Illinois nursing homes rank third worst in the country, nonprofit group says

Jun. 13--Illinois is the third worst state in the country for nursing home quality, according to a new report from an advocacy group.

Families for Better Care gave Illinois an F for the quality of its nursing homes and ranked it 49th in the country, above only North Carolina and Texas in its ratings, which include Washington, D.C.

A nursing home association in Illinois, however, says the rankings are subjective and don't reflect the quality of many of the state's nursing homes.

"The state of nursing home care in Illinois covers a broad spectrum," said Matt Hartman, executive director of the Illinois Health Care Association, which represents about 250 skilled nursing homes in the state. "There are those that fail to do a proper job and there are those that are excellent providers."

Illinois' ranking dropped from 44th in the country in 2014, according to the report, which based its latest rankings on 2017 data from the federal and state governments, including the number of caregiver hours residents received and the percentage of facilities cited for severe deficiencies.

"To see that the care is getting that much worse is just appalling, and seniors deserve better," said Brian Lee, executive director of the nonprofit Families for Better Care, which describes itself as a citizen advocacy group. The group used to be funded by trial lawyers who represented patients in lawsuits against nursing homes but is now mostly funded through private donations, Lee said.

The report said that nursing home residents in Illinois received an average of about 1.6 hours of professional nursing care a day and an average of 2.2 hours of direct care, which relates to daily needs such as going to the bathroom, getting out of bed and being turned in bed to avoid sores, Lee said.

About 97 percent of nursing homes in the state had federal deficiencies or citations, and nearly 28 percent had severe deficiencies, according to the report.

"You have too many operators out there looking at the bottom line (rather) than looking at the sustainability of care and safety of the residents," Lee said.

Many Illinois nursing homes, however, are challenged by low payments from Medicaid.

Hartman said for his member nursing homes, typically about 75 percent of their residents are on Medicaid, which is a state and federally funded insurance program. Nationwide, Medicaid covered more than 60 percent of nursing home residents, according to a 2017 Kaiser Family Foundation report. Otherwise, the cost of care would be beyond reach for many: In 2016, the typical annual cost of nursing home care was $82,000, according to the Kaiser Family Foundation.

The state's Medicaid reimbursements pay about $30 to $35 dollars a day less per resident than what it actually costs to take care of residents, Hartman said.

Those low reimbursement rates, along with a general shortage of nurses, can make it difficult for some nursing homes to hire more staff, he said.

"We believe staffing is the biggest driver of quality in facilities," Hartman said.

Nursing homes are hoping the state's newly adopted budget will offer some relief. The budget includes another $240 million for Medicaid funding for nursing homes, including $70 million specifically for staffing.

It also includes potential financial penalties for homes that fail to meet staffing requirements. Nursing homes that violate the requirements will also have to post notices explaining as much at all of the publicly used doorways into their facilities, in their main lobbies, next to registration desks and on their websites.

Illinois law requires nursing homes to provide 3.8 hours of nursing and personal care a day for residents who needed skilled care, and 2.5 hours a day for residents needing intermediate level care.

A 2018 investigation by Kaiser Health News and the Tribune found that staffing levels for nurses and aides in Illinois nursing homes were among the lowest in the country.

According to the Families for Better Care report, the top states for nursing homes are Hawaii, Delaware and Alaska. The federal government also rates individual nursing homes across the country, giving them overall star ratings based on a number of factors at Nursing Home Compare.

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