Posts Tagged ‘Nursing Home Care Issues’

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Federal Requirements for Long Term Care Facilities

Written By: Kenneth LaBore | Published On: 14th April 2018 | Category: Nursing Home Abuse and Neglect, Nursing Home Care Issues | RSS Feed
Federal Requirements for Nursing Homes and Long Term Care Facilities

Federal Requirements for Nursing Homes and Long Term Care Facilities

Federal Requirements for Long Term Care Facilities – 42 CFR 483

The federal requirements and regulations for long term care facilities also known as nursing homes are contained at 42 CFR 483.   Each regulation sets for the minimum standard of care which is then inspected by the Center for Medicaid Service and Minnesota Department of Health in surveys or complaint investigations.

Here is the Nursing Home Reform Act Federal Requirements for Long Term Care Facilities

These federal requirements for long term care facilities set the standard of care for the facility, staff and medical providers.

42 CFR 483

§483.1
Basis and scope.
§483.5
Definitions.
§483.10
Resident rights.
§483.12
Admission, transfer and discharge rights.
§483.13
Resident behavior and facility practices.
§483.15
Quality of life.
§483.20
Resident assessment.
§483.25
Quality of care.
§483.30
Nursing services.
§483.35
Dietary services.
§483.40
Physician services.
§483.45
Specialized rehabilitative services.
§483.55
Dental services.
§483.60
Pharmacy services.
§483.65
Infection control.
§483.70
Physical environment.
§483.75
Administration.

Many of the quality of care issues are addressed in 42 CFR 483.25, which has many subparts each on a specific type of care issue including:

42 CFR 483.25 Quality of care.

Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident’s choices, including but not limited to the following:

(a) Vision and hearing. To ensure that residents receive proper treatment and assistive devices to maintain vision and hearing abilities, the facility must, if necessary, assist the resident—

(1) In making appointments, and

(2) By arranging for transportation to and from the office of a practitioner specializing in the treatment of vision or hearing impairment or the office of a professional specializing in the provision of vision or hearing assistive devices.

(b) Skin integrity.

(1) Pressure ulcers. Based on the comprehensive assessment of a resident, the facility must ensure that—

(i) A resident receives care, consistent with professional standards of practice, to prevent pressure ulcers and does not develop pressure ulcers unless the individual’s clinical condition demonstrates that they were unavoidable; and

(ii) A resident with pressure ulcers receives necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing.

(2) Foot care. To ensure that residents receive proper treatment and care to maintain mobility and good foot health, the facility must—

(i) Provide foot care and treatment, in accordance with professional standards of practice, including to prevent complications from the resident’s medical condition(s) and

(ii) If necessary, assist the resident in making appointments with a qualified person, and arranging for transportation to and from such appointments.

(c) Mobility.

(1) The facility must ensure that a resident who enters the facility without limited range of motion does not experience reduction in range of motion unless the resident’s clinical condition demonstrates that a reduction in range of motion is unavoidable; and

(2) A resident with limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.

(3) A resident with limited mobility receives appropriate services, equipment, and assistance to maintain or improve mobility with the maximum practicable independence unless a reduction in mobility is demonstrably unavoidable.

(d) Accidents. The facility must ensure that—

(1) The resident environment remains as free of accident hazards as is possible; and

(2) Each resident receives adequate supervision and assistance devices to prevent accidents.

(e) Incontinence.

(1) The facility must ensure that a resident who is continent of bladder and bowel on admission receives services and assistance to maintain continence unless his or her clinical condition is or becomes such that continence is not possible to maintain.

(2) For a resident with urinary incontinence, based on the resident’s comprehensive assessment, the facility must ensure that—

(i) A resident who enters the facility without an indwelling catheter is not catheterized unless the resident’s clinical condition demonstrates that catheterization was necessary;

(ii) A resident who enters the facility with an indwelling catheter or subsequently receives one is assessed for removal of the catheter as soon as possible unless the resident’s clinical condition demonstrates that catheterization is necessary, and

(iii) A resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible.

(3) For a resident with fecal incontinence, based on the resident’s comprehensive assessment, the facility must ensure that a resident who is incontinent of bowel receives appropriate treatment and services to restore as much normal bowel function as possible.

