Avoid Mandatory Arbitration
By: Michael Monheit, Esq.
Do Not Agree to Mandatory Arbitration Clauses. They Limit Your Rights!
Before signing on the dotted line, ask about the mandatory arbitration clause or dispute resolution mechanism. This clause strips you of your rights to ever retain a lawyer in order to file a lawsuit. While the process of voluntary arbitration is not a bad idea, mandatory arbitration is more restrictive and there’s nothing voluntary about it.
In an industry that is deemed responsible for the care of those who cannot care for themselves, nursing homes should be exposed to more public scrutiny not less. Mandatory arbitration allows nursing homes to become less accountable in the eyes of the law when they are exempt to exposure of grievous practices and nursing home abuse.
Most consumer groups oppose mandatory binding arbitration clauses because arbitration does not follow clear, well-established, consistent rules and procedures such as those required for litigation in the court system. Consumers may have difficulty getting necessary information to support their claims. Nothing requires arbitrators to take the law and legal precedent into account before making their decisions although they are supposed to do so. Most decisions cannot be appealed, and there are generally no review bodies or other oversight to ensure that arbitrators follow fair procedure or the law. The nursing home picks the arbitrator.
Patients’ Rights
According to Medicare, nursing home residents have patient rights. Patients must receive a copy of their rights which include: t he right to be treated with dignity and respect; to be informed in writing about services and fees prior to entering the nursing home; the right to privacy and to keep and use your personal belongings and property as long as it doesn't interfere with the rights, health, or safety of others; and the right to be informed about your medical condition, medications, and to see you own doctor. You also have the right to refuse medications and treatments. How they are enforced is another story entirely.
What Should You Know Before Placing Your Parent in a Nursing Home?
The time has come. Nobody is ever ready to take that step but there seems to be no viable alternative. It’s time to place your mother or father in a nursing home. The doctors, the social workers, your siblings and other family members say the time is right – so why do you have a pit in your stomach and a feeling of dread in your heart?
You’re satisfied with the cheerfully painted walls and pretty landscaping. But before signing on the dotted line, you must educate yourself about what rights you and your parent have while in a nursing home.
The nursing home industry is a big profitable business where patient care decisions are based on the facilities bottom line. You and your family may be paying the bill or part of the bill for your parent’s care or Medicare or Medicaid may be paying the bill. Somebody is paying the nursing home for care.
What happens if you are unhappy about the care received? What happens if you find their care sub-standard or worse -- negligent? What happens if your parent shows signs of physical or emotional abuse?
What can you do to fight back and make wrongs right?
Nursing Home Regulations
Nursing homes that receive Medicare and Medicaid federal funds must comply with federal legislation which calls for a high quality of care. Though all states must comply, at a minimum, with the federal regulations, some states have adopted tougher laws.
Nursing homes must adhere to a list of compliances such as:
Initially conducting a comprehensive and accurate assessment of each resident's functional capacity; from developing a comprehensive care plan for every patient to having an adequate number of staff to carry out the compliances.To maintain good grooming, nutrition, and personal oral hygiene to prevent the deterioration of a resident's ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to communicate.To ensure patients do not develop bed sores or pressure sores; to receive proper treatment and assistive devices to maintain vision and hearing abilities;To ensure that the resident receives adequate supervision and assistive devices to prevent accidents.To ensure that the resident has the right to choose activities, schedules, and health care.Are eligible for pharmaceutical services.Are free of any significant medication errors.To provide appropriate treatment and services to incontinent residents to restore as much normal bladder functioning as possible.To maintain accessible records for each resident;To administer in a manner that enables the nursing home to use its resources effectively and efficiently.To maintain dignity and respect of each resident and to promote each resident’s quality of life.
Basic regulations and laws are in place but how they are enforced?
Before placing your loved ones in a nursing home, do your research, visit many homes and pop in unexpected not just during their scheduled times, and don’t hesitate consulting elder care experts and get referrals from friends and family who you actually know.
Nursing Home Abuse
Nursing home abuse is a broad topic of actions that revolve around neglect and negligence. Some but not all examples include fall injuries, bedsores, failure to receive the proper medication on schedule, receiving the wrong medication or injections, lack of adequate hydration or nutrition, receiving the wrong food which may cause allergic consequences, verbal abuse and threats, intentional acts by other residents and staff, and violence.
If you have a mother or father who is repeatedly infected from bedsores and is afraid to be left alone – how would it feel if you had no legal rights to fight for the wrongs committed against your loved one?
One Word: Quality
By: Amer. Assoc. of Homes and Services for the Aging
Safety
Safety is at the top of the list when it comes to finding a nursing home. Any nursing home you’re considering should have a copy of their official inspection report posted in their facility. Nursing homes are required by law to make their most recent report available to the public. Ask where it is, assistance interpreting and how the home has addressed any violations. You should also determine if a home is accredited by JCAHO, a nonprofit health accreditation organization.
Visit the Center for Medicare and Medicaid Services” Nursing Home Compare Web site, (see link below), to evaluate how different nursing homes’ performed in their annual inspections. These inspection address a variety of important safety issues, include fire safety procedures, medication errors and restraint use.
Safety is especially important if your parent is living with dementia or Alzheimer’s disease. Many nursing homes have special services and units to keep these individuals safe. Find out what makes this unit different from the main long-term unit other than the lock or alarm on the door. The unit should have a simple layout (often circular) that allows for safe wandering and that is clearly marked. The unit’s staff should be specially trained to deal with Alzheimer's and dementia residents.
Senses
Your five senses are important tools in determining nursing home quality. If you visit a nursing home, make the most of them. Look for things like residents participating in activities and see if they have accessibility to different area. Watch how staff interact with residents both in and out of their rooms. Check out the walls. Are there pictures, crafts, and memorabilia on them? Don’t forget to get of glimpse at closets, corners, shower facilities, wheelchairs and walkers.
Listen if staff members talk to residents and if they know their names. You shouldn’t hear just the television either. Keep your ear open for the sounds of residents’ voices and different activities. Touch is also an important part of quality care. Do staff members greet residents with a handshake or a hug? Do they stop to a hold their hands and listen to their concerns?
You should also smell for odors. They usually indicate either that linens aren’t being changed promptly or bedsores are not being properly treated. Don’t forget to taste the food too. Living in a nursing home may help your mom recover from a hip replacement, but it won’t do nearly as much as good if she hates the meals.
Staffing
Nursing home staffing is the best proxy to quality we have. Luckily, there is data you can use to evaluate a nursing home’s staff. The nursing home compare site includes information on resident to staff ratios, daily nursing and direct care staffing for each resident. Many homes also conduct staff satisfaction surveys. Ask to see the results. If there are high satisfaction rates, it’s likely the people working at the home there because they like the work, not just because it’s a job.
But staffing isn’t just about statistics. It’s about seeing the staff in action. Watch how the staff interact with residents. Do they yell if a resident is hard of hearing? Do they act annoyed or overworked? You answers are all important issues to consider.
The most important thing you can do is speak up. Talk to your parents about their needs and preferences. Ask friends and colleagues for tips or recommendations. And don’t forget to share your questions and concerns with a nursing home provider. It’s their job to ensure people like your loved one have a high quality of care and life.
In the end, the most important question you can ask is: “Is this a nursing home my parent and I can trust?” If the answer’s yes, you’ve found a place that provides the quality care your parent deserves.
