New rule protects nursing homes and promotes secrecy

The Washington Post had an article about the Bush administration's rule to stop a source of information about abuse and neglect in long-term care facilities that are crucial to finding answers.

The rule designates state inspectors and Medicare and Medicaid contractors as federal employees, a group usually shielded from providing evidence for either side in private litigation.  The new rule, which was issued in September, generally prohibits state health departments and contractors from participating in private lawsuits involving facilities that are in the federal assistance program without approval by the head of the Department of Health and Human Services.

The restrictions affect about 16,000 nursing facilities and 3 million residents in the United States. The practical effect is to force families to go to greater lengths, including seeking court orders, to get inspection reports or depositions for cases they are pursuing.

The change, which affects the $144 billion nursing-home industry, was enacted with no public notice or attention.

"This change hurts nursing-home residents and their families by allowing bad practices to be kept in secret by nursing homes and inspectors," said Eric M. Carlson, an attorney with the National Senior Citizens Law Center in Los Angeles. "Government inspectors have the right to go into nursing homes and investigate, and they learn things that residents and families otherwise could never find out."

The effect of the directives has started to play out in the nation's courtrooms. Requests for information, once fairly routine, now are stalled between state and federal officials.

 

Are nursing home inspections worth doing?

 I have read several articles recently about how some cities like Cincinnati may stop conducting nursing home inspections.  That is fine with me since most inspectors in South Carolina are so overworked and underfunded that the inspectors don't have the time and resources to properly insure that the nursing home is properly caring for the residents. 

Typically, the nursing homes know when they are coming and improve conditions before the inspectors get there.  We hear countless stories from ex-employees of nursing homes in the area that all repeat the same chorus.  "They increase staff and clean everything when they know the survey team will be coming in". 

I have not seen any complaints substantiated or any fines incurred against any of the for profit nursing homes. The inspectors in South Carolina seem to ignore violations, and the concerns of residents and family members. Instead, they criticize the county run nursing homes or the charitable organizations that run the mom and pop nursing homes.  I can't tell if it is corruption or incompetence but certainly the inspection program in South Carolina isn't doing anything to provide better care or oversight for the residents.

Below is a summary of a story by Dan Horn about Cincinnati dropping nursing home inspections

The Cincinnati Health Department is considering whether to drop its inspection program for nursing homes and residential care facilities. Budget cuts and retirements could soon leave the department unable to keep up with annual inspections. Cincinnati is the only city in the state that does its own nursing home inspections, a policy that city officials have said allows the city to react more quickly and aggressively to problems.   He said the program once operated with six inspectors and supervisors, but that number fell to four by the start of this year. Another retirement will drop the total to three employees by this fall.

 

 



 

Poliakoff & Associates, P.A., is one of South Carolina’s most respected and distinguished law firms. The Poliakoff firm began nearlyMore...