Ombudsman Program North Delta Planning & Development District Area Agency on Aging Elgalene Close, MSW District Ombudsman

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1 2014 Elder Law Conference Abuse/Neglect/Exploitation of Vulnerable Persons Ombudsman Program North Delta Planning & Development District Area Agency on Aging Elgalene Close, MSW District Ombudsman

2 How Many Long Term Care Facilities Are in the U.S.? 16,639 Nursing Homes with 1,736,645 beds(nors, 2010) 52,681 Board & Care Homes with 1,212,015 beds(nors, 2010)

3 How Many People Live in Long Term Care Facilities? 3.2 million Americans resided in nursing homes during 2008 (CMMS, 2009) According to the National Center for Assisted Living (2008), more than 900,000 people nationwide live in assisted living settings.

2009) According to the National Center for Assisted Living

4 Who Lives in Long Term Care Facilities? Individuals 25% Female Male 75% 2 out of 3 are female residents in facilities

5 Residents in Facilities Percentages 6 of 7 are 65 years old or older residents 86% 7% 7% 7% 1 of 7 are under 65 year old residents 1 in 200 are under 30 year old residents 65 years Plus 65 years and under 30 years old and younger

year old residents 1 in 200 are under 30 year old

6 How Prevalent Is Elder and Vulnerable/Dependent Adult Abuse? Nearly 1 in 3 U.S. nursing homes were cited for violations of federal standards that had potential to cause harm or that had caused actual harm to a resident during the two years Nearly 1 out of 10 homes had violations that caused residents harm, serious injury, or placed them in jeopardy of death. (2001 U.S. House of Representatives Report) In a study of 2,000 interviews of nursing home residents, 44% said they had been abused and 95% said they had been neglected or seen another resident neglected. (Broyles, 2000) Over 50% of nursing home staff admitted to mistreating (e.g. physical violence, mental abuse, neglect) older patients within the prior year in one study. Two thirds of those incidents involved neglect. (Ben Natan, 2010)

Nearly 1 out of 10 homes had violations that caused residents harm, serious injury, or placed them in jeopardy of death. (2001 U.S.

7 One survey of certified nursing assistants (CNA) found that 17% of CNAs had pushed, grabbed, or shoved a nursing home resident. 51% reported they had yelled at a resident and 23% had insulted or sworn at a resident. (Pillemer & Hudson, 1993) 7 % of all complaints regarding institutional facilities reported to long term care Ombudsmen were complaints of abuse, neglect, or exploitation. (NORS Data 2010)

51% reported they had yelled at a resident and 23% had insulted or sworn at a resident.

8 What Types of Abuse Are Occurring? Types of Abuse Complaints In US Nursing Homes (2010 NORS Data) Types of Abuse 22% 7% 29% Physical Abuse Sexual Abuse Psychological Abuse Gross Neglect 14% 7% Resident to Resident Abuse 21% Financial Exploitation

9 Types of Abuse Complaints in US Board & Care Facilities (2010 NORS Data) Complaints Physical Abuse 14% 25% Sexual Abuse Psychological 15% 7% Financial Exploitation 15% 24% Gross Neglect Resident to Resident Abuse

10 Roles of Ombudsman Complaint Process Services to assist consenting residents of long term care facilities to resolve problems or complaints through investigation, verification, and notification

facilities to resolve problems or complaints

11 Advocacy Issues Advocating for the improvement of practices and conditions affecting long term care residents by analyzing, monitoring and commenting on legislation, regulations and policies affecting residents of long term care

residents by analyzing, monitoring and commenting on

12 Information and Assistance Providing information to individuals on long term care of the needs and rights of long term care residents.

