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Supreme Court: Rights of nursing home residents outweigh rights of nursing homes in discharge proceedings

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Dec 6, 2019

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The Illinois Supreme Court ruled that following the intent of the state’s Nursing Home Care Act – to protect the rights of nursing home residents – is more important than following the letter of the sometimes contradictory law.

Lakewood Nursing and Rehabilitation Center LLC brought legal action against the Illinois Department of Public Health in 2014, arguing the state took too long to approve its request to involuntarily discharge a resident who had stopped paying. Under state law, Lakewood said, a hearing on involuntary discharge must be held within 10 days of the resident’s request, and the department must issue a decision on the request within 14 days. In this case, the discharged woman filed a request for hearing on Nov. 1, 2013, and the hearing was not conducted until March 24, 2014. The department issued its final administrative decision to approve the involuntary discharge on May 6, 2014.

A Will County circuit judge determined the statute’s time requirements are directory, but an appellate court found them to be mandatory. In its analysis, a unanimous state Supreme Court agreed with the circuit judge's interpretation.

The Nursing Home Care Act was enacted to protect the rights of nursing home residents. It prevents nursing homes from involuntarily transferring or discharging residents except under a narrow set of circumstances, including nonpayment. It requires the facility to serve notice to the resident of an impending transfer or discharge and gives the resident 10 days to request an administrative hearing before the Illinois Department of Public Health. The transfer or discharge is suspended until the hearing concludes.

Writing for the court, Justice P. Scott Neville Jr. noted that the various sections of the statute contain contradictory time frames. One section provides that hearings will commence within 30 days of a resident’s request, while another provides that the hearing should take place within 10 days. One section gives the director of public health 30 days from the hearing’s conclusion to render a decision, while another gives the director 14 days from the hearing’s request.

Lakewood argued that Section 3-411, which provides 10 days in which to hold a hearing and 14 days to reach a decision, provides mandatory time frames. Because the nursing home must continue to provide care for the resident while the discharge hearing is pending, Lakewood said, “the timeliness of the discharge hearing and decision by the department must be construed as mandatory because it impacts both public interests and private rights.”

The court pointed out that it is not the rights of nursing homes or even the public that the Nursing Home Care Act is designed to protect.

“While a prompt hearing and expeditious decision by the department often will be beneficial to the resident, a mandatory construction of the (time frames) is not critical to achieve that purpose,” Neville wrote. “In fact, in some cases, the resident’s right to a timely hearing and decision by the department will be injuriously affected by an inflexible application of those time limits.”

The court’s framework does not consider whether any rights of any entity will be adversely affected by a directory interpretation, Neville wrote, only the rights of those the statute is designed to protect.

“The only rights referred to in section 3-411 are those of the resident to receive a hearing and decision by the department prior to involuntary removal,” Neville wrote. “The fact that a nursing home facility may be adversely impacted … is not determinative.”

The justices took notice of Lakewood’s argument that a directory interpretation could allow a discharge proceeding to be delayed indefinitely. The court acknowledged that prolonged hearings not justified by the health of the resident or the constraints of the process should be avoided and urged the Department of Public Health to be aware of that fact.

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