Counting on Care

May 1, 2008 9:14:40 AM PDT
Thousands of people counting on care at Illinois nursing homes are being let down by the state. The I-Team has uncovered a gaping hole in Illinois nursing home regulations that has left some families devastated.

You might call this situation "catch me if you can."

The 1,200 nursing homes now operating in Illinois are not required to carry any liability insurance whatsoever nor do they have to disclose that fact to residents or their families.

What that means is, if your loved one is mistreated at nursing home with a lack of insurance, good luck recovering any damages.

The Illinois Department of Public Health investigated more than 4,600 complaints against nursing homes last year and found nearly 300 violations.

"Patients need to be protected," said State Rep David Miller, D-Dolton.

Miller is sponsoring new legislation that would require nursing homes to carry liability insurance.

"People are living longer, healthier lives and with that trend comes with the issues of making sure these homes are safe," he said.

"Doctors are not required to have liability insurance and my understanding is a lot of hospitals aren't either," said Larry Vander Maten, FMR Nursing Home, owner.

Until recently, Vander Maten owned the Rosewood nursing home chain in Illinois. If the state requires nursing homes to carry liability insurance, Vander Maten says lawyers stand to make a fortune by suing nursing homes for insurance money and exorbitant legal fees.

"It opens the door, as far as I'm concerned, to the possibilities of having an entire industry suffer extortion through the commercialization of our legal process," said Vander Maten.

A quarter of the nursing homes in Illinois do not have conventional liability insurance; some of those are self-insured or have policies with Caribbean companies. But U.S. courts don't have jurisdiction over offshore companies and cannot force them to pay.

That was the case at the Rosewood nursing home in northwest suburban Inverness. In a court case that concluded in 2006, the previous owners of the facility were ordered to pay $600,000 to the family of a resident who died. At the time, Rosewood's owners had a policy with a company in the Caribbean islands, an insurance firm that has not paid the judgment to the Illinois family. And Rosewood is appealing the case.

"I didn't know that nursing homes were not required to carry insurance," said Jill Szczekocki, granddaughter.

In another case at Rosewood in 2006, Szczekocki's grandmother was left alone in a washroom; according to state records, by a new employee who hadn't finished orientation or been told of the 93-year old's mandatory care needs. Mae Blake fell and hit her head.

"Six weeks later, she was put on hospice and she passed away," said Szczekocki.

After paying more than $110,000 from her life savings to live at Rosewood, the nursing home "committed violations" according to an Illinois Health Department report that she was "not properly supervised" before falling. It's a ruling Rosewood is appealing.

"They just refused to take any responsibility for it all," said son Gene Blake.

"They are taking the position that we won't settle this claim, we don't settle claims, if you want money from Rosewood take us to trial and told us they don't have insurance for this claim as well," said John Perconti, attorney.

"I do know that he has a reputation as a lawyer who has made millions of dollars suing nursing homes," sai d Vander Maten.

Vander Maten provided the I-Team with proof they did have insurance at the time and says Mae Blake's family lawyer either misunderstood or is using the case to push for state mandated nursing home insurance.

"The purpose of the legislation should not be to encourage lawsuits, which merely benefit trial lawyers with enormous fees that go well beyond the settlements they have obtained for their clients," said Vander Maten.

Perconti says he knows what he was told, but the spat between lawyers underscores what some state lawmakers say is the problem: that without better regulations, the consumer may end up paying for such disagreements.

A spokesman for Illinois' Nursing Home Association said they favor a compromise mandatory insurance law that would be less complicated and less expensive.

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