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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.

Department of Justice Launches National Nursing Home Initiative

April 8, 2020/in Blog/by Yao Dinizulu

Attorney General William P. Barr announced the launch of the Department of Justice’s (DOJ) National Nursing Home Initiative (NNHI), which will investigate nursing homes nationwide that provide “grossly substandard” care to their residents. The DOJ indicated that it was dedicating significant resources to partner with the U.S Department of Health and Human Services and local and state prosecutors to respond to life-threatening quality of care issues the nursing home industry currently faces.

The DOJ is committed to combatting elder abuse and financial fraud, as it affects at least 10% of Americans every year. Elder abuse is an intentional or negligent act committed by any person that causes harm or a serious risk of harm to an older adult. Through enforcement actions, training and resources, research, victim services, and public awareness, the DOJ serves to prevent all forms of abuse and neglect.

The DOJ announced nearly 30 investigations in nine states that are currently underway. The NNHI focuses on identifying, investigating, and prosecuting the most problematic nursing homes nationwide, including those that:

Consistently fail to provide adequate care to residents
Failure to adhere to basic protocols of hygiene and infection control
Failure to provide residents with enough food so they become sick or weak
Withholding medication, or
Using physical or chemical restraints or sedating a resident, unless otherwise stated by the resident’s physician

For example, care failure can cause residents to develop pressure sores, or bedsores, down to the bone. Residents should be turned every 2 to 3 hours when laying in a bed, while they should be turned every 15 minutes when sitting in a wheelchair. If nursing home staff act carelessly or fail to do their job, they leave residents vulnerable to developing an illness, or in some instances death.

Federal regulators and law enforcement have had the authority to develop and enforce quality-of-care standards for nursing homes, while state regulators have traditionally played a leading role in investigating and prosecuting nursing homes for quality of care violations. The Department prosecuted claims under the False Claims Act (FCA) which relates to the federal spending on nursing home care for Medicare and Medicaid beneficiaries.

“The HSS Office of Inspector General continues to pursue nursing home operators who provide potentially harmful care to residents who are often unable to protect themselves,” said Chief Counsel to the Inspector General Gregory Demske. “Creating the Initiative sends a message to those in charge of caring for beneficiaries that substandard care will not be tolerated.”

The NNHI is part of a broader commitment by the Department to combat elder abuse and fraud, two things that often happen in nursing facilities. The Elder Justice Initiative (EJI) was developed in 2016, which will coordinate the NNHI. The task force is dedicated to coordinating the prosecution of elder abuse, including physical abuse, financial fraud or exploitation, caregiver negligence or abandonment, sexual abuse, or psychological abuse.

According to a press release by the DOJ, all entities must meet state and federal requirements and are encouraged to consider the following:

Reviewing all surveys over the past 5 years and addressing citations of substantial quality of care
Ensure all internal and external complaints are appropriately addressed
Ensure the entity has a compliance program that flags and escalates any complaints or concerns to ensure they are properly handled

Under the DOJ’s increased scrutiny, operators and investors in nursing homes, assisted living facilities, and other skilled nursing facilities are encouraged to discuss the quality of care standards and concerns.

If you or a loved one has experienced abuse or neglect at the hands of a caregiver, you will need an experienced nursing home neglect and abuse attorney. Our team has proven success in nursing home cases and will use our extensive legal experience to help you navigate the process and to get you full and fair compensation for you or your loved one’s injuries. To receive a free consultation, please call (312) 384-1920 or visit our website.

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.

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

Senate Reports More Than 400 Facilities with “Persistent Record of Poor Care”

September 30, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Nursing home abuse is extremely under-reported in the United States; however, a list released by the Senate named nearly 400 facilities across the nation that had a record of “persistent poor care.” According to documents and interviews, budget cuts are the contributing factor by reducing available funds to focus on the inspections that are required for nursing homes.

Two Senators released a report in June for the families that are struggling to find the right nursing home for their loved ones. Many people had questions regarding why some homes were not disclosed, while others were publicly identified.

