Understanding Residents’ Rights in Illinois Nursing Homes

If you or a loved one lives in an Illinois nursing home or skilled nursing facility, it’s essential to understand the legal protections that apply every single day, from the right to be treated with dignity to the right to challenge an unsafe discharge. These rights come from both Illinois law and federal regulations, and they’re enforceable through state oversight and the courts.

This guide explains the core rights, what facilities must do, how to spot problems, and how to take action if something goes wrong.

Where Residents’ Rights Come From

Illinois Nursing Home Care Act:  Illinois’ primary law for nursing home residents is the Nursing Home Care Act (210 ILCS 45). Among other protections, the Act spells out resident rights and provides a private right of action (you can sue) if those rights are violated. The Act also allows successful residents to recover their actual damages plus their costs and reasonable attorneys’ fees.

Federal regulations (OBRA ’87 / 42 C.F.R. Part 483): Any nursing facility that participates in Medicare or Medicaid must follow robust federal standards, including the Resident Rights rule at 42 C.F.R. § 483.10 and the Admission, Transfer, and Discharge Rights rule at 42 C.F.R. § 483.15. These regulations guarantee a dignified existence, self-determination, and protections during admission and discharge.

Oversight and advocacy. In Illinois, the Department of Public Health (IDPH) licenses and regulates nursing homes, and the Illinois Long-Term Care Ombudsman Program helps residents resolve concerns and navigate complaints.

Core Nursing Home Resident Rights

While the full list is extensive, the following themes come up most often:

1. Dignity, respect, and quality of life: Residents must be treated with courtesy and respect and cared for in a way that promotes quality of life and individuality. Facilities must support resident choices whenever possible.
2. Freedom from abuse, neglect, and exploitation: Residents have the right to be free from physical, mental, verbal, and sexual abuse, neglect, and financial exploitation. Facilities must protect residents from retaliation for asserting their rights.
3. Safe care and adequate staffing: Facilities must provide necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being. Illinois sets staffing and care obligations by statute and rule, and federal regulations mandate comprehensive assessments and care planning.
4. Participation in care planning and medical decisions: Residents can participate in developing their care plan, choose their physician, and be informed of their condition and treatment options. They may refuse treatment to the extent permitted by law.
5. Privacy, visitors, and communication: Residents are entitled to privacy in personal care and communications and have rights regarding visitation by family, friends, and advocates, subject to reasonable clinical and safety restrictions.
6. Autonomy and personal property: Facilities cannot require third-party guarantees of payment as a condition of admission, cannot force residents to waive legal rights, and must take reasonable steps to safeguard personal property.
7. Financial rights: Residents may manage their own money or designate a representative. If the facility manages funds, it must follow strict accounting, safeguarding, and reporting rules.
8. Admission, transfer, and discharge protections: Except in limited circumstances, facilities must provide written notice at least 30 days before a transfer or discharge, explain the reason, the effective date, the destination, and the right to appeal. A copy must go to the state Long-Term Care Ombudsman. Shorter notice is allowed only in specific emergencies (e.g., endangerment to health or safety).

Arbitration Clauses During Admission: What to Know

You may be presented with an arbitration agreement in the admission packet. Under current federal rules, facilities may use pre-dispute binding arbitration agreements, but they cannot require a resident to sign one as a condition of admission or continued care. The agreement must be explained in plain language, and the facility must keep copies and make them available to regulators. Signing is voluntary. If you don’t understand it, don’t sign until you get advice.

Enforcing Your Rights: How Complaints and Lawsuits Work

Informal resolution and Ombudsman help. Many problems can be resolved by raising the concern with nursing staff, the Director of Nursing, or the Administrator, and by involving the Illinois Long-Term Care Ombudsman Program, which provides confidential assistance to residents and families.

State complaints (IDPH). Anyone, residents, family members, staff, or visitors, can file a complaint with IDPH’s Central Complaint Registry. You can file by phone, online, mail, or fax.
• Phone (Nursing Home Hotline): 800-252-4343 (TTY 800-547-0466)
• Online: via the IDPH “File a Healthcare Complaint” portal
• Paper form available for mail/fax submission
IDPH investigates and may cite violations and impose penalties when warranted.

