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.

February 28, 2014

Illinois Elderly Scammed out of Hundreds of Thousands of Dollars

Bilking is the act of obtaining money from someone by deceit or without justification, and the elderly are at greater risk than the general population of being affected by it. Recently, an Illinois couple was found liable for bilking a group of 1,000 or more elderly victims out of more than $800,000. One member of the couple was recently sentenced to more than 13 years in a federal prison.

To implement the scam, she pretended to be a fraud investigator, seeked out vulnerable elderly people and told them she was investigating potential frauds on their financial accounts. Once the scam artist developed a relationship with the victim, and gained their trust, her and her husband would gather the victim's financial information and in some cases even gained access to their actual credit cards.

To ensure this scam would work, the couple targeted one of society's most vulnerable demographics, the elderly. They visited nursing homes and approached residents that had trouble getting around or seemed weak. One of their victims even needed to be hooked up to an oxygen tank. To say the least, most of the victims were not in a position to protect themselves from such experienced and determined scam artists. Sadly, in many nursing homes today the elderly are neglected making it easier for people with unwholesome intentions to take advantage of them. This story, is one of many examples that illustrates why family members need to pay attention to the elderly people in their life. The first step in helping one's relatives is knowing who to contact to protect their rights as well as employing some preventative measures to keep those rights intact.

One way is to put your loved ones in a reputable nursing home. U.S. News & World Report has recently published rankings for nursing homes in every state. Here is a link to the Illinois rankings. The Nursing Homes are rated using a 5-star rating system. The rated categories are: "Overall, Health Inspection, Nurse Staffing, and Quality Measures." The lists are organized by states and zip codes. For example, a Chicago native can enter their zip code and find a quality nursing home with within the metropolitan area or the surrounding suburbs.

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.

February 14, 2014

TRIAD: A Partnership Built to Keep Elders Safe

The elderly have been long recognized as a valuable and cherished fabric of society. At the same time they have been considered to be one of the most vulnerable sectors of society as well, susceptible to injury, abuse and neglect. People need to be aware of the safety of the elderly in their lives, and hopefully will receive the same treatment when they reach that point in their life. TRIAD is a partnership that decided to put action behind this ideology in 1988.

The American Association of Retired Persons (AARP), The International Association of Chiefs of Police (IACP), and the National Sheriffs Association (NSA) joined together to figure out a way to "reduce crime against older adults". The organization also focuses on reducing the fear of crime that the elderly may experience as well, which enhances the overall comfort of the elderly in our communities.

TRIAD organizations can be found throughout Illinois and in particularly in Cook County and its surrounding areas. Illinois State TRIAD furnishes its site with useful tips and common activities that disproportionately negatively affect older citizens. For example, mail order and door to door scams. The Illinois TRIAD's usually consist of local law enforcement figures and community activists. They arrange meetings in communities so citizens have an acute awareness of dangers facing the elderly, and therefore the ability to prevent those particular situations.

This national network of elderly support and safety groups were created for a reason. In some cases, families have to act as their own TRIAD organization for their loved ones and be aware of the dangers facing them. This may even be more necessary if your family member is not by your side and living in a nursing home facility. If you have a family member in a nursing home facility be sure to know the type of care they are receiving and be ready to protect them if need be.

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.

February 11, 2014

Across the Pond it is More Difficult to Hold Nursing Homes Responsible for Their Actions

At Hillcroft nursing home in England, three former staff members have been sent to jail for abusing up to eight separate patients, between 2010 and 2011. However, due to English law the directors of the nursing home could not be prosecuted. On February 4, 2013 the Bill Committee in England will review the Care Bill, the English law that regulates abuse in nursing homes, and discuss an amendment that imposes liability on culpable, negligent owners.

In Illinois, nursing homes can be held liable for negligent behavior. The law provides remedies for families seeking a remedy for the abuse done to their loved ones. The lawyers at Ed Fox and Associates can help you protect the vulnerable people in your life.

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.

February 11, 2014

Illinois Hospice Owner Chain Charged With Fraud: Another Reminder to Make Sure Your Medical Bills are Correct

Seth Gilman, a representative agent of Passages Hospice, LLC and Asta Healthcare Company, has been charged with fraudulent billing practices by the federal government. Passages Hospice has a presence in almost every county in Illinois, and Asta Healthcare provides nurses to elders in need in the Northwest suburbs. The charges are against Gilman in his personal capacity.

