By Suzanne Paolucci, LCSW
I was deeply saddened by the recent news of a Medford nursing home being accused of stealing $60 Million dollars of Medicaid funds that were supposed to be used to provide staffing and care to its frail residents. I am saddened not only for the families that entrusted these professionals to provide the care and ended up having to endure the pain of watching their loved ones be neglected while they were at their most vulnerable, but I am also saddened by the potential of this news tarnishing the view of all the hard working professionals who dedicate themselves everyday to what I believe to be one of the hardest professions imaginable. Above all, this incident highlights the great importance of our frail elderly needing advocates to insure their rights are protected and that they are always treated with dignity and respect. As an advocate, I hope to shed light below on what actions family members can take if they suspect mistreatment at a facility.
For those not familiar with the events that transpired at The Medford Multicare Center, Newsday recently brought this incident to light. In brief, the owners of this facility were accused of allegedly siphoning off millions in public funds that were to be used for care of its residents but instead were taken to fund exorbitant salaries. Despite these large salaries, Newsday claims the facility neglected to provide adequate staffing and care. This lack of care resulted in residents being neglected and injured. All in all, 17 licensed and certified workers are being charged with neglect and the falsification of records. Furthermore, over the past six years there have been over 5,000 reported incidents and accidents resulting in injuries including the death of one resident who was not properly connected to a ventilator. Please click on this link for the full article.
http://www.newsday.com/long-island/suffolk/ag-60m-looted-from-medford-nursing-home-patient-s-death-cited-1.7029887
Advocating for a loved one in a nursing facility is not an easy task. It is never easy to challenge or question the medical profession. After all, these are professionals and they should know what they are doing! In my years of advocating alongside families, the biggest fear a family member will present to me is that they fear their loved one will suffer retribution by receiving poor quality care or even be evicted from the facility if they were to make a complaint. I truly believe this fear, along with not knowing where to turn for help, often keeps families from properly advocating for the better care of their loved one. It is due to this hesitancy that I felt it very important to convey some important information which I hope will help family members and residents avoid experiencing neglect or mistreatment.
Advocating Tips
1. Know Your Loved One’s Rights
Every nursing facility resident has rights and these rights are to be made available by the facility to its residents. I wanted to highlight a few very important rights that speak to the issue above and hopefully will empower families to take action if they feel neglect and mistreatment is present:
All Residents have the right to:
• “be treated with Dignity and Respect”;
• “be free from verbal, sexual, mental or physical abuse, corporal punishment and involuntary seclusion, and free from chemical and physical restraints except those restraints authorized in accordance with nursing home minimum standards; this includes but is not limited to doctor’s orders, specified time periods, close monitoring, periodic re-evaluation of need, conferring with a family member or designated representative and documentation in the record”;
• “action for damages or other relief for deprivation or infringement of your right to adequate and proper treatment and care”;
• “receive information for agencies acting as resident’s advocate and be given the opportunity to contact these agencies”;
• “right to voice grievances without discrimination or reprisal”;
• “prompt resolution of your grievances including those with respect to the behavior of other residents”;
These rights can be found at the New York Department of Health website:
http://www.health.ny.gov/facilities/nursing/rights/docs/your_rights_as_a_nursing_home_resident.pdf
2. Visit Frequently and Know the signs of Abuse and Neglect
Visit your loved one at different times of the day. By doing so you can observe how care is being performed at different shifts. For example, if your loved one is always clean in the morning but is unkempt or smells of urine in the late afternoon, it could indicate that there is not enough staff present to attend to your loved one’s needs.
Signs of possible abuse and neglect include:
Physical Abuse – can include unreasonable physical restraint, deprivation of food and water, giving too much medication, or not enough medication, unexplained injuries, forcing an older person to stay in a room.
Neglect – lack of care for existing medical problems, disregard for activities of daily living, poor hygiene that includes smelling like urine or feces, bad breath, matted hair, dirty clothes, poor dental hygiene, cuts and bruises which could indicate falls and may indicate inadequate supervision, sores on neck, back, buttocks, heels or elbows which may indicate your loved one is not being properly re-positioned if bed-bound.
Verbal/Emotional Abuse- Humiliating, insulting or threatening behavior , or ignoring behavior toward family and friends.
To learn more about abuse call the NY State Office of Children and Family Services at 518-473-7793 or visit www.ocfs.state.ny.us/main/psa or visit The National Center on Elder Abuse’s website at www.ncea.aoa.gov.
3. Discuss Your Concerns
This is perhaps the hardest part for most families as they do not want to come across as complainers or problem-makers. Often families will keep it to themselves and wait until the issue blows up or the condition unfortunately worsens for their loved one. I advise families to report all concerns first to the Nurse in Charge and or the Social Worker with the hope the issue will be resolved as quick and satisfactorily as possible. I recommend that families keep a log of who they spoke with, the date and time they reported the incident, and what the feedback or resolution they received from the staff was.
Oftentimes, the issue will be resolved as most facilities and staff do want to do what is in the best interest for their residents. If the problem persists, these are the steps I often recommend for our clients:
1. I would request a formal Care Planning Meeting. This meeting will afford the resident and family an official opportunity to sit down with staff to address their concerns and questions. Care Planning meetings are generally held at the beginning of a resident’s admission and usually once a year thereafter, however, a family or resident can request a meeting at any time. I generally will request a formal Care Planning meeting for our clients if there are two significant changes in a clients condition or there are repeated issues with care that are not getting resolved.
2. If there is no resolution to an issue after a formal Care Planning meeting, I would then recommend alerting the Administrator of the facility in writing with the concerns at hand. I would recommend letting the Administrator know what steps were taken, (i.e. alerting the Nurse in Charge, requesting a care planning meeting), to try to rectify the problem. If there is still no resolution to the situation, a family may want to enlist the help of an advocate.
3. The Long Term Care Ombudsman Program (or LTCOP) is a federal advocacy program dedicated to protecting people living in long term care facilities. Each facility has a designated Ombudsman and they are there to assist in advocating for the rights of their residents. To find your local Ombudsman, you can follow this link: http://www.ltcombudsman.ny.gov/whois/directory.cfm. Each facility is required to have the name and number of the assigned Ombudsman posted in an easily identified location for all residents and families to see. Oftentimes, a sign will be posted by the elevator.
4. Finally, if you remain unhappy with the care your loved one is still receiving or you witness an incident of neglect or abuse the facility, then you can make a formal complaint to The New York State Department of Quality and Surveillance of Nursing Homes. This call can be anonymous. All complaint and incidents received about nursing homes are reviewed by the Department through the Centralized Complaint Intake Unit with appropriate action taken. The investigation will determine whether a facility has failed to meet federal and/or state requirements. In cases where the Department determines the nursing home has violated certain regulations, then the Department will issue a citation to the nursing home. The facility must then submit a plan of correction that is acceptable to the Department and correct the deficient practice.
To make a complaint about a Nursing Facility in New York State contact
Tel: 1-888-201-4563
To make a complaint about an Adult Care Facilities in New York State contact
Tel: 1-866-893-6772
As I stated in the beginning, providing care for our loved ones can be very difficult work and most facilities do a good job at doing so. However, as with all of life, sometimes the bad things can occur. If they do, it is important to be empowered with the appropriate information and action steps so that you can best advocate for your loved one.
Suzanne Paolucci, LCSW, is the Elder Care Coordinator at Tully Law, PC, and elder law firm with offices in Melville, NY.
