Illinois is one of 42 states, plus Washington, D.C., that alleged Johnson & Johnson deceptively promoted and misled consumers, in advertisements, about the safety of some of its talc powder products. The states filed lawsuits Tuesday that were settled with simultaneous consent judgements, which must still be court approved, according to the New Jersey attorney general’s office.

Illinois’ lawsuit, filed in Cook County Circuit Court’s chancery division, alleged that Johnson & Johnson knew that its talc products were “sometimes tainted with carcinogenic asbestos and that women who used talc-based powders in the genital area had an increased risk of ovarian cancer. … Despite this knowledge, J&J continued marketing of Talc Powder Products as safe, pure and gentle, and as suitable for use in and on female genitals.”

Johnson & Johnson stopped selling baby and body powder products containing talc in recent years. Under the consent judgment, Johnson & Johnson would not be able to sell, manufacture, market, promote or distribute the products moving forward.

“Consumers rely on accurate information when making decisions about which products to purchase for their families,” Illinois Attorney General Kwame Raoul said in a news release Tuesday. “Any company — no matter how large — must be held accountable when laws protecting consumers are broken and their trust is violated.”

The company did not admit any wrongdoing or liability as part of the consent judgments. Johnson & Johnson previously confirmed to The Wall Street Journal in January that it had reached an agreement in principle on the settlement.

Johnson & Johnson “continues to pursue several paths to achieve a comprehensive and final resolution of the talc litigation,” Erik Haas, worldwide vice president of litigation for the company, said in a statement. “That progress includes the finalization of a previously announced agreement that the Company reached with a consortium of 43 State Attorneys Generals to resolve their talc claims.”

The settlement does not resolve many other lawsuits filed by private plaintiffs alleging that talc causes health issues, including mesothelioma and ovarian cancer, according to Raoul’s office.

Thousands of residents and fellows in the Chicago area have voted to unionize in the last year — at University of Chicago Medicine in May, Northwestern Medicine in January and West Suburban Medical Center in Oak Park in November. University of Illinois at Chicago residents and fellows unionized in 2021.

Residents have long had to work many hours for relatively low pay, as they train to become specific types of physicians after medical school. Traditionally, residents have been expected to put their heads down and grind, for years, as they gain on-the-job experience and progress toward more lucrative, prominent careers.

But residents say that attitude is shifting, amid changes in the business of health care, frustrations that arose out of the pandemic, and growing unionization across many industries.

“Hospitals rely on us, but we have not been able to rely on them to guarantee fair working conditions,” said Dr. Anis Adnani, chief resident for the University of Illinois at Chicago emergency medicine residency program. “At some point we decided to become self-reliant and demand fair working conditions not only for ourselves, but for what we see every day in terms of taking care of patients.”

Before the union at the University of Illinois at Chicago reached its first contract last year, first-year residents were making a little less than $60,000 a year for up to an average of 80 hours a week of work — an income that’s about minimum wage, if broken down hourly, Adnani said. Under the contract, residents were able to secure an 18.5% raise over four years and establish a committee focused on resident well-being, among other gains, he said.

“Any entity that relies so much on a pool of labor to operate should ensure their labor force is well taken care of,” Adnani said.

Residents at Northwestern, UCMedicine and West Suburban have not yet reached contracts with their respective hospitals, having unionized more recently.

They say they were inspired to unionize partly by the success at UIC and other institutions across the country.

In general, unionization has been growing across industries in recent years, and enjoying strong support. About 67% of Americans surveyed in 2023 said they approved of labor unions, up from a long-term average of 62%, according to Gallup — an environment that has helped residents’ unions flourish.

The Committee of Interns and Residents — which represents doctors at Northwestern, UIC and UCMedicine — has seen its membership nearly double to more than 33,000 doctors nationwide since 2020. The committee is part of the Service Employees International Union and also represents doctors in California, Massachusetts, New Jersey and New York, among other places.

“There’s been a huge upswing,” said Dr. Philip Sossenheimer, a palliative medicine fellow at Stanford Health Care who was on the organizing committee for the unionization campaign at Stanford.

In the past, doctors at hospitals on the East Coast were more likely to be unionized than those in other areas of the country, and it was more common at public sector hospitals, he said. For example, residents at Stroger Hospital in Chicago, which is a public hospital, unionized in affiliation with a different group, the National Union of Hospital & Health Care Employees, in 1974. The union at West Suburban is now part of that same group.

