October 19, 2014

Centers for Medicare & Medicaid Services' five-star Nursing Home rating system to be Overhauled

President Obama recently signed into law the Improving Medicare Post-Acute Care Transformation Act (IMPACT), which means that soon when trying to locate a nursing home for yourself or a loved one, CMS' rating will actually reflect the quality of the facility. At the present time, Medicare relies on self-reported and unverified information from nursing homes as well as its own citation data to rank facilities. Thus, comparing nursing homes ranked by Medicare on its website primarily depends on the accuracy and completeness of the information provided by the facilities. These self-reporting practices have been often criticized leading experts to question CMS' rating system as a true indication of the quality of care provided by the nursing home facilities.

Medicare's five-star rating system came under fire after an August 2014 report was released by the U.S. Department of Health and Human Services Office of Inspector General. The report found that in a random sampling of 245 nursing homes, only fifty-three percent (53%) of allegations of abuse or neglect were reported as federally required. These findings clearly indicate the unreliability of nursing home facilities' self-reported data upon which the five-star rating system is based.

Changes in the rating system are scheduled to begin in January and will include adding measurable data. For example, nursing homes will be rated on the percentage of residents re-admitted to a hospital and the percentage receiving antipsychotic drugs. CMS will also start gathering data regarding staffing numbers and turnover rates directly from payroll records rather than relying on a facility's self-reported numbers. Cheryl Phillips, M.D., LeadingAge's senior vice president of public policy told Long-Term Living Magazine that "[t]he inclusion of verified staffing information based on payroll data is especially important, as staffing levels are often the best proxy [indicator] for quality."

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October 16, 2014

Nursing Home Chain to Pay $38 Million Dollars in U.S. Settlement

In a stunning victory that will hopefully have widespread ramifications across the country, a skilled nursing home chain has agreed to pay $38 million dollars to resolve ongoing allegations related to resident care. Extendicare Health Services, Inc., owners of nursing homes in eight states, including Wisconsin and Indiana, were accused by the United States Government of substandard care in 33 of its skilled nursing homes. These allegations stem from a federal government investigation into Extendicare between 2007 and 2013.

A number of allegations were made against the quality of care at Extendicare which led to the charges by the federal government. Namely, they were accused of failing to provide appropriate care, follow safety protocols or maintain enough skilled nurses. As a result, the government insisted that they wrongfully billed Medicare and Medicaid for such substandard care. Even more alarming is the effect this substandard care had on nursing home resident at the facilities throughout the country. Investigators found that these lapses in appropriate care "resulted in head injuries to residents, falls, bed sores and fractures." They also found that many residents suffered from malnutrition, dehydration and infection.

As acting Associate Attorney General Stuart Delery rightfully stated, "protecting this nation's vulnerable populations, including our seniors, has been and continues to be one of this department's highest priorities." We at Ed Fox & Associates commend the government for stepping in to help end the pattern of neglect and abuse many residents were threatened with and experienced on a day-to-day basis at Extendicare facilities. It is our hope that this multimillion dollar settlement will go a long way in correcting the issues highlighted by the federal investigations. Not only will extendicare be required to pay $38 million dollars, but it will also be required to enter into a five-year, chain wide compliance agreement with the Department of Health and Human Services. As part of this compliance agreement, the company will be required to hire an independent monitor and make other changes necessary to correct the issues reported by the federal government.

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September 12, 2014

Illinois: Cameras in Nursing Homes?

Concerns surface over whether or not video cameras should be used in nursing homes to monitor staff's behavior towards residents as proposed by Illinois Attorney General, Lisa Madigan. Cameras could help deter nursing home abuse and neglect and hold those responsible when abuse or neglect occurs. The Attorney General's office is drafting a bill which would allow video cameras and audio recording devices in nursing homes as long as residents consent and they or their family can cover the costs.

Although agreeing that cameras can be helpful in cases where the resident consents, many elder care advocates are concerned about the privacy of seniors in cases where consent is difficult to determine. Many residents of long term care facilities are mentally impaired, such as those residents whose mental capacity has been affected by a stroke, claims a representative of suburban Cook County for the Legal Assistance Foundation, a senior advocacy organization. No one knows if those residents who require help in getting dressed or changing a diaper would want to be recorded.

However, Madigan and supporters of the proposal say that cameras are appearing everywhere these days, so why not allow them in nursing homes. The recordings from the cameras or audio devices would be allowed in court and anyone who tried to tamper with or obstruct the devices would be penalized under the proposal. It is no surprise that abuse and neglect in nursing homes is a growing concern. According to the attorney general's office, the Illinois Department of Public Health receives 19,000 calls per year alleging abuse or neglect and responds to about 5,000.

