Illinois Strenghtens Disciplinary Sanctions Against Nursing Home Administrators

 State authorities said Friday they are reviewing laws and policies to strengthen the disciplinary sanctions taken against nursing home administrators in cases of wrongdoing and patient harm.

Despite continued serious violence against nursing home residents, administrators are rarely punished by the Department of Financial & Professional Regulation, or IDFPR, which licenses the administrators and other professional staff, according to a Tribune examination of government records as well as interviews with elder advocates.

Department officials have been discussing possible reforms with Gov. Pat Quinn's Nursing Home Safety Task Force, which was formed in response to Tribune reports about recent allegations of rape, assault and murder inside the facilities.

Not a single nursing home administrator has had his or her license revoked since January 2005, despite repeated violations found by Health Department investigators and despite a series of violent incidents in homes that accept growing numbers of psychiatric patients with felony records, department records show.

The department has received 587 complaints about nursing home administrators in that time, including 407 from the state Department of Public Health inspectors, Bluthardt said. He said 20 administrators have been disciplined. But in response to a Tribune Freedom of Information Act request filed in October, the department said it could provide records showing discipline of only 12 administrators.

Three other administrators had their licenses placed on "refuse to renew" status because they had defaulted on student loans, the department said.

Most of the 12 cases had disciplines ranging from reprimands to suspensions, the records show. In one case an administrator was fined $1,200, and another was fined $1,500.

Nursing home administrators are responsible for planning, directing and supervising the operation of homes. But state laws are written so that they can only be sanctioned if authorities prove they had a direct, active role in an instance of wrongdoing.

As a result, the few sanctions meted out are typically for financial malfeasance or license lapses, and not for systemic patient safety breakdowns in the homes, a Tribune analysis of state records found.

Nursing home operators defend the current disciplinary process.

Of the dozen disciplinary cases, perhaps the most serious involved Stacy Dikeman. She was the administrator at East Peoria Gardens Nursing Home in 2006 and 2007 when state inspectors found multiple health violations and linked the deaths of two residents to allegedly negligent care, according to an IDFPR consent order. Dikeman did not contest the citations and her license was suspended for a minimum of one year. She allowed the license to lapse, according IDFPR's Web site and could not be reached for comment Friday.

Another serious case involved former Somerset Place administrator Jeremy Boshes. Last year, he and his staff allegedly allowed a mentally ill resident to leave the facility even though she was on a "pass restriction" because she was known to be using cocaine and prostituting herself. That woman, Maratta Walker, was later found murdered in a nearby Uptown motel.

The allegation that Boshes failed to prevent Walker from leaving the facility unsupervised could have constituted grounds for revoking or suspending his license, state records show.

But without admitting guilt, Boshes in July entered into a consent order with state authorities and received an official reprimand.

Marshall Kapp, a Southern Illinois University professor of law and medicine, said Illinois' disciplinary system was typical of most states -- very few nursing home administrators have disciplinary sanctions taken against them, and when that happens it's usually over financial matters, he said.