When you decide to place a loved one in a nursing home, you expect dignity, safety, and professional care. In Illinois, both federal and state laws exist to help enforce that protection. Unfortunately, not every facility meets these standards. Knowing your rights and the responsibilities of a nursing home can help you recognize when it’s time to step in on behalf of a family member.
At the Law Offices of David H. Brinton, LLC, we help families across the Chicago area navigate issues of nursing home abuse, neglect, and mistreatment. This guide outlines what nursing homes are not allowed to do under the Illinois Nursing Home Care Act and federal law, including the Nursing Home Reform Act of 1987.
What Nursing Homes Are Not Allowed to Do in Chicago
Nursing Home Abuse of Any Kind
Abuse of any kind should not be tolerated under any circumstances; this includes physical, emotional, sexual, or financial abuse. Under the Illinois Nursing Home Care Act, residents have the right to be free from abuse and corporal punishment (210 ILCS 45/2-107).
When staff members at a facility engage in behaviors such as hitting, yelling, threatening, isolating, stealing, or any other harmful action, they are breaking this regulation and should be held accountable. One way nursing homes can support their staff in avoiding an abusive situation is through training and support.
Some subtle signs of abuse to look out for could include:
- Nursing staff are ignoring cries for help.
- A nurse speaking condescendingly to a patient who is suffering from dementia.
- A resident was repeatedly left out of group activities as a silent punishment for being too “difficult”.
Neglecting Residents’ Basic Needs
Neglect occurs when staff fail to provide essential services, including nutrition, hydration, correct medications, hygiene needs, or medical treatment. By law, Illinois requires that every facility provide adequate and properly supervised nursing care and personal care (210 ILCS 45/1-117).
Under the federal Nursing Home Reform Act, facilities must also offer services that maintain the highest practicable physical, mental, and psychological well-being. Some examples of what nursing homes are not allowed to do are:
- A caregiver’s failure to monitor water intake led to dehydration, which in turn worsened an existing medical condition.
- Someone with allergies or diabetes is served food that will worsen their condition.
- A resident leaves the property unnoticed.
Denying Necessary Medical Treatment
Residents are at the mercy of their care team to provide appropriate medical care in a timely fashion. This could mean medication, therapy, wound care, or access to specialists when requested.
A facility should never delay or withhold treatment, no matter the reason. A facility’s failure to provide this care is considered neglect. Under 42 CFR §483.25, nursing homes are federally mandated to provide quality medical care. Withholding or delaying necessary medical treatment violates this federal standard.
Some examples you may see in a loved one who is denied medical treatment are:
- Staff are ignoring repeated complaints of chest pain or shortness of breath.
- A resident’s pain medications were abruptly stopped or never refilled.
- Staff claim that “the doctor will be in next week” for urgent medical issues that require immediate attention.
Violating Resident Privacy
Every resident of a nursing home has the right to private communication, their own personal space, and confidentiality about their medical care. Because of this, staff must knock before entering a room, provide private areas for calls or visits, and follow HIPAA and Illinois confidentiality laws.
The Illinois Nursing Home Care Act ensures residents’ rights to privacy regarding their medical and personal care.
Some examples you may see of this breach are:
- Residents discussed openly in hallways or common areas.
- Visitors enter shared rooms without express permission.
- A resident’s bathroom door was left open during hygiene care.
Isolating Residents from Visitors
In most circumstances, residents can receive any visitor they choose. Isolation can lead to emotional decline and is therefore considered a form of abuse. Even during public health emergencies (such as COVID-19), facilities must still follow guidelines from both the Illinois Department of Public Health (IDPH) and the Centers for Medicare & Medicaid Services (CMS).
While the federal rule 42 CFR §483.10(f)(4) ensures residents’ rights to receive visitors, it also allows for limitations in cases where safety or health concerns arise. These could look like visitor screening or limits to the number of visitors. Each restriction should be clearly communicated and reasonable.
Most importantly, a resident should be allowed to add or take away consent for visitor access at any time. Furthermore, visitors should not be discriminated against based on sex, race, or disability. Facilities are also required to provide transparent policies to visitors, even amidst emergencies.
Making Decisions Without Consent
A nursing home cannot act as a guardian and make decisions on behalf of a resident without consent or legal authority (such as a power of attorney). This includes medical procedures, medication changes, or end-of-life care decisions.
Residents should always maintain autonomy, unless a judge has legally declared they are incapable. To this end, staff must help the resident be informed about their decisions for medical care, allow them to refuse care, and allow DNR orders. Illinois law (210 ILCS 45/2-104) and the federal Patient Self-Determination Act protect these rights.
Some ways these rights might be violated include:
- A resident given inadequate information to feel comfortable with a medical decision.
- A staff member is manipulating the resident by telling them their decision is wrong.
- Despite a DNR order, a staff member performs CPR.
- The nursing home makes decisions without reaching out to an existing designated power of attorney.
Retaliating Against Residents Who Complain
Residents have the right to file complaints without fear of retaliation. Nursing facilities must post information around the nursing home on how to file a complaint with the Illinois Department of Public Health (IDPH). Any form of punishment or intimidation in response to complaints is illegal under both state law and federal regulations. This includes subtle coercion, such as staff telling a resident that filing a complaint will lead to delays in care or a change in how they are treated.
Evicting Residents Without Proper Notice
A nursing home cannot suddenly discharge or evict residents. Under Illinois law, residents require advanced written notice and a good reason for discharge (such as non-payment or safety concerns). Residents then have the right to appeal this eviction. The resident must also be provided with discharge planning support. This is according to 210 ILCS 45/3-401.
Some appropriate reasons for discharge include:
- A resident failing to pay for care after an adequate time to address the issue.
- A change in health that the facility cannot accommodate safely.
