Regulation of Illinois Nursing Homes
Nursing homes in Illinois are licensed, regulated, inspected and/or certified by a number of public and private agencies at the state and federal levels, including the Illinois Department of Public Health (IDPH) and the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS). IDPH, through a survey process, is responsible for ensuring nursing homes fully comply with mandatory state regulations as well as ensuring that facilities accepting Medicare and Medicaid payment meet federal regulations. All nursing facilities in Illinois are required to meet mandatory state standards that set the minimum and essential requirements of care that must be provided. Facilities are required to comply with the standards to provide the highest quality of care possible. One part of this is, of course, to prevent abuse and neglect in nursing homes.
Survey teams inspect and evaluate whether facilities meet the required standards and, if so, certify their success in meeting specific care standards. Facilities failing to meet the standards are subject to fine or other enforcement actions. IDPH conducts approximately 1,300 full, on-site licensure inspections annually of nursing homes and responds to approximately 6,000 complaints annually. Some Illinois nursing homes are members of national accrediting organization, such as the Joint Commission (JC), which independently inspects member facilities to assess performance.
IDPH surveys are generally conducted on-site. The state’s inspection teams evaluates all aspects of resident care and nursing home procedures and practices, assessing facility compliance with more than 1,500 state and federal standards. The evaluation of the facility and the care it provides may include an inspection of medical records, observation of resident care, inspection of all areas of the nursing home, and interviews of residents, family members, staff or other individuals. Inspections in response to complaints are generally shorter in duration than licensure surveys and focus primarily on those areas of resident care alleged to be at fault. If, during the course of a complaint investigation, additional problems are uncovered, a full on-site inspection may be initiated. The state average for inspection of Illinois Nursing Homes is once every 12 months and is conducted without notice to the facility (e.g. they are unannounced).
At the conclusion of each inspection, IDPH’s findings are shared with nursing home administrative staff in an exit interview and are included in a survey report, called a Statement of Deficiency) that is forwarded to the facility. If IDPH has determined that the nursing home failed to comply with all applicable state and federal licensure standards, the facility will be cited for deficiencies.
A deficiency is a determination by IDPH that a nursing home has violated one or more specific licensure or certification regulations. When deficiencies are alleged, the facility is given an opportunity to rebut the deficiencies. If deficiencies are cited, IDPH requires the nursing home to submit a written plan of correction within 10 days detailing how and when each deficiency will be corrected. In many cases, nursing homes are given the opportunity to correct less serious deficiencies without incurring fines or other penalties. If warranted, however, IDPH may impose a fine, curtail admissions, appoint a temporary manager, issue a provisional license, suspend or revoke a nursing home’s license, close an unlicensed facility, or use other remedies for violations of statutes as provided by state or federal law, or as authorized by federal survey, certification, and enforcement regulations and agreements. Nursing homes with repeat or severe violations of federal licensing standards may have their Medicare or Medicaid certification suspended or revoked by CMS. These nursing homes do not receive reimbursement for services given to program participants while the facility is under such a sanction.
The information about the inspections and complaint investigations is available from IDPH These inspection reports show only a one-time “snap-shot” of nursing home compliance with established standards. To more fully assess the quality of care provided by a facility, it is important that you review current and past survey reports. You may also wish to discuss services and performance levels with your doctor and with family members or friends who have used the facility.
Complete survey reports and nursing home plans of correction, edited to ensure patient confidentiality, are available at each nursing home as well as at IDPH. The most recent federal inspection surveys are posted on the web at www.medicare.gov/NHCompare/home.asp.
To request a copy of an inspection file through IDPH, write to:
Illinois Department of Public Health
Freedom of Information Officer
535 W. Jefferson St.
Springfield, IL 62761
Attn: Division of Communications
Freedom of Information Officer
535 W. Jefferson St.
Springfield, IL 62761
Attn: Division of Communications
Anyone wishing to file a complaint, such as for Nursing Home Nelgect or Abuse, about an Illinois nursing home, should call the IDPH toll-free hotline at 1-800-252-4343.
Filed Under Federal Law to Prevent Neglect, How to Choose a Nursing Home, State Law |
Tagged With Federal Law to Prevent Neglect, Federal Regulations, How to Choose a Nursing Home, Illinois State Law, Inspections, Prevent Abuse, Prevent Neglect, Surveys
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