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Our sorry state

Tuesday, Oct 19, 2021

* Hannah Meisel

In the early days, weeks and months of the pandemic, COVID-19 ravaged nursing homes, killing thousands of elderly and frail residents and forcing the isolation of thousands more.

Though long-term care facilities statewide locked down, forbidding outside visits from family members, staff from the Illinois Department of Public Health charged with investigating complaints of abuse and neglect should still have been going in to those facilities.

But for the first three and a half months of the pandemic, they weren’t. Pritzker’s administration admitted to that error last summer after severing ties with two IDPH officials and catching up on the 272 missed abuse and neglect complaints, substantiating 17 of them. The agency hired a former federal prosecutor to review the unsubstantiated claims.

“Our top priority as a regulator of long-term care facilities in Illinois is ensuring vulnerable Illinoisans are kept safe by those responsible for their care,” IDPH Director Ngozi Ezike said in a course-correcting news release last August. “Anything short of that is unacceptable, and our entire department is committed to getting this right as we move forward.”

In service of that goal, IDPH also paid $425,000 to an outside firm to examine what went wrong inside the agency and how its processes could be improved to prevent such a major dereliction of duty from happening again.

More than 13 months later, however, the report remains unpublished, though it’s been complete since Nov. 30, 2020. A copy obtained by NPR Illinois shows the outside review was critical of IDPH, its Bureau of Long Term Care and the Office of Health Care Regulation directly responsible for investigating nursing home abuse and neglect complaints.

But as Pritzker and some Democrats in the General Assembly attempt to overhaul how the state reimburses nursing homes with Medicaid patients — a move they say will engender more accountability and equity — the report paints a complicated picture that neither fully bolsters Pritzker’s argument for an overhaul nor the resistance from the nursing home industry warning its cash-poor facilities will close en masse.

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According to the national Staff Time and Resource Intensity Verification, or STRIVE Project, Illinois accounts for 47 of the 100 most understaffed facilities in the nation when comparing actual staffing levels against their target levels within STRIVE.

The persistent staffing issue is at the heart of Pritzker’s proposed overhaul to how the state pays nursing homes; the Department of Healthcare and Family Services wants to increase nursing home reimbursement rates, but have those increases tied to a facility’s staffing levels and other safety improvements.

But Manatt’s consultants found IDPH has long had the power — and has actually been obligated by state law — to enforce skilled nursing facility staffing ratio requirements, but hasn’t.


- Posted by Rich Miller        

  1. - IL Gal - Tuesday, Oct 19, 21 @ 12:46 pm:

    IDPH is not mandated by the Governor to take the Covid vaccine. Even “vendors” are required to vaccinate. It seems there is a pattern here. The folks in charge of others are exempt from vaccination ie; Congress. Is it hypocritical to anyone else except myself that IDPH would be exempt whilst others are mandated? I cry “foul”.

  2. - Unionman - Tuesday, Oct 19, 21 @ 12:46 pm:

    Maybe if the owners of the nursing homes stopped seeing nursing homes as a for profit business in which they try to extract the largest margin of profit possible. Maybe they should mandate that nursing homes must be run as non-profits that will solve staffing problems.

  3. - Captain Obvious - Tuesday, Oct 19, 21 @ 12:56 pm:

    Last week in a story it was asked is there anything Ezike cannot do? Found it…

  4. - Almost the Weekend - Tuesday, Oct 19, 21 @ 12:57 pm:

    I think a problem with the Priztker administration is talking about and implementing these big ideas then having no idea how to internally implement these policies with the existing infrastructure.

    The cannabis lottery

    And now this.

    Republicans can’t even hit him on these though because they have no idea how to govern nor want too.

  5. - Back to the Future - Tuesday, Oct 19, 21 @ 1:09 pm:

    Very good reporting by Hannah Meisel. We are lucky to have reporters like her in Illinois.
    Not surprised at Team Pritzker hiding the report for almost a year. That is typically how they operate.
    The fact that nursing home deaths were so high for so long is really awful.
    Reminds me of the Veterans Home death mess up.

  6. - OneMan - Tuesday, Oct 19, 21 @ 1:21 pm:

    Maybe if the owners of the nursing homes stopped seeing nursing homes as a for profit business in which they try to extract the largest margin of profit possible. Maybe they should mandate that nursing homes must be run as non-profits that will solve staffing problems.