- Lack of compliance with rules, such as smoking or breaking curfew.
- Overcrowding issues.
- A facility loses its certification or license. (In this case, the resident should be moved to another facility.)
Hiring Unqualified or Dangerous Staff
When hiring, the nursing home should perform a background check on that individual. This should reveal past abuse or neglect. The Illinois Health Care Worker Background Check Act and the federal Elder Justice Act require rigorous screening and ongoing monitoring of staff. Failure to comply can put residents at serious risk.
If the nursing home discovers that staff members become a risk after employment, they must notify residents and make immediate changes. If you would like to learn more about background checks in a nursing home and how to protect your loved one from dangerous staff, you can read our blog.
Financial Exploitation of Residents
It is illegal for staff to access, manage, or influence a resident’s finances without legal authority. If your loved one has unexplained account activity (such as store purchases even though they have not left the facility), if belongings go missing, or if there are any changes to wills or financial documents, this could be a warning sign of financial abuse.
If a resident’s personal property is missing or there are unusual transactions on their account, the facility is required to follow a reporting protocol. This should be treated as a potential theft or fraud case, and immediate action should be taken.
The Illinois Nursing Home Care Act (210 ILCS 45/2-102) and federal law protect residents from financial exploitation.
Failing to Report Injuries or Accidents
If you discover that your loved one was injured by staff (including falling, bruises, and unexplained injuries) and no one from the nursing home informs law enforcement of a suspected crime within 2 or 24 hours of the incident (depending on the injury), then this is a violation of your loved one’s rights. Under 42 CFR §483.12 and other state regulations, failure to report injuries is a serious breach that may result in fines or license suspension.
Ignoring Staffing Requirements
Understaffing is prohibited under Illinois state law because chronic understaffing leads to delayed care, accidents, and a risk of neglect. There must be a minimum nurse-to-patient ratio at all times; this minimum depends on whether it’s a skilled or intermediate care facility, and remains the same even during holidays or weekends.
Nursing homes are required to declare their staffing levels publicly, and you can find these reports on the Illinois Department of Public Health (IDPH) website.
According to state law:
- Skilled Care facilities must provide a minimum of 3.8 hours of nursing care per resident per day.
- Intermediate Care facilities must provide a minimum of 2.5 hours per resident per day.
If you suspect the reported care hours are incorrect, you should gather as much information from residents and observations as possible. Then, file a formal complaint with the Illinois Department of Public Health (IDPH).
Medicare and Medicaid vs. Private Insurance Protections
Medicare- and Medicaid-certified facilities must follow strict federal regulations under the Centers for Medicare & Medicaid Services (CMS). These programs protect residents in slightly different ways:
- Medicare tends to cover short-term skilled nursing or rehabilitation stays after a hospital admission, but it does not pay for long-term custodial care. It should cover some costs for up to 100 days.
- Medicaid will provide coverage for long-term nursing home care for residents who meet financial and medical eligibility requirements.
For both programs, federal law guarantees certain resident protections, including:
- The right not to be discharged due to pending Medicare or Medicaid status (42 CFR §483.15(c))
- Equal quality of care regardless of payment source
- Limitations on extra charges for services covered by Medicare or Medicaid
By contrast, facilities that accept only private insurance may have more flexible (and sometimes less comprehensive) internal policies. However, all facilities in Illinois are still bound by the state’s Nursing Home Care Act. Families should review a facility’s participation in Medicaid or Medicare and ask for written policies on coverage, discharges, and resident rights.
How to Report Abuse in Chicago
If you suspect abuse, here are the steps you should take in Illinois:
- IDPH Hotline: 1-800-252-4343 (24/7)
- Illinois Long-Term Care Ombudsman Program: Advocates for residents and helps mediate complaints
- Chicago Department of Family & Support Services: Can investigate elder abuse or neglect cases
How an Attorney Can Help You
Having an attorney on your side can help your loved one get the rights they are entitled to. A lawyer can identify and investigate potential violations. Check out this blog for more information on how you or a lawyer might prove negligence. Your lawyer may help you:
- Request a detailed inspection record when a violation occurs.
- Review complaint histories and staffing reports to find patterns of abuse.
- Investigate hiring practices.
- Interview witnesses and staff.
- File FOIA requests or subpoenas for internal communications.
- Build a legal case to protect your loved one.
What to Do If a Nursing Home Breaks the Law
If you believe your loved one is experiencing abuse of their rights, then you can take the following steps:
- Document every interaction and all the information you are given.
- File a complaint with the Illinois Department of Public Health.
- Contact a local ombudsman or elder care advocate.
- Speak with a nursing home abuse attorney to explore legal action.
The Law Offices of David H. Brinton, LLC, is committed to helping families protect their loved ones. We offer free consultations and work with families to investigate claims, pursue justice, and hold negligent facilities accountable.
How Can an Illinois Nursing Home Abuse Lawyer Help You?
If you suspect your loved one’s rights are being violated in their nursing home, an attorney can help protect them and ensure they receive justice. A lawyer can investigate the situation, collect evidence, file lawsuits against the responsible parties, and negotiate with insurance companies to secure compensation for any medical expenses or pain and suffering endured by your loved one. In some cases, an attorney may even be able to hold abusers criminally responsible for their actions. In any case, a lawyer can provide important legal guidance and protect your loved one’s rights during this difficult time.
By seeking the help of an experienced attorney, you can help put a stop to nursing home abuse and ensure that those responsible are held accountable for their actions. It is important that we all take a stand to protect our elderly loved ones and help ensure they are living in an environment of safety and respect.
If you or someone you love has been affected by nursing home abuse, please contact the Law Offices of David H. Brinton, LLC. You can call 312.445.4908 or contact us to set up your free consultation.