With time running out in the spring legislative session, lawmakers are facing pressure to get an important more set of reforms through the General Assembly: fixing the state's broken nursing home system. The substandard care and safety concerns in many of these facilities came to light over the past year thanks to investigations from The Chicago Reporter and subsequently the Tribune. Lawmakers are clearly facing public pressure to improve conditions, but it remains to be seen whether they'll adopt substantive reforms or bow to the nursing home industry -- a generous campaign contributor.

Currently, a handful of working groups -- composed of health care advocates and nursing home officials -- have been crafting legislation around a series of recommendations (PDF) laid out in February by Gov. Pat Quinn's Nursing Home Safety Task Force. That report sets out to improve security and screening in the facilities as well as raise the quality of care, which is particularly bad for African-American seniors. Not surprisingly, the Tribune reports that the nursing home industry is putting up resistance to what senior advocates see as the most essential reforms -- increasing the number of staff and finding better-suited facilities for problematic patients.

With the spring session deadline just a month away, advocates are growing concerned that House Speaker Michael Madigan (D-Chicago) may try to ram through yet another set of eleventh-hour "reforms" that do little to protect nursing homes residents.  As of now, they're working off of Madigan's recently-introduced bill (HB 6440), which lays out a series of reforms. Individuals close to the negotiations tell us, however, that the bill is still a work in progress.

Specifically, advocates want to raise the bar on nursing home staffing to eliminate the sort of disparate care revealed by The Reporter:

The Reporter found that white homes were rated significantly higher for their staffing of registered nurses, who are the most skilled nursing staff. Excellent ratings were given to white homes 21 percent of the time, compared with just 4 percent for black homes. Conversely, black homes scored poorly 73 percent of the time, compared with 11 percent for white homes [...]

Wendy Meltzer, executive director of the Chicago-based advocacy group Illinois Citizens for Better Care, said Illinois is known to have “ridiculously low” minimum staffing ratios. “We should adopt the minimum suggested federal staffing ratios, which I think would at least double the nursing staff, professional and certified, working in Illinois nursing homes,” she said.

Under federal recommendations (PDF) issued in 2001, each nursing home patient should receive 4.1 hours of skilled care each day. As written, HB 6440 would require facilities to apply those guidelines to needy patients. However, the bill currently suggests that 2.8 hours of care could be sufficient for patients that only need intermediate services.  These standards will likely be decided by members of the House Rules Committee. As far as advocates are concerned, industry-friendly lawmakers could potentially write a huge loophole that favors nursing homes instead of prioritizing patient care.

A counter-proposal (SB 685) introduced by State Sens. Heather Steans (D-Chicago) and Jackie Collins (D-Chicago) clearly defined the requirements for care, but it appears to be dead this session.  Now it's a wait-and-see game over what will emerge in the ongoing negotiations. Stay tuned.