(f) Colostomy, urostomy, or ileostomy care.  The facility must ensure that residents who require colostomy, urostomy, or ileostomy services, receive such care consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(g) Assisted nutrition and hydration.  (Includes naso-gastric and gastrostomy tubes, both percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy, and enteral fluids). Based on a resident’s comprehensive assessment, the facility must ensure that a resident—

(1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident’s clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;

(2) Is offered sufficient fluid intake to maintain proper hydration and health; and

(3) Is offered a therapeutic diet when there is a nutritional problem and the health care provider orders a therapeutic diet.

(4) A resident who has been able to eat enough alone or with assistance is not fed by enteral methods unless the resident’s clinical condition demonstrates that enteral feeding was clinically indicated and consented to by the resident; and

(5) A resident who is fed by enteral means receives the appropriate treatment and services to restore, if possible, oral eating skills and to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers.

(h) Parenteral fluids.  Parenteral fluids must be administered consistent with professional standards of practice and in accordance with physician orders, the comprehensive person-centered care plan, and the resident’s goals and preferences.

(i) Respiratory care, including tracheostomy care and tracheal suctioning.  The facility must ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents’ goals and preferences, and §483.65 of this subpart.

(j) Prostheses.  The facility must ensure that a resident who has a prosthesis is provided care and assistance, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences, to wear and be able to use the prosthetic device.

(k) Pain management.  The facility must ensure that pain management is provided to residents who require such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(l) Dialysis.  The facility must ensure that residents who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences.

(m) Trauma-informed care.  The facility must ensure that residents who are trauma survivors receive culturally-competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident.

(n) Bed rails.  The facility must attempt to use appropriate alternatives prior to installing a side or bed rail. If a bed or side rail is used, the facility must ensure correct installation, use, and maintenance of bed rails, including but not limited to the following elements.

(1) Assess the resident for risk of entrapment from bed rails prior to installation.

(2) Review the risks and benefits of bed rails with the resident or resident representative and obtain informed consent prior to installation.

(3) Ensure that the bed’s dimensions are appropriate for the resident’s size and weight.

(4) Follow the manufacturers’ recommendations and specifications for installing and maintaining bed rails.

Consumer Voice produced a chart of changes and new federal nursing home rules and regulations.

If you have any questions about injury or assault or care provided at a nursing home or other type provider such as assisted living or memory care, contact Nursing Home Neglect and Abuse Lawyer Kenneth LaBore, toll free at 1-888-452-6589 or 612-743-9058 or by email at KLaBore@MNnursinghomeneglect.com.

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Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

 

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Nursing Home Arbitration Agreements

Written By: Kenneth LaBore | Published On: 5th February 2017 | Category: Admission and Discharge Issues, Nursing Home Abuse and Neglect, Nursing Home Care Issues, Wrongful Death | RSS Feed
Nursing Home Arbitration Agreements

Nursing Home Arbitration Agreements

Minnesota Nursing Home Arbitration Agreements

Nursing homes cannot seek pre-dispute arbitration agreement as condition for admission.  Pursuant to federal regulations 42 CFR 483.70(n), binding arbitration agreements. (1) A facility must not enter into a pre-dispute agreement for binding arbitration with any resident or resident’s representative nor require that a resident sign an arbitration agreement as a condition of admission to the LTC facility.

Nursing homes attempt to get arbitration agreements many of which limit the rights of person who is injured or even killed due to the neglect of the facility.  Anything that limits your rights is not a good idea and a really bad idea if it reduces the exposure to the owners of the facility for mistakes made during resident cares.  The arbitration agreement acts as a disincentive to provide the highest quality of care, supervision and services practicable.

Arbitration agreements usually do not allow you to litigate your case to a jury and may limit the parties that can hear the dispute.  There is an inherent conflict in a system where the same arbitration association hears all the disputes for the nursing home since they deal with the injured plaintiff only once but are selected by the nursing home in every case in the arbitration agreement.  If the arbitration awards go against the facility they can simply decide to choose another company to hear the disputes, this could make the arbitration association or arbitrators they use dependent on facility awards, hence creating a bias to a party which is supposed to be neutral.

Here are the Conditions When There Are Signed Arbitration Agreements

Pursuant to 42 CFR 483.70(n)(2), if, after a dispute between the facility and a resident arises, and a facility chooses to ask a resident or his or her representative to enter into an agreement for binding arbitration, the facility must comply with all of the requirements in this section.

