Long-Term Care - Illinois General Assembly

Additionally, it is far more cost effective to revitalize existing nursing homes than construct new
ones from scratch. Effective financing and bonding approaches can aid existing facilities to
upgrade for modern technology, resident centered equipment, and solar panels and other
heating efficiencies.
Nursing homes promote resident-centered care, meeting the specific needs of each individual
resident. This theme is the hallmark of the Pioneer Movement: designing programs to give
residents more day-to-day choices in their life routines, and empower front-line staff to make
more care decisions for the residents they serve. Across the nation, nursing home providers
are looking beyond the traditional nursing home model to develop new and innovative ways to
meet each resident's individual care needs. The kind of management and staffing changes
these programs require, however, are often beyond the means of Medicaid nursing homes. The
state should sponsor an incentive program for those progressive Medicaid facilities willing to
invest in innovative, non-traditional approaches to care.
Besides promoting innovation, the state can better meet residents' specific health care needs by
certifying nursing facilities based on their specialties. Categories for certification include
Alzheimer's disease, stroke, cardiac care, diabetes, skin care and many others. These
certifications would help consumers make better nursing home choices, selecting nursing
facilities that have the most expertise in the treatment of specific medical conditions.
The state could also help consumers make sound health care decisions by developing resident
and family customer satisfaction surveys, sharing these results with the public through the
Internet or by publishing an IDPH consumer guide on choosing a nursing home. These
materials should emphasize 3 key areas: the restorative and rehabilitation services that each
nursing home provides; the medical specialties of each facility; and the customer satisfaction
levels of the individuals served by each home.
This emphasis on care delivery and outcomes should carry over to the state's survey
enforcement system as well. The state should focus its system on the results of the care
residents receive, with less emphasis on the hundreds of current survey items that have no
impact on resident well-being.
3 key areas for change:
• Create quality staff for quality care.
• Develop smaller and more specialized facilities in a continuum of community based care.
• Refocus on resident-centered care within the context of cost accountability.
Related recommendations for short and long-term changes:
• The Illinois nursing home system should be dramatically transformed and strengthened.
• A 5.9% rate cut last year, no increases this year, skyrocketing staff and liability costs,
and erratic and unpredictable payments from the state have all created a crisis
atmosphere where some facilities will not survive. Illinois needs to stabilize Medicaid
payments and restore the 5.9% Medicaid rate cut made in July 2002, with future
Medicaid reimbursement reflective of the continuing cost of caring for an increasingly
fragile population.
78