Solving Problems in Nursing Homes

OPTIONS FOR SOLVING PROBLEMS
IN NURSING HOMES

It can be difficult for nursing home residents or their families to know how to deal with problems that may arise in the nursing home. Some residents feel they must defer to the authority of the nursing and administrative staff. Others don’t want to cause trouble for anybody or they don’t want to be seen as a complainer. Some residents believe voicing their concerns do no good, nobody will listen. Others may fear retaliation.

Federal and state law gives specific rights to residents of nursing homes, rights that nursing homes are obligated to respect. Among these rights are the resident’s right to be treated with dignity and respect, the right of a resident to be personally involved in the creation of their plan of care, the right to the reasonable accommodation of needs and preferences, and the right to voice grievances free from retaliation and to have those grievances acted upon promptly.

The Chain of Command – WHO SHOULD I TALK WITH?

Identify the person who has the knowledge and authority to respond to your concern. For example, if you are concerned about your care, speak to the charge nurse on your unit or the director of nursing for your facility. If the problem involves your meals, speak to the dietary supervisor. Go just high enough in the chain of command to find somebody who is willing and able to address your concerns.

If the staff does not respond appropriately, ask to speak to the administrator of the facility. The administrator is responsible for managing the entire home and has the authority to direct the staff to respond to your concerns.

Nursing homes are required to have written in-house grievance procedures. In addition, there must be a staff person available at all times who is responsible for receiving and investigating complaints. Ask for information about the grievance procedure and a copy of a complaint form. Consider putting your complaint in writing. Often, written complaints get more attention. Keep a copy of your complaint so you can document the steps you have taken.

CARE CONFERENCES

At least once every three months and whenever there are significant changes in your needs, the nursing home must hold a care conference to plan your care. You have the right to attend these meetings. Health care professionals from the nursing home, such as nurses, dieticians, therapists, social workers, and your doctor may attend the care conferences. These meetings are a good opportunity to get information and to raise questions or concerns about your care.

If you have several concerns, you may want to schedule a special meeting in order to make sure there will be enough time for a thorough discussion. If you would like assistance in presenting your concerns, your Local Long Term Care Ombudsman can help.

For more information on care conferences, contact your local ombudsman for a copy of “Assessment and Care Planning in Nursing Homes.”

CONTACTING THE OWNER

If the administrator has not responded appropriately to your problem, you may want to contact the owner or operator of the nursing home. The owner or operator hires the administrator and has authority over him or her. Owners who care about their business will take your concerns seriously. You are the customer.

While the owner may not directly resolve your problem, he or she has the authority to make changes at the home. Just contacting the owner may convince the nursing home staff to take your concerns more seriously. Your local ombudsman can help you identify who the owner is and how to contact them.

RESIDENT AND FAMILY COUNCILS

Resident Council is an organized group of persons living in a nursing home who meet on a regular basis to discuss concerns, develop suggestions, and plan activities. Family Councils, made up of family members and friends of residents, also meet regularly and have a similar purpose.

Not all homes have resident or family councils, but residents and families have the right to organize and to meet privately in the nursing homes. The nursing home is required to listen to grievances brought by resident and family groups. Recommendations must be seriously considered by the home and responded to by the administrator. To the extent possible, the nursing home must attempt to accommodate recommendations made by resident and family councils.

If your nursing home has a resident or family council, it may be a good place to discuss your concern. You may find that others share your same concerns. By joining with other residents and family members, you can work together for positive change. If there is no council, consider helping to start one. Your local ombudsman can be of assistance.

FILING FORMAL COMPLAINTS

If the nursing home will not address your concern, you may want to file a complaint with a government agency. Several agencies oversee nursing homes to make sure they follow state and federal law. Each of the following agencies investigates certain types of complaints it receives about nursing homes. Your Local Long Term Care Ombudsman has information on filing complaints and can assist you with the complaint process.

To report problems concerning quality of care, abuse or other violations of residents’ rights, call or write:

Michigan Department of Community Health

Bureau of Health Systems Complaint Intake Unit
P.O. Box 30664
Lansing, MI 48909
1/800 882-6006

To report abuse by nursing home employees or Medicaid fraud, call or write:

Michigan Department of Attorney General
Health Care Fraud Division
P.O. Box 30218
Lansing, MI 48909
1/800 242-2873

If you believe you have been discriminated against due to your race, handicap, or age, write or call:

Regional Manager Office for Civil Rights – Region V
Department of Health and Human Services
105 W. Adams, 16th Floor
Chicago, Illinois 60603
(312) 886-2359

To report problems with Medicaid bills or payment, call or write:

Michigan Department of Community Health
Medical Srvs Administration/Recipient Help Line
P.O. Box 3047
Lansing, MI 48909-7979
1/800 642-3195

For assistance with problem solving and communicating with nursing home staff, please contact your Local Long Term Care Ombudsman.