He has been accused of training staff to look for symptoms in patients that would qualify them for general inpatient care, which means higher daily payments, even if the care was unnecessary. This is a unique case where the deceptive practice of the nursing home results in better care for your loved one, but for more than it should have cost. Families need to not only be vigilant about making sure their families are safe, but that they are not being taken advantage of financially as well. The charges are based on activity between August 2008 and January 2012.

Find the story here.

June 25, 2013

A Few Recent Stories Remind Us to Remain Vigilant

Although it is difficult and painful to imagine the possibility of your loved one(s) suffering abuse or neglect at the hands of a caretaker, a quick Google search for nursing home abuse reveals just how pervasive these problems are. New stories of abuse emerge almost daily. With the horrifying story of Joan Vila, a man who was recently convicted of murdering 11 nursing home residents under his care in Spain, it is important to remember to do everything you possibly can to protect your loved ones who need care.

So, what can you do to prevent or stop this from happening? The first step is simply to be aware of the problem. After that, it is important to remain vigilant and to look for any signs of abuse or neglect. If you do suspect that your loved one is being mistreated or may be receiving inadequate care, here is a list of actions to take. Now, let's look at a few recent stories showing the types of problems that can and do occur.

Physical Abuse
First, a 32 year-old employee at The Place, a nursing home located in Augusta, Georgia, was arrested on June 19th and charged with battery for physically abusing a resident. The incident report states that caretaker Lashanda Annette Johnson woke the resident to change her bed sheets. The resident, an Alzheimer's sufferer, resisted Johnson's care. Johnson then pushed the patient back into bed and told her that she would hit her if she resisted again.

Police decided to investigate after a bump was found on the resident's head a couple days after the incident. During the investigation, surveillance footage showed the abuse happening (using cameras to capture incidents like this one is a very interesting topic that we will cover in an upcoming blog post). Although caring for Alzheimer's and dementia patients may be difficult at times, violence should simply never be used as a tactic to subdue or restrain them.

Story located here

Sexual Abuse
Next, a 25 year-old man was recently charged with sexually assaulting a 78 year-old resident of the Ann Pearl Nursing Facility in Kaneohe, Hawaii. No word on how the abuse was discovered, but the man was charged with three counts of third-degree sexual assault. It is important to know that sexual abuse in this type of setting does often go unreported and to keep an eye out for any signs.

Story located 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 14, 2013

Medicaid Cuts Affecting Care for Star Residents

On May 13, 2013, hundreds of nursing home staff members gathered outside of the Thompson Center in downtown Chicago to protest the most recent cuts for medical services. While Illinois lawmakers allege that cuts are being made across the board, members of the cheering crowd rallied behind the idea that cutting Medicaid funding for nursing home residents is "just wrong."

One concerned citizen in particular stated that her brother is a resident at a facility in Aurora and recently the frames on his glasses broke. However, he is unable to get a new pair for at least 2 years, which is the mandatory waiting period. This is just one example of the repercussions from the state reducing or eliminating Medicaid funding for prescription drugs, dental care, eyeglasses, chiropractic care, and a variety of other services.

The Medicaid cuts that effectively eliminated dental, vision, and podiatry were supposed to save Illinois approximately $1.6 billion. However, state officials have admitted that those projected savings feel short by nearly 30%.

Fortunately, there is an increasing amount of awareness. For example, resident of a nursing home located in Quincy recently took it upon themselves to persuade Illinois lawmakers to restore some of the services that were cut as a result of Medicaid reform last year. The residents gathered to show their support for the Health Care Council's campaign titled, "Be a Star for Nursing Home Residents." The council is a professional association representing more than 80,000 nursing home professionals who serve more than 80,000 residents throughout 500 different nursing facilities in Illinois.

In furtherance of their campaign, representatives spoke to specific detriments of the funding reductions/eliminations. For example, a cut on a person's foot may not be thought of as a fatal issue. However, when the patient is a diabetic a simple cut can cause serious problems.

In order to show Governor Quinn and his staff that they truly are "stars," the residents were decked out in Hollywood attire, including crowns, feathered boas and fedoras. The residents then signed a petition that will be delivered to Governor Quinn, along with legislators.

On the other hand, the campaign did acknowledge that restoring Medicaid funds for dental, vision and podiatry would cost Illinois approximately $3 million to $4 million per year. However, with nearly 85% of residents within certain facilities relying on Medicaid funding, it is crucial to find a way to restore the funding and ensure that the residents will receive adequate care. The residents are real people with real medical needs.