(i) The facility must ensure that:

(A) The agreement is explained to the resident and their representative in a form and manner that he or she understands, including in a language the resident and their representative understands, and

(B) The resident acknowledges that he or she understands the agreement.

(ii) The agreement must:

(A) Be entered into by the resident voluntarily.

(B) Provide for the selection of a neutral arbitrator agreed upon by both parties.

(C) Provide for selection of a venue convenient to both parties.

(iii) A resident’s continuing right to remain in the facility must not be contingent upon the resident or the resident’s representative signing a binding arbitration agreement.

(iv) The agreement must not contain any language that prohibits or discourages the resident or anyone else from communicating with federal, state, or local officials, including but not limited to, federal and state surveyors, other federal or state health department employees, and representatives of the Office of the State Long-Term Care Ombudsman, in accordance with §483.10(k).

(v) The agreement may be signed by another individual if:

(A) Allowed by state law;

(B) All of the requirements in this section are met; and

(C) That individual has no interest in the facility.

(vi) When the facility and a resident resolve a dispute with arbitration, a copy of the signed agreement for binding arbitration and the arbitrator’s final decision must be retained by the facility for 5 years and be available for inspection upon request by CMS or its designee.

Contact Attorney Kenneth LaBore Before of After Signed Arbitration Agreements

It is best to have a lawyer review any agreement, especially a nursing home arbitration agreement before the resident or their legal representative signs, however if there is an injury contact an elder abuse attorney to review the contract before agreeing to terms as well.  There are requirements in the law that may effect the enforceability of all or part of the arbitration agreement and there are situations where you may be able to contest the agreement or some of its terms.

If you have questions about your rights and an arbitration agreement or to discuss a nursing home injury call Kenneth L. LaBore for a free consultation at 612-743-9048 or 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Minnesota Nursing Home Regulations

Written By: Kenneth LaBore | Published On: 20th January 2017 | Category: Caregivers Resources, Nursing Home Abuse and Neglect | RSS Feed
Minnesota Nursing Home Regulations

Minnesota Nursing Home Regulations

Minnesota Nursing Home Regulations

In addition to federal regulations for nursing homes and long term care facilities there are also Minnesota Nursing Home Regulations designed to protect residents and set minimum standards for care, services, supervision and treatments.

Health & Supportive Services

Nursing Homes – Minn. Stat. §§ 144A.01-.37; Minn. R. 4658 et al

Veteran’s Homes – Minn. Stat. §§ 198 et al; Minn. R. 9050 et al

Boarding Care Homes – Minn. Stat. §§ 144.50-144.56; Minn. R. 4655 et al

Home Care Licensure Law – Minn. Stat. § 144A.43-.48; Minn. R. 4668

Housing with Services Establishment Act – Minn. Stat. § 144D

Assisted Living Services – Minn. Stat. § 144G

Memory Care – Minn. Stat. §§ 144.6503; 144D.065; 144A.45, Subd. 5; and 245A.04, Subd. 12

Patient Rights

Assisted Living Bill of Rights Addendum– Minn. Stat. § 144A.441

Health Care Bill of Rights – Minn. Stat. § 144.651

Home Care Bill of Rights – Minn. Stat. § 144A.44

Hospice Bill of Rights – Minn. Stat. § 144A.751

Maltreatment of Minors Act – Minn. Stat. § 626.556

Minnesota Human Rights Act – Minn. Stat. § 363A

Vulnerable Adults Act – Minn. Stat. § 626.557 -.5573

Employee Regulation

Nurse Practice Act – Minn. Stat. §§ 148.171148.285

Criminal Background Study – Minn. Stat. §§ 144.057 & 245C et al

Advertising

Assisted Living Title Protection – Minn. Stat. § 144G.01-.02

Attorney General responsibility related to Prevention of Consumer Fraud – Minn. Stat. § 8.31

Consumer Fraud Act (Senior Citizens & Disabled Persons) – Minn. Stat. § 325F.71

Disclosure of Special Care Status for Memory Care – Minn. Stat. § 325F.72

False Statement in Advertisement – Minn. Stat. § 325F.67

Housing

Landlord Tenant Law – Minn. Stat. § 504B

Building and Fire Codes(See i.e. Construction Codes and Licensing – Minn. Stat. § 326B)

