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CMS Issues Memo Reaffirming Nursing Home Residents’ Right to Vote

October 22, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The Centers for Medicare & Medicaid Services (CMS) has issued a memo affirming the continued right that nursing home residents are allowed to exercise their right to vote. The memo recognizes limitations visitors have to enter facilities to assist residents in voting; however, nursing homes must still ensure residents are able to exercise their Constitutional right to vote.

Residents’ Rights include:

483.10(b) Exercise of Rights: The resident has the right to exercise his or her rights as a resident of the facility and as a citizen or resident of the United States
483.10(b)(1): The facility must ensure that the resident can exercise his or her rights without interference, coercion, discrimination, or reprisal from the facility
483.10(b)(2): The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights as required under this subpart

A resident has the right to vote and must not be impeded in any way by the nursing home facility and its staff. Nursing homes should have a plan in place to ensure residents are able to exercise their right to vote, whether in-person, by mail, absentee, or other authorized process. Some states may have specific programs to enable nursing home residents to vote in which the facility should coordinate and engage with those programs. This may include:

Mobile Polling in residential facilities performed by a bipartisan team of workers; and/or
Assistance in registering to vote, requesting an absentee ballot, or completing a ballot from an agent of the Resident’s choosing, including family representative, LTC Ombudsmen or nursing home staff

If a resident is unable to cast their ballot in person, nursing homes must ensure residents have the right to receive and send their ballots via the U.S. Postal Service, or other authorized mechanism allowed by the State or locality.

CMS regulations specific to use of mail, which also apply to voting, for voting, include:

483.10(g)(7): The facility must protect and facilitate that resident’s right to communicate with individuals and entities within and external to the facility, including reasonable access to: (i) A telephone, including TTY and TDD services; (ii) The internet, to the extent available to the facility; and (iii) Stationery, postage, writing implements and the ability to send mail
483.10(h)(2) The facility must respect the residents right to personal privacy, including the right to privacy in his or her oral (that is, spoken), written, and electronic communications, including the right to send and promptly receive unopened mail and other letters, packages and other materials delivered to the facility for the resident, including those delivered through a means other than a postal service
- Promptly meaning the delivery of mail or other materials to the resident within 24 hours of delivery by the postal service, including a post office box, and delivery of outgoing mail to the postal service within 24 hours, except when there is no regularly scheduled postal delivery and pick-up service.

Additional information is available from the HHS Administration for Community Living related to voting rights and resources, as well as contact information for Long Term Care Ombudsmen can be found here.

October is Long-Term Care Residents’ Rights Month

October 20, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Each day, families bring their loved ones to be admitted into nursing homes across the country. Some may feel uncertain about their loved one receiving the quality care they deserve. Unfortunately, in many nursing home facilities there are track records of willful neglect, abuse, and preventable accidents and illnesses. October is a time to remind families the rights residents have that are designed to protect them from these situations.

“Resident’s Rights Month” is an annual event held by the National Consumer Voice for Quality Long-Term Care (Consumer Voice) to celebrate and focus the public’s attention on awareness of dignity, respect, and long-term resident’s value. Resident’s Rights Month is an opportunity for families, residents, staff, ombudsman programs, and other advocates to promote quality long-term care.

Review of Nursing Home Resident’s Rights

Residents in nursing homes have rights that are guaranteed under federal law. The Nursing Home Reform Law requires nursing homes to promote and protect the rights of each individual resident and stresses individual dignity and self-determination. Many states include residents’ rights in state law or regulation but varies by state.

Right to a Dignified Existence

Equal access to quality care
Be treated with consideration, dignity, and respect, recognizing each resident’s individuality
Freