Articles Posted in Ombudsmen and Resident Advocates

We hear it all the time: nursing homes do not have enough money to provide proper care to their residents. When neglect or abuse is uncovered and serious problems are identified–often insufficient staffing levels–then the first line of defense is usually the difficulty these companies have in bringing in enough money to pay for the care needed. Of course, the actual front-line care workers are rarely to blame for issues like lack of staffing; they are just doing their job the best they can, often with unmanageably low support. But just because a company claims to lack resources does not mean that they actually do not have the funds they need to provide proper care.

After all, most of those making these complaints are private businesses. Why would they be running these facilities if it was not profitable? Would they continue in business if the cost of providing adequate, safe care was more they they received from those paying for it? The truth is, they wouln’t. The owners and operators continue to make steady profits on these businesses, and claims about lack of resources often just mean one thing: they do not want to cut into their healthy profit margin.

There is no harm in making a profit in business–that’s the whole point. But when your business is providing skilled medical care to others, then it is not acceptable to make excuses of profit when poor care leads to serious harm to those vulnerable consumers counting on you. Sadly, that is exactly what happens in so many corners of the skilled nursing home business world.

The new Russell Sage e-book on long-term care (viewed here), includes a chapter on the payment systems for these crucial services. It is impossible to separate programs to tackle the elimination of neglect and abuse without taking finances into account. Who pays for this care, how they pay for it, and how the funds are used is at the center of all discussions about quality of care.

In general, long-term care services–including stays in a nursing home or via at-home support–are paid for by insurance. Some individuals have private long-term care insurance while others (a majority) rely on public insurance programs (Medicaid) to pay for the care. It is undeniable that public coffers are stretched to the bone. No one is quite sure how the Medicaid system will be able to continue paying for the current level of services indefinitely, especially considering the growing number of seniors who will likely need long-term care paid for via Medicaid in the future. However, there has yet to be a strong push for increased use of private insurance to ease the burden on the public. Some hope this changes.

Private Long-Term Care Insurance

The American Association of Justice recently discussed a new ruling that may bring certainty to a previously unsettled area of nursing home law. The Eleventh Circuit, a federal appellate court, ruled that proceeds of wrongful death lawsuits following nursing home deaths belong to the surviving children, not Medicare. This holding reverses a lower court decision that found otherwise.

Specifically, with this decision the court rejected claims by Medicare (managed by the US Department of Health and Human Services), that it was entitled to first and full reimbursements for payment it had made following settlements after negligent nursing home deaths. Of course, that meant that the surviving family members of the nursing home victim would be treated as second-in-line, to receive only whatever remained following the initial payment of the settlement funds to Medicare.

Put more succinctly, the court of appeals judge in this case explained that the real issue was simple: “whose property is the settlement?”

An article in The Gazette, a monthly publication of the National Consumer Voice for Quality Long-Term Care, pointed to an interesting new study that suggests new methods that may help extend the life of cancer victims in nursing homes.

The research out of the New England Journal of Medicine specifically found that “palliative care” extended the length and quality of life of patients who had been diagnosed with lung cancer. According to, the treatment is a medical specialty that includes a variety of techniques to improve the quality of life of patents facing serious illness. It focuses on intense communication with the patient, managing of pain, and coordination with personal development.

In other words, palliative care includes all of the components to patient care besides the basic treatments of surgery, radiation, and chemotherapy. The treatment is often confused with hospice care. While hospice care typically involves some palliative care, the two are not synonymous.

May 9-15 has been declared National Nursing Home Week by the American Health Care Association. This is an important week because every year thousands of nursing home residents become victims of elderly abuse and neglect. This week is a good week to reflect on what everyone can do to better protect these vulnerable residents. The Chicago nursing home lawyers of Levin & Perconti have handled nursing home cases since 1992. We believe that it is essential for people to understand the exact meaning of nursing home abuse and neglect and what can be done if they suspect their loved one is a victim.

There are many signs of nursing home abuse and neglect. They not only affect an elderly resident’s physical well-being but their mental and emotional spirit as well. Some signs to watch for with nursing home neglect include:

– Falls – Pressure ulcers – Malnutrition and/or dehydration – Over-medication – Cuts, bruises or broken bones – Poor hygiene – An unclean environment and/or smells – Weight loss – Changes in demeanor – Wandering or elopement – Medication errors

The National Consumer Voice for Quality Long-Term Care has released their January Gazette. This newsletter includes important articles on nursing home abuse. The newsletter highlights the Chicago nursing home abuse that occurs when felons live in facilities. The newsletter also discusses eviction rights and the U.S. News and World Report highlighting the benefits of Resident-Centered Care. This gazette is a must read for all nursing home lawyers. To read the Gazette, Please click the link.

The National Consumer Voice for Quality Long-Term Care has issued their November Gazette newsletter. This is a great resource for nursing home advocates and ombudsmen. It highlights recent legislation and current issues in nursing home health care. To read the November issue, please click the link.

The National Consumer Voice for Quality Long-Term Care has designated this week as Resident’s Rights Week. Residents’ Rights Week is celebrated the first full week in October each year to honor residents living in all long-term care facilities. It is a time for celebration and recognition. This is also an opportunity for every nursing home to focus on and celebrate awareness of dignity, respect and the value of each individual resident. Ombudsmen, citizen’s advocacy groups, family and residents councils and long-term care facilities across the country are honoring residents with several events. NCCNHR has put together five ways to participate in resident’s rights week. First visit a resident of a nursing home. While there, encourage a facility to use one of the activity examples from NCCNHR’s Residents’ Rights Week packet. Also you should educate families and the community about Residents’ Rights by writing a letter to the editor of your local newspaper about Residents’ Rights. Finally host a residents’ rights week event. To read more about ways to celebrate residents’ rights week, please click the link.

The National Consumer Voice for Quality Long-Term Care has issued their September Newsletter. The newsletter discussed the recent budget cuts to Illinois Ombudsmen Programs. On October 1, planned state budget cuts will significantly reduce funding to Illinois’s long-term care ombudsmen program. These budget cuts will place further strain on the program that helps prevent nursing home abuse and neglect. The budget cuts will reduce funding from $2.34 million to 1.9 million. This will inevitably mean a decrease in ombudsmen, who routinely address the questions and concerns of residents. The president of the Illinois Association of Long-Term Care Ombudsmen stated that the regular presence of an ombudsman is vitally important especially for those who do not have family and friends to advocate on their behalf. The decrease of ombudsmen will reduce the amount of help that elderly residents receive in nursing homes. The newsletter also discussed that nursing home executives are excluded from federal health care programs and the fact that the inspector general has released reports on hospice in nursing homes. To read the entire newsletter, please click the link.

Illinois ombudsmen help the staff understand the rights of residents. In order to make sure those residents’ rights are upheld, the agency sponsors the Long-Term Ombudsman Program which covers 16 counties in Illinois. It serves residents age 60 in over 139 licensed health facilities, 11 assisted living facilities and seven supportive living facilities. There are 10 long-term facilities in Vermillion County that benefit from the ombudsmen work. They aid in issue such as nursing home abuse and neglect. They refer the worse cases of nursing home abuse to the Illinois Department of Public Health. The paid staff with the ombudsman program visits the facilities once every quarter, or four times a year. Residents are urged to call the ombudsman’s office if problems cannot be resolved. One can become an ombudsman by completing an application and interview process. They then have to go through basic training and mentoring. Currently, Vermillion County has one community ombudsman. To read more about how to become an ombudsman, please click the link.

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