Illinois Task Force Proposals
The Chicago Tribune had an article about the weak and disappointing proposals to improve safety and the quality of care in nursing homes. A panel appointed by Gov. Pat Quinn proposed an array of sweeping reforms designed to end the chronic violence and abuse that plague some nursing homes, while fostering better treatment for people with serious mental illness living in those facilities. The proposals range from tightened criminal background checks of new nursing home residents to stronger sanctions and enforcement of facilities with chronic safety breaches.
Quinn's Nursing Home Safety Task Force also recommended that state police begin searching nursing homes for residents with outstanding warrants, and urged the state to increase minimum staffing requirements of the facilities to bring them up to standards spelled out in federal government studies on nursing home care. "Urge"? Why don't they propose specific hours per patient day?
27 "preliminary recommendations" will be refined before a final report is delivered to the governor. Quinn's task force was formed in response to a series of Tribune reports on assaults, rapes and murders in the state's nursing homes. Illinois as most states, extensively mixes geriatric and mentally ill nursing home residents, and understaffed facilities have failed to treat and monitor their most violent patients, government records show.
Mark Heyrman, a University of Chicago Law School professor and chair of public policy for Mental Health America of Illinois, was more cautious, saying the recommendations "do not go far enough. ... We are concerned that, once the media attention dies down, the state will be under renewed pressure not to enforce either the old laws and rules or the new ones proposed by the task force."
The task force recommended that the state Department of Public Health hire additional nursing home inspectors and retrain its current inspectors to focus on safety and care issues involving the mentally ill. Although mentally ill people, if given proper treatment, are no more likely than others to be dangerous or to commit crimes, many facilities provided grossly substandard care, the Tribune found. Many of the psychiatric patients are clustered in a relatively small subset of nursing facilities whose impoverished residents have few other options, and the paper's analysis showed the homes with the most felons had the lowest nursing staff-to-patient ratios.
Among the reforms that might be put into place fairly rapidly are a tightening of criminal background checks and screenings of people entering nursing homes. The Tribune's review of confidential case files showed the state's criminal background checks on new residents were riddled with errors and omissions that grossly understated their criminal records and danger to others. Some of these poorly screened offenders went on to commit assaults and other serious crimes inside the homes where they lived.
The task force recommended more detailed assessments to gauge people's potential for engaging in violent behavior, and said the criminal checks should be started before people are admitted to facilities. Also, the task force urged the state to sanction homes that do not promptly complete the screening reports.
The Health Department should get greater authority to revoke the licenses of nursing homes that repeatedly violate state safety regulations, the task force said. And government agencies should mete out more severe sanctions on nursing home administrators and top employees who engage in misconduct.
The Tribune reported that frail and elderly residents often were pumped with powerful anti-psychotic drugs without their consent and without a proper diagnosis. One of the nation's most prolific prescribers of psychiatric drugs provided assembly-line care for thousands of mentally ill patients housed in Chicago-area nursing homes -- while a large pharmaceutical company paid him to promote the drugs despite doubts about his credibility.
