Learning More About a Nursing Home



1.  General Information 


The Illinois Department of Public Health "Nursing Homes in Illinois" website has basic information about every licensed nursing home in Illinois at its website.  It also has information about every hospital in Illinois that has "extended care" or "swing beds" for patients who are being discharged from the hospital but need therapy or other services that are covered by Medicare, and choose to get them in the hospital rather than in a nursing home.  

Among the information on the website is the kind of care for which the facility is licensed, how many licensed beds it has, how many (if any) Medicare and Medicaid beds it has, and a summary (outdated) of the age and primary diagnoses of its residents, and of the number of various kinds of nursing and non-nursing staff (also outdated.)  


If the website shows that the total number of licensed skilled and intermediate care beds a nursing home has, is more than its total of Medicaid beds (add the numbers the website shows for Medicare/Medicaid beds and Medicaid[only] beds,) then the nursing home is what is called "distinct part certified."  This means that only part of the nursing home is in the Medicaid program, and the nursing home may choose not to accept new residents on Medicaid.  If it follows the correct procedure, it may also be able to refuse to accept Medicaid for residents who enter paying with Medicare or paying privately.  You can learn more about the implications of "distinct part certification" in Chapter 10, Section 9 of SMARTCARE.


The "ownership information" page lists all people with at least a 5% ownership interest in the home.  Clicking on an owner's name will show you any other nursing homes that person owns in Illinois.


This website also has some information about nursing home violations.  We discuss violation information below in Section 3


The IDPH website allows you to see information about only one nursing home at a time. The only way to compare information about different homes, is to copy the information and either print it or save it on your computer.



The federal website, Medicare Nursing Home Compare,  has some information about every nursing home in the Medicare or Medicaid programs. (This means almost every nursing home in Illinois.) It also has information about every hospital in Illinois that has "extended care" or "swing beds" for patients who are being discharged from the hospital but need therapy or other services that are covered by Medicare, and choose to get them in the hospital rather than in a nursing home.  



Pages 11 - 15 of the ICBC How to Choose a Nursing Homes in Illinois  discuss the information on the Nursing Home Compare website.  



2.  Information about Convicted Felons Living in a Nursing Home


Illinois  allows people with serious criminal records (Illinois calls them "identified offenders") to live in nursing homes, so long as the home takes appropriate measures to make sure that these residents do not endanger other residents, visitors, or staff. To find out whether their residents have criminal convictions in Illinois, nursing homes are required to do a criminal background check on all residents who are physically able to put other residents, staff, or visitors in danger.   This is why a nursing home may have asked you what you thought were ridiculous questions about whether your mother had been convicted of any crimes, and had you or her sign paperwork to see if state records indicated she had any serious criminal convictions.  If she was in the hospital before entering a nursing home, it may have been the hospital that initiated the criminal background check.


There is no directory available of persons with criminal convictions living in Illinois nursing homes. (Remember: we are not saying that all people with criminal convictions, even serious criminal convictions, are dangerous. Some nursing home residents were convicted of crimes 50 or more years ago, and have been in no trouble ever since.)


Every nursing home must advise current and prospective residents and their guardians, that they can ask if there is an "identified offender" living in the home.  A notice about the right to ask, must also be posted "prominently" in the nursing home.  If asked, the facility staff must tell the resident or prospective resident or guardian if any resident is an "identified offender."  They do not have to tell the names of the residents.  In practice, many nursing homes that house "identified offenders" will post that information in the lobby and on each floor. 


There are two state websites that list the residences of some people in Illinois with serious criminal convictions. The  Illinois Department of Corrections lists people currently out on parole from the Department of Corrections for sex offenses. You cannot check a particular address, but you can search by city or zip code.


The Illinois State Police is a broader listing of registered sex offenders in the state, including some people who were convicted of crimes in other states. Again, you cannot check a particular address, but you can search by city or zip code.  (Enter the information on the left-hand side of the page.)


The State Police registry is the only website that has any information about out-of-state convictions.


