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What's Your Question About Nursing Homes?
By Kathy Gannoe - February, 2009
Question:
My fiancé just placed her grandfather in a nursing home. He has Alzheimer’s Disease. Three hours later they told her to come and get him because he was “a danger to himself and others”. She went and got him. Can they do that?
Answer:
It’s too late now, but she shouldn’t have gone to get him! Upon admission, a nursing home resident has some very specific rights. Among those rights are some related to involuntary discharge. First of all, the facility has to provide written notice of the discharge specifying the reason for the discharge, the date of the discharge, the place to which the person will be discharged, and the full information about how the resident can appeal the discharge. The circumstances you relate obviously don’t meet these federal and state requirements.
Question:
They said that they weren’t equipped to take care of him. They said that since he has dementia he needs a specialized nursing home. Does that make a difference?
Answer:
All nursing homes are licensed to provide the same level of care. A nursing home may choose to cater to one type of resident or another but they cannot say of a resident who lives there that they are “not equipped to take care of him” and that the resident needs to move to the nursing home down the road. Federal and state laws require a facility to assess the needs of a resident and to develop a plan of care to meet those assessed needs. Some nursing homes market themselves as “special facilities”. If they do this, they must be able to demonstrate what they do that is special and what extra training their staff has had which makes their care special. A specialized facility may be a plus but, if a resident wants to remain in a certain nursing home, that home must provide for his assessed needs and not just shuffle him off somewhere else.
Question:
Well, what exactly is a specialized unit?
Answer:
To really be “special” the facility must provide an area where the environment is adapted to the special needs of dementia victims. Staff should have extra training in how to handle the challenging behaviors which occur during the progress of most dementing illnesses. There should be accommodations made in meal times, activities, social services, and schedules; accommodations which take into account the changes dementia causes in elders. Staff to resident ratios should be low and staff should be closely assisted by a variety of professionals.
Note: a locked door and a sign do not make a specialized unit.
Question:
Well, this nursing home said they didn’t have a special unit and that’s why they sent her grandfather back home. What do we do now? He needs a nursing home and they wouldn’t let him stay.
Answer:
The nursing home violated the law and should be reported to the Office of Inspector General at 502/564-2888. Your fiancé can contact the local Ombudsman for help. The local Social Services office should help the grandmother, as well. They are in the phone book under Department for Social Services. Another resource is the Alzheimer’s Association. They have tons of information and may be able to steer you to a support group. Their number is: 1/800-272-3900.
Question:
A social worker I talked with said that her grandfather has special needs and that she needs to move him to a nursing home in Ohio where they have specialized facilities. Is this the only possibility?
Answer:
Absolutely NOT!!! Here’s the deal. Ohio is experiencing an extreme dip in nursing home occupancy and owners are trying to filltheir beds. Let me tell you —a nursing home is a nursing home is a nursing home. The regulations and requirements are the same in every state of the union. If a person’s needs can be met in Ohio, they can be met in Kentucky. Our experience is that some nursing homes promise the moon to families in Kentucky facilities and then give the exact same care to the residents that they would/should be getting in Kentucky. This may not always be the case, some Ohio facilities may indeed provide special services. And, if you live on the border of Ohio and the Ohio nursing home is really close, it might not make any difference. But to take a person from the middle of the state and move them to the middle of Ohio in the hopes that the Ohio nursing home is somehow special is wrong.
This column is presented as a public service of the Nursing Home Ombudsman Agency of the Bluegrass. If you have a question, send it to:
Kathy Gannoe
Nursing Home Ombudsman Agency
1530 Nicholasville Rd.
Lexington, KY, 40503