Long-Term Care - Illinois General Assembly

The ultimate penalty under the federal certification program is decertification – i.e., the cutoff of
all Federal funding to that facility. The threshold for decertification is much greater than
revocation, so a facility can be decertified, but continue to have a license to operate. Most often
decertification makes it financially impossible for a facility to continue operation.
The department operates a nursing home web page where the public can access information
about all long-term care facilities regulated by the department. The page includes information
about every regulated facility, and includes a guide on how to choose a nursing home. It also
provides specific data on each facility, including the ownership of the facility, staffing levels,
information related to the types of care provided, whether they're Medicare/Medicaid certified,
and what their private pay rates are. The page also includes actual surveys conducted by the
department, so individuals seeking to place someone in the nursing home can actually review
the deficiencies cited at that facility.
The department also operates a toll-free, 24-hour hotline for filing complaints. All complaint
allegations are investigated by our surveyors. Depending upon the severity, investigations may
be initiated within 24 hours if the allegation relates to some imminent hazard to a resident. If
there's an allegation of abuse or neglect, the department initiates the complaint investigation
within seven days, and all other complaint investigations are initiated within 30 days of receipt.
The department has a long-standing focus aimed at reducing the occurrence of abuse in Illinois
nursing homes. The department has a working relationship with the Illinois State Police
Medicaid Fraud Control unit, and it works with the department to address the criminal aspects of
these investigations. Any allegation of abuse and neglect that the department receives is
immediately referred to the Illinois State Police for them to determine whether or not there
should be a criminal aspect to the investigation. The department plans to continue this role, and
also to expand interactions with local law enforcement agencies, local prosecutors, and more
recently, interaction with local coroners. The goal is to bring the full force of law to bear against
those individuals who choose to abuse.
The issue of the relatively young, able-bodied seriously mentally ill in long-term care facilities is
a priority for the department. Working with the Department of Public Aid, the Department of
Human Services, the Department on Aging, and representatives of the industry and advocacy
groups, the department developed a comprehensive set of licensure standards that specifically
address the provision of mental health care to residents in long-term care facilities. The
department is currently in the process of implementing those regulations.
In addition, in partnership with those other state agencies, the department is looking at the preadmission
screening process for the admission of individuals with serious mental illness into
long-term care facilities. The goal is to assure that those who clearly need the services of a
nursing home are admitted to a facility, and that the facility receiving them is able to meet their
mental health needs.
During the course of these summits, the department has heard comments that relate to the
survey process and the punitive nature of that process. The survey process is actually driven
by federal survey protocols and, admittedly, the federal survey process is a somewhat punitive
process. It relies solely on the application of fines and other penalties as the only means to
assure compliance. Having a big hammer is very helpful in situations where you have serious
problems that need immediate action. At the same time, having the hammer as the only tool
available to you may not be an effective process. There may be regulatory situations where
something other than hitting the facility with a hammer may be the most effective means of
assuring facility compliance. With this in mind, Dr. Eric Whitaker, our director, is pursuing a
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