Common Interest Community and Cooperative Laws – Minn. Stat. § 515B

Payment

Medical Assistance for Needy Persons – Minn. Stat. § 256B

Additional Minnesota Nursing Home Regulations and Information

Choosing a Nursing Home

Selecting an Elder Care Facility

Minnesota Department of Health Complaints Against Nursing Home

Special Focus Facility Nursing Homes

Medicare & Medicaid Quality of Care Surveys

Nursing Home Abuse

Nursing Home Neglect

Reporting Nursing Home Abuse and Neglect

Nursing Home Resident Rights

Federal Nursing Home Resident Right Regulations

Rights for Nursing Home Residents

Definition of Vulnerable Adult

Federal Requirements and Nursing Home Regulations

Nursing Home Facilities with Substantiated Neglect

Nursing Home Abuse and Neglect Injuries

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about medication errors, improper use of medical equipment, falls or any other form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

Disclaimer

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

Nursing Home Abuse and Neglect Lawyer Kenneth LaBore Offers Free Consultations and Serves Clients Throughout the State of Minnesota Call Toll Free at 1-888-452-6589

 

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Elder Abuse and Neglect Summaries

Written By: Kenneth LaBore | Published On: 19th January 2017 | Category: Nursing Home Abuse and Neglect | RSS Feed
Summaries of Issues Related to Elder Abuse and Neglect

Summaries of Issues Related to Elder Abuse and Neglect

Nursing Home Elder Abuse and Neglect Topic Summaries

The following are issues related to finding a nursing home and prevention of elder abuse and neglect, related state and federal regulations as well as ways to research and get information about facilities and providers and types of injuries often suffered by residents who do not receive proper care.

Choosing a Nursing Home

Selecting an Elder Care Facility

Minnesota Department of Health Complaints Against Nursing Home

Special Focus Facility Nursing Homes

Medicare & Medicaid Quality of Care Surveys

Nursing Home Abuse

Nursing Home Neglect

Reporting Nursing Home Abuse and Neglect

Nursing Home Resident Rights

Federal Nursing Home Resident Right Regulations

Minnesota Nursing Home and Elder Care Regulations

Rights for Nursing Home Residents

Definition of Vulnerable Adult

Federal Requirements and Nursing Home Regulations

Nursing Home Facilities with Substantiated Neglect

Nursing Home Abuse and Neglect Injuries

For more information about elder abuse and neglect or questions on how to hold negligent care providers accountable call attorney Kenneth LaBore at 612-743-9048 for a free consultation or by email at KLaBore@MNnursinghomeneglect.com.  There is no fee unless a verdict or settlement with the wrongdoer.

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Lakeside Medical Center on Special Focus Facility List Due to Deficiencies

Written By: Kenneth LaBore | Published On: 7th January 2017 | Category: Facilities - Nursing Homes, Nursing Home Abuse and Neglect, Nursing Home Care Issues | RSS Feed
Numerous Quality of Care Deficiencies Lead to Placement of Lakeside Medical Center in Pine City on CMS Medicare Special Focus Facility List

Numerous Quality of Care Deficiencies Lead to Placement of Lakeside Medical Center in Pine City on CMS Medicare Special Focus Facility Iniative List

Information About Lakeside Medical Center

Name: LAKESIDE MEDICAL CENTER
Address: 129 SIXTH AVENUE SE
PINE CITY,  MN  55063
Phone: 320-629-2542   Fax: 320-629-1093
Administrator: MR. MAX BLAUFUSS
Minnesota Classifications: (Housing With Services)   (Assisted Living Services)

Survey Results from Lakeside Medical Center

Results from a survey dated August 18, 2016, indicated that Lakeside Medical Center had  deficiencies which were severe enough to place them on dubious list of special focus facility list of nursing homes with high numbers of serious deficiencies.

Under federal FTag F225, 42 CFR 483.13(c)(1)(ii)-(iii), (c)(2)-(4), the facility must not employ individuals who have been found guilty of abusing, neglecting, or mistreating residents by a court of law, or have had a finding entered into the State nursing aide registry concerning abuse, neglect, maltreatment of residents or misappropriation of their property; and report any knowledge it has of actions by a court of law against an employee, which would indicate unfitness for service a nurse aide or other facility staff to the State nurse aide registry or licensing authorities.

