16 Comments - Anon - Monday, Jan 4, 16 @ 1:23 pm: ===So, in other words, we’re going to have to wait for a gruesome video to emerge before anybody will do anything about staffing problems.=== If you haven’t, you should read John M. Gaus’ The Ecology of Public Administration. While it may be somewhat cynical of an essay, Illinois breeds cynicism like it’s unfunded pension liabilities. - VanillaMan - Monday, Jan 4, 16 @ 1:26 pm: Reality television gave us Kim Kardashian, Jackass and Donald Trump. I’m not optimistic that any video is going to improve things, regardless of how shocking it is. Worse, ugly video can be put to funny music and shown on “America’s Funniest”. With the right producer and editing, we can stomach anything. - 47th Ward - Monday, Jan 4, 16 @ 1:29 pm: I think we’ve reached the point where a truly gruesome video is the only thing that will generate any action. Otherwise no one pays much attention. It seems like too many of us think some of these issues are just hypothetical. Then you see a horrible video, now it’s a crisis, and now we should “do something.” We really ought to know better and try harder before there’s a tragedy. - The Way I See It - Monday, Jan 4, 16 @ 1:29 pm: There is a lot that happens in nursing homes that is shocking, and the actual abuse (hitting residents, etc.) will catch the media’s attention. What the awful staffing ratios do is result in people not getting the care they need, so there will be a lot of video with nothing happening. It’s bad TV, so it probably wont address poor staffing ratios unless it happens to catch an event like someone strangling themselves in a side rail and then no one discovers the body for hours. Grim stuff any which way you slice it. - Union Man - Monday, Jan 4, 16 @ 1:36 pm: All part of Rauner’s Drive-a-Wedge plot. - Precinct Captain - Monday, Jan 4, 16 @ 1:53 pm: 47th, There is simply no will on the part of the public or legislators to deal with many issues, especially ones that require investment of money. The title of this post could apply to so many issues facing our society. - Aldyth - Monday, Jan 4, 16 @ 2:00 pm: Human services has been underfunded since Jim Edgar started making cuts lo those many years ago. Rates aren’t adjusted for inflation, resulting in rates that are entirely inadequate for the work. Factor in the cuts that came with the crash of 2008 and you now have skeleton crews manning the facilities. I remember when they did the huge cuts in 2008 and the exec of an agency asked a speaker from DHS if regulations were going to be adjusted accordingly. She was told that the federal regulations would remain the same and facilities were expected to meet them on less money. I’m sure she was being facetious when she asked the question, but she made the point that has been completely ignored by the State of Illinois. These are jobs that require human beings to perform. You can’t automate it, computerize it, or cut manpower and services beyond a certain level before you jeopardize the recipients of those services. Overworked and undercompensated people are not only more likely to make mistakes, but are more likely to run along the edge of abuse and neglect. Hit a bad day and people who never meant to be neglectful or abusive can cross over the line. When an organization’s pay rates result in them competing with fast foods for employees, you are at a distinct disadvantage. Generally speaking, the worker behind the cash register at the local pizza place doesn’t have to help customers go to the toilet or clean them up when they don’t make it there in time. That’s the state of the business in Illinois. We continue to win the race to the bottom. - Muscular - Monday, Jan 4, 16 @ 2:00 pm: Many people in nursing homes are on Medicaid. Increasing the staffing ratio will likely cause nursing home owners to call for increased reimbursements. The General Assembly has liked to pass on mandates without taking responsibility for paying for them. I am doubtful if the politically influential nursing home owners will quietly accept increased staffing mandates without increased reimbursement. - wendy - Monday, Jan 4, 16 @ 2:18 pm: If Illinois were actually enforcing its supposedly minimum staffing ratios, the numbers would look better. And the grade. If people do actually put cameras in residents’ rooms — the law does not make it automatic that this can happen — the results are more likely to show not abuse, but widespread neglect. Meaning no staff coming into a resudent’s room for long periods of time, staff responding to call lights by turning them off and walking out, people who need help eating having their meals left by their bedside. - too obvious - Monday, Jan 4, 16 @ 2:34 pm: Well if there are problems in our nursing homes, Bruce Rauner is the obvious man to address the issue. . . oh wait. - Hoping for Rational Thought - Monday, Jan 4, 16 @ 2:45 pm: Current staffing ratios are not enforced. That is a the big problem. Nursing homes pay a tax which was imposed to cover the increased staffing ratios. So they are getting paid but not performing. It is important to note like anything there are many nursing homes who do the right thing and few very bad players who cheat the system. - JoanP - Monday, Jan 4, 16 @ 2:47 pm: and he doesn’t know the correct use of “beg the question”, either. - Just sayin',.... - Monday, Jan 4, 16 @ 2:50 pm: Copy an idea for police, Body Cams on nurses. - cdog - Monday, Jan 4, 16 @ 4:31 pm: It is obvious that the “nursing home lobby,” whether public or private/family corporation, has long had an effective method in controlling how much rule/law becomes fact. It is interesting that this monitoring act made it past the dogs. It has to be a very difficult business to manage effectively, from crazy clients, to crazy staff, to crazy insurance companies. Let’s hope that the decision-makers in the industry have their minds and hearts in the right place, finally. Can we shoot for a “C” grade, class? - Central Guy - Monday, Jan 4, 16 @ 4:53 pm: The majority of residents in Illinois nursing homes are the responsibility of the State’s Medicaid program because they have outlived their resources. The Illinois Medicaid nursing home rate is the 49th LOWEST in the nation, and does not even cover the cost of providing their care. While the majority of health care providers in the State had their Medicaid rates reduced by 2.25 percent last year, nursing homes had their Medicaid reimbursement rates reduced 12.6 percent. Again, this reduction was not on a rate that covers the costs of providing care or has a profit margin. State staffing levels are observed and monitored in nursing homes. Any families who believe staffing levels are not followed can call the State’s hotline. It is time Illinois prioritizes the care provided for seniors in nursing homes and provide a reasonable Medicaid rate. The day of reckoning is fast approaching when facilities will no longer survive financially and will have no other choice but to close their doors……… Other states have a reasonable Medicaid rate, why cant’ Illinois? The majority of long - term care facilities in Illinois are quality providers. The reputation of all is damaged by the poor performance by a small minority. - yinn - Monday, Jan 4, 16 @ 5:26 pm: That’s right, the Medicaid reimbursement rate in Illinois is horrible. Homes have to market a certain percentage of their beds to short-term Medicare rehab cases to try to make up for it, especially true for those that specialize in (expensive) psych patients. Another problem is the proportion of time spent in direct care vs. documentation. Proper documentation is key to obtaining full reimbursement, but if you’re chronically understaffed it tends to get neglected — better that than the patients, right? — but it can turn into a vicious cycle. 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