Now, residents at an increasing number of large, academic medical centers across the country are getting in on the action, including in Illinois, which has more union-friendly laws.

“There has been an appetite for this for a long time,” Sossenheimer said. “(Older doctors) all talked about similar dissatisfaction they had back in their day, but I think there are a few things that have changed.”

For one, residents are no longer mostly white men with stay-at-home wives. About 48% of active, U.S. citizen residents with MDs in 2022 were white, and about 48% of residents and fellows were women in 2022, according to the Association of American Medical Colleges.

Residents are concerned about benefits such as parental leave, or freezing their eggs if they want to have children after their residencies, which can sometimes last as long as seven years, he said.

There’s also been upheaval when it comes to the business of health care. In the past, doctors often practiced independently. In recent decades, that has shifted. In 2022, about 47% of doctors worked in private practice, compared with about 60% a decade earlier, according to the American Medical Association — a change that stems from the economic, administrative and regulatory burdens that can face doctors in private practice, according to the association.

“The generation that preceded us as physicians did not conceive of unionization as a thing because they weren’t employees,” Sossenheimer said. “They owned their own practices. That’s changed drastically in the last 15 years.”

That new reality means doctors must now contend with employers that are watching their bottom lines and often involved in mergers and acquisitions. They feel more uncertainty about their futures.

“What changed is these interns really began to think about themselves as employees … and maybe that long-term medical professional career might take longer to get,” said Robert Bruno, a professor of labor and employment relations at the University of Illinois at Urbana-Champaign. “The industry is changing, they might find themselves in a different labor market situation.”

Residents also say that COVID-19 was a catalyst for organizing. It was a stressful period for everyone in health care, and, for many residents, highlighted their lack of power and standing at their institutions, residents say.

“In COVID, when residents were certainly on the front lines in many places, they realized how little protection they had as residents,” said Dr. Mugdha Mokashi, who is finishing her second year of residency at Northwestern Memorial Hospital.

A big reason that Mokashi, who is on the bargaining committee for her union, wanted to unionize was to give residents more power when it comes to how the hospital functions. As a resident at Northwestern, Mokashi spends half her time at Northwestern Memorial and the other half at Stroger.

“We are caring for patients with the least amount of support, the least amount of resources, and despite that, we also have the smallest voice in how the health care system works,” Mokashi said. “We don’t have any say in how finances are allocated to the department. I think the people on the front lines should have an active voice in how funds are allocated and why.”

Vanessa VanDruff, a third-year resident at UChicago Medicine, said she wanted to unionize not because she dislikes her workplace, but because she cares so much about it. Residents want the power to help improve their hospitals, she said.

University of Chicago Medical Center said in a statement it “remains committed to continuing to foster an exceptional learning and care environment for our 1,040 residents and fellows.”

VanDruff believes the unionizations at UChicago Medicine, Northwestern, UIC and West Suburban are just the beginning.

“I think unionization of residents is going to spread to almost every institution,” VanDruff said. “I think it’s that important.”

The email accounts of several hospital workers were accessed between Jan. 4 and Jan. 30, the hospital said in a news release. When the hospital learned of the incident, it took steps to secure those email accounts, and it launched an investigation.

In late March, the hospital determined that the email accounts contained health information, and for some people may have also included Social Security numbers, passport numbers, driver’s license numbers, insurance information, billing information and access information, such as security questions and answers.

“UCMC remains committed to protecting the confidentiality of all faculty, staff, students and patients and takes cybersecurity threats to its systems seriously,” the hospital said in a news release. “It has taken steps to prevent a similar occurrence from happening again, including implementation of additional technical safeguards.”

Phishing is when cybercriminals attempt to access sensitive data through fraudulent emails or websites, according to the National Institute of Standards and Technology.

Affected individuals may call 833-918-4065 Monday through Friday from 8 a.m. to 8 p.m. with questions.

The security incident follows a string of high-profile cyberattacks on health care institutions in the Chicago area and across the country. Earlier this month Ascension, which has 14 hospitals in Illinois, said it was the victim of a ransomware attack. The attack led Ascension to postpone some nonemergency elective surgeries, tests and appointments and temporarily divert ambulances carrying new patients from one Illinois hospital.

In January, Lurie Children’s Hospital in Chicago also faced a cyberattack. It took more than a month for Lurie to get all of its systems back online after the attack.

Health care institutions are often targets for cybercriminals because of their size, their dependence on technology and the large amounts of sensitive data they hold, according to the U.S. Department of Health and Human Services.

