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Improving the Quality of Care in Illinois Nursing Homes

Like many states, Illinois attempts to ensure the quality of care in nursing homes and long-term care facilities by enacting legislation to punish facilities that fail to meet state standards. But a recent article in the Annals of Long Term Care argues that a state-sponsored incentive program would be much more effective in improving conditions in nursing homes and long-term care facilities.

Improving the quality of nursing home care in Illinois continues to be a struggle. In pursuit of this goal, the Illinois legislature enacted the Nursing Home Care Act. This traditional approach seeks to improve the quality of care by imposing fines and sanctions on facilities that fail to meet state standards. Yet each quarter, the Illinois Department of Public Health releases a report of the many facilities that are found to be in violation of the Nursing Home Care Act. This approach only incentives nursing homes to meet a minimum standard of care for residents – it does nothing to reward those facilities that provide exceptional services for their residents.

Incentive Program
In the recent article A State-Sponsored Approach to Quality Improvement in Nursing Homes: Insights From Providers, authors Kathleen Abrahamson, Priscilla Arling, and Greg Arling argue that a performance-based incentive payment program (PIPP) can be more effective in improving the quality of care in nursing homes than traditional methods. In exploring the possibilities for incentivizing increased quality of care, the authors examined Minnesota’s PIPP program, created in 2006. The Minnesota PIPP program encouraged long-term health care providers to create sustainable quality improvements in their facilities. The state provided funding for projects that addressed quality issues such as falls, psychotropic medications, pain control, mobility, continence, resident-centered care, and care transition.

Ultimately, many of the projects substantially improved the quality of care for elderly residents within participating facilities. These projects serve as models for other nursing homes, and the increased state funding provides an additional incentive to raise the quality of care beyond the minimum required by state law.

Illinois’ Attempt at an Incentive Program
In 1985, Illinois enacted the Illinois Quality Incentive Program. The stated goal of the program was to reward facilities for improving resident care beyond minimum state and federal standards. Under the program, nursing homes were given a separate bonus payment per Medicaid day for achievement in six categories: (1) structure and environment; (2) resident participation and choice; (3) community and family participation; (4) resident satisfaction; (5) care plans; and (6) specialized intensive services.

Despite these admirable goals, the program failed to meet its goals. The Long Term Care Community Coalition found that there was a disconnect between the incentives and the quality for care. For example, adding a fish tank would earn a facility a reward, despite the fact that this addition had little impact on the quality of care for residents. The program was criticized for incentivizing “paper compliance,” rather than a significant improvement in the quality of care. After seven years, the program was discontinued.

Illinois can learn from Minnesota’s success. Unlike Illinois’s program, the Minnesota PIPP allowed providers to identify the areas in need of improvement, plan how to implement a change, and then execute the plan. Rather than blanket funding based on arbitrary standards, providers were required to submit individualized plans in order to receive funding. By modeling an incentive program after Minnesota’s success, Illinois can improve the quality of care for nursing home residents beyond the bare minimum required by law.

Improving the quality of care in nursing homes remains a struggle. Vulnerable residents often become victims of abuse and neglect. If you suspect that your loved one is being mistreated at a nursing home, it is important that you contact a qualified attorney. Our skilled lawyers have extensive experience in litigating all types of cases related to nursing abuse and neglect in Illinois. Contact us today to learn how we may be able to help.

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