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Only 16% of Illinois nursing homes are in compliance with federal staffing standards (Updated)

Wednesday, Jul 10, 2024 - Posted by Isabel Miller

* Capitol News Illinois in May

Employment in skilled nursing facilities nationwide as of February was down 8.3 percent compared with February of 2020, the month before the pandemic hit. Although the current staffing levels have somewhat recovered from their lowest point in early spring 2022 – when staffing was down 15.5 percent from pre-pandemic levels – other areas within health care have recovered much faster, according to a Kaiser Family Foundation analysis […]

But with a tight budget year, leaders in the General Assembly can’t promise a huge windfall for the struggling industry. House Majority Leader Robyn Gabel, D-Evanston, who leads a working group on Medicaid issues, told Capitol News Illinois the industry asked for $75 million to make up for increased property taxes, which the state had at one time subsidized.

But in the waning days of legislative session, Gabel said the working group is still exploring ways to help the industry but was explicit that General Assembly can’t give the industry anywhere near the $75 million it requested. […]

The industry is also fearful a new federal rule designed to implement minimum staffing ratios will have the unintended effect of further closures. […]

But, Gabel said, the state can only do so much when the entire nursing home industry is up against trends that have been festering for years.

* Today from WTTW

A new federal staffing minimum rule from the Centers for Medicare and Medicaid Services (CMS) was designed to help those stranded without care like Payne. In May, CMS officially published the final rule of the first-ever federal minimum staffing standards for long-term care facilities. […]

But just 108 of the 670 Illinois nursing homes that provided the agency data meet all three of these requirements as of June, according to a WTTW News analysis of homes that submitted their staffing data to CMS. Eleven additional homes did not provide data.

    -60% of the reporting nursing homes do not meet the total nurse staffing standard.

    -41% do not meet the RN standard.

    -81% do not meet the nursing aide standard. […]

If a home does not meet these requirements, there is a set of escalating penalties, like corrective plans of action or fines. Termination from the CMS program is the “enforcement item of last resort,” according to Health and Human Services (HHS) officials.

When presented with the low number of homes meeting the new CMS rules, the Illinois Department of Public Health, which regulates long-term care facilities, said the state already has staffing requirements. Illinois requires a minimum staffing ratio of 3.8 hours per resident per day needing skilled care and 2.5 hours per day for residents needing immediate care. However, repercussions for Illinois homes not meeting these requirements have been delayed until 2025.

*** Adding *** Lindsey Hess, the Communications Director at the Health Care Council of Illinois…

Most Illinois nursing homes are in compliance with Illinois’ staffing mandates, which actually require nursing staffing of 3.8 hours per resident per day (versus the proposed federal mandate of 3.48 hours). HCCI is vehemently opposed to CMS’ proposed plan of staffing mandates; one significant reason is the requirement of registered nurses on all shifts. Currently, CMS requires one registered nurse on duty per day, and licensed practical nurses may fill the remaining open shifts. In Illinois, where Medicaid is the largest payor of nursing home services, it would be unsustainable for safety net nursing homes to replace licensed practical nurses with registered nurses and ensure access to care for elderly citizens. In addition, nursing homes are still recovering from a historic labor crisis, and there’s a growing caregiver shortage. We support increasing the nursing home workforce, but a one-size-fits-all approach will not improve quality care.


  1. - Which one is Pink - Wednesday, Jul 10, 24 @ 10:34 am:

    Sort of makes you not want to end up at a nursing home.

  2. - DuPage Saint - Wednesday, Jul 10, 24 @ 11:18 am:

    If these are the requirements then I think Medicare and Medicaid and the Federal government should step in and enforce the rules but first they should help make certain staff gets a decent salary
    And if these are non profits they should see what the owners make and supervisors and any other administrator. Tie their pay to staff pay. Make really non profit.

  3. - Appears - Wednesday, Jul 10, 24 @ 11:18 am:

    Do the State of IL Veterans Homes meet the Federal staffing standards?

  4. - levivotedforjudy - Wednesday, Jul 10, 24 @ 11:25 am:

    I don’t think this is a nefarious scheme at the senior facilities (although there are always bad players). My guess is its the overall lack of workers just like the general shortage of health care workers, police, bus drivers, truckers, hotel staff, you name it.

  5. - Little pond - Wednesday, Jul 10, 24 @ 11:44 am:

    Mom was in long-term care for over 3 years. I watched firsthand as the aids & nurses worked their tails off in often very difficult circumstances. Underpaid, double shifts and understaffed was the norm.
    Free or subsidized training for nursing aids might go a long way towards helping the situation.

  6. - SaulGoodman - Wednesday, Jul 10, 24 @ 11:48 am:

    ** But with a tight budget year, leaders in the General Assembly can’t promise a huge windfall for the struggling industry.**

    LOL - the NH industry has received HUNDREDS of millions of dollars in new money in recent years. It’s not a money problem. They continue to beg for more money, crying poor, and then don’t use the money for staff but instead just make more money.

  7. - Nick Name - Wednesday, Jul 10, 24 @ 12:38 pm:

    Thanks to SCOTUS overturning Chevron, in due time this won’t matter at all.

    SCUTUS: the best constitutional law money can buy.

  8. - 13TH - Wednesday, Jul 10, 24 @ 12:48 pm:

    Go read “Where so the billions of dollars go? A look at nursing home related party transactions” from, that says a lot of why

  9. - Anon for this one - Wednesday, Jul 10, 24 @ 1:11 pm:

    The demand for placements that are covered by Medicaid is insane.

    I’m in Springfield, and am trying to find a LTC placement for an elderly parent on Medicaid (Medicare won’t cover LTC). Pending site visits, the closest feasible option is Taylorville until something opens up closer.

  10. - Downstate - Wednesday, Jul 10, 24 @ 2:03 pm:

    “They continue to beg for more money, crying poor, and then don’t use the money for staff but instead just make more money.”

    A majority of nursing homes are in real trouble. Staffing shortages require them to reduce their bed count…..thus reducing revenue. To keep staff, they have to increase wages. But their reimbursement is pretty much capped. Other operational costs (property taxes, etc.) aren’t going down.

    Buying a nursing home today is like catching a falling knife.

  11. - Pot calling kettle - Wednesday, Jul 10, 24 @ 4:34 pm:

    ==Buying a nursing home today is like catching a falling knife. ==

    The actions of private investment firms seem to indicate otherwise. They buy them and close them within a few years and manage to turn a tidy profit in the process. (If that were not the case, they would stop.)

    I would like to see a breakdown comparing how the for-profits, non-profits, and gov’t owned facilities stack up in terms of staffing concerns.

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