Under the bill, doctors’ offices and clinics affiliated with hospitals would have to report allegations of patient abuse to the Illinois Department of Public Health, triggering an investigation by the state. Now, hospitals must only report allegations that happen at hospitals.

The House unanimously passed the bill Tuesday night. The Senate also previously passed the bill unanimously. The bill now goes to the governor for his signature.

The governor’s office did not immediately respond to a request for comment on the bill Wednesday.

The bill comes several months after a Tribune investigation found that well-known health systems allowed workers accused of sexually abusing patients to continue providing care, and, in some cases, those same health care workers were then accused of abusing additional patients.

As part of the investigation, the Tribune also detailed the role Endeavor Health played in allowing former obstetrician-gynecologist Dr. Fabio Ortega to continue working despite complaints from patients. Some of the complaints against him involved alleged incidents that happened at Endeavor-affiliated doctors’ offices — outside hospital walls.

Ortega has faced lawsuits from more than 60 patients accusing him of sexual assault or abuse, and he pleaded guilty in 2021 to aggravated criminal sexual abuse of two patients. Most of the patients who filed those lawsuits also accuse the health systems where Ortega worked of failing to protect them.

The Illinois Hospital Association and the Illinois Department of Public Health both collaborated with Illinois Rep. Kelly Cassidy, D-Chicago, who originally proposed the bill. Attorneys representing dozens of women who have filed suit against Ortega also worked with Cassidy on the bill.

One of those attorneys, Tamara Holder, who represents most of the women who have sued Ortega and Endeavor along with her co-counsels Johanna Raimond and Stephan Blandin, called the bill’s passage “a huge victory.”

“Women are going to finally be heard when they complain about doctor misconduct in an office or outside of a hospital setting where doctor patient abuse predominantly occurs,” Holder said.

During the legislative session Tuesday night Cassidy told her colleagues in the House that the bill closes an existing loophole in the law. “We have more work to do to make sure that patients are safe in health care situations, but this is an important first start,” she said.

The bill’s Senate sponsor, Karina Villa, D-West Chicago, called the bill a “strong step” toward preventing future patient abuse in a news release after the measure passed through the chamber over the weekend.

Carrie Ward, CEO of the Illinois Coalition Against Sexual Assault, said the bill is an “important expansion” of reporting requirements.

Tribune reporting also identified several hospitals that had not reported patient allegations of abuse to the state’s health department as required. Those facilities appeared to face few consequences as a result.

The investigation revealed that gaps in state laws and slow action by the state agency responsible for disciplining licensed health care providers sometimes resulted in doctors and other health care workers continuing to provide care for months or years after patients alleged sexual misconduct.

Illinois Department of Financial and Professional Regulation spokesperson Chris Slaby said in a statement that the agency, which oversees licensing and discipline for health care professionals, is working on additional reforms with legislators and “plans to pursue legislation in the fall veto session.”

Chicago Tribune’s Jeremy Gorner contributed to this report.

The bill’s passage follows years of outcry from patients with asthma and other lung conditions over the cost of inhalers, which can be hundreds of dollars a month.

“It is cost prohibitive,” said Rep. Laura Faver Dias, D-Grayslake, House sponsor of the bill, during floor debate Wednesday. “When the (patient) is paying out-of-pocket co-pays at such a high rate they don’t adhere to their treatment plan because they cannot afford it, and then we see them ending up in the ER more.”

The bill passed the House 87-21 on Wednesday, and now moves to the governor for his signature. When asked whether the governor plans to sign the bill, a spokesperson for Gov. J.B. Pritzer’s office said in an email Thursday that he “will give it a careful review” once it reaches his desk.

No insurance industry group opposed the bill, but some Republican lawmakers spoke against it during floor debate, before it passed.

“Somebody is now paying for that,” said Rep. William Hauter, R-Morton. “You don’t think the insurance company is eating that. … Everyone else in the plan is now paying a higher premium.”

The bill would not apply to all insurance plans, only those regulated by the state. Many large employers have plans that are regulated by the federal government.

The bill’s advocates praised its passage this week, saying it will make a difference for patients, especially those from low-income communities of color, which are disproportionately affected by asthma.

“This just changes the whole game in my opinion,” said Erica Salem, senior director of strategy, programs and policy at the Respiratory Health Association, which helped work on the bill. “It makes everything so much more affordable and it will save the state millions.”

Mia Fritsch-Anderson said the bill could help her for years to come. Fritsch-Anderson, who recently finished her freshman year of college at the Illinois Institute of Technology, was diagnosed with severe asthma when she was a year old. She estimates that her family now spends about $6,000 a year on inhalers.

“It’s a heavy price and that’s something everyone with asthma has to deal with, so it’s really amazing they’re able to cap it at $25 now,” said Fritsch-Anderson, a volunteer patient advocate with Respiratory Health Association. “It’s going to help a lot of families afford this medication.”

Minnesota and New Jersey have passed similar legislation, Faver Dias said.

The bill also comes after several major manufacturers of inhalers pledged earlier this year to cap out-of-pocket costs for inhalers at $35 a month, starting in June and early next year. Those pledges came several months after a U.S. Senate committee launched an investigation into the costs of inhalers in the U.S.

If the governor signs the bill, it would go into effect in January 2026.

Chicago Tribune’s Olivia Stevens contributed.

Howard Brown plans to shutter its Diversey clinic at 2800 N. Sheridan Road on Aug. 31, and its Thresholds South clinic at 734 W. 47th St. on Sept. 30. The organization decided to close the clinics following an expected $6.6 million budget shortfall this fiscal year; because of the departure of the clinics’ sole providers; and because the clinics’ leases are up, according to Howard Brown.

“These closures mark a business decision that will ensure our ability to serve patients with quality care for the next 50 years,” Dr. Robin Gay, interim president and CEO of Howard Brown, said in a news release.

Howard Brown will work to ensure that the clinics’ patients continue to receive care, including at other Howard Brown clinics within 15 minutes of the ones that are closing, Howard Brown said in the release.

The “vast majority” of staff members at the clinics will be reassigned to other Howard Brown sites “wherever positions are available,” Howard Brown said. There are 24 staff members at the two clinics, said a Howard Brown spokesperson.

The Illinois Nurses Association, which represents workers at Howard Brown, criticized the decision Monday to close the clinics. Tristan Bock-Hughes, a senior lead organizer at the union, called the announcement “sudden” in a statement and expressed concern that Howard Brown had not yet promised, as of early Monday afternoon, to avoid layoffs.

“We just ratified a contract that requires bargaining over the impacts of such a change and are dismayed that Howard Brown’s communication did not mention their requirement or intention to negotiate,” Bock-Hughes said in the statement. Howard Brown and non-nurse workers represented by the Illinois Nurses Association recently reached their first contract agreement.

Tiffany Foster-Mitchell, lead medical assistant at the Thresholds South clinic, said in a statement: “This change in plans will have a major negative impact on the psychiatric patients who benefit greatly from the integration with the Thresholds social services sharing the same building. Thresholds patients are the most vulnerable population Howard Brown serves, often people facing homelessness and experiencing severe mental illness.”

The closures follow a challenging couple of years at Howard Brown, which is a federally qualified health center, meaning it receives federal dollars to help patients with low incomes. Howard Brown specializes in caring for patients who are LGBTQ+ and people living with HIV.

Non-nurse workers represented by the Illinois Nurses Association went on strike twice last year, in January and November. The first strike came after more than 60 employees were laid off, as Howard Brown said it faced a potential $12 million shortfall. At the time, Howard Brown blamed the anticipated shortfall on changes to a federal drug discount program and the end of federal COVID-19 relief dollars.

In July, a regional office of the National Labor Relations Board found merit to allegations that Howard Brown engaged in unfair labor practices, after complaints from the union. Howard Brown then offered to reinstate the laid-off workers, and 25 agreed to return. A full settlement has not yet been reached. The NLRB issued a complaint against Howard Brown in March, and a hearing before an administrative law judge has been set for October.

Next, cybercriminals attacked Ascension, a large nationwide health system with 14 hospitals in Illinois.

In both cases, the hospital systems kept providing care, but took down their electronic health record systems and MyChart online patient portals.

It took more than a month for Lurie to get all of its systems back online after the January cyberattack. Ascension — which rescheduled some nonemergency surgeries and temporarily diverted some ambulances as a result of a hack earlier this month — is still untangling the mess.

“We are focused on getting systems back up and running as safely and as quickly as possible,” Ascension said in a statement Wednesday. “Please be aware that it may still take some time to return to normal operations.”

Lurie and Ascension are hardly alone when it comes to battling increasingly sophisticated cybercriminals going after health care organizations. Last year, a record 725 large health care security breaches were reported to the U.S. Department of Health and Human Services Office for Civil Rights, according to the HIPAA Journal, which covers news related to the Health Insurance Portability and Accountability Act. The number of large, reported health care breaches increased by 93% between 2018 and 2022, according to the health and human services department.