Private lawsuits under the NHCA. If resident rights are violated, Illinois law allows residents (or their representatives) to bring a civil action. If they prevail, the court must award actual damages and shall award costs and reasonable attorneys’ fees, a key feature intended to make justice accessible. Courts and practice guides emphasize this fee-shifting as a central enforcement tool under the Act.

Transfer and Discharge: Your Specific Protections

Because involuntary transfers and discharges can be traumatic, federal rules provide detailed safeguards:

• Advance notice. At least 30 days’ written notice is required in most cases, stating the reason, effective date, destination, appeal rights, and Ombudsman contact information. Shorter notice is permitted only in narrow circumstances (e.g., resident’s urgent medical needs, endangerment to others, or newly certified for a higher level of care).
• Valid reasons. A facility may discharge or transfer only for specific reasons such as the resident’s welfare and needs cannot be met, safety of individuals is endangered, the resident’s health has improved sufficiently, nonpayment after appropriate notice, or facility closure.
• Right to appeal and remain. Residents have the right to appeal an involuntary discharge or transfer decision; services generally continue during the appeal period. A copy of the notice must be sent to the Ombudsman.

Practical Ways to Use These Rights

1. Keep a care notebook. Track changes in health, missed medications, falls, pressure ulcers, or significant weight changes. Note dates, names, and what was reported and when. This is invaluable for care conferences and any complaint.
2. Attend care plan meetings. Prepare concerns in advance: mobility, toileting, pain management, skin care, nutrition, behavior supports, activities, and goals. Ask for the plan in writing, and request revisions if needs change.
3. Speak up early. Raise concerns with charge nurses and the Director of Nursing. If not resolved quickly, escalate to the Administrator and call the Ombudsman for help facilitating solutions.
4. Know the warning signs of neglect or abuse. Frequent falls without follow-up, untreated pressure injuries, repeated medication errors, sudden behavioral changes, poor hygiene, or unexplained bruising warrant prompt attention. (The IDPH’s public notices and enforcement actions show how such issues lead to citations and fines.)
5. Check the admission contract. Look for any waiver of rights, third-party payment guarantees, or arbitration clauses. Federal regulations bar facilities from requiring residents to waive rights or obtain third-party guarantees as a condition of admission; arbitration must be voluntary. Ask questions and consider legal advice before signing.
6. Use the complaint process. If internal efforts fail or if there’s immediate danger, file with IDPH right away and inform the Ombudsman. IDPH can investigate and, when appropriate, cite the facility and require corrective action.

What Facilities Must Do (and Must Not Do)

Must do:

• Provide the care and services necessary to help residents reach their highest practicable level of well-being, based on comprehensive assessments and a person-centered plan.
• Protect residents from abuse, neglect, exploitation, and retaliation; investigate and report allegations.
• Give proper notice and assistance for transfers or discharges, including appeal rights and Ombudsman notification.
• Safeguard resident property and finances and maintain transparency when managing resident funds.

Must not do:

• Require an arbitration agreement or third-party payment guarantee as a condition of admission or continued care.
• Request or require residents to waive their legal rights under state or federal law.
• Retaliate against a resident who complains, participates in the Ombudsman program, or asserts rights.

Contact the Experienced Chicago Nursing Home Abuse and Neglect Lawyers at John J. Malm & Associates

At John J. Malm & Associates, we know how overwhelming it can be when a loved one’s rights in a nursing home are ignored or violated. Families place their trust in these facilities, and when that trust is broken, residents deserve justice. Our attorneys have extensive experience holding nursing homes accountable for neglect, abuse, and violations of the Illinois Nursing Home Care Act. If you believe your loved one’s rights have been violated, don’t wait, contact our office today to schedule a free consultation. We will review your case, explain your legal options, and fight to protect your family’s rights.