The local nursing home resident ombudsman is supposed to be told about every nursing home resident in her/his area who is an "identified offender."  Without giving you residents' names, the ombudsman should be able to tell you if any residents of a particular nursing home are "identified offenders."  



3.  Information About Nursing Home Violations 


(1) The easiest place to get violation information about a single nursing home is at that nursing home. Every nursing home in Illinois is required to keep the last 5 years of its survey history - annual surveys, complaint investigations, follow-up surveys, notices of fines, plans of correction - available to any member of the public who wants to see them. They are usually kept either in the administrator's office or at the front desk: just ask. The latest survey is supposed to be posted in place easily accessible to members of the public. While you may think looking at 5 years' worth of records is a bit much, we do suggest reading records of at least the past 2 to 3 years, when choosing a nursing home.


The surveys at the nursing home will include citations for violating both state and federal requirements.


If the facility refuses to let you see any material you are entitled to see, you can file a complaint with the Illinois Department of Public Health, 1-800-252-4343.


Going to a nursing home to look at violation records is not an option when trying to screen out facilities with unacceptable histories, from a long list of possible choices. There are several other ways to get at least some violation information about Illinois nursing homes.


(2) The Public Health "Nursing Homes in Illinois" website for each nursing home may also include violations for which the facility has been cited. To see what violation information is on the Public Health website, first choose a single nursing home, then click on "SURVEYS" on the right hand side of the page for that nursing home. The surveys (and, sometimes, facility responses) that are available on the website are shown with the date of the survey in blue. Fewer than half the surveys for many nursing homes are available on the IDPH website; many of those that are shown have no violations. The surveys that are listed with the date in light gray are not on the internet.  


To get more surveys from the Department of Public Health, you must file a Freedom of Information request. See Section 4, below, for information about how to do this.



(3)  The surveys on the "Nursing Homes in Illinois" website do not show how serious the state thinks the violations are.  They do not show if or how the nursing home was fined or otherwise punished. 

The violations of state law that the Department of Public Health thinks are the worst, are found on a "Quarterly Violators' List." 


The Quarterly Violators' List does not include information about violations of federal requirements.


(4) To get a complete set of surveys from Public Health you must file a Freedom of Information request.  Public Health has made this easy to do.  Click here  

The Public Health form gives you the choice of going to an office to examine the records, or being sent a paper or electronic copy.  The Department may try to charge a fee for sending more than 10 pages of records.  You can ask that the fee be waived, or that you be told if the fee is more than a certain amount.  If you are asking for records for a family council or other group that wants to improve care for all residents and is not a profit-making entity, you should say this on the form, since this is a reason to waive the fee.

You can fill out the form online, and then e-mail it to the Department by clicking on "Submit by Email" in the top right-hand corner.  Or you can mail or fax it, following the instructions at the bottom.


(5) The federal website, www.Medicare.gov, has a summary of violations of federal nursing home requirements (the feds call these "deficiencies,") committed by every nursing home in the Medicare and Medicaid programs. The information on the federal website includes a count of violations for the past 3 years, along with information about the number of deficiencies committed by this facility compares to averages for the state and the entire country. 


The federal website also includes the text of the surveys in which "deficiencies" were cited.  Often the actual details of what happened make a citation more meaningful and understandable.  If you are interested in how well a particulary nursing home is functioning, read them.  Do not be surprised if you consider the event described in the survey to be more serious than how it was cited.


Most surveys are not posted on the federal website until six months or more after the inspection.  You should be aware of this if you need more current information about a nursing home.  



4.  Cost Reports: How a Nursing Home Spends its Money

Every nursing home in the Medicaid programs is required to file a complete description of its income and expenses every year with the Illinois Department of Healthcare and Family Services (formerly the Illinois Department of Public Aid.) These cost reports are on the State website.  The nursing home cost reports are found under "Reports for Long Term Care Facilities filed with the department."


Cost reports are where you can see how much money a nursing home is making (or losing,) and how much it is spending on staffing.  You can even use them to figure out what the staffing is.  This is information a family council might find useful.


Because cost reports take some experience to understand, we encourage you to call ICBC for help in analyzing them.