Author: Tom Wardrip
Under a new law taking effect January 1, 2025, Illinois nursing homes must ensure adequate staffing levels to meet the needs of residents or face fines. The Illinois Nursing Home Care Act establishes healthcare staffing ratios for direct care staff including registered nurses, licensed practical nurses, certified nursing assistants and other specialized roles. The ratios are designed to ensure adequate care for residents requiring skilled or intermediate care.
The Illinois Department of Public Health (IDPH) aims to ensure that healthcare facilities maintain staffing levels to provide quality care to residents, using a structured approach to compliance and accountability. At the same time, attracting and retaining staff to maintain mandated levels has become increasingly difficult.
Non-compliance fines start at 125% cost of wages and benefits
Under the new law, IDPH may levy monetary penalties for non-compliance using data gathered beginning January 1. Facilities it finds non-compliant will receive written notices and must submit correction plans. Regulators will calculate penalties based on the cost of wages and benefits for missing staffing hours, with increasing penalties for repeated offenses.
Non-compliant nursing homes will be on the hook for 125% of the cost of wages and benefits for the first offense and 150% for the second. For the third offense and any that may follow, the fine will increase to 200% of the cost of wages and benefits for missing staffing hours. IDPH retains discretion to adjust penalties for minor deviations or unforeseen circumstances.
Prior to 2020, The IDPH used a system for determining adequate staffing standards using data from the Centers for Medicare and Medicaid Services' (CMS) payroll-based journal and facility-reported census data. Now, the state assesses compliance quarterly as of January 1 and addresses discrepancies in job titles, according to the new rule.
Talent attraction and retention remain challenging
To stay compliant and compete for talent, nursing homes must evaluate their compensation programs and verify competitiveness in the market. A competitive compensation program will allow organizations to meet required staffing levels before they incur fines. Potential fines could significantly outweigh the costs to bring employee pay up to market standards.
Annual salary increases, market adjustments, recruitment, turnover and benefits represent costly expenses that nursing home leaders must manage appropriately. Internal inequities and external competitiveness issues quickly can become major sources of employee dissatisfaction as well as create difficulty in hiring and retaining staff.
Assess your risk and make a plan
Gallagher advisors can perform a compensation assessment for your organization. This detailed, actionable plan guides your business through the implications of your current program, ascertains your market position and defines a compensation and total rewards philosophy. Using this foundation, your Gallagher advisor works with you to build a compensation program that allows you to see your compensation philosophy in action as you strive to meet patient care and strategic human resource goals.
