Guardianship Reforms Approved
Illinois Lawmakers Approve New Safeguards for Hospital Guardianship Cases After Investigation
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Illinois lawmakers have unanimously passed a bill to protect vulnerable adults from being placed under guardianship without their family's knowledge — a direct response to a Chicago Tribune investigation into how hospitals used the legal process to move patients into nursing homes. The bill now awaits a signature from Gov. JB Pritzker, with most provisions set to take effect January 1, 2025.
The Chicago Tribune found that Chicago-area hospitals filed more than 500 guardianship petitions over just 18 months in 2022 and 2023. In roughly 25% of those cases, reachable family members were not told a guardian had been appointed until after the fact.
Tribune Investigation Exposed a Hospital-to-Nursing-Home Pipeline
Illinois law allowed hospitals to ask a court to appoint a guardian for patients deemed too mentally incapacitated to make their own decisions. The system was designed to help people with no family. But the Chicago Tribune's "The Caretakers" series, published in February 2024, found hospitals were using it to discharge "difficult" long-stay patients — routing them into nursing homes, often against the wishes of patients or relatives.
Hospitals frequently bypassed the county's Public Guardian — a government official — and instead recommended private, for-profit guardians. Those private guardians often charged fees to the patient's estate. Critics called it a conflict of interest, since the same hospital seeking discharge was recommending the guardian who would approve it.
Bill Passed Both Chambers 108-0 and 56-0
State Senator Ann Gillespie and State Representative Lindsey LaPointe introduced emergency legislation within days of the Tribune's first report. Senate Bill 3496 cleared the Illinois Senate 56-0 on April 12. The House passed it 108-0 on May 23. The Senate then concurred with House changes on May 24, sending the bill to Pritzker's desk.
LaPointe said the Tribune's reporting "exposed a system where hospitals could essentially hand off patients to private guardians who had no connection to the individual." She called the bill a "speed bump that demands transparency," according to WTTW News.
New Rules Require Family Searches and In-Person Meetings
Under the new law, any institution that petitions for guardianship and recommends a private guardian must give the court a detailed written account of its efforts to contact the patient's nearest relatives. It must also notify the county Public Guardian's office so a government watchdog can step in if there is a conflict of interest.
Private professional guardians will also have to meet the disabled adult in person before being appointed. That closes a loophole that allowed "paper-only" guardianships — cases where a guardian took legal control of a person's life without ever speaking to them. Zena Naiditch, president of Equip for Equality, said "the lack of notice to families was the most egregious part of the old system."
Hospitals and Guardians Raise Concerns About Delays
The Illinois Health and Hospital Association said hospitals use guardianship only as a "last resort" for patients with no capacity and no available family. Some hospital administrators privately worried the new family-search requirements could slow discharges and worsen overcrowding in urban emergency rooms, according to reporting by the Chicago Tribune.
Private guardians also raised concerns. The Illinois Association of Professional Guardians argued that the new in-person meeting rule, while well-meaning, could be hard to fulfill in immediate medical emergencies. No major hospital system officially lobbied to kill the bill, however — and the final vote counts left no room for dissent.
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