Provider Notice issued 01/20/12

Williams v. Quinn (05 C 4673)

This notice provides information and guidance about the next steps in the implementation of the Williams V. Quinn consent decree. Facilities were initially informed of this process in a June 28, 2011 Informational Notice, Williams v. Quinn (05 C 4673).

Resident Assessments

The University of Illinois, College of Nursing (UIC/CON) will be conducting the Resident Review assessments for the William's Class members beginning in late January 2012. UIC/CON has established four multi-disciplinary review teams that have been assigned to cover the 24 Institutes for Mental Disease (IMDs) in the state. Each team is headed by a team leader who has contacted or will be contacting facility Administrators to schedule an initial facility visit. During the initial visit the team will meet with key administrative and clinical staff, share contact information, establish space for the assessments, discuss scheduling of reviews, and receive information about how facility records and clinical teams are organized.

Resident Assessment Selection Protocol

The state has two years from the completion of the consent decree (September 30, 2011) to conduct reviews of all current IMD residents, as well as any new admissions which may occur at any time during the five-year period covered by the decree. Residents/guardians who initially decline review will be offered an assessment at least annually by UIC/CON.

Healthcare and Family Services (HFS) will randomly select residents for the initial round of reviews, based on a process that was agreed to by the parties. This list will be forwarded to the UIC/CON team which will schedule assessments with the individual and designated facility staff. The teams will be conducting reviews in all of the IMDs by the end of March 2012.

Resident Review Results and Report

Information from facility staff and records are, as always, critical to the Resident Review process. The UIC/CON teams will not be providing results or potential results to the facility or facility staff during the process. After the process and state submissions are complete, your facility will receive a written report from the state which includes: Resident Review findings, level of care determinations, recommendations regarding community transition at the point of the review, and recommendations for facility care planning and intervention. Questions or comments about this Resident Review process or results should be directed to HFS Bureau of Long Term Care.

Electronic Reporting of Admissions/Discharges/Change in Status

The Court Monitor requires that the state maintain an accurate/current list of class members, including any and all new admissions, transfers, and discharges. It continues to be an expectation that all facilities will report admission/discharge/change in status information electronically using the MEDI or REV software applications as directed in an Informational Notice, Electronic Submittal of Changes in Resident Status, dated March 11, 2011.

HFS is working proactively with the Department of Human Services to prioritize the timely Medicaid application, LTC authorization and electronic submission of admissions for the IMDs necessary for the collection of "real time" required reporting information.

Destination Information

The facility is required to track the destination for residents who leave the facility. If transferred to another facility, the name of the receiving facility must be recorded. For persons who are discharged to the community, the living arrangement and community provider contact information must be recorded. For those who leave against medical advice, whatever information the facility obtains regarding destination, living arrangement, or community provider contact must be recorded. In the future, the HFS will add data fields in the reporting requirements to capture this information electronically.

In the meantime, we will continue to utilize the Master Resident file started by your facility and HFS Bureau of Long Term Care staff to capture any required data not collected currently through the MEDI or REV systems. Since the UIC/CON assessment teams will be onsite at your facility, they will work with your staff to collect the updates for this data going forward.

Guardianship

In cases where a court-appointed guardian has been assigned, the guardian will be contacted prior to the assessment for their approval and potential involvement in the assessment process.

Resident Refusal

If a resident does not wish to be evaluated, his or her decision will be respected; however, each will be re-contacted by UIC/CON concerning the assessment. Agreement to Resident Review also does not bind the individual or his/her guardian to community transition. We strongly encourage facilities to support participation in the Resident Review process and to actively re-assure any concerned individuals that participation in the review does not equal any final transition decision.

Thank you in advance for your cooperation in these important matters. If you have questions please contact Dennis Smith or Jean Summerfield at the Bureau of Long Term Care.

Dennis: (217)524-7210 or Jean: (312)793-3872 or by e-mailing the HFS Webmaster.

Sincerely,

Theresa A. Eagleson, Administrator

Division of Medical Programs