The facility must ensure that all alleged violations involving mistreatment, neglect or abuse, including injuries of unknown source and misappropriation of resident property are reported immediately to the administer of the facility and to other officials in accordance with established procedures (including to the State survey and certification agency).

The facility must have evidence that all alleged violations are thoroughly investigated, and must prevent further potential abuse while the investigation is in progress.

The results of all investigations must be reported to the administrator or his designated representative and to other officials in accordance with State law (including to the State survey and certification agency) within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken.

According to the Department of Health and Human Services Lakeside Medical Center, determined that above requirement was not met evidenced by: based on interview and document review, the facility failed to ensure alleged violations of mistreatment were identified and immediately reported to the administrator and state agency and investigated regarding scolding and rude treatment of 1 of 4 residents reviewed for abuse.

Lakeside Medical Center was also obligated under federal FTag F 226, 42 CFR 483.13(c), which states that the facility must develop and implement written policies and procedures that prohibit mistreatment, neglect, and abuse of residents and misappropriation of resident property.

It was determined that Lakeside Medical Center the above requirement was not met as evidenced by: based on interview and document review, the facility failed to ensure implementation of written policies and procedures related to identification and immediate reporting to the state agency regarding potential abuse for 1 of 4 residents reviewed for abuse.

Click here for the rest of the August 18, 2016 survey.

For more information from the Minnesota Department of Health, inspection surveys and reports, website, which usually has the most recent survey and the one taken before that.

To speak with an Attorney Kenneth LaBore concerning elder abuse or neglect or related injuries call his direct number 612-743-9048 or by email to KLaBore@MNnursinghomeneglect.com.

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Nursing Home Health Facility Complaints

Written By: Kenneth LaBore | Published On: 5th January 2017 | Category: Assisted Living Care Issues, Caregivers Resources, Department of Health Complaint, Nursing Home Abuse and Neglect, Nursing Home Care Issues, Patient Rights | RSS Feed
Nursing Home Complaints Minnesota Department of Health

Nursing Home Complaints Minnesota Department of Health

Minnesota Department of Health Facility Complaints

Allegations of physical and sexual abuse as well as neglect are investigated administratively by the Minnesota Department of Health, Office of Health Facility Complaints, (OHFC).   They conduct onsite investigations, review records, speak with staff members and resident and his/her family.  The OHFC does not review every complaint and therefore they are not all addressed on their website.  The determine on the concerns that are investigated include, unsubstantiated, inconclusive and substantiated.   The goal is a substantiated complaint which will usually require a root cause analysis and internal investigation and new policies and procedure which are then trained to the nursing home care staff.

View Resolved Minnesota Department of Health Complaints

To search the MDH website by type of result, such as “substantiated” as well as by the type of provider, city, county or provider name.

According to Minnesota Administrative Rule 4658.0015, COMPLIANCE WITH REGULATIONS AND STANDARDS.
A nursing home must operate and provide services in compliance with all applicable federal, state, and local laws, regulations, and codes, and with accepted professional standards and principles that apply to professionals providing services in a nursing home.

Contacting the Office of Health Facilities Complaints

The Office of Health Facility Complaints (OHFC) serves the general public. Complaints, questions, or concerns must relate to licensed facilities:

  • Hospitals
  • Nursing homes
  • Boarding care homes
  • Supervised living facilities
  • Assisted living
  • Home health agencies

For questions about complaints, call 651-201-4200 or 1-800-369-7994. For all other OHFC inquiries, call 651-201-4201.

OHFC can help patients and residents to enforce their rights.

OHFC does not charge for its services.

Resident Rights to Contact OHFC

According to Minnesota Statute 144A.13, COMPLAINTS; RESIDENT’S RIGHTS, Subdivision 1. Processing, all matters relating to the operation of a nursing home which are the subject of a written complaint from a resident and which are received by a controlling person or employee of the nursing home shall be delivered to the facility’s administrator for evaluation and action. Failure of the administrator within seven days of its receipt to resolve the complaint, or alternatively, the failure of the administrator to make a reply within seven days after its receipt to the complaining resident stating that the complaint did not constitute a valid objection to the nursing home’s operations, shall be a violation of section 144A.10. If a complaint directly involves the activities of a nursing home administrator, the complaint shall be resolved in accordance with this section by a person, other than the administrator, duly authorized by the nursing home to investigate the complaint and implement any necessary corrective measures.