The information in this blog was provided by Matt Hopf of the Herald-Whig. The article can be located at http://www.whig.com/story/22148391/nursing-home-residents-rally-to-restore-cuts-in-service.

Additional information regarding the recent protest outside of the Thompson Center in downtown Chicago can be located at http://chicago.cbslocal.com/2013/05/13/nursing-home-workers-protest-medicaid-spending-cuts/.

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 8, 2013

The Effects of Filial Support Laws on Nursing Home Costs

Recent developments in the area of filial support law have the potential of affecting how families budget for nursing home costs. Currently, 29 states (not including Illinois) have what are called filial support laws on the books. Filial support laws are put in place in order to require certain family members of an indigent elderly person to provide financial assistance for his or her unpaid care. These laws have various levels of requirements depending upon the state that you are in. A recent law review article by law professor Katherine C. Pearson, which was published in the Spring 2013 edition of the University of Illinois Law School's Elder Law Journal, took an in-depth look at some of the states where these laws are taking a more prominent role in nursing home funding.

One of the cases that Pearson looked at was the Pennsylvania HCRA v. Pittas case. In September of 2007, John Pittas' (who was the appellant) mother was admitted to an HCR facility for skilled nursing care and treatment where she resided and was treated until March of 2008. In March of 2008, Pittas' mother relocated to Greece. A large portion of her bill at the HCR facility went unpaid and, as a result, HCR sued Pittas for $93,000 under the state's filial responsibility law. After a three-day trial, the trial court ruled against Mr. Pittas in the amount of $92,943.41. On appeal, the appellate court affirmed this ruling and refused to consider imposing joint responsibility on his mother's husband or her two other adult children.

In a recent article reacting to this decision in the Southern Illinoisan Business Journal by Richard Habiger, he states that "[w]ithout proper planning by both parents and children, and without legal advice from an experienced elder law attorney, children may very well be on the hook for thousands of dollars of care required by their aging parents." Although there are no filial support laws currently on the Illinois books, there are some experts, like Professor Pearson, who believe that more states may adopt similar laws in the upcoming years. This puts a premium on making sure that families plan for the costs of nursing home care in advance of admitting their loved ones into a long-term care facility.

Professor Pearson concluded her article with this theory on where legislation may be heading "It seems reasonable to conclude that when a nation is both willing and financially able to provide adequate public support to assist poor elders, filial support laws are less important and less frequently used. In the United States, when the federal government was willing to fully fund Medicare and Medicaid for elders' health care and long-term care in nursing homes, federal policies led states to repeal or limit the use of filial support laws to mandate financial support for parents by their adult children. However, as the large demographic cohort of baby boomers ages, thus increasing the likelihood of costly health care and long-term care, there may be heightened interest among the U.S. states in using filial support laws against adult children." Our office encourages you and your family to take the necessary steps to plan for nursing home care costs so that you will not have to worry about the effects of this potentially growing area of law. This may very well include seeking legal counsel for advice on how best to plan for funding, and how current state or federal law could affect your family's liability for the costs of long term 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.

