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Frequently Asked Questions
Concerning Nursing Home Care
By Kathy Gannoe

Question: My sister is in an assisted living facility. They don’t take care of her like they should. Just what is an assisted living and what are they supposed to do? 

Answer:  An assisted living facility (ALF) in Kentucky is considered to be independent living. They feature independent apartments with locked doors and a private toilet and shower.  They provide 24-hour, non-professional supportive services.

Question:  What are “supportive services.”  I don’t think my sister is getting any services.

Answer:  Supportive services mean that the resident receives assistance with the activities of daily living (ADLs). These ADLs are bathing, eating, dressing, grooming, toileting, transferring, and self administration of medications.  They can also receive assistance with shopping, laundry, housekeeping and activities like that. This is all the ALF is required and allowed to provide.  And note that the words are “assistance with.”  If a person needs someone to actually do the bathing, feeding, dressing, grooming, toileting, transferring, or to give the medicine, their care needs are beyond the scope of service for an ALF. 

Question: Well, my sister can’t walk, she is in diapers, and they leave her in a chair all day long.  They told me that they could take care of her as long as she lives. Can they do this? 

Answer:   Assisted living is independent and not regulated by the state like nursing homes are.  Since the residents are considered to be living independently, if they need more care than the ALF is required to provide, they must contract with a home health agency to provide the care they need.  That’s just like anyone can do who lives in the community. The ALF must inform the client in writing about policies relating to getting additional services. If someone wants to live in an ALF and get the level of care a nursing home offers, then they have to hire outsiders to provide the care.  The ALF can’t do nursing home care. In theory, a person could be very sick and need a lot of care and still live in assisted living as long as the care is provided by someone other than the ALF staff. One problem for consumers is that this outside care can be expensive. Insurance, Medicare, or Medicaid don’t really cover this care for the long-term. When you add the cost of outside services to the cost of the ALF, people sometimes choose to skimp on their care.  This can lead to “self-neglect” which may need to be reported to Adult Protective Services (1-800-752-6200).

Question: I don’t think my sister has any outside help from a home health agency or anyone else. If she does, they aren’t doing a good job. It seems like the ALF staff is all she has. How can I make them take better care of her?

Answer:   Lease agreements (contracts) are key in this setting; only services agreed to in the contract.  An ALF may offer different levels of services but its services can’t exceed what the regulations allow. If you can, check your sister’s contract. What did the ALF say they would do for her? You might check to see if your sister is using a home health agency. If she is, you might discuss your care concerns with her agency nurse. If you think she is being neglected to the point where she is being harmed, you must (per Kentucky statute) report this to Adult Protective Services (1-800-752-6200).  If you believe the ALF is doing something wrong, the only place you can go with a complaint is to the state.  Your contact there is the Department for Aging and Independent Living at 1-502/564-6930.

Note: If you want to learn more about assisted living, check out this internet site:  http://www.ccal.org/consumers_care.htm.  You can also get more information about resident rights and nursing home care in general at www.ombuddy.org.  Check out  http://www.nursinghomeaction.org for information on a national scope.

DON’T FORGET...

MORE THAN 23,000 PEOPLE IN NURSING HOMES IN KENTUCKY NEED US. THEY ARE KENTUCKY’S "FORGOTTEN PEOPLE."



Bernie Vonderheide
KENTUCKIANS FOR NURSING HOME REFORM
Tel: (859) 312-5617