New Illinois LTC Law Addresses Staffing Deficiencies

In June 2019, the Illinois State Legislature passed a bill to address nursing home staffing by vastly increasing funding for struggling long-term care facilities.  Under the law, the 2020 fiscal year budget increases nursing home providers’ budgets by $240 million to be shared equally by the State and Federal governments, with $70 million allocated to assist facilities to meet staffing requirements. Arguably, there is a direct correlation between staffing and incidents that may give rise to litigation.  Financial and staffing components often directly factor into the quality of care residents receive, and legislative action such as that undertaken by Illinois is critical to improve the care long-term care facilities provide.

Under the Illinois law, nursing homes will be required to develop and submit individualized staffing plans and quarterly reports to demonstrate funding is being used satisfactorily.  Once facilities meet staffing minimums, additional funds may be used for wage increases, staff retention, or hiring to alleviate staff workloads. 

Healthcare union president Greg Kelley called the law “historic” in response to the bill’s passage.  “Nursing home workers deserve a safe and secure working environment where caregivers are not constantly overburdened, exhausted, and stressed trying to care for sometimes up to 30 to 40 residents, if not more, at a single time,” he said.

The Illinois legislature implemented the budget increase to address a trend of 20-plus skilled-and intermediate-care facility closures in the past five-years due to budget cuts and decades-old Medicaid reimbursement rates.  An investigation concluded that nursing and aide staffing levels at Illinois nursing homes were among the lowest in the country.

“These facilities are closing, and I can tell you more are going to close,” said Pat Comstock, Executive Director of the nursing home advocacy group Health Care Council of Illinois.  “Our members are thrilled, but they’re also relieved because these dollars are going to provide some much needed relief from the struggles to survive that members are experiencing.”

As a condition or the budget increase, the legislation also imposes fines upon nursing homes that fail to meet staffing minimums and safeguards against the inappropriate, unapproved use of psychotropic drugs.  AARP was among those who advocated for fines after a newspaper investigation found a correlation between sepsis and chronic staffing shortages.

The Illinois Health Association, which represents more than 500 nursing homes, did not oppose the law after its leadership participated in drafting its language.  “We believe centers that understaff should absolutely be fined and cited for their failure to staff appropriately, and this bill moves to do that more aggressively,” said Executive Director Matt Hartman.

The law will require state regulators to obtain Medicaid payroll information from each facility to calculate whether facilities meet required staffing standards.  Regulators project fines may double the amounts facilities may save if they fail staff appropriately.  Violators will also be required to advertise state staffing violations on their web sites, lobbies, and registration desks.  Regulators must begin issuing fines to violators by 2021.