March 14, 2013

The Illinois Financial Crisis May Force the Elderly into Nursing Home Facilities

Illinois currently funds programs that allow 80,000 elderly and disabled people to live at home. However, Illinois foresees itself running out of funding for such programs by March 15, 2013, which is 3-1/2 months before the fiscal year ends on June 30, 2013.
Once these funds are exhausted, smaller non-profit home healthcare agencies will be forced to close, layoff employees, and leave thousands of elderly people scrambling for alternatives to in-home care, according to Bob Thieman, executive director of the Illinois Association of Community Care Program Healthcare Providers. Thieman further stated, "The state's going to pay for this one way or another. If these seniors cannot be picked up by other in-home providers, they're going to wind up in nursing homes, which will cost a lot more."
It is becoming increasingly evident that the state legislature has failed to improve reforms for the pensions that will reduce the cost. Consequently, the state has been forced to delay in paying its bills in order to balance the budget.
While state officials claim that the situation is improving, Thieman indicated that it is actually getting worse for home healthcare providers. In fact, home healthcare providers already wait nearly 6 months to be paid by the state. Nevertheless, the state has advised them to continue submitting invoices even though they have no intention to paying them immediately.
As for the source of the problem, the department blames the action on overdue bills from last year, which it indicated "ate up" 1/4 of the $687 million budgeted for the current year. This spending strategy was intended to help elderly people remain independent by paying for in-home care.
Unfortunately, this would not be the first time that the state has encountered a problem of this magnitude. In fact, this is the 2nd time in 2 years that the state has exhausted its funds before the end of the fiscal year, according to Thieman. However, this year's warning arrived much earlier. Nevertheless, this early warning caused a much larger backlog of bills.
As previously stated, the program, which includes 40 providers, currently serves approximately 80,000 elderly people each month, according to the Department of Aging. These 40 providers are comprised of entities ranging from nonprofits such as Catholic Charities to for-profit companies such as Addus HealthCare. Further, the 40 providers employ nearly 25,000 home-care assistants, according to Thieman.
One may find themselves blaming the economy as a whole. However, no other state has institutionalized late payment of bills quite like Illinois, according to the National Council of State Legislatures. By the end of the 2012 fiscal year, the state's backlog of unpaid bills stood at $8.7 billion, which was approximately a quarter of the state's annual revenue. This number has the ability to sky-rocket to nearly $22 billion within 5 years unless the state takes action in order to curb its public pension costs. Furthermore, the state currently has $96.8 billion in unfunded pension liabilities.
With regard to possible solutions, Illinois Comptroller Judy Baar Topinka propositioned lawmakers to either approve increased spending or require state agencies with surplus funds to return them for other agencies to use. The legislature responded by approving additional funding. However, it did not allocate any funds for the elderly and people with disabilities, according to Topinka's spokesman, Brad Hahn.
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.
The information in this blog was provided through an article in The Huffington Post authored by James B. Kelleher. If you would like to read the article in its entirety, please visit

February 21, 2013

Is Litigation Really the Problem?

A recent article out of Wisconsin has been making the rounds on a lot of local blogs. Changes in Wisconsin law, which took effect in February 2011, prevent families from using state health investigation records in state civil suits against long-term providers including nursing homes and hospices. It also makes these records inadmissible in criminal cases against health care providers accused of neglecting or abusing patients.

A 32 year-old man, who is brain damaged and paralyzed from the chest down, was living in a group home in Menomonie, WI. In October 2011, he had to be rushed to a local hospital for treatment of a bedsore that had gotten so bad, doctors thought he might be permanently bedridden. A Wisconsin state health department investigation report later found that he had the bedsore for four month before being hospitalized. The facility never reported it to the state or told his family about it. The family is currently suing the facility, seeking damages for negligence, but due to the changes in Wisconsin law, their attorney cannot use state investigation records as evidence in the lawsuit.

Supporters of the bill, which include Wisconsin Governor Scott Walker, argue that this law only has a minimal effect on the use of investigation records. Critics say the law removes a good tool for revealing abuse and neglect because attorney's cannot use state inspection reports to support allegations or impeach a witness. This also has a big effect on injured residents who do not have the capacity to testify about what happened to them.

Around 270 tort reform laws have been implemented in 49 states since 1990. Some, including the one in Wisconsin, can be traced back to the American Legislative Exchange Council (ALEC), which is a group funded by private industry that focuses on pro-business model legislation used mostly by Republican law makers. Supporters of the bill insist that it will help fuel the economy by reducing corporate litigation costs. Brian Hagedorn, Governor Walker's chief legal counsel, said that the law is aimed at jobs, and went on to state "[t]hese changes send a symbolic and substantive message that Wisconsin is open for business." That bears the question, at what cost?

Other proponents of the bill claim that implementation of this law allows healthcare providers to discuss problems more openly "without fearing a (personal injury attorney) is going to come [and read his or her report]." Walker said in an interview that the bill has helped slow the "constant pattern of litigation" that could be seen as a negative by employers.

Judge William Hanrahan, a Dane County (WI) Circuit Court Judge, with 19 years of experience prosecuting crimes against the elderly, expressed concern about the law because it forbids district attorneys and the state Department of Justice from using these records as evidence in criminal cases. He went on to state "I can't imagine if it were a homicide, it would be like saying the police reports couldn't be used."

Laws like this make it harder for attorneys like those at Ed Fox & Associates to do their jobs to the best of their ability in order to protect victims of nursing home negligence and abuse. What is more troubling is that the driving force behind these sorts of laws is stimulating the economy and job growth. There was very little mention of the needs of nursing home and long-term care facility patients by the proponents of this legislation. As was mentioned above, through the work of ALEC (which provides model bills for this type of legislation), 270 similar laws have been implemented across the United States. We have to work hard to make sure that these laws, veiled by good intentions, do not get implemented on a more widespread basis and lead to a lack of justice for those who are victims of neglect or abuse.