Subd. 2. Resident’s rights. The administrator of a nursing home shall inform each resident in writing at the time of admission of the right to complain to the administrator about facility accommodations and services. A notice of the right to complain shall be posted in the nursing home. The administrator shall also inform each resident of the right to complain to the commissioner of health. No controlling person or employee of a nursing home shall retaliate in any way against a complaining nursing home resident and no nursing home resident may be denied any right available to the resident under chapter 504B.

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

See resolved substantiated complaints, special focus facility initiative lists and other information on this website at the “facilities” page which is updated regularly.

If you have concerns about elder abuse or neglect contact Minnesota Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Nursing Home Survey Process

Written By: Kenneth LaBore | Published On: 5th January 2017 | Category: Caregivers Resources, Nursing Home Care Issues, Patient Rights | RSS Feed
Minnesota and CMS Medicare Medicaid Nursing Home Survey Process

Minnesota and CMS Medicare Medicaid Nursing Home Survey Process

Minnesota Nursing Home Survey Information

According to CMS Medicare.gov, the inspection results are recorded in a form called (HCFA-2567) where deficiencies in the quality of care in the nursing home are recorded.  The inspections assess whether facilities are meeting “minimum” standards at the time of the survey. To be part of the Medicare and Medicaid programs, nursing homes must meet certain requirements set by Congress. The Centers for Medicare and Medicaid Services (CMS) has entered into an agreement with state governments to do health and fire safety inspections of these nursing homes and investigate complaints about nursing home care.

Minnesota Nursing and Boarding Care Home Survey Inspection Findings

Pursuant to Minnesota Statute 144A.10, Subd. 2. Inspections. The commissioner of health shall inspect each nursing home to ensure compliance with sections 144A.01 to 144A.155 and the rules promulgated to implement them. The inspection shall be a full inspection of the nursing home. If upon a reinspection provided for in subdivision 5 the representative of the commissioner of health finds one or more uncorrected violations, a second inspection of the facility shall be conducted. The second inspection need not be a full inspection. No prior notice shall be given of an inspection conducted pursuant to this subdivision. Any employee of the commissioner of health who willfully gives or causes to be given any advance notice of an inspection required or authorized by this subdivision shall be subject to suspension or dismissal in accordance with chapter 43A. An inspection required by a federal rule or statute may be conducted in conjunction with or subsequent to any other inspection. Any inspection required by this subdivision may be in addition to or in conjunction with the reinspections required by subdivision 5. Nothing in this subdivision shall be construed to prohibit the commissioner of health from making more than one unannounced inspection of any nursing home during its license year. The commissioner of health shall coordinate inspections of nursing homes with inspections by other state and local agencies consistent with the requirements of this section and the Medicare and Medicaid certification programs.

The commissioner shall conduct inspections and reinspections of health facilities with a frequency and in a manner calculated to produce the greatest benefit to residents within the limits of the resources available to the commissioner. In performing this function, the commissioner may devote proportionately more resources to the inspection of those facilities in which conditions present the most serious concerns with respect to resident health, treatment, comfort, safety, and well-being.

These conditions include but are not limited to: change in ownership; frequent change in administration in excess of normal turnover rates; complaints about care, safety, or rights; where previous inspections or reinspections have resulted in correction orders related to care, safety, or rights; and, where persons involved in ownership or administration of the facility have been indicted for alleged criminal activity. Any facility that has none of the above conditions or any other condition established by the commissioner that poses a risk to resident care, safety, or rights shall be inspected once every two years.

You can search the Minnesota Department of Health website for Medicare & Medicaid nursing home survey results for information on inspection findings pertaining to federal and state health and safety regulations.

According to the Minnesota Department of Health, Health Regulation Division, under a cooperative agreement with the Centers for Medicare and Medicaid (CMS), is responsible for ensuring that facilities accepting Medicare and Medicaid payment for services provided to program beneficiaries meet federal regulations and certification rules.

Search for surveys by city, county, or provider name.

Click here for a link to Minnesota Department of Health Nursing Home Survey pamphlet.

