Long-Term Care - Illinois General Assembly

• Teach families of residents how to help their relatives when they move into a nursing home,
including what nursing homes’ obligations are to their residents. Tie this into the universal
prescreening.
• Especially since Medicaid reimbursement is going to be based on the Minimum Data Set
(MDS), we need to be checking on the accuracy of the information nursing homes enter in
the MDS. Nobody does that now. Even the annual Public Health survey is a small,
weighted sample of residents. It is unconscionable to pay out so much money with no real
check on where it goes.
• Future Medicaid rate increases should be "targeted" — that is, their use restricted — to
salary for direct care staff and food.
• While in some ways the IDPH website is helpful, the majority of nursing home violations are
not posted, despite the legal mandate that they be there. IDPH should either do the work
itself, or contract with an entity able to do the job.
• Strengthen the ombudsman program. In some areas of the state, the ombudsmen are
vigorous resident advocates; in others they are no more than friendly visitors.
• It would improve residents' lives if high school mandatory service programs expanded to
include having students assigned to specific residents and visit them regularly.
• The Office of State Guardian (OSG) needs both the resources to spend enough time on all
its wards, and the mandate to function with the same vigor as would any private guardian
concerned with a ward's welfare. Unless things have changed very recently, OSG is not
permitted to pull its wards out of a nursing home unless it is actually being decertified or
closed. It never uses what should be its considerable clout to force improvements the
facilities that house its wards. These policies should be changed.
• Increase the personal needs allowance. Nursing home residents on Medicaid are allowed
to keep $30/month of their own income. Everything else goes to the nursing home. This
has gone up $5 in thirty years. If the personal needs allowance had kept pace with inflation,
it would be over $90/month. What this means is that every Social Security cost-of-living
increase residents should be receiving, goes to supplement the Medicaid budget. Residents
are left unable to buy shoes, buy a winter coat or underwear, a newspaper, stationery. They
cannot afford public transportation, go to McDonald's, or go to a movie.
• Care in nursing homes will improve only when the people working in them feel personally
obligated to do a good job. The CNA abuse/neglect registry is at least an attempt to hold
CNAs liable for poor care. There is nothing comparable for people higher up on the food
chain. The Department of Professional Regulation does not even open files on the large
majority of referrals the Department of Public Health makes to it, of medical professionals
and nursing home administrators who appear to have violated their responsibilities under
the Nursing Home Care Act. Public Health does not bother to make referrals of mandatory
abuse/neglect reporters who ignore their legal obligations.
What this means in practice is illustrated by the situation at Chateau Village in
Willowbrook, where numerous women in the Alzheimer's unit were repeatedly
sexually assaulted over a 16 month period, by 2 male residents who were
housed on the unit even though they did not have dementia. The staff
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