“They keep coming,” said Ashraf Shehata, U.S. Sector Leader for Health Care for KPMG, an accounting and advisory firm. “When there’s a successful attack, you’re going to see more and more and flow into that space.”

Cyberattacks have been a problem facing many industries for years. But health care systems are particularly attractive targets for cybercriminals because of their size, their dependence on technology and the large amounts of sensitive data they hold, according to the health and human services department.

Hospitals and health care systems have patients’ names, medical histories, billing information and addresses on file, among other things.

And when hospitals are hit with a cyberattack, the consequences can be dramatic.

In addition to postponing some appointments and surgeries, caring for hospital patients became more difficult for a time after the attack, said nurses at one Ascension Illinois hospital.

Hospitals typically take down some of their electronic systems following a cyberattack in order to isolate the problem, and to prevent hackers from doing any further damage, experts say. But that lack of access to electronic health records and systems is challenging, nurses say.

For a day or so after the attack, nurses couldn’t automatically see when doctors entered orders for patients, such as for tests and medications, said Paula Koranda, a staff nurse at Ascension Saint Joseph-Joliet hospital. They only learned about an order if they spoke with the doctor, she said.

Also, normally, when administering medication, nurses scan barcodes on the medication containers and on patients’ hospital bracelets to make sure they’re giving the right medication to the right patient. They also temporarily lost the ability to do that after the attack, Koranda said.

Koranda, who said she has been a nurse at the hospital for 48 years, remembers how those tasks were done before computers, with paper and pen. But many nurses aren’t used to working like that, she said.

“It was definitely very hard to make sure we were very safe with the patients and the patients got everything they needed when we went down,” Koranda said.

An Ascension Illinois spokeswoman did not comment on the specific concerns, but Ascension said on its website: “Caring for our patients remains our highest priority. We understand there may be concerns, but our workforce is well trained in providing patient care with established downtime procedures.” Downtime procedures include moving to pen and paper for tasks, including dispensing medication, inputting medical records and ordering tests, Ascension said on its website.

Ascension also placed Ascension Alexian Brothers-Elk Grove Village hospital on ambulance bypass — meaning ambulances were told to bring new patients elsewhere — for about 14 hours following the attack.

Hospitals can also face serious financial consequences after a cyberattack. Last year, one rural Illinois hospital — St. Margaret’s Health-Spring Valley — closed its doors after a cyberattack. Hospital leaders blamed the facility’s demise partly on the COVID-19 pandemic, the cost of agency nurses and a “computer hacking” that damaged its ability to bill for its services, in a document submitted to the Illinois Health Facilities and Services Review Board.

In some cases, hospitals also face lawsuits from patients who sue following cyberattacks. At least two people have already filed lawsuits against Ascension in the days since it announced the cyberattack. Ascension Saint Mary-Chicago patient Katherine Negron filed a lawsuit seeking class-action status in U.S. District Court for the Northern District of Illinois on May 12, alleging Ascension failed to safeguard patients’ personal information, putting them at greater risk of identity theft and fraud following the data breach. Another lawsuit was filed in federal court in Texas.

Cybercriminals hope that the consequences of attacks on hospitals are so severe that hospitals will give them what they want. Ascension has confirmed that the cyberattack on it involved ransomware, which is a type of malware that encrypts files in a system, rendering them unusable unless the owner pays a ransom.

The FBI and the National Cybersecurity Alliance don’t recommend paying ransoms in ransomware attacks. But some health care organizations, desperate to get back to normal operations, pay the ransoms.

UnitedHealth Group confirmed that it paid a ransom to the perpetrators of the cyberattack against Change Healthcare earlier this year — an attack that made it difficult for providers to get paid by health insurance for services. The CEO of UnitedHealth Group told lawmakers that the company paid a $22 million ransom. UnitedHealth Group said the attack cost it nearly $900 million.

Nearly 12% of 229 cybersecurity professionals who responded to a 2023 Healthcare Information and Management Systems Society (HIMSS) Healthcare Cybersecurity Survey said their organizations experienced ransomware attacks in 2023. About one quarter of those people said their organizations paid the ransom.

Part of the reason health care has become a popular target for ransomware and cyberattacks in recent years may also be because health care was slower than some other industries, such as the financial industry, to prioritize cybersecurity, said Lisa Plaggemier, executive director of the National Cybersecurity Alliance.

The health care industry spent years focused on simply putting modern systems, such as electronic health records, in place, Shehata said.

“Health care, as an industry, is also likely going to have to catch up to some industries that have been in this automated world a little longer,” Shehata said.

The health care industry has, however, slightly increased its spending on cybersecurity recently. For a time, health organizations tended to spend 6% or less of their information technology budgets on cybersecurity, said Lee Kim, HIMSS senior principal of cybersecurity and privacy. They’re now spending, on average, at least 7% or more on cybersecurity, according to the 2023 HIMSS survey. Nearly 58% of respondents to the HIMSS 2023 survey said they expected their cybersecurity budgets to increase in 2024.

Health care providers still don’t spend as much as other industries, such as banking and financial services and software publishing and internet services, according to Gartner, a global research and advisory company.

But health care leaders recognize that cyberattacks are a problem, and they’re not going away. If anything, health care systems must now figure out how to adapt their cybersecurity defenses to deal with new technologies, such as artificial intelligence, experts say.

“Health care is one of the very few industries where pretty much everyone is impacted when a cyberattack happens,” Kim said.

Under current law hospitals must promptly report allegations of patient abuse, including sexual abuse by a health care worker, to the Illinois Department of Public Health, triggering an investigation into the hospital’s handling of the matter. But allegations of patient abuse that occur at doctors’ offices or clinics outside of hospital walls, even those connected with hospitals, are not currently required to be reported to the state’s health department.

“This is just a simple commonsense fix to make clear that hospitals have responsibility for providers at any of their facilities,” said Illinois Rep. Kelly Cassidy, D-Chicago, who is behind the legislation. “It kind of falls into that category, do we really need to tell somebody out loud that that’s what we expect of them? Apparently we do, so we are.”

Earlier this year, a Chicago Tribune investigation revealed that several well-known health systems allowed workers accused of sexually abusing patients to continue providing care. In several instances, those same health care workers were then accused of abusing additional patients.

In one of the most prominent cases in the state, former Endeavor Health gynecologist Dr. Fabio Ortega has faced lawsuits from more than 60 patients accusing him of sexual assault or abuse. In October 2021, Ortega pleaded guilty to aggravated criminal sexual abuse of two patients following incidents that occurred at two Endeavor-affiliated offices. Many of the alleged incidents described in the lawsuits occurred at hospital-affiliated facilities where the doctor regularly practiced. In the suits, the women accuse the health systems where he worked of failing to protect them.

The Tribune reported on the pivotal role Endeavor, formerly NorthShore University HealthSystem, played in keeping the doctor in place despite multiple complaints from patients.

Cassidy said the bill directly addresses what happened with Ortega.

“This is literally closing the most egregious loophole with the understanding that there is a lot more to do here,” Cassidy said.

Tamara Holder, an attorney who represents most of the women who have sued Ortega and Endeavor along with her co-counsels Johanna Raimond and Stephan Blandin, said the bill is a good start, and will help force “health care institutions to listen to women.” Holder and her co-counsels also helped work on the bill.

“This is important because women spend most of their time receiving gynecological and obstetrical care in a clinic, not in a hospital setting, and the Ortega case and other cases across the country show that most of the abuse does occur in a clinical setting or in an office setting because that’s where doctors have more privacy and alone time with patients,” Holder said.

The Illinois Health and Hospital Association also collaborated on the bill. “The hospital community condemns any form of patient abuse, and supports reporting requirements to protect patients and ensure governing bodies are aware of these incidents,” association spokesperson Amy Barry said in an emailed statement.

Endeavor Health said in a statement Thursday it “is grateful for the good faith efforts of Illinois lawmakers and the hospital community regarding proposals for reporting parity between hospitals and wholly owned external sites” and it will “continue to evaluate the implications of any changes to Illinois law on our patients and staff.”

Sen. Karina Villa, who leads the Illinois Senate Public Health Committee, said she plans to be a sponsor of the bill when it reaches the Senate. She said hospital affiliates shouldn’t be exempt from having to report allegations of abuse. Citing the Tribune’s findings, she called the new legislation “a positive start” and said there’s more work to be done in future legislative sessions.

The Tribune’s reporting also identified several failings in state oversight, including gaps in state laws and slow action by the state agency responsible for disciplining health care workers that resulted in some doctors and other workers accused of abuse continuing to provide patient care for months or years. When hospitals failed to report patient allegations of abuse, they appeared to face few consequences from the state, the Tribune found.