    The St Joseph example from the article would seem to indicate that isn’t the solution you think it is.

    Gaynor said it’s a harbinger for mass nursing home closures. Just last week, St. Joseph’s Home of Springfield announced it will close in December. The non-profit home cited staffing issues at the facility, which has been owned and operated by the Sisters of St. Francis of the Immaculate Conception for more than 100 years.

    “This is not something we want to do,” congregation President Sister Kathleen Ann Mourisse said in a statement. “We do not have enough Sisters to continue this beloved ministry. Many, if not most, religious communities in our country are also facing the same dilemma. In addition, the climate created by COVID-19 has contributed to both a reduction in the resident census and a severe staffing shortage, not only at St. Joseph’s but throughout the healthcare industry.”

    But let’s take that aside for a second, where exactly are these non-profits to run all of these facilities going to come from? Being profit vs non-profit doesn’t change the staffing challenges. The average salary for a Nursing Assistant is $16.67 per hour in Illinois.
    So a bit over a dollar an hour over what you can make at Best Buy and you don’t need any certifications at Best Buy or a need to work nights.
    The staffing issue is in large part a supply problem, not a demand problem. Nurses who can are leaving hospitals and working as travel nurses (the pay average for travel nursing is $108,070 with some folks earning significantly more), this opens up positions at hospitals. Hospitals that offer better pay and benefits and better working conditions than nursing homes. New BSN nurses are seeing opportunities (and pay) at hospitals that were very uncommon pre-pandemic.

    It’s a complex issue without an easy solution.

  7. - SaulGoodman - Tuesday, Oct 19, 21 @ 3:26 pm:

    **IDPH is not mandated by the Governor to take the Covid vaccine. **


  8. - SaulGoodman - Tuesday, Oct 19, 21 @ 3:27 pm:

    **The folks in charge of others are exempt from vaccination ie; Congress.**

    Sigh… Congress is not “exempt” from a vax mandate. The POTUS is not legally capable of putting a mandate on a different branch of government.

  9. - Now I'm down in it. - Tuesday, Oct 19, 21 @ 5:10 pm:

    The results of this report are heartbreaking and, tragically, not surprising at all. State government does not operate well in virtually every way, and the most vulnerable pay dearly for it. It’s not people like JB and his family that are affected. You’d think he would be careful not to walk into that particular attack, but here we are watching the wealthiest politician in the country prove how disaffected he is. I’m sure there will be plenty of mentions of the previous administration and zero accountability from JB. Maybe a few more heads will roll. Whatever they perceive will look good will happen, and you can bet it will be nothing substantive. As usual, good on Hannah Meisel for holding the administration accountable.

  10. - Al - Tuesday, Oct 19, 21 @ 6:47 pm:

    To be perfectly honest, the State has very few adults working in this area. Staffing and personnel issues plague the State and precludes the identification of best practices and sound executive implementation.

  11. - Wallace Gator Bradley - Tuesday, Oct 19, 21 @ 10:02 pm:

    Look, Listen, Learn and Share. I too thank Hannah for writing this story and I thank Illinois State Representative Camille Lilly for Chairing the Illinois State House Joint Committees Hearings on Reforming the Nursing Home Industry:

  12. - Friendly Bob Adams - Tuesday, Oct 19, 21 @ 10:28 pm:

    Getting for-profit nursing homes to do anything they don’t want to do has always been a major problem for IDPH.

  13. - Narc - Wednesday, Oct 20, 21 @ 6:58 am:

    “ IDPH is not mandated by the Governor to take the Covid vaccine.”

    Yeah, what? From the IDPH website:

    “Who is required to get vaccinated?
    Health care workers, school personnel, higher education personnel and students, and state-employees and contractors who work at state-owned or operated congregate facilities are required to be fully vaccinated.“

  14. - SandyC - Wednesday, Oct 20, 21 @ 10:52 am:

    I worked in Illinois nursing homes up until 2000. I can personally tell you it was a mess back then and an even worse situation now. My spouse is disabled and I vowed to NEVER place him in a home unless I can’t help it (ie; I’m dead). Illinois has a long standing reputation of failing residential/nursing homes, as does the VA. Until we have leadership and owners of nursing homes that actually care (sarcastic tone), we’ll walk this walk infinitely. JMHO

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