Illinois nursing homes with 'serious quality issues' face coronavirus outbreaks

Four Illinois nursing homes already identified by federal medical authorities as having a history of serious quality issues have suffered outbreaks of the coronavirus in the past two months.

Twenty-four nursing homes are listed under the federal Special Focus Facility program, which is overseen by the federal Centers for Medicare & Medicaid Services. Four Illinois nursing homes are in the Special Focus program and another 20 are candidates for the program, as of February 26.

One of the four nursing homes with coronavirus outbreaks that is in the Special Focus Facility program, while the other three are on the candidate list.

The four Illinois nursing homes associated with the program that have reported outbreaks are:

Aperion Care Bradley, which is in the special program located in Kankakee County, has two cases of outbreak reported.
Bria of Belleville, a candidate for the SFF program located in St. Clair County, has 11 cases of outbreak reported and one death.
Elevate Care Waukegan, a candidate for the SFF program located in Lake County, has four cases of outbreak reported and one death.
Generations at Rock Island, a candidate for the SFF program located in Rock Island County, has 10 cases or outbreak reported and two deaths.

Three of the homes did not return calls for comment but a statement from Generations at Rock Island stated that the facility has implemented all best practices in infectious disease protocol in the nursing home, including screening all visitors and staff before entering the building, limiting building access to essential healthcare workers, screening residents twice per shift and modifying communal dining to comply with recommendations from health departments.

They also said they had adequately stocked personal protective equipment and raised the staff’s hourly wages by four dollars.

“We are working around the clock to protect residents and staff from this threat,” according to the statement. “We rigorously adhere to all policies and procedures from the Illinois Department of Public Health and the Centers for Disease Control to ensure continued safety of our residents and staff.”

While Bria of Belleville did not return phone calls, its outgoing phone message said the facility is implementing special measures against coronavirus, such as restricting visitation to essential personnel, screening staff before each shift, increasing the rate of disinfecting surfaces and monitoring all residents throughout the day.

The Illinois Department of Public Health is providing weekly updates to COVID-19 outbreaks among residents and staff in long term care facilities. A total of 278 facilities have reported cases of outbreaks and more than 600 deaths. Many nursing homes in Illinois have been cited for not having effective infection prevention and control programs in 2019.

No cases have been reported in Champaign County nursing homes as of last week, according to Julie Pryde, public health administrator at Champaign-Urbana Public Health District. The nearest nursing home with an outbreak is Fair Havens Senior Living in Macon County. The facility has reported 38 cases of outbreaks and 10 deaths.

The Special Focus program notes that “most nursing homes have some deficiencies, with the average being six to seven deficiencies per inspection. However, we have found that a minority of nursing homes have:

• More problems than other nursing homes (about twice the average number of deficiencies),

• More serious problems than most other nursing homes (including harm or injury experienced by residents), and

• A pattern of serious problems that has persisted over a long period of time (as measured over the three years before the date the nursing home was first put on the SFF list).”

The program states that those nursing homes may periodically institute enough improvements to correct problems identified in one inspection, significant problems would often re-surface by the time of the next inspection.

“Such facilities with a “yo-yo” or “in and out” compliance history rarely address underlying systemic problems that give rise to repeated cycles of serious deficiencies, which pose risks to residents’ health and safety. To address this problem CMS created the “Special Focus Facility” (SFF) program.”

Nursing homes in the programs are closely monitored and inspected twice as often as other nursing homes. The program stated most of the nursing homes in the program nationally do “significantly improve their quality of care within 18 to 24 months after being selected, while about 10 percent tend to be terminated from Medicare and Medicaid.” The state Department of Public Health does the inspections and passes on findings to Medicaid and Medicare programs.

According to a CMS report, Illinois nursing homes in the program that have showed no signs of improvement are three facilities owned by the for-profit chain, Aperion Care, a corporation that owns nursing homes with locations in Illinois and Indiana. The Special Focus nursing homes and their recent citations are:

Aperion Care Bradley in Bradley
- In August 2019, the facility was fined $25,000 for “failure to assess and treat a pressure wound for a resident.” The failure resulted in the hospitalization of a resident, as the facility failed to assess and treat a pressure wound 1 month after it was discovered.
Aperion Care Cairo in Cairo
- In May 2019, the facility was fined $75,000 for “failure to supervise a resident and provide individualized interventions; to implement immediate interventions to prevent abuse; and identify, assess, monitor, and treat wounds according to the physician’s orders.” The failures resulted in a paraplegic resident being thrown from his wheelchair and another resident being hospitalized for traumatic subarachnoid hemorrhage, lip laceration and nasal fractures. The failures also led to a resident’s worsening injuries, eventually leading to surgical amputation of his left second, third and fourth fingers and a potential need for amputation of his left hand.
Aperion Care Capitol in Springfield
- In March 2018, the facility was fined $25,000. The facility was cited for failure to ensure appropriately trained staff to perform reinsertion of gastrostomy tube for a resident, which resulted in the resident sustaining a bowel obstruction and perforation secondary to insertion of urinary catheter for gastrostomy tube.

According to the same CMS report, a Illinois nursing home in the Special Focus program that showed improvement was Aperion Care Bloomington. But in April 2019, the facility was fined $25,000 for “failure to respond to an exterior door alarm sounded with a resident with poor safety awareness and severe cognitive impairment left the facility.” The failure resulted in the resident leaving the facility undetected, subjected to cold weather and eventually being returned from the hospital hours later.

According to a CMS report on the Special Focus program, Illinois nursing homes that are candidates for the program include two Champaign facilities, Champaign Rehab Center and Champaign Urbana Nursing & Rehab.

Other candidates in addition to Bria of Belleville, Elevate Care Waukegan and Generations at Rock Island, are: