Long-Term Care - Illinois General Assembly

• Make doing home care, and working in equivalent programs — day training, adult day
care — more attractive by providing health insurance to the people who do this work.
• Stop using nursing homes as housing of last resort, sticking people in them because
there is no place else to go.
These are some of the things what needs to be done:
• As a general rule, Illinois should require a minimum percentage occupancy to participate
in the Medicaid program. There have to be exceptions to this in rural areas, where
closing a nursing home would mean that families would have to travel unreasonable
distances to visit their relatives. When exceptions are made, the priority should be on
funding the county homes and the not-for-profits, at least those not-for-profits that agree
to admit residents on Medicaid.
• Increase the number of Public Health nursing home surveyors. So many have taken
early retirement, the department has lost its ability to do thorough complaint
investigations, or initiate surveys of facilities that have repeated serious violations.
• Expand the IDPH legal staff, so that the department does not feel pressured to settle
cases because it does not have the staff to try them.
• Inform families and guardians of residents when a violation occurs in a nursing home
that affects them.
• 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.
• Since Medicaid reimbursement is going to be based on the “MDS,” we need to be
checking on the accuracy of the information nursing homes enter in the “MDS.” “MDS”
refers to the new Minimum Data Set methodology that has been recently promulgated by
the Department of Public Aid that will be used to determine payments to nursing homes
for the cost of patient care.
• 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.
• While having the ombudsmen function as friendly visitors is inappropriate, 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 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.
82