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Thursday, March 11, 2010 07:30 am

Assaults at Springfield nursing home illustrate statewide problem

Task force reports on ‘toxic mix’ of frail elderly with mentally ill

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Incidents of assault at a Springfield nursing home highlight safety concerns as a state task force on nursing home reform calls for sweeping changes.

In 2009, Springfield police were called to Springfield Terrace nursing home, located at 525 S. Martin Luther King Drive, for a variety of incidents involving residents with mental illnesses and criminal backgrounds. Examples include a 32-year-old mentally ill resident who was accused of sexually assaulting a staff member and a registered sex offender still on probation who attacked a staff member with a wheelchair foot rest.

Last year, Springfield Terrace housed at least 15 residents with criminal backgrounds, at least six of whom were registered sex offenders, according to records from the Illinois Department of Public Health. That number has since dropped to 12 criminal offenders and 4 registered sex offenders. Police were also called on multiple occasions because new residents needed to be registered in the Illinois Sex Offender Registry or the Child Murderer and Violent Offender Against Youth Registry.

Springfield’s other nursing homes do not seem to house mentally ill patients or registered sex offenders, though records may not be current due to constant resident turnover.

Even more troubling are serious incidents of violence in Chicago-area nursing homes uncovered last year by a Chicago Tribune investigation. The Tribune featured the story of 63-year-old Thomas Donovan, an amputee suffering from diabetes, kidney failure and schizophrenia, who was beaten to death by mentally ill residents at Burnham Healthcare nursing home near Chicago.

The Tribune investigation prompted Gov. Pat Quinn to create the Nursing Home Safety Task Force, to examine safety issues in long-term care facilities housing both the elderly and mentally ill. The panel issued its final report Feb. 19, calling for better patient assessments, higher standards of care and more facilities to house different types of patients separately.

“The task force learned that many of the younger adult nursing home residents are suffering from serious mental illness,” the report states. “Unfortunately, Illinois funds so few supportive housing units that nursing homes continue to be the default option. The combination of younger, active residents with older, frail adults leads to possibilities for violence that could be avoided. This mix of populations becomes more toxic when nursing home residents with mental illness do not receive the care and treatment essential to avoid anti-social behaviors.”

The report makes 38 recommendations to change how nursing homes are run. Among the recommendations are criminal background checks for incoming residents, higher staffing level requirements and more frequent, in-depth assessments of patients to determine needs and risks.

The report noted that nursing homes which serve predominantly poor and minority populations are at a disadvantage because they often have more residents paid for by Medicaid, which has a low payout rate.

“The lower quality of homes serving predominantly minority residents is unacceptable,” the report states. “Adopting and enforcing higher staffing standards for all nursing homes will address this.”

The panel also recommended steps to maximize federal matching funds for Medicaid.

In some cases, the recommendations would require laws to be changed. One example is the recommendation to remove confidentiality restrictions that prevent the Department of Financial and Professional Regulation from referring misconduct cases to appropriate agencies.

“By law, DFPR cannot refer cases of misconduct by administrators or other licensees to law enforcement or other agencies,” the report states. “Some egregious misconduct has not been pursued as a result.” The task force’s report makes clear that not all mentally ill patients are violent.

“Indeed, evidence underscores the fact that people with mental illness are much more often the victims of violence rather than perpetrators,” the report says. “But the relatively few mentally ill nursing home residents who exhibit violent behavior, most of them younger adults, have caused significant harm to other residents.”

Contact Patrick Yeagle at pyeagle@illinoistimes.com.

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