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September 5, 2014

New Illinois Law proposes minimum direct care nurse hours

Our Chicago Nursing Home abuse firm has been tracking recent legislative activity within the United States Senate and House of Representatives. Congresswoman Jan Schakowsky (D-IL 9th District) has proposed a bill that, if put into effect, would require long-term care facilities to use the services of at least one registered nurse to provide "assessment, surveillance and direct care to residents 24 hours a day, 7 days a week." This program would apply to Medicare and Medicaid nursing homes and skilled nursing facilities.

Schakowsky introduced her bill on July 31, 2014. Under present law, Medicare and Medicaid nursing homes and skilled nursing facilities are only legally required to have a nurse on duty for eight hours a day. Low staffing levels can lead to elder abuse or neglect. We at Ed Fox & Associates have handled a wide variety of cases in nursing homes, especially with regards to issues of abuse and neglect of nursing home residents.

Congresswoman Schakowsky also recently sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mariyln Tavenner urging CMS to fully implement the provision of the Affordable Care Act which requires nursing home staffing information be obtained through a payroll data collection system. In the letter, Congresswoman Jan Schakowsky wrote "People who need nursing home care for themselves or their loved ones are looking at staffing levels to see whether the services they need will be there. They deserve to have reliable data and it is time that CMS acts to meet the requirements of the law".

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September 2, 2014

Reports of Elder Abuse rise in DuPage County

As DuPage County's demographics have changed, so have the number of reports of elder abuse. As documented in the Doings, a Chicago Sun-Times Publication, as of halfway through 2014 DuPage County has already reported 297 cases of elder abuse. In the fiscal year of 2013, DuPage County reported 467 cases of elder abuse. If this pace continues, DuPage County would have over 100 more reported cases of elder abuse in 2014 as compared to 2013.

DuPage County has not determined the exact cause of this increase in pace of elder abuse reports, but a 2013 change in Illinois law may be considered a factor. Out of the 297 reported cases thus far in 2014, 37 of these reports involve alleged abuse against disabled individuals.

It is important to note that nursing home abuse may not only take place in substandard nursing homes. Abuse can also take place from caregivers within ones' own home. Abuse can include, but is not limited to, physical abuse, neglect, emotional abuse, confinement or even sexual abuse.

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August 22, 2014

Federal Inspector General Finds That Nearly 25% of Nursing Homes Fail to Report Abuse or Neglect Allegations

The United States Department of Health and Human Services' Office of the Inspector General (OIG) has released its findings related to an investigation surveying approximately 250 nursing home care facilities throughout the United States. While this survey is a small cross-section of all nursing home care facilities within the entire nation, its findings are deeply troubling. The investigative report concluded that only seventy-six percent (76%) of the nursing homes maintained policies that address federal regulations for reporting allegations of abuse or neglect. Additionally, only fifty-three percent (53%) of care facilities actually reported the findings of any investigation completed in response to allegations by residents or their loved ones concerning abuse or neglect at the hands of a care provider at the nursing facility, as federally required.

Of those nursing home facilities complying with their federal requirements of reporting abuse and neglect, a total of 149,313 allegations of abuse or neglect were brought to the attention of the OIG in 2012. Of all these reports, abuse was the most common type of allegation, accounting for half of the allegations in 2012. Even more alarming than the significant number of allegations reported are those that fail to be reported. Very often, when this occurs, the individuals being abused or neglected suffer in silence.

The purposes of these reporting requirements are clear: to ensure the safety of nursing home residents and create a mechanism by which there is complete transparency within the nursing homes when it comes to allegations of abuse and neglect, and any subsequent investigative findings into the allegations. That being said, this study clearly indicates that further measures need to be implemented to ensure complete compliance by all nursing home facilities across the country. The OIG, in this investigative report, recommends that the Centers for Medicare & Medicaid Services (CMS) guarantee that nursing home facilities:

(1) Maintain policies related to reporting allegations of abuse or neglect;

(2) Notify covered individuals of their obligation to report reasonable suspicions of crimes; and

(3) Report allegations of abuse or neglect and investigation reusults in a timely manner and to the appropriate individuals, as required.

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August 20, 2014

New Illinois Laws Target Senior Care Complaints in Nursing Homes and Long-Term Care Facilities

Our Chicago Nursing Home abuse firm has been tracking recent legislative activity within the Illinois House of Representatives and Illinois Senate. As a result of a bill sponsored by both Illinois Republicans and Illinois Democrats, Governor Pat Quinn has, within the last week, signed into law a Long-Term Ombudsman program. This program is designed to expand ombudsman rights, an official who investigates complaints regarding nursing home conditions and patient care, and to expand protection for vulnerable individuals living in nursing homes and community based care. This law will take effect on January 1, 2015 and will be effective statewide.

