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Who Regulates Nursing Homes

Michael Agruss

Written and Reviewed by Michael Agruss

  • Managing Partner and Personal Injury Lawyer at 844SeeMike.
  • Over 20 years of experience in Personal Injury.
  • Graduated from the University of Illinois Chicago School of Law: Juris Doctor, 2004.

Nursing homes in Illinois are regulated, inspected, and licensed by various agencies at the state and federal levels including the U.S. Department of Health and Human Services Center for Medicare and Medicaid Services (CMS) and the Illinois Department of Public Health (IDPH). In addition to these agencies, some Illinois nursing homes are members of national accrediting organizations that independently inspects its member facilities to assess their performance.

The IDPH is responsible for ensuring that Illinois nursing homes fully comply with mandatory state regulations. In a partnership with the CMS, the IDPH also ensures that facilities that receive Medicare and Medicaid payments for patients meet federally mandated regulations and certification rules.

Each year, the IDPH conducts over 1,300 on-site inspections, called surveys, for nursing home licensing, to respond to complaints, and to review the nursing home, its employees, policies, procedures, and finances. Nursing homes are inspected on average of every 12 months, although inspections can be done every six-15 months. These inspections are completely unannounced and survey schedules are changed annually to avoid nursing homes from anticipating when the survey will be conducted. In general, nursing home facilities that have numerous complaints and poor survey results are surveyed more frequently.

Surveys of nursing homes are normally done on weekdays, but they are known to be completed during evenings, weekends, and holidays. When a survey is completed, an exit interview is conducted with nursing home staff and the report is sent to the facility. If the nursing home fails to comply with state or federal standards, they will be cited for deficiencies and fined.

Deficiencies are violations of regulations and can range from minor violations that do not affect the health and safety of nursing home residents to widespread violations that put the health and safety of residents at risk.

When deficiencies are found, the nursing home is given an opportunity to rebut the findings and must create a plan-of-action within 10 days of the citation. The IDPH can give recommendations on what needs changed and if they deem that conditions pose an immediate risk to staff or residents, the IDPH can demand immediate action be taken.

In most cases where deficiencies are minor, the nursing home is given the opportunity to make corrections without a fine. However, if it is warranted, the IDPH can institute severe penalties. These penalties include:

  • Fines-$10,000 per civil violation, $50 to $10,000 a day for federal violations, recommendations to CMS for state fines;
  • Restricting admissions;
  • Issue provisional licenses;
  • Institute a temporary manager;
  • Suspension of the nursing home license;
  • Revoking the nursing home license;
  • Closing the facility.

Nursing homes with multiple or severe violations can have their Medicare or Medicaid certification revoked or suspended by the CMS, meaning they will not receive reimbursement for services provided while the nursing home is being penalized.

If you believe a loved one has been abused or neglected at a long-term care facility, contact 844 See Mike, for a free consultation. We are a Chicago injury law firm representing individuals and families who have suffered an injury or loss due to an accident. 844 See Mike, will handle your personal injury case quickly, will advise you every step of the way, and will not hesitate to go to trial for you.

Lastly, 844 See Mike, does not get paid attorney’s fees unless we win your case. Our no-fee promise is that simple. Therefore, you have nothing to risk when you hire us–just the opportunity to seek justice.

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