The Basics of Nursing Homes

1. The Basics of Nursing Homes

2. What is a nursing home? • Facility that provides 24 hour care • Staffed by licensed nursing professionals • Residents may receive assistance with any and all tasks of daily living

3. What is a nursing home? • What is a nursing home not? • Assisted living/Supportive living – 210 ILCS 9 • Private rooms • Residents get assistance with limited tasks • Independent living community • Private apartments • No assistance with tasks of daily living • Communities/buildings with an exclusively senior population

4. Nursing Home Specialties Behavioral health • Units with a special proficiency in caring for persons with severe mental illness • Subpart S of Skilled Nursing and Intermediate Care Facilities Code Memory Units • Units with a special proficiency in caring for seniors with Alzheimers or dementia • Subpart U of Skilled Nursing and Intermediate Care Facilities Code Non-Specialized Skilled Nursing • Highest level of certification for facilities

5. Residents’ Rights Goal of Residents Rights • Nursing home residents should be able to make all the same decisions and have the same options as people living in the community Many rights can be limited by a guardian • But a guardian can exercise all these rights on behalf of the ward

6. Residents’ Rights • All rights guaranteed by the Constitution • 210 ILCS 45/2-101 • Manage own financial affairs – 210 ILCS 45/2-102 • Can choose to have nursing home manage finances • Keep own personal property – 210 ILCS 45/2-103 • Facility is required to provide storage and safeguarding

7. Residents’ Rights • Have your own physician – 210 ILCS 45/2-104 • Nursing home does not have to let your physician practice in the nursing home but you must be able to go and visit your physician if you so choose • Participate in the planning of your care – 210 ILCS 45/2-104 • Go to care plan meetings • Get information about side effects etc.

8. Residents’ Rights • Be free of experimental treatment without your consent – 210 ILCS 45/2-104(a) • Refuse medical treatment – 210 ILCS 45/2-104(c) • Including psychiatric medications • Freedom from unnecessary drugs – 210 ILCS 45/2-106.1(a) • Informed consent to psychotropic medication – 210 ILCS 45/2-106.1(a) • No ID wristlet unless specifically ordered by physician – 210 ILCS 45/2-106a

9. Residents’ Rights • Regular re-screening if diagnosed with a serious mental illness – 210 ILCS 45/2-104.3 • Respect – 210 ILCS 45/2-105 • Privacy– 210 ILCS 45/2-105 • Confidentiality - 210 ILCS 45/2-105

10. Residents’ Rights • Freedom from restraints if used for – 210 ILCS 45/2-106(b) • Punishment • Convenience of facility personnel • Restraints may be used only if ordered by a physician - 210 ILCS 45/2-106(b) • Some facilities have instituted a “restraint-free” policy • There is no certification for this

11. Residents’ Rights • Inspect and copy resident’s own clinical records – 210 ILCS 45/2-104(d) • Nursing home can charge a statutory fee for copies • Unimpeded, private and uncensored communication – 210 ILCS 45/2-108 • By mail • By telephone • By visit • Including the right to reside in the same room if two residents are married

12. Residents’ Rights • Right to free exercise of religion, including – 210 ILCS 45/2-109 • Arrangements to attend religious services • Freedom from imposition of religion • Right to receive notice prior to involuntary discharge – 210 ILCS 45/3-402 • Freedom to be discharged after giving notice – 210 ILCS 45/2-111 • Right to refuse to perform labor – 210 ILCS 45/2-113 • Right to air grievances – 210 ILCS 45/2-112

13. What Can You Do If Rights Are Violated? • Complain to Illinois Department of Public Health • Call the Long Term Care Ombudsman • Sue under the Illinois Nursing Home Care Act

14. Long Term Care Ombudsman • What are our goals? • Empower residents to advocate for themselves • Advocate for residents • Improve quality of life for residents • What do we do? • Intake line • Visit nursing homes and assisted/supportive living • Quarterly visits are required • Investigate and potentially respond to specific complaints • Look at records • Speak to family/friends/nursing home staff • File/prepare public benefits applications • Represent in administrative hearings • File suit in circuit court

15. How to contact us • Chicago Ombudsman • (312) 744-4016 • Regional Ombudsman – Bernard Cobbins • Bernard.cobbins@cityofchicago.org • Suburban Cook County Ombudsman • (888) 401-8200 • Regional Ombudsman – Kathy Swanson • kswanson@lafchicago.org • Where to find Ombudsman contacts for other counties • http://www.cbrx.il.gov/aging/1directory/ombudsmen.pdf

16. Key Points To Know About the Ombudsman • We are resident-directed • We will always talk to the resident to get permission to investigate • EVEN if there is a guardian • We can take direction from a guardian once we determine that a resident cannot assist us or if the Resident agrees

17. Working Together • What we can do • Refer relatives/friends of residents to programs which can help them get guardianship (eg CVLS) • What you can do • Be a complainant when you see/hear something wrong • Need not be directly related to the guardian/ward relationship (ie concerns which you could not bring to the probate judge) • Refer guardians to long term care Ombudsman • Use the relationship you have built to get them to assistance • We can provide specific nursing home related information • We can direct a guardian to appropriate resources

18. Thank you!Questions?Please feel free to contact me with further questions at:mfarbstein@lafchicago.org