Additionally, a second bill the governor signed has made it easier for individuals living in nursing homes and long-term care facilities, along with their families and loved ones, to submit complaints to the Illinois Department of Public Health. These complaints may now be submitted electronically to the Illinois Department of Public Health in order to expedite the process when residents of care facilities and/or their families have concerns regarding the care facility. These complaints may range anywhere from issues of care and treatment to the physical conditions of the nursing home facility itself. We at Ed Fox & Associates have handled a wide variety of cases in all these areas, especially with regards to issues of abuse and neglect of nursing home residents.

These laws are integral to the nursing home care system within the state of Illinois. The elderly residents of these nursing homes and long-term care facilities are some of the most vulnerable members of our population. They deserve the most basic human rights in order to protect their physical, emotional and mental well-being. These laws are one small step in the right direction of protecting and enforcing the rights of any and all residents. That being said, there is still much that has left to be done in order to protect these residents from the abuse and neglect that occurs all too often in the state of Illinois.

Continue reading "New Illinois Laws Target Senior Care Complaints in Nursing Homes and Long-Term Care Facilities" »

May 29, 2014

Nursing Home Bill of Rights Gaining Momentum

The Health Care Council of Illinois is conducting a "Protect the Rights of Nursing Home Residents" campaign. They are traveling to different communities in Illinois and informing people of their goal to convince the Illinois legislature to pass legislation creating a Nursing Home Bill of Rights.

The Nursing Home Bill of Rights consists the following:

• Opportunity to choose where they want to get their care
• Protects their right to live in the nursing home they have called home
• Seamless delivery of care that they, their family, and their doctor request
• Care that serves their best interests, not a managed care organization's bottom line
• Care approval line that open when health changes, 24 hours every day of the year
• Appeal process that requires the managed care company to prove the care isn't needed
• Help understanding the plans and making the right choice, protection from direct mail and telemarketers
• Care delivery decisions that never trump their needs, their doctor's orders, or family wishes

The Bill of Rights was made to protect seniors who rely on Medicaid for their care. Not included are rights related to abuse or neglect. However, nursing home residents do have the right to be treated with a certain standard of care.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

May 26, 2014

Nursing Home Abuse Updates from Across the Nation


Recently, a Tulsa reporter has uncovered some disturbing practices at a local nursing home. The nursing home reportedly, at times employs 2 aides to take care of the residents in a facility of 76 people. The lack of staffing leads to unattended residents, and injuries such as bedsores, and bed wounds. The state of Oklahoma has stringent mandates that regulate how many caretakers a facility needs for a certain number of residents, depending on the time of day. From 7 am - 3 pm, nursing homes are expected to have one direct care staff member for every seven residents. Federal regulations on the matter are less informative, requiring "adequate staff" at nursing homes. The state is now taking a closer look at the nursing home system and common practices of the industry.

You can find the story here.


Federal authorities have fined a Kansas nursing home $185,000 based on charges of neglect and abuse. As an incentive to fix the problems as soon as possible, the home will be fined an extra $1,000 for every day that the problems are not fixed. The Kansas Department of Aging and Disability Services aided in the investigation by interviewing 27 residents of the facility. The violations originated from abusive actions of the staff, as well as inaction resulting in resident on resident abuse.

You can find the story here.


An employee of a Lincoln, Nebraska nursing home has been charged with the assault and abuse of three elderly residents. She allegedly slapped the three residents, and was too physical with them during other interactions. The employee has since been fired.

You can find the story here.


The discussion revolving around allowing cameras in nursing home rooms is a controversial one. It is now being discussed in Illinois. The movement started, or at least grew immensely after a the family of a Kansas nursing home resident placed a camera in their mother's room, and ended up witnessing her being abused. The fight to get cameras placed in the rooms is not only being fought by people who currently have family member's in nursing homes, but people who believe camera's could have helped their previously deceased loved ones. Sometimes, it only takes one instance to change a state legislature's mind. For example, footage of elder abuse in Oklahoma convinced the governing body to allow voluntary video cameras in the rooms. Most of the pushback is based on privacy concerns stemming from HIPPA. It will be interesting to see how this debate unfolds.

You can find the story here.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

May 22, 2014

Illinois Attorney General's Office Attempts to Combat Financial Scams Targeted at Elderly with the "Silver Beat"

The Illinois Attorney General's office has noticed a problem consisting of financial scams aimed at the elderly population. Criminals see the elderly as attractive targets for these schemes because of their general access to fixed sums of money such as retirement accounts and pensions. In response, the office has created the "Silver Beat" program aimed at educating the elderly about possible scams and giving them tools to detect the scams and avoid them.