Click on link for more newly posted nursing home survey reports.

Click on link for information on provider searched by city, county or name of provider.

If you have concerns about nursing home surveys or questions about elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Special Focus Facility Process

Written By: Kenneth LaBore | Published On: 5th January 2017 | Category: Caregivers Resources, Nursing Home Abuse and Neglect, Patient Rights | RSS Feed

 

Medicare Medicaid CMS Special Focus Facility Nursing Home Deficiency List

Medicare Medicaid CMS Special Focus Facility Nursing Home Deficiency List

Special Focus Facility Initiative

The Centers for Medicare and Medicaid CMS creates a Special Focus Facility “SFF” list of nursing homes that have a history of serious quality issues and are included in a program designed to seek improvement in care.  The list is updated regularly with new facilities being added as needed and other falling off due to significant improvement in the quality of care or  from being terminated from Medicare.

The Special Focus Facility list is generated from data received through the CMS inspections or surveys which are focused on looking for deficiencies in care based on federal nursing home regulations.  According to the CMS website, Most nursing homes have some deficiencies, with the average being 6-7 deficiencies per survey. Most nursing homes correct their problems within a reasonable period of time. However, we have found that a minority of nursing homes have:

  • More problems than other nursing homes (about twice the average number of
    deficiencies);
  • More serious problems than most other nursing homes (including harm or injury experienced by residents); and
  • A pattern of serious problems that has persisted over a long period of time (as measured over the three years before the date the nursing home was first put on the SFF list).

Effect of Being on Special Focus Facility List

According to Medicare CMS, there are more frequent surveys and inspections to facilities on the SFF list usually about twice per year.  The longer the problems and deficiencies exist the more stringent the response from CMS, with penalties ranging from civil fines to being terminated from CMS from Medicare and Medicaid payments.

Within about 18-24 months the nursing home is expected to have one of three possible outcomes:

  • The ideal outcome is the facility shows improvement and the facility graduates from SFF due to significant improvements in the quality of care which has continued over time;
  • The facility is terminated from Medicare after failing to make significant and lasting improvements; and
  • There can also be an extension of time given when there are signs of very promising improvements.

Information on the most recent Minnesota Special Focus Facility nursing homes can be found on my website located at the Information About Facilities.

Click the following links for more information about the Medicare & Medicaid CMS survey process and information on filing a complaint with the Minnesota Department of Health for concerns about the quality of care or abuse and neglect suffered by a Minnesota nursing home resident.

If you have concerns about  Special Focus Facilities or questions about elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Community Memorial Hospital Cloquet Complaint

Written By: Kenneth LaBore | Published On: 12th April 2015 | Category: Medication Administration Mistakes, Medication Drug Error | RSS Feed

 

Medication Administration

Medication Administration, Community Memorial Hospital Cloquet Substantiated Complaint

Community Memorial Hospital Cloquet Complaint Findings for Medication Administration

In a report concluded on January 10, 2013, the Minnesota Department of Health cites Community Memorial Hospital Cloquet for medication administration.

It is alleged that the facility is not following standards for medication administration based on the following: the facility has inadequate medication administration/pharmacy procedures and as a result significant medication errors were made regarding dosages of a narcotic medication administered to a resident.

Substantiated Complaint Community Memorial Hospital

According to the National Institute of Health, The Institute of Medicine’s (IOM) first Quality Chasm report, To Err Is Human: Building a Safer Health System, stated that medication-related errors (a subset of medical error) were a significant cause of morbidity and mortality; they accounted “for one out of every 131 outpatient deaths, and one out of 854 inpatient deaths”. Medication errors were estimated to account for more than 7,000 deaths annually. Building on this work and previous IOM reports, the IOM put forth a report in 2007 on medication safety, Preventing Medication Errors. This report emphasized the importance of severely reducing medication errors, improving communication with patients, continually monitoring for errors, providing clinicians with decision-support and information tools, and improving and standardizing medication labeling and drug-related information.

