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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.

Illinois lawmakers seek hearings after failure to investigate nursing home complaints

September 15, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The Illinois Department of Public Health has hired a former U.S. Attorney to review the department’s failure to investigate complaints of nursing home abuse and neglect in long-term care facilities for more than three months over the course of the pandemic.

Last month, Deputy State Long-Term Care Ombudsman Chuck Miller said he and others could not properly advocate for residents they represent due to COVID-19 restrictions. “I’ll just say our program has had difficulties because we’re not regulators,” he said.

The department said that for more than 15 weeks during the COVID-19 shutdown, the Bureau of Long-Term Care was not properly processing or investigating claims.

Illinois law requires abuse and neglect complaints to be reviewed within certain time frames was not suspended. IDPH personnel did not complete reviews of allegations of abuse and neglect in a timely manner between March 15 and June 30.

According to the Washington Examiner, the department has more than 272 allegations of abuse and neglect from that period and substantiated the factual circumstances of 17 of those complaints.

To ensure findings are thorough and accurate, IDPH has hired former U.S. Attorney Cox to conduct a thorough review of the complaints that IDPH found to be unsubstantiated.

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.

How do I report nursing home abuse in Illinois?

December 3, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Making the decision to place a loved one in a nursing home facility can be very stressful for the person, as well as the family. You can do all the research for your loved one and where you think may be best suited for their needs. You can even talk to the facility, staff members, and tour the facility to make sure it is their best option.

But even then, the facility may not turn out to be as great as you thought it was. What if you visit your loved one, and notice something may be off? Nursing home abuse is more common than you think, and often is not reported. You may be confused and not know what’s going on, and sometimes your loved one can’t verbalized what they’re experiencing. According to the Nursing Home Abuse Center, these are the steps you should take if you suspect your loved one is being abused:

Evaluate the situation

Before reporting abuse, you should assess why you want to report suspected abuse or neglect. It’s a good idea to write a summary of what has happened so you don’t miss anything when reporting a nursing home facility. Some questions to ask yourself include:

Did my loved one complain about treatment that he or she is receiving in the nursing home? Have other residents voiced similar complaints?
Have I seen signs of abuse and neglect such as bed sores, cuts, or bruises?
Did I personally witness abuse or neglect of my loved one?
Who has inflicted the harm my loved one has suffered?
When did the harm occur?

The more you understand your concerns, the better you will be able to communicate these concerns to authorities. Please assess whether your loved one may be facing immediate harm. If so, you should take steps to immediately remove him or her from the facility.

File a complaint with local Illinois Long-Term Care Ombudsman or Senior Helpline

Once you understand the situation at hand, contact your local Illinois Long-Term Ombudsman Program. This program provides nursing home residents with their own advocates that will help them with any complaints they may have, as well as enhance their overall quality of life. This program is normally free of charge. The Ombudsmen are able to:

Listen to the concerns of the patient and their family members
Inform residents of their rights and possible legal action
Provide information on different nursing home options
Work with the current nursing home staff to make changes
Get law enforcement involved, if necessary.

You can find contact information for your local Ombudsman by visiting the Department of Aging website, or by calling the toll-free number (866) 800-1409 or (888) 206-1327 (TTY).

The Ombudsman may attempt to work directly with the nursing home facility to address the issue raised by your complaint. If that doesn’t resolve the issue, the Ombudsman will assist you in a complaint with the Illinois Department of Public Health (IDPH).

You can also report suspected abuse or neglect by contacting the Senior HelpLine. The Senior HelpLine is available Monday through Friday from 8:30 a.m. to 5 p.m. You can call their toll-free number at (800) 252-8966 or (888) 206-1327 (TTY) or by e-mail at aging.ilsenior@illinois.gov.

File a complaint with IDPH

The next step is to file a complaint with the IDPH. You can download the IDPH Complaint Form and send it to IDPH by fax or mail, or you can use the form to guide you if you’d like to report by phone.

Be prepared to answer the following questions:

Who was the resident that was abused or neglected? Be prepared to give the name and age of your loved one. Please provide the names of staff members or administrators you believe to be involved.
What happened to the nursing home resident? Be prepared to describe specific acts of abuse or neglect that you believe to have occurred. For example, was your loved one assaulted by a staff member? Are staff members administering medications without authorization? Have you found bedsores on your loved one from nursing home staff failing to re-position them?
When did the abuse or neglect occur? Provide specific dates or time periods in which the abuse or neglect occurred.
Where is the facility located? You will need to provide the name of the nursing home and where the facility is located. You can verify this information by visiting the IDPH’s nursing home directory. Please provide the room number and floor number the mistreatment occurred on.
How was the resident harmed or potentially harmed? Keeping a journal to note the harm your loved one has endured is important so you are able to relay this information to IDPH and potentially the authorities. Being able to describe specific instances of harm your loved one has experienced is critical.

You can contact IDPH at:

Phone: (800) 252-4343 or (800) 547-0466 (TTY)
The hotline is open from Monday through Friday 8:30 a.m. to 4:30 p.m.

Fax: (217) 525-8885

Mail: Illinois Department of Public Health
Office of Health Care Regulation
525 W. Jefferson Street, Ground Floor
Springfield, IL 62761-0001

If you would prefer to stay anonymous, you can do so; however, if you would like to receive a written confirmation that your complaint has been received and to be informed of the results of IDPH’s investigation, you must give your name, address, and phone number. IDPH will not reveal your identity as the one who filed the complaint unless:

You give written permission.
Your identity is essential to the investigation.
A court case is filed by IDPH against the nursing home.

It’s important to know the facility cannot retaliate against your loved one which includes harassment, discharge or transferring the resident, simply because you filed a complaint. The IDPH is legally obligated to investigate your complaint. If you report abuse or neglect, IDPH must complete an investigation within seven days. All other investigations must be completed within 30 days.

Keep an eye out

Although you reported abuse or neglect, it’s important to still keep an eye out for your loved one until the issue is resolved. Whenever your visit your loved one, make sure to take a look around and check for anything that may be out of order. It’s also important to make sure your loved one is happy and healthy. If you ever find yourself suspecting abuse occurring in your loved ones facility, report it immediately. Time is crucial, especially in a circumstance like this.

Contact a lawyer

It’s important to contact an experienced and knowledgeable nursing home abuse lawyer to ensure your loved ones rights are fully protected. A lawyer can serve as a liaison between your family, the nursing home, and IDPH during the investigation, or can conduct an independent investigation.

A lawyer will help your assess your options for seeking relief through a lawsuit which can include compensation for any physical, emotional, or financial harm your loved one has endured.

To schedule a free, no obligation consultation, you can contact our office at (312) 384-1920 or (800) 693-1LAW (toll-free). Please visit our website for any additional information including verdicts and settlements.