Cassidy said she plans to discuss measures to address accountability in the summer.

But when her primary care doctor recently suggested a new blood test to help look for signs of the disease, Harris was intrigued. She had her blood drawn the same day, in the same building as her doctor’s appointment.

“It was something that was accessible at the moment, so it was like, ‘Sure, let’s go ahead and do that and see how the results are,’” said Harris, 67, of Pekin. Harris, who is a longtime smoker, said if the results are positive, she’ll get a low-dose CT scan next to screen for the disease.

“Science just keeps moving forward,” she said.

Harris is among the first group of patients in Illinois to get the blood test as part of a pilot program at health system OSF HealthCare, which is offering the test at 18 locations. OSF leaders hope the blood test will improve early detection of lung cancer, which kills more people in the U.S. than any other single type of cancer.

OSF’s adoption of the blood test is part of a growing movement in medicine to use less invasive screenings to look for signs of cancer in patients, especially patients who may be reluctant to undergo more traditional, involved tests. A number of blood tests to help detect various types of cancer are now in development, according to the University of Texas MD Anderson Cancer Center. Some health systems, such as OSF, are starting to offer the blood tests to patients, while others are waiting with cautious optimism for more long-term data on the tests.

“This is the future,” said Dr. Jared Meeker, a pulmonologist at OSF, said of the new blood test.

The blood test being used at OSF is not meant to replace a low-dose CT scan, which involves lying on a table that slides in and out of a type of X-ray machine.

The FirstLook Lung blood test, developed by Delfi Diagnostics, based in California and Maryland, cannot diagnose lung cancer. But doctors hope that patients who might not want a CT scan – perhaps because it would require too much time, travel or effort – will consent to undergoing the blood test. If the blood test comes back positive, indicating a possibility of lung cancer, OSF leaders hope patients will then be more likely to agree to a low-dose CT scan.

The U.S. Preventive Services Task Force recommends that people at higher risk of developing lung cancer get low-dose CT scans annually. Higher-risk patients are those who are between the ages of 50 and 80 who have been moderate to heavy smokers, who are current smokers or who quit within the past 15 years. But only about 4.5% of those people actually got low-dose CT scans in 2022, according to an American Lung Association report.

“If everyone who was eligible for low-dose CT scanning was having it already, our test wouldn’t be helpful,” said Dr. Peter Bach, chief medical officer at Delfi. “The problem we have is they’re not, so what we’re trying to do is accelerate the conversations between them and their doctors about low-dose CT and inform them.”

The blood test works by looking for patterns of DNA fragments in the blood that could indicate lung cancer. If a person has lung cancer that would be detectable on a low-dose CT scan, there’s an 80% chance the blood test will come back positive, while if the blood test is negative, there’s a 99.8% chance the person does not have lung cancer, Bach said.

Delfi is seeking approval of its test from the U.S. Food and Drug Administration, which in recent weeks announced it plans to more tightly regulate laboratory developed tests. Until now, it’s primarily been the Centers for Medicare & Medicaid Services regulating laboratory testing. Delfi says the blood test has breakthrough designation from the FDA, which is a designation meant to help speed up the development, review and assessment of certain devices and products.

The blood test is not covered by health insurance, and Delfi declined to give a price. OSF leaders say they are still working out the pricing but are aiming to make the test as accessible as possible to patients. Neither OSF nor Delfi would say whether patients now undergoing the test at OSF are being charged. Low-dose CT scans are covered by health insurance.

Blood tests made by other companies to help detect cancers have list prices of about $900 to $950.

OSF doctors hope the blood test will lead to earlier detection for patients with lung cancer. The five-year survival rate for people with very small tumors that haven’t spread to the lymph nodes is 90%, but the five-year survival rate for people with lung cancer that has spread to other organs is only 7%, according to the Cleveland Clinic.

“No one wants to diagnose Stage 3 and Stage 4 lung cancer,” Meeker said. “It’s devastating.”

Patients might not always fully understand the implications of late diagnosis, said Dr. Tim Vega, chief population health officer at OSF.

“People think, ‘I’m smoking, if I get it, I’ll just check out very quickly,’” Vega said. “They don’t realize it could be years of difficulty for them and their families.”

At OSF, about 33% of eligible patients already receive low-dose CT scans — far better than national numbers — but still not as high as doctors would like, Vega said.