With the growing reliance on medication therapy as the primary intervention for most illnesses, patients receiving medication interventions are exposed to potential harm as well as benefits. Benefits are effective management of the illness/disease, slowed progression of the disease, and improved patient outcomes with few if any errors. Harm from medications can arise from unintended consequences as well as medication error (wrong medication, wrong time, wrong dose, etc.). With inadequate nursing education about patient safety and quality, excessive workloads, staffing inadequacies, fatigue, illegible provider handwriting, flawed dispensing systems, and problems with the labeling of drugs, nurses are continually challenged to ensure that their patients receive the right medication at the right time. The purpose of this chapter is to review the research regarding medication safety in relation to nursing care. We will show that while we have an adequate and consistent knowledge base of medication error reporting and distribution across phases of the medication process, the knowledge base to inform interventions is very weak.

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about medication administration or any other form of elder abuse or neglect contact Elder Abuse and Neglect Attorney Kenneth LaBore toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Minneapolis Nursing Home Taken Over by State

Written By: Kenneth LaBore | Published On: 20th June 2014 | Category: Caregivers Resources, Nursing Home Abuse and Neglect, Nursing Home Care Issues | RSS Feed
Nursing Home Taken Over By State of Minnesota After Care Concerns

Nursing Home Taken Over By State of Minnesota After Care Concerns

Management of Nursing Home Taken Over by Minnesota State Officials

The Minnesota Department of Health made the decision to take over a Minneapolis nursing home, stating that it violated regulations and suffered from management issues.

The move occurred two months after the state cited the nursing home for 47 violations, including some that created a great deal of risk for residents, according to the state in a news release.

The health department also questioned the financial stability of the home. The CEO of the parent company states that reduction in Medicaid reimbursement rates hurt the facility because reimbursements made up all but 20 percent of the annual revenue that the facility received.

It is always a last resort when the Minnesota Department of Health has to step in and take over a nursing home. This occurs when it is found that the home is not keeping its residents safe and when it is not meeting the basic standards of care that are required in Minnesota.

The 87-bed facility’s parent company has stated that it will not make any attempts to resume control of the nursing home. The CEO said that he had taken responsibility for the problems at the facility, stating that it struggled financially due to a majority of its residents being Medicaid patients. He further stated in an interview that the facility had some challenges when the parent company took it over. It was believed at first that the challenges would be able to be overcome, but that did not come to fruition. It was not the outcome that was desired for those who worked to try and turn it around. Now the CEO states that he is doing everything he can for the stakeholders and he is assisting with the transition so that it is as smooth as possible.

Nursing Home Taken Over and Run By Nonprofit

America National Services, a nonprofit, will manage the nursing home facility for the state.

As for the financial situation, the state expressed concerns that the financial state of the center had deteriorated to the point that caregivers could walk off the job due to not getting paid wages, leaving the residents vulnerable due to lack of care. When the home’s director resigned in May, there were only two nurses at the home and there were 67 patients needing care, according to the court petition.

In March, it was found that there were two residents that were hospitalized after they accessed alcohol or drugs while at the facility. This indicated nursing home neglect because the residents were not adequately monitored.

When the takeover occurred, there was a court order in hand and Volunteers of America were there at that time. The acting administrator was ordered to leave. Residents were told that evening of the change.

The Minneapolis nursing home has a very diverse mix of residents. There are some with mental illness, some with chemical dependence, and around half are dementia sufferers. One long-term resident said that the conditions at the nursing home had become intolerable in early 2014. The facility ran out of a medication that she needed for her Parkinson’s disease and she went without her medication for a week. She also said the call light next to her bed stopped working for a number of weeks just after she had surgery.

Due to the very thin staff, authorities are trying to avoid a situation that occurred in another state in 2013 when a nursing home was abandoned with 14 sick and elderly patients left to their own devices.

Report Suspected Elder Abuse – Nursing Home Taken Over to Protect Residents

Click Here For Link To Report Abuse To Adult Protection

Click Here For Link To Report Abuse To Adult Protection

For more information from the Minnesota Department of Health, Office of Health Facility Complaints concerning nursing homes, assisted living and other elder care providers view resolved complaints at the MDH website.

If you have concerns about any form of elder abuse or neglect contact Minnesota Elder Abuse Attorney Kenneth LaBore toll free at 612-743-9048 or toll free at 1-888-452-6589 or by email at KLaBore@MNnursinghomeneglect.com.

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Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589

Free Consultation on Issues of Elder Abuse and Neglect Serving all of Minnesota Toll Free 1-888-452-6589

 

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