13 Consultation to Facilities Providing/exchanging information in person or by phone with facility staff

14 Routine Visitation to Facilities Visit to nursing facility, assisted living facility or a personal care home for the purpose of monitoring and assessing the general condition of residents and/or the physical plant of the facility

home for the purpose of monitoring and assessing the

15 Community Education Presentations to community groups or to groups of residents or families of long term care issues

16 Advisory Council Developing maintain or serving on councils made up of representatives from community to provide community involvement in the LTCO program

17 Interagency Coordination Activates which involve meeting or coordinating with other agencies to learn about and or improve conditions for one or more residents of long term care facilities

18 Resident/ Family Councils Provision of technical assistance, information, training or support to residents and /or facility staff regarding developing, informing or maintaining a resident/family council

19 In- Services Education to Facility Staff Presentations to long term care facility staff on long term care issues

20 Volunteer Management Recruiting training managing and providing technical assistance to volunteers assisting the district long term care ombudsman programs in carrying out its routine visit's responsibilities

assisting the district long term care ombudsman

21 Technical Assistance Providing guidance to Area on Aging s, provider agencies, and local ombudsmen in carrying out program activities

23 Resident Rights guarantee Quality of Life: 1987 Nursing Home Reform Law requires that each nursing home/assisted living and personal care home to care for its residents in a manner that promotes and enhances the quality of life of each resident, ensuring dignity, choice and self determination. All nursing homes are required to provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well being of each resident in accordance with a written plan of care that is initially prepared with participation to the extent of practicable, of the resident, the resident s family or legal representative.

24 This means that a resident SHOULD NOT decline in health or well being as a result of the way a nursing facility provides care

25 1. The Right to be Fully Informed of: Available services and the charges for each service. Facility rules and regulations, including a written copy of resident rights. Address and telephone number of the State Ombudsman and state survey agency State survey reports and the nursing home s plan correction Advance plans of a change in rooms or roommates Assistance if a sensory impairment exists Residents have a right to receive information in a language they understand ( Spanish, Braille, etc)

26 2. Right to Complain: Present grievances to staff or any other person without fear of reprisal and with prompt efforts by the facility to resolve those grievances To complain to the ombudsman program To file a complaint with the state survey and certification agency

27 3. Right to Participate in One s Own Care Receive adequate and appropriate care Be informed of all changes in medical condition Participate in their own assessment, care planning treatment, and discharge Refuse medication and treatment Refuse chemical and physical restraints Review one s medical record Be free from charge for services not covered by Medicaid or Medicare

28 4. Right to Privacy and Confidentiality Private and unrestricted communication with any person of their choice During treatment and care of one s personal needs Regarding medical, personal or financial affairs

29 5. Right to Dignify, Respect, and Freedom To be treated with consideration, respect, and dignity To be free from mental and physical abuse, corporal punishment, involuntary seclusion and physical and chemical restraints To self determination Security of possessions

30 6. Rights to Visits By a resident s personal physician and representatives from the state survey agency and ombudsman programs By relatives, friends and other of the residents choosing By organizations or individuals providing health,social, legal or other services Residents have the right to refuse visitors

31 7. Right to make Independent Choices Make personal decisions, such as what to wear and how to spend free time or what time to get up Reasonable accommodation of one s needs and preferences Choose a physician Participate in community activities both inside and outside the nursing home Organize and participate in a Resident Council Manage one s own financial affairs

32 8. Rights During Transfers and Discharges Remain in the nursing facility unless a transfer or discharged: is necessary to meet the resident s welfare; is appropriate if resident s health improves and no longer requires nursing home care, protect the health and safety of other residents or staff; and have failed to charges regarding their bill at the nursing home. Receive thirty day notice of transfer or discharge which includes the reason, effective date, location to which the resident is transferred or discharged, the right to appeal and the name, address and telephone number of the state long term care ombudsman Safe transfer or discharge though sufficient preparation by the nursing

33 Contact Information North Delta Planning & Development District Area Agency on Aging North Delta Planning & Development Website: PO Box Power Drive Batesville, MS Office Phone Number: Ext: 4133 or Office Fax: Elgalene Close, MSW District Ombudsman E mail: eclose@ndpdd.com

34 RESOURCES The National Consumer Voice for Quality Long Term Care ursinghome/residents rights April Mississippi Department of Human Service Division of Aging and Adult Services: Mississippi Ombudsman Policy and Procedure manual, Jackson MS:2011.

2007 Residents Rights Week Training Suggestion

2007 Residents Rights Week Training Suggestion Training topic: Residents Rights The Basics (estimated training time = 1 hour) Intended audience: Residents, family members, long-term care staff, volunteer