Appellate court overturns cap on nursing home fines


SPRINGFIELD -- The Illinois Department of Public Health no longer is barred from fining nursing homes more than $10,000 when they provide bad care, but the department doesn’t plan to immediately issue higher fines, a spokeswoman said Thursday.

An Illinois Appellate Court last month threw out a Sangamon County judge’s ruling capping the fines, but Public Health spokeswoman Melaney Arnold said the appellate decision doesn’t resolve legal questions about the department’s previous practice of issuing fines as high as $300,000,

Sangamon Circuit Judge Leo Zappa raised those questions in a ruling last year in which he said the state health department lacks the authority to fine nursing homes more than $10,000.

Zappa ruled in favor of Peoria’s Rosewood Care Center, which had appealed a $20,000 state fine connected with the 2006 death of a former Rosewood.

Zappa said the health department had been illegally inflating nursing home fines in conflict with state law and using unapproved guidelines.

Arnold said the department will continue to limit nursing home fines to $10,000 to avoid more legal disputes, at least for now.

The department will urge that state law be changed to explicitly allow higher fines, she said.

Public Health also will continue to use a tactic officials began to employ after Zappa’s ruling: issuing multiple $10,000 fines instead of one large fine against nursing homes found to be providing substandard care.

Some nursing homes have complained about that approach, but the department believes the practice is legal, Arnold said.

“A fine is one of the few things we can do to make sure a nursing home is compliant with the law,” she said.

Terry Sullivan, regulatory coordinator for the Health Care Council of Illinois, which represents the nursing home industry, said higher fines don’t necessarily lead to better care.

Wendy Meltzer, director of Illinois Citizens for Better Care, which advocates for nursing-home residents, said she hopes fines can be increased through nursing-home reform legislation moving through the General Assembly. One bill would set minimum fines at between $25,000 and $50,000 per violation.

State officials wanted the caps on fines thrown out, but the court didn’t address that issue. Instead, the judges decided the case on a legal technicality. The department took too long after an internal hearing on the original fine to issue a final decision, the court said.

Dean Olsen can be reached at 788-1543.

Impact throughout state

Sangamon County Circuit Judge Leo Zappa’s February 2009 ruling capping nursing home fines at $10,000 has had an impact throughout Illinois.

The ruling prompted the Illinois Department of Public Health to reduce some nursing home fines that hadn’t been paid at the time of the ruling, department spokeswoman Melaney Arnold said.

Some fines issued after that point were lower than they would have been before the ruling, she said, although the department in some cases issued multiple $10,000 fines as a way of getting around the ruling.

The department issued $1.95 million in fines against nursing homes in 2009, compared with $2.6 million in 2008, according to the Health Care Council of Illinois.

The Zappa ruling had “some impact” on the reduction, Arnold said. “To what degree, we can’t say,” she said.

Nursing homes often pay lesser amounts to settle state fines, and some fines are overturned through an internal dispute process.

— Dean Olsen