What are some common issues connected with nursing home care?
Nursing home care raises many understandable emotions and concerns. Many elderly persons worry that they will be forced to go into a nursing home. Except in emergency situations, no one can be involuntarily committed to an institution unless a court authorizes the action after a hearing. At the hearing, the court must determine whether an individual is mentally ill, unable to care for himself or herself, or a danger to himself or herself or others. A person subject to a hearing has the right to be represented by an attorney.
Another concern is how to finance a nursing home stay. Medicare only covers skilled nursing home care ordered by a doctor, involving daily skilled nursing activities or rehabilitation services that can only be provided in a residential setting. Medicare does not cover custodial care to assist with daily living tasks and needs if no skilled services are necessary. Medicaid may cover nursing home custodial care if income and asset requirements are met, but would-be residents cannot transfer their assets simply in order to qualify for this assistance. Other financing options such as state programs and reverse mortgages may be available. If a child or other relative pays for nursing home care, that person may be able to deduct the expenses on his or her taxes.
Once a person moves to a nursing home, he or she may have concerns about the level of care and the maintenance of his or her personal rights. Relatives may worry about whether their elderly family member will be comfortable and stable in the new setting. Violations of a nursing home resident's rights are a form of elder abuse, which all states prohibit. Definitions of elder abuse most commonly include physical, psychological, and financial abuse, as well as neglect. Many states have adult protective services agencies that enforce compliance with their elder abuse laws. Violators of elder abuse laws generally are subject to criminal and financial penalties.
Once a resident has settled in, he or she cannot be moved legally without proper consent unless the resident endangers the safety or health of other residents, develops medical needs that can no longer be met by the home, recovers to the point that residential care is no longer necessary, fails to pay for services, or must leave because the facility is closing. Other rare situations may prompt a move, including a staff strike or loss of license, but in these cases alternative housing is usually provided. When a transfer is imminent, a resident must receive a thirty-day written notice citing the reason for the transfer and how to challenge the proposed change. A resident may have a right to a hearing regarding the change.
Nursing homes are highly regulated by both the state and federal governments, which require licenses, inspections, complaint procedures, and penalties for non-compliance. Residents and their families have many mechanisms for resolving disputes. The complaint procedure at the facility is a resident's first recourse, followed by governmental watchdog organizations and regulatory agencies. Residents also can sue their nursing homes on a large number of legal grounds.