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

January 31, 2013

Controversial changes coming in long-term care insurance pricing

A recent Chicago Sun-Times article has "sounded the alarm" on changes that the Long Term Care (LTC) insurance industry will soon be implementing. The article bluntly stated that "Gender discrimination is coming - and it's perfectly legal." The LTC insurance industry has come to the realization that women generally live longer than men. This means that women will use more benefits from their LTC policies. In an effort to increase profit, the LTC insurance industry has decided to move away from a unisex, age-centered model, and adopt a gender-specific model (as we see in life insurance) where policy prices will rise as much as 40 percent for some women. Genworth has announced that they will implement this gender-specific model in the second quarter of this year, and many other insurers are set to follow suit. The article suggests that if you are a woman who is considering purchasing LTC insurance, you should act now before prices start skyrocketing.

The article goes on to quote an employee of the insurance brokerage MAGA, LTC who stated that if someone buys a policy today, it is less likely that his or her premiums will increase by a large amount because "insurers have planned better." He also stresses that having even a small amount of LTC insurance will gain you entry into better facilities which prefer privately insured customers as opposed to those relying solely on Medicaid.

There has been some backlash to this gender-specific model which charges women more for the same plan that is given to men due to this perception that all women live longer. Based on the National Women's Law Center's (NWLC) 2012 report entitled "Turning to Fairness," the practice of "gender rating" costs women approximately $1 billion in the individual health insurance market in a year. It also states that on average insurance companies charge non-smoking women more than male smokers. Currently only thirteen (13) states have banned gender rating (Illinois is not one of them). The report states that gender rating also occurs in the group market where businesses with a predominantly female workforce will often pay more for coverage.

The NWLC report ends by documenting some of the effects that the Affordable Health Care Act (ACA) will have on these practices. Section 1557 of the ACA prohibits discrimination in health programs receiving federal dollars, including insurance, and other programs conducted by the federal government, including health insurance exchanges. Most of these provisions will take effect in 2014, and unfortunately will not reach those insurance programs that are not federally funded. The hope of the NWLC is that the implementation of the ACA will influence private insurance providers to adopt similar practices so that women will be treated with the same factors as men in the market.

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.

January 22, 2013

Fines Continue to Add Up for Illinois Nursing Homes

According to an article by Deborah L. Shelton, a Chicago Tribune reporter, Illinois ranks 3rd among states in the number of times federal officials suspended payments to a nursing home due to serious deficiencies. In the past 3 years, payments for Medicare and Medicaid have been suspended 91 times at 78 different homes. Suspending such funds occurs when the deficiencies at a facility are so serious that regulators must press for immediate improvement.
The Illinois Department of Public Health conducts surveys of nursing homes under contract with the Centers for Medicare and Medicaid Services. Facilities are rated on an A to L scale, with L indicating the most serious deficiencies. In Illinois, D was the most common rating by far.
Scores of J, K, and L signify "immediate jeopardy to resident health or safety." For example, a J score signifies an isolated incident while a K score signifies that the deficiency was part of a pattern. An L score, which is the most severe, signifies that the occurrence was widespread. Among the 773 nursing homes in Illinois, 144 nursing homes were cited for at least one J, K, or L deficiency within the last 3 years. However, 54 were able to escape without any fines from Medicare or Medicaid. In regards to nursing homes in the Chicago area, All American Nursing Home had the highest number of serious deficiencies, 11, according to the Centers for Medicare and Medicaid Services.
Additionally, a total of $2.43 million in fines were levied against 199 nursing homes, with the average fine being $6,031. The penalties ranged from an $80,160 fine imposed against a Chicago nursing home for having 53 deficiencies to a $650 fine imposed on a Peoria nursing home cited for 27 deficiencies.
Further, some nursing home facilities have been designated as a special focus facility, which means that the facility has a history of serious quality issues and is part of a special program to stimulate improvements in care. According to Illinois surveys, Fairview Care Center of Joliet was one of three homes that tied for having the most deficiencies in the state, 82. Due to these deficiencies, the facility has had their payments suspended twice and has been designated a special focus facility. In fact, last year a resident was attacked with a metal container by another resident. The resident was hurt and had to get six staples and six stitches to the head. State auditors cited the facility for failing "to respond appropriately to resident's behavior in a timely manner, provide appropriate interventions and adequate supervision to prevent resident to resident physical abuse."
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.
To read this news article in its entirety, please click http://articles.chicagotribune.com/2012-12-24/health/ct-nw-illinois-nursing-homes-20121224_1_deficiencies-special-focus-facility-three-homes.