Senator Bob Casey, D-PA, and Senator Pat Toomey, R-PA issued the report stating, “we’ve got to make sure any family member or any potential resident of a nursing home can get this information, not only ahead of time but on an ongoing basis,” according to the Associated Press.

The report comes after the Center of Medicare and Medicaid Services (CMS) provided a list of nursing homes with ongoing issues and documented problems that were not publicly disclosed. More than 1.3 million Americans live as a nursing home resident in more than 15,700 facilities.

There is a Special Focus Facility Program in which CMS did not disclose the names of roughly 80 smaller nursing homes that are getting special inspection to help solved documented problems. Nursing homes that don’t improve and fix their standard of care could potentially be cut off by Medicaid and Medicare.

Medicare provides a website entitled “Nursing Home Compare” with detailed information regarding all Medicare and Medicaid-certified nursing homes across the country. Nursing homes that are in the Special Focus Facility Program can be identified by a small icon that is a yellow triangle.

CMS Administrator Seema Verma singled out federal budget problems as a factor according to the AP. Verma mentioned, “The number of special focus slots and total number of special focus candidates are based on the availability of federal resources. In 2010, there was room for 167 nursing homes and 835 candidates; now it’s down to 88 slots and 440 candidates.” Federal budget cuts were reduced in 2014.

Federal budget cuts are not the only factors: staffing level and clinical outcomes should be considered.

According to Modern Health Care, recent studies show that nursing home staffing levels are often much lower than what facilities are reporting. Half of the facilities that were analyzed met staffing levels less than 20 percent of the time; moreover, registered nurses in 91 percent of organizations met expectations less than 60 percent of the time. For-profit facilities were more likely to report higher staffing levels compared to not-for-profits.

This is a crucial factor when deciding what facility to place your loved one in. The Consumer Voice mentioned direct caregivers such as an RN, LPN, LVN, or CNA can have up to 5 residents in a day, 10 in the evening, or 15 at night; in addition to licensed nurses including RN, LPN, or LVN, during the day having 15 residents, in the evening 20, and at night 30 residents.

You don’t want to put your loved one in a nursing home where the staff to resident ratio is not sufficient enough care your loved one should be and needs to be given. On average, a RN in a nursing home in the United States has a salary of $61,363 as of August 2019; however, the range typically falls between $57,744 and $64,973 (Salary). It’s important to note many nursing homes are under-staffed, which means staff is overworked and underpaid, often times neglecting your loved one – especially if family is not consistently visiting.

Modern Health reported RNs spent 42 percent less time with residents on weekends, licensed practical nurses spent 17 percent less, and nurse aids spent 9 percent less. Large facilities often have a bigger decreased in staffing levels over the weekends – weekends tend to be busier than the weekdays. Staff that works long hours are more likely to lead to an increase of error while working with residents.

Clinical outcomes that should be evaluated beyond nurse staffing and patient safety, is evaluating nurses’ working conditions. Nurses could over-administer a patient’s medication, or perhaps equipment failure. Although this may seem like a small error, this can interrupt important patient care.

Nursing homes are required to provide residents with quality care. The World Health Organization defined quality of care as a “key component to the right to health, and the route to equity and dignity.” Quality of care includes safe, effective, timely, efficient, equitable, and people-centered care. Many nursing homes fall short of these expectations and requirements, and deficiencies can even go unnoticed.

It’s important to do extensive research on nursing home facilities before placing your loved one in one. Go to visit – check how residents and staff interact, what daily activities are offered, what kind of living accommodation your loved one will be in, and visiting hours.

Abuse in nursing homes and is not limited to physical, emotional, mental, or sexual abuse. It can also include financial exploitation, as well as neglect. It’s important to notify nursing home management and local law enforcement immediately if you suspect your loved one is suffering from neglect or abuse.

Our experienced nursing home abuse lawyers work diligently to seek compensation and justice for your loved one. Please call (312) 384-1920 or visit our website to schedule a free, confidential consultation in our downtown Chicago office, or we can meet wherever is convenient for you.

Contact info:
Dinizulu Law Group, Ltd.
221 N. LaSalle St., Suite 1100
Chicago, IL 60601