Some of the programs also concentrate on letting seniors know about common financial mistakes that seniors make that are not necessarily based on illegal actions, but could still be detrimental to the senior's financial well being. For example, they have created simple fact sheets about credit card debt, reverse mortgages, monitoring credit reports, and debt collection.

The program is community oriented, meaning they accept volunteers to host "silver beat" meetings and are willing to train people to educate the elderly in their communities. The hope is that once a core group of seniors learn the skills offered by the program, they can go back to their communities and pass some of the information along. With that being said, it could be useful for anyone in the community who has an elderly person in their life to be part of the program. Some of the onus falls on the elderly person's support system to help them stay safe, especially if they are living away from the loved ones in a nursing home.

Elder abuse can be physical or financial. If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

May 19, 2014

Illinois Nursing Homes Receive Failing Grade from Non-Profit

Nursing home watchdog and non-profit Families for Better Care, has ranked and graded the nursing home systems in all fifty states. The group ranked Illinois forty second out of all fifty states and gave it one of eleven failing grades. The grades were based on a number of different categories. These categories included the average staffing statistics from each state, the amount of personal care hours given to residents of each state, results of health inspections, the number of verified ombudsman complaints, and the amount of facilities containing deficiencies or severe deficiencies.

Illinois ranked at the bottom in most of categories mentioned above. The most apparent weakness was the lack of average direct staffing hours per resident in the state. They ranked last and each resident only received about 2 hours of direct resident care per day. The report also indicates that Illinois' score in not just based on a few rogue nursing homes, as 96% of nursing homes in Illinois were cited for at least one deficiency.

The conclusions from this report make it as important as ever for family members and friends of nursing home residents to be vigilant in maintaining that person's well being. It is important to visit your loved ones often to catch signs of abuse and neglect, and be aware of the remedies available to you if you do notice something wrong. This can be anything from filing a complaint with the state's complaint process to hiring legal representation.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

April 3, 2014

Illinois Long-Term Care Ombudsmen Program Expanded by Legislature

The Illinois Act on Aging created the Long Term Care Ombudsman Program. 20 ILCS 105/4.04. The program was created to make sure older persons and others with disabilities receive quality care in long-term care facilities. The idea behind the program is to give elders a government ran support system, which they may not have had otherwise. Elders and their families are able to go to the ombudsman with complaints and in turn the ombudsman will advocate on behalf of them. This advocacy manifests itself in many ways. Ombudsmen inform long-term care residents and their families of their rights, resolve complaints they may have, provide information about residents' needs and concerns to long term care facilities, and generally advocate for good individualized care. More information about the program can be found here.

Legislation expanding the Illinois Ombudsman Program was signed into law in August of 2013. The expansion's goal is to have ombudsmen advocate for seniors in home care and managed care situations as well as for ones in long-term care facilities. This expansion will not affect the role of the ombudsmen, "serving as an independent voice and advocating for individuals receiving long term services." What it will do is increase the impact of that mission. The decision to expand was a choice made by the State to offer services already provided to a certain population of seniors, to other seniors who may also be in need.

In an attempt to make the service convenient to residents throughout Illinois the Long Term Care Ombudsman Program has regional offices all over the state. The addresses and contact information of the offices can be easily found on this list.

The recent expansion of this program in Illinois may be a reaction to a growing problem in the state: an increase in elder abuse and neglect combined with a lack of knowledge of how to deal with it. One effect of the increase of ombudsmen presence could be an increase in general awareness that elder abuse goes on, and this heightened sense alone could empower a sector of society's most vulnerable people.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

March 25, 2014

Florida to Vote on Bill Aimed at Limiting Tort Liability in Nursing Home Litigation

Florida is one of the nation's most popular destinations for the elderly, which has made nursing homes and other long term care facilities a major part of the state's economy. The Florida legislature has recently addressed an important issue facing this sector of their economy: the extent of liability in nursing home tort litigation.

HB 569/SB 670 has been proposed in the state house and senate. The bill proposes the following: (1) liability arising from the violation of a duty to a nursing home patient can only be filed against licensees, management or consulting companies, managing employees, and/or any direct caregiver employees or contractors; and (2) if a nursing home facility fails to pay a judgment the Agency for Healthcare Administration may revoke its license or decide not to renew the license. At the moment, the bill is in its preliminary stages, as it was introduced to the Florida House of Representatives March 24, 2014. Meaning, there is time for heated debate on the subject.

