.4 million elderly or disabled individuals receive care in more than 15,500 nursing homes. CMS, an agency within the Department of Health and Human Services (HHS), defines the standards nursing homes must meet to participate in the Medicare and Medicaid program.

Often times, nursing home residents have physical or cognitive limitations that can leave them vulnerable to abuse. Abuse of nursing home residents can occur in many forms – including physical, mental, verbal, and sexual – and can be committed by staff, residents, or others in the nursing home. Any incident of abuse is serious and can result in potentially devastating consequences for residents such as mental anguish, serious injury, and even death.

What to do if You Suspect Abuse

You should contact an attorney immediately who is knowledgeable and experienced in nursing home abuse to ensure your loved one’s rights are fully protected. A lawyer may serve as the liaison between your family, the nursing home, and IDPH during the investigation, or can conduct an independent investigation.

An attorney will help assess your options to seek relief through a lawsuit, which can include compensation for any physical, emotional, or financial harm your loved one has endured.

To schedule a free consultation, please contact our office at (312) 384-1920 or (800) 693-1LAW. Please visit our website for any additional information including previous verdicts and settlements.

CMS Adds New Transparency on Nursing Home Abuse

October 23, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – The Centers for Medicare & Medicaid Services (CMS) announced that it will now be easier for the public to find nursing homes that have violated rules regarding abuse, neglect, or exploitation beginning today, October 23, 2019.

The agency’s Nursing Home Compare website provides detailed information about every Medicare and Medicaid-certified nursing home nationwide. The tool allows you to search by location and/or nursing home names. There is now an icon next to the nursing homes that have been cited reported violations.

Consumers are able to see violations through the inspection reports provided on the website; however, CMS stated that inspection reports are becoming too difficult to access and adding the icon feature will make it easier to find information about abuse citations. The icon warns consumers about the harmful abuse of a resident within the last year, and the potentially harmful abuse of a resident within the last two years. CMS will be updating data information monthly.

In April, CMS announced they were adding improvements to the State Performance Standards System (SPSS) including ending the freeze on the health inspection domain of the Five Star Quality Rating System by resuming traditional methods of calculating health inspection scores by using three cycles of inspections. They will be adding the long-stay hospitalization measure and a measure of long-stay emergency department transfers to the rating system. CMS will also be adjusting the thresholds for staffing ratings. Finally, the threshold for the ‘number of days without a registered nurse onsite’ which will trigger an automatic downgrade to one star will be reduced from seven to four days.

CMS Administrator Seema Verma said, “By holding inspectors accountable for conducting timely and consistent inspections, we’re holding nursing homes accountable for providing safe, high-quality care–helping ensure safe nursing home environments.”

CMS hopes to become more consistent and transparent, requiring hospitals to post their list prices for consumers and force them to post their payer-negotiated rates starting in January 2020. The U.S. Department of Health and Human Services (HHS) and Congress are thinking of ways to force drug companies to disclose to consumers the real cost of drugs. The measure, passed in May, was intended for healthcare consumers with price transparency for prescription medications to help lower prescription costs.

According to the Nursing Home Abuse Center, nearly 1-2 million U.S. citizens 65 years or older have been mistreated, exploited, or injured by a caregiver. Only about 20 percent of cases or abuse and neglect are reported. If you’re looking to place a loved one in a nursing home facility, it’s important to do your research before placing them in one. Now that CMC has provided consumers with nursing homes that have been cited for abuse, neglect, and exploitation, it will be much easier to assess facility’s that will be better suited for your loved one.

If you think you or a loved one has experienced abuse, neglect, or been exploited while at the hands of a caregiver, please call one of our experienced nursing home abuse attorney’s right away to schedule a free consultation. Do not wait to hear what the facility is going to do going forward to address this issue. Due to the statue of limitations, we will have to begin working on your case right away. For any additional information, please check out our website.

Phone: (312) 384-1920

Address:
221 N. LaSalle St., Suite 1100
Chicago, IL 60601