South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

The Hartford Courant has an article about proposed reforms in nursing homes by the Connecticut Ombudsman's office.  I wish the South Carolina Ombudsman's office would play a proactive role in protecting resident's care and preventing neglect.  Below is a summary of the article.

Connecticut's long-term care ombudsman is proposing reforms in oversight that would protect residents who complain about poor care from retaliation and encourage state agencies to monitor and evaluate the performance of chains, rather than just individual homes.

The program outlined a dozen reforms, including protections for residents who complain about poor care such as preventing nursing homes from issuing involuntary discharges to people who file complaints for at least a year following the complaint.

The ombudsman's office also wants the Department of Public Health to impose "significant sanctions" when patient-care deficiencies result in death, and to weigh "common ownership and management" as a factor in imposing penalties against corporate operators. 

The recommendations were prompted by revelations about the troubled record of one of the state's largest nursing-home chains, Haven Healthcare, which filed for bankruptcy in November and faces a federal fraud investigation. Some of the chain's 15 Connecticut homes had escaped severe sanctions despite repeated citations for serious patient-care deficiencies resulting in death. The chain also defaulted on millions of dollars in bills for supplies and services, while its owner used corporate assets for personal profit.

Democratic state senators proposed strengthening state oversight of nursing homes and boosting staff levels. 

The ombudsman's office wants to require more financial "transparency" from nursing-home corporations, including disclosures of detailed information about related business entities. Owners shield excessive profits by diverting money to related ventures without detailing those transactions.

Other proposals call on the state to more carefully review the public-health and financial records of any new owners or managers of nursing homes or assisted-living facilities, and for "improved communication" among state agencies charged with overseeing elderly care.

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Description of Federal Requirements

The federal regulation (483.12) articulates rights that the resident has related to admission, transfer, or discharge, some of the procedures facilities must follow, and records they must keep. The definition of transfer and discharge here applies to movement to a bed outside the certified facility (including differently licensed beds in the same physical plant), but does not apply to movement to a different bed in the certified facility. (Those Intra-facility transfers are discussed under 483.10, Resident Rights.)

The rules regarding transfer or discharge (a) establish the conditions under which a resident may be transferred involuntarily, including that the facility is closing, the resident has improved so that he/she no longer needs the care, the facility is unable to provide the resident with the necessary care, the resident is a danger to self or others, and the resident has failed to pay for care or (if supported by third parties, including Medicaid) has failed to have the care paid for.

The federal rule establishes expectations for documentation regarding transfers (including the reason), and written notice to the residents of at least 30 days, unless the reason for transfer is related to urgent medical needs of the resident or health and safety of others.

 The written notice must include the reasons for the transfer/discharge, the effective date, the location of discharge or transfer, the right of appeal, and notification of how to reach the long-term care ombudsman and/or the appropriate Protection and Advocacy agency in the case of individuals with developmental disabilities or persons who are mentally ill. Further, the facility “must provide sufficient preparation and orientation to residents to ensure safe and orderly transfer or discharge from the facility.”

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