The bill has evoked opinions from groups advocating differing point of views. Those in favor of the bill see it as a compromise between the Florida Health Care Association (FHCA), the Florida Justice Association, and AARP. They believe it is an important step to protecting one of Florida's biggest industries, while providing the flexibility for victims of nursing home abuse or neglect to receive redress from the people directly responsible. That view is expressed in this editorial.

Proponents against the bill see it as the result of an enormous lobbying effort from the nursing home industry and feel that it shields nursing home executives and other powerful nursing home entities from liability. They believe this grants a potential defense to primary decision makers who are insulated from the actual execution of their orders. The detractors' sentiment is that there is a low overall standard of care in nursing homes currently, and elders need tort reform that gives them more protections, not less. This view is expressed in this editorial.

As the Tort reform debate rages on in Florida, in Chicago and other parts of Illinois senior citizens are subject to similar health risks and are just as vulnerable. It is important to stay vigilant in checking up on your family members and protecting their rights. If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

March 18, 2014

Elderly Abuse Proving to be a National Problem in Recent Months


An incident occurred at Rosewood Care Center in St. Charles, Illinois, a suburb in Chicago. The St. Charles Police accused two employees of the facility of aggravated battery of a person older than 60 as well as an unlawful videotaping of the incident. Thankfully, there are no lingering physical injuries suffered by the victim.

Find the story here.

New York

The Medford Medical Center in Long Island, New York has been reprimanded more than once since its inception in 2003, but the most recent incident may be the final straw. The New York's Attorney General's is prosecuting a Medford employee for negligent homicide following the death of Aurelia Rios. Doctors mandated that the 72 year old Rios be connected to a ventilator throughout the night. One night in October 2012, Rios' ventilator was not connected properly. During that night, an alarm went off every 15 minutes for 2 hours and no staff member, even the one assigned to check on that room, responded to the alarm. Rios died later that evening. Other employees were charged after the fact for covering up the death. The Rios family is planning on filing a civil law suit against the nursing home to compensate them for their loss.

Find the story here.


The Delaware Attorney General's office has filed charges resulting from an investigation of a New Castle County Group nursing home. The investigation was triggered by complaints made to the Delaware Division of Long Term Resident's Protection. The employee arrested was responsible for multiple residents at the home and charged with abuse, neglect, and exploitation or Mistreatment of an Infirm adult. This investigation and result has provoked the Delaware Attorney General's Office to solicit more complaints in an effort to bring justice to the state's elderly residents.

Find the story here.


A jury found a nursing home in Massachusetts liable for resident abuse and awarded the victim $2 million. There were no eyewitnesses but the physical evidence combined with expert testimony convinced the jury that assault occurred. The victim was 87-year old.

Find the story here.

The wide spread nature of nursing home abuse should be a reminder to families who have loved ones in nursing homes to be vigilant in checking up on their vulnerable family members. For information on what steps to take if you suspect nursing home abuse is happening to a family member or friend follow this link.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.

March 11, 2014

Nursing Home Abuse Statistics Refocus Attention to the Issue

According to a Digital Journal article, there are currently five million seniors living in long-term facilities and 11 million seniors who live alone. Of the five million seniors that live in those facilities, a staggering 95% of them claim they have either been abused or have seen another senior being abused in their facility. Even 50% of nursing home staffers have admitted to abusing patients.

These statistics are even more troubling than they seem. The National Center on Elder Abuse has reported around 1 in 14 cases of elder abuse is reported, and even cited another study only focused on New York nursing homes which found only 1 in 24 cases of elder abuse were known by authorities. Not only are elderly people being abused, but most of the abuses are going undetected.

This problem will get worse because people over the age of 85 are the fastest growing segment of our society. This means in the coming years, the targets of nursing home abuses will become more plentiful. Chicago may be affected more than other areas around it because it is home to a large population of those entering into senior citizenship. The increasing instances of nursing home abuse have even influenced the development of a new industry for elder care professionals, Senior Care Auditors. This is a private service that a family can hire to check on their loved one's facilities and detect nursing home abuse. Solving the problem preemptively will undoubtedly have a positive change, but it will not eradicate the problem completely. Sometimes one must deal with nursing home abuse and neglect after the fact.

One way to control this problem is to punish the abusers after the nursing home abuse takes place. Hopefully, this will show people who take advantage of the elderly that their actions have consequences as well as empower other senior's to speak up if they have endured abuse themselves. If a senior in your life has been treated poorly by a nursing home's staff, Ed Fox and Associates can provide you and your family guidance on how to handle it.

If you or someone you love has been injured, neglected, or abused in a nursing home at the hands of nursing home caretakers, please contact Ed Fox & Associates today.