OSF leaders are looking toward the success of Cologuard as a model of how the new blood test might help patients. The U.S. Food and Drug Administration approved Cologuard about 10 years ago as an at-home screening test for colon cancer. Patients mail a stool sample to a lab, which then analyzes it — a much quicker and less invasive task for patients than undergoing a colonoscopy.

As with the Delfi blood test, a positive result from Cologuard is not a cancer diagnosis, but means a person may have it and needs further testing. OSF started offering Cologuard to patients a few years ago and found that when patients get positive test results, they almost always agree to have a colonoscopy next, Vega said.

OSF isn’t the only health provider with high hopes for the blood test.

The White House recently noted, in an announcement about President Joe Biden’s Cancer Moonshot, that Delfi is working with the Indigenous PACT Foundation to improve lung cancer screening among American Indian tribes in the Pacific Northwest. Delfi is also working with City of Hope on a clinical study, funded by the American Cancer Society, to improve lung cancer screening in underserved Los Angeles County communities.

Doctors are keeping an eye on other types of blood tests as well, watching how they perform. Companies Grail and Guardant Health also offer blood tests to help detect various types of cancer.

University of Illinois Cancer Center is now involved in a clinical trial to help study Grail’s blood test, which screens for a cancer signal shared by multiple cancers.

“I still think that we have a long way to figure out how these types of tests fit into the broader context of cancer prevention and screening, but it’s very exciting,” said Dr. Ameen Salahudeen, an assistant professor of medicine at University of Illinois Chicago, a member of the UI Cancer Center and an investigator in the trial, which is sponsored by Grail. “I never want to see someone with advanced cancer that could have been caught sooner, so personally, I believe that tests like these will have a role in the future.”

Dr. Rajat Thawani, an assistant professor of medicine at University of Chicago Medicine and thoracic oncologist, said such blood tests are promising, but before they’re adopted widely, more long-term data is likely needed about whether the tests can help lead to better quality and length of life for patients.

“There’s a lot of excitement in the utility of how it’s going to play out in the future, but I think right now we have to make sure it actually leads to a meaningful change in the longevity of patients,” Thawani said.

If the Delfi blood test makes a difference at OSF, leaders hope to offer it throughout the health system within a year, said Ryan Luginbuhl, OSF service line vice president for oncology services. OSF HealthCare has nearly 160 locations, including 16 hospitals, in Illinois and Michigan. Most of its locations are in central and northern Illinois, and the system includes OSF Little Company of Mary Medical Center in Evergreen Park as well as primary care, practices and urgent care centers in the Chicago area.

“We will do everything we can when we hope this proves to be effective … to get this to as many patients as possible,” Luginbuhl said.

An earlier version of this story misstated the name of the institution Dr. Ameen Salahudeen is affiliated with.

Each organization assesses hospitals using its own methodology, meaning a facility rated highly by one may carry a lower score with another. To help readers easily weigh these valuations across hospitals, the Tribune created the searchable database below using reports from three prominent sources: U.S. News & World Report, the Leapfrog Group and Medicare.gov.

Here’s a breakdown of what the ratings mean and how they’re calculated. Use the searchable database to see where each Illinois hospital ranked across the three reports.

U.S. News & World Report

U.S. News & World Report releases a list every year ranking the top hospitals overall in the state as well as across certain specialties, like cancer, cardiology, neurology and orthopedics.

For 2024, only 23 hospitals were ranked overall in Illinois. These number rankings, not including other specialties, are featured in the database below.

Leapfrog

The Leapfrog Group semiannually releases a report on hospital safety, awarding medical facilities a letter grade from A to F based on 22 measures of safety, including hand hygiene, falls and trauma, and death rates among surgical patients with serious but treatable complications.

The group recently released its spring 2024 report, which assessed close to 170 hospitals across the state, scoring approximately 110 of them. The remaining locations were given an “NG” grade to indicate they were not graded by Leapfrog.

Medicare.gov

The federal health insurance program publishes two rating metrics: an overall star rating, based on how well a hospital performs across five categories, and a patient survey rating, which comes from surveys given to patients about their care experience.

For the database below, the Tribune used the hospitals’ overall star rating. Medicare calculates that rating using factors such as death rates, safety of care, readmission rates, patient experience, and timely and effective care. Hospitals can receive between one to five stars, based on how well they performed compared with other U.S. hospitals. The more stars, the better the hospital scored across those five areas. In instances where Medicare did not evaluate a medical center or there was not enough data available to give an overall star rating, the entry will read “not available.”

Search the database to see each medical facility’s rating and compare Illinois hospitals.