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Pro Bono Spotlight: Pro Bono and Long-Term Care

By: Karen Alice Kloppe

October was Residents’ Rights Month.  This annual observance event was created by The Consumer Voice for Quality Long-Term Care to direct focus on the needs of individuals living in long-term care facilities and those receiving in-home and community-based care at home. 

Common Legal Issues

Despite ongoing advocacy and monitoring efforts, this population remains at risk of abuse, adverse benefit eligibility determinations, caregiver negligence, financial exploitation, involuntary discharges, retaliation, substandard quality of care, and the unauthorized use of restraints in violation of clear protections in federal and state laws.[2]  Some do not know that their constitutional and human rights[3] are being violated, others are afraid of rocking the boat if they complain[4], and the rest will not be likely to obtain legal assistance due to the persistent and growing civil legal justice gap[5] although there is no specific national statistic for purposes of documentation.

[2] Care recipients and residents of long-term care facilities have numerous rights under the federal Nursing Home Reform Act of 1987/Omnibus Budget Reconciliation Act of 1987, the Illinois Nursing Home Care Act, the ID/DD_Community_Care_Act, the Abused_and_Negelcted_Long_Term_Care_Facility_Residents_Reporting_Act, and the Illinois Adult Protective Services Act.  Facilities seeking governmental reimbursements - Medicare and Medicaid - must comply with these laws. 

[3] Your Rights and Protections as a Nursing Home Resident summarizes key safeguards, including:  (1) being informed about the exercise of rights; (2) freedom from abuse, neglect, exploitation, and any chemical or physical restraints used without medical necessity; (3) autonomy and choice, including participating in planning care and refusing treatment; (4) enjoying confidentiality and privacy with respect to care, communications, visits, and records; (5) knowing about and controlling services and financial charges; (6) expressing grievances without fear of retaliation; (7) contractual guarantees relating to admissions, transfers and discharges, including the right to appeal; (8) communicating freely; and (9) purchasing and installing audio and/or video devices with consent of any roommate and after notifying the facility.   For more information, visit:  https://ilaging.illinois.gov/programs/ltcombudsman/residents-rights-in-l....

[4] Residents fear subtle and hard to prove punishments such as being labeled a “troublemaker,” delayed response times to requests for assistance, hostile confrontations, restriction of privileges for the residential unit, and even involuntary transfer actions.

[5] See:  https://justicegap.lsc.gov/.  The Legal Services Corporation (LSC) Justice Gap Report indicates that 62% to 74% of low-income older adults and seniors experience at least one civil legal problem annually, with 92% of those substantial legal needs receiving inadequate or no professional legal help. For information about low-income households in the Midwest, visit:  https://justicegap.lsc.gov/resource/midwest/.

Ramifications

Sadly, at present, recent studies consistently rank Illinois nursing homes near the bottom in terms of quality and compliance issues.[1]  If left unresolved, any one of these legal issues could impose an emotional, financial, and/or physical toll, unnecessarily jeopardizing the health and safety of at-risk individuals whose prospects for recovery are more limited due to various personal challenges.  Moreover, as a matter of our collective self-interest[2], considering the rate at which the population of persons who are age 60 or older continues to grow,[3] and that most of us will likely need long-term care at some point during life[4], ensuring greater availability of legal representation with attorneys having basic competency in public benefits, disability, and elder law for both the aging and disability populations is an important consideration for the future of pro bono programming. 

Self-Study Resources

A variety of self-study resources are available to help attorneys learn more about advocacy, nursing home rights, and how to handle complaints:

Professional legal help. View more information about low-income households in the Midwest.

[6] Illinois placed 47th in a  U.S. News & World Report and 49th according to Families for Better Care.  Also see:  https://www.nursinghomeabusecenter.com/research/best-and-worst-states-fo....

[7] Almost everyone will eventually have a loved one or personal future in a long-term care facility.  See:  https://crr.bc.edu/who-will-have-unmet-long-term-care-needs/.

[8] See:  Illinois Department on Aging Annual Report FY2025 at p. 6.  https://ilaging.illinois.gov/content/dam/soi/en/web/aging/resources/news...

[9] See: https://aspe.hhs.gov/reports/what-lifetime-risk-needing-receiving-long-t....

[10] Home Care Ombudsman work to protect the rights of adults with disabilities and older persons living in the community who are (1) enrolled in the Medicare Medicaid Alignment InitiativeNational Ombudsman Resource Center (NORS):  Offers a Four-Part Online Training Course covering complaint codes, case documentation, and advocacy procedures.

Medicare Medicaid Alignment Initiative (MMAI) and receive services from a managed care organization or (2) receive services from one of the following Home and Community Based Services (HCBS) Waiver Programs:  Persons who are Elderly, Persons with Disabilities, Persons with Brain Injury, or Person with HIV or AIDS Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) or Dual Eligible Special Needs Plans(D-SNPs

[1] Long-term Care Ombudsmen provide free, confidential advocacy and independent mediation between residents and staff.

  • Reporting & resolving nursing home problems
  • Learn the steps to take to report nursing home issues, such as how to file a complaint.
  • Filing a complaint about your quality of care
  • Find quality of care complaints examples and who to contact to make a complaint.
  • Reporting Abuse in Long-Term Care Facilities:  Provides contact information for entities that will accept a report of suspected abuse, neglect or exploitation of persons living in a long-term care facility.[7]
  • https://justiceinaging.org/systemic-and-individual-advocacy-to-reduce-re...

Advocacy and Pro Bono Opportunities

Interested attorneys can find volunteers opportunities for pro bono services to support individuals receiving long-term care services by visiting any of the following links:

[12] The State Survey Agency is the Illinois Department of Public Health (IDPH).

Author
Karen Alice Kloppe is a graduate of Illinois State University (B.A.) and the University of Illinois College of Law (J.D.).  She is employed as the Legal Assistance Developer at the Illinois Department on Aging in Springfield, Illinois.

This article has been written by the author in her personal capacity for informational purposes only.  It is not an official document of the Illinois Department on Aging or the State of Illinois.

Posted on October 29, 2026 by Marybeth Stanziola
Filed under: 
Practice News
Topic: 
Delivery of Legal Services Spotlight on pro bono

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