Watching Nursing Home Regulators
Each state inspects its nursing homes to make sure they comply with state and local laws. In Illinois, each home is inspected, on average, once a year. But once the inspection is made, what happens to the results? One thing we know, they are not sent automatically to the residents or the families of residents at a home.
MemberoftheFamily.net puts it this way: "Federal Regulations do not require State inspectors or the nursing home to notify patients and their families that a particular patient's care has been the subject of a survey violation. Even a finding of substandard care or actual harm does not require notification."
Illinois law doesn't require such notification, either.
Here's part of what the Illinois Department of Public Health says about the inspection process: "The Illinois Department of Public Health is responsible for ensuring nursing homes comply fully with mandatory state regulations. (U)nder a cooperative agreement with U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services (CMS), (IDPH) is also responsible for ensuring that facilities accepting Medicare and Medicaid payment for services rendered to program beneficiaries meet federal regulations and certification rules. Each year, (IDPH) conducts approximately 1,300 full, on-site licensure inspections of nursing homes and responds to approximately 6,000 complaints."
By the way, if you want to file a complaint about an Illinois nursing home, you can call the IDPH toll-free hotline at 1-800-252-4343.
IDPH notes that licensure inspections evaluate the fitness and adequacy of a nursing home, its equipment, staff, policies, procedures and finances. Illinois has some 200 surveyors employed in teams that each consist of a registered nurse, a nutritionist and an environmental health practitioner. These experts may be joined by life safety code experts and other professionals.
Complaint surveys are conducted by experts in the areas involved in charges lodged.
IDPH notes, "Illinois' licensure surveys are generally conducted on-site over a three- to four-day period during which the ... teams evaluate all aspects of resident care and nursing home procedures and practices, assessing facility compliance with more than 1,500 specific state and federal standards. (Some areas of care reviewed include resident rights, access to care, activities, assessment and care plans, health care and dietary services, housekeeping, staffing, quality of care and quality assurance.)
"The Department's evaluation 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. (IDPH) also may (analyze) statistical data reported by nursing homes or (review) reportable event information or other notices filed with IDPH. Reportable events include administrator or director of nursing personnel changes; interruptions of three or more hours of services essential to the health and safety of residents; alleged or suspected crimes investigated at the facility by police; and all fires, disasters, deaths or other risks to resident life or health resulting form accidents or incidents at the facility. ...
"Nursing homes are inspected at least once every six to 15 months. The state average is once every 12 months."
Facilities are not told in advance about inspections.
IDPH shares its findings with nursing home administrative staff in an exit interview at the end of each inspection. The findings are also included in a survey report sent to the facility. If IDPH finds the nursing home failed to comply with licensure standards, it is cited for deficiencies, which it has to correct.
So, information is available but, since the home where our loved one may be staying isn't required to let you or the patient know about inspection results, we have to act to keep up with what's going on. Find out the home's policy on releasing reports. Talk to your loved one's doctor and to the person in charge of the home. If you don't get a satisfactory answer, an attorney can help.
Information on reports and a home's status are important. You have to know what you're dealing with to make sure a nursing home is giving proper care. You should be able to get inspection reports and the nursing home's response from the home or IDPH. You can ask IDPH for an inspection file by writing the Illinois Department of Public Health Freedom of Information Officer at 535 W. Jefferson St. Springfield, IL 62761 (Attn: Division of Communications)
In addition, federal inspection surveys are at www.medicare.gov/NHCompare/home.asp.
Michael Kosner, President
The Kosner Firm Chtd.
