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Nursing Home Guidelines for Care: Is it Negligence?

Written by kwmlaw on . Posted in Kelly & West News.

Nursing homes are hitting the news this year, including a case of abuse here in Lillington. As people read about this and as our population ages, more people are asking about long-term care facilities. According to the CDC, more than 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year. Nearly one million people live in assisted living facilities.

Questions often lead to more questions: after all, what is a nursing home compared to another type of facility? We’ve talked about the signs of nursing home abuse and also what you can do about it. But if you’re caring for your parents or loved ones, you should also know more about the laws for nursing homes versus other types of care facilities.

What is a Nursing Home?

There are many types of long-term care facilities. Here are some definitions, according to the National Institutes of Health.

● Board and Care Homes – Also called residential care facilities or group homes, these are small private facilities. Most have 20 or fewer residents, who receive personal care and meals, but no medical or nursing care.
● Assisted Living – This type of home is for those who need a bit more help, but not full care. Many offer different levels of care. Residents here usually live in their own apartments or rooms. Assisted living homes offer meals, assistance with personal care, help with medications, housekeeping, and laundry. They also offer supervision and social and recreational activities.
● Nursing Homes – A nursing home or skilled nursing facility provides a broad range of health and care services, with a strong focus on medical care. They may also offer physical or occupational rehabilitation or speech therapy. Some people live in a nursing home for a time after a hospitalization, getting extra care, but then go home. Other residents are permanent, requiring daily help and supervision.
● Continuing Care Retirement Communities – You might hear these called life care communities. These homes are a type of assisted living, with independent apartments for most residents, social activities, and some help when needed. Most CCRCs have a nursing home on site for those who need to move later in life.

Nursing Home Care
Photo by Matthias Zomer from Pexels

Some Nursing Home Guidelines

One thing to know about nursing homes, in particular, is that they are not allowed to discharge people except in limited circumstances. Nursing homes are also expected to maintain a standard of health care. Breaching these care guidelines can be considered negligence — something you can take legal action against if it occurs.

If you suspect abuse at a Lillington nursing home or Harnett County nursing home, contact us for help.

What You Can Do about Nursing Home Abuse

Written by kwmlaw on . Posted in Kelly & West News.

More than 7 million people over the age of 65 required long-term care in 2014. In 2015, almost 1.4 million of these people were in a nursing home. A nursing home offers the most extensive care a person can get outside of a hospital.

While most nursing homes offer excellent care, some residents suffer abuse or neglect while living there. Abuse is intentional infliction of injury, physically or mentally, while neglect refers to a failure to provide a person with the care and services necessary to ensure freedom from harm or pain. This problem hit the news in Raleigh earlier this year, when someone put a camera in her father’s room, catching the staff treating her father poorly. Another case of mistreatment at a facility owned by the same group was just reported here in Lillington, NC.

If you feel uneasy about your loved one’s care, here are some signs of abuse or neglect at a nursing home.

  1. Outward signs of physical or emotional abuse. Examine your loved one for outward signs of physical abuse. Check for bruises, pressure ulcers, and cuts on the skin, especially in places that aren’t readily visible. Emotional symptoms of neglect and abuse can be a bit more difficult to detect. Watch for changes in behavior. Your loved one may become withdrawn or less apt to speak. Watch for sudden changes in appetite or sleep. These could all be a result of being spoken to in a condescending way.
  2. Lacking in personal hygiene. A big part of nursing home care is daily hygiene, brushing teeth, brushing hair, bathing, clipping nails, and more. If care facilities are understaffed, these things can go undone. Some nursing home residents cannot manage these tasks on their own. Lack of hygiene is a form of neglect.
  3. Dirty living spaces. Cleanliness is imperative to avoid diseases and sickness. Check if their sheets and room are clean. Check to make sure their clothes smell fresh. If any of these things are lacking, your loved one could be suffering from neglect. These unsanitary conditions could be detrimental to their health.
  4. Staff. Although most of the time you should check your loved one for any issues, sometimes the answer lies among the staff. Monitor the people caring for your loved one. If they seem unhappy or if things are always chaotic, you may have a reason to worry. Also, watch for constant staff turnover and make sure staff know who your loved one is. If your loved one says that they don’t want to be cared for by a certain provider, you may want to look into why.

