Nursing Home Reform in Illinois

Nursing homes have the sacred duty of caring for the most vulnerable members of our families and society. Older adults and those with physical and mental disabilities entrust nursing care facilities with their health, safety, and dignity. Sadly, nursing homes have not always delivered the care required to the great detriment of residents and their families, and if you need help holding a facility accountable, contact Horwitz, Horwitz & Associates to speak with a Chicago nursing home abuse lawyer.

Legislation reform is one primary way to respond to nursing homes’ inadequate care practices. The treatment of residents will likely improve substantially if federal and state regulations are responsive to abusive and neglectful behavior occurring daily in long-term care facilities.

An elderly woman and her caretaker hilding hands. Nursing Home Reform in Illinois

History of nursing home reform in Illinois

1970s

In the decades leading up to the 1970s, nursing homes “became the de facto placement” for people with mental illness as states lacked adequate means or alternative, more appropriate placements. Staff often did not have proper training and, therefore, could not address the specific needs of their mentally ill patients.

Problems with care did not just affect patients with mental illness. Studies conducted in the 1950s and 1960s alerted the government–and the public–to serious inadequacies, reporting that “few nursing homes were of high quality. Most facilities were substandard, had poorly trained or untrained staff, and provided few services.”

In response, the government created committees and passed acts to improve facility care, including the 1979 Illinois Nursing Home Reform Act, whose main provision included the right to:

  • Safety and good care without abuse
  • Participate in one’s own care
  • Privacy
  • Stay in the facility

Illinois Citizens for Better Care (IBC) is a leading organization that strives to improve the quality of nursing home care in Illinois. It played a considerable role in advocating for the passage of the 1979 Illinois Nursing Home Reform Act.

1980s

The IBC and others continued to fight for better care for nursing home residents and enforcement of laws established to protect them. Despite some victories, budgetary constraints and politics generated more challenges. Facilities funded by government money were bursting at the seams and in need of more support.

The United States Congress passed the Omnibus Budget Reconciliation Act (OBRA) in 1987. The law stated that mentally ill or mentally disabled nursing home residents “who do not need nursing care must receive treatment to help them achieve independence or to overcome psychotic episodes.” If facilities did not comply, they would lose funding. The result was the deinstitutionalization of many mentally ill and disabled people.

1990s

The OBRA 1987 Act also specified that nursing facilities “must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care …” as quoted in a study in the National Library of Medicine (NLM). These specifications potentially paved the way for better care for nursing care residents in the 1990s and beyond.

In 1990, the Health Care Financing Administration (HCFA) mandated assessments of nursing homes and specific requirements for medical and psychosocial services.

The NLM report indicates care in nursing facilities did see resulting improvements, for example, reductions in the inappropriate use of physical and chemical restraints, but continuing deficiencies in sanitary conditions, individual care plans for patients, food preparation, and maintaining the dignity of patients.

2010s

A nursing home reform law was passed in 2010. One major highlight of the reform was a condition that increased nursing home staffing requirements. By January 1, 2014, nursing homes were required to have enough licensed staff and certified nursing assistants to provide 3.8 hours of care for every resident needing skilled care, twice the previous requirement. Much of the 2011 reform law incorporated the existing rules within the 2010 reform.

2020s

Efforts to continue reform legislation in the nursing home industry have steadily increased; however, the need for reform is constant. The ICBC has pushed for restrictions on using physical restraints on residents and limits on the administering of psychotropic drugs to residents. It advocated for air conditioning in long-term care facilities, which became a requirement for nursing homes in Chicago.

In 2022, Illinois Governor Pritzker signed equity-focusing nursing facility legislation, HB246. The legislation puts accountability on facility owners by connecting funding to efforts to improve resident care.

Reforms include tying funding to staffing levels–more staff typically improves health outcomes–increased wages and a new pay scale for certified nursing assistants, and connecting funding to key quality measures. Hopefully, this new legislature will further the fight for quality care for residents.

Be an advocate; let your voice be heard

Let your voice be heard! You can change Illinois nursing home reform efforts by becoming an advocate and contacting your legislator. The Illinois Citizens for Better Care explains how to contact your legislator and discuss the issue you want to address in a bill. These contacts can be made by phone, email, letters, and in-person meetings.

Visit the Illinois Citizens for Better Care website to learn more about becoming an advocate for residents of nursing homes. You can make a difference in the life of an elderly resident in a nursing home so that they can live a happier, healthier life.

Contact Horwitz, Horwitz & Associates today to see how our nursing home abuse lawyers can help. Call (800) 985-1819 for a free consultation.