What You Can Do if You Suspect Nursing Home Abuse

  • Drop by unannounced. If you suspect problems, stop by to see your loved one at spontaneous times, and assess how the care compares each time. If you’re there more often, you can get a better feel for the type of care your loved one is receiving.
  • Ask questions. If the staff doesn’t answer you or deflects the question, it may be a sign that neglect or abuse could be happening. When staff aren’t around, ask your loved one questions about the care and how they feel.

A Note About Cameras

It may be illegal in North Carolina to use a camera to spy on staff. Speak to your lawyer about this issue if you have questions.

Steps to Report Nursing Home Abuse

If you don’t feel your loved one is in imminent danger, talk first with the person administering hands-on care. If things don’t change, speak with the floor supervisor, and then the home administrator.

However, if things still aren’t getting better, contact the North Carolina ombudsman. The ombudsman office handles customer complaints for government-regulated agencies. You can also file a complaint with the NC Division of Health Service Regulation.  You may also file a complaint with your local Department of Social Services. DSS will do an investigation and can fine the nursing home if they find they are not compliant with the laws and regulations.

Keep open communication with both your loved one and the staff at his/her nursing home. Feel free to contact us for questions and help with elder law and nursing home abuse.

How to Protect Your Assets When You Go Into a Nursing Home

Written by kwmlaw on . Posted in Kelly & West News.

If you have to move into a nursing home or another type of assisted living facility, who will pay the high costs for care? Will you be able to keep any of your money to leave to your family? Or will the government take everything you have?

These questions and many others are often asked by clients who are concerned about their future. The average cost of nursing home care is approximately $6,300 per month. That means even if you have assets, you might be spending through them very quickly — especially if you end up staying in the facility much longer than expected — so proper planning is crucial.

Why Protect Your Assets

In North Carolina, generally speaking Medicaid will pay for nursing home care if you “spend down” your assets so that your “countable assets” do not exceed a house, car and $2,000 in the bank. Once you have met the threshold test, Medicaid will pay the difference between your income and the facility rate for care.

At Kelly & West, we work with clients to design a plan to protect your assets. By making your “countable assets” “non-countable assets” we can work to make sure what you own is not counted by Medicaid and that you qualify for government assistance. For example, you may be allowed to have up to $40,000 in government bonds and these bonds be considered “non-countable assets” or you can use your money to prepay for your funeral arrangements, as long as you have a plan that complies with Medicaid’s rules and regulations.

Photo credit: LendingMemo via Visualhunt / CC BY
Photo credit: LendingMemo via Visualhunt / CC BY

Who Will Qualify?

Not everyone will be able to qualify for Medicaid. People with IRAs, stocks, bonds, and other money might not be able to spend down or move it all to a non-countable form in order to qualify.

Also, some people might qualify, but might not want to do this. Many people prefer not to rely on the government for their care, especially since they may receive better care by privately paying for it.

Those who have paid for long-term health care insurance also may not want to obtain government assistance. If insurance is covering the cost of your care, this may leave your assets intact and available to pass to your family. But be careful, not all long-term care insurance contracts provide enough to cover the costs of care. Or, if you have a “traditional” long-term care policy, this could just mean that you are only saving the government money as this would just be considered income to you and may not help you as much as you think.

Make a Plan Now

A lot of people thinking about a nursing home are in their mid-60s and are likely still too young to want that type of care just yet. However, buying long-term care insurance at that age means paying a much higher premium. That’s why many people come to us and discuss these options early. We can develop a plan of action now for when the time comes later. We are happy to talk to you to discuss your options as this can be a great relief to you and you can end up saving your family quite a bit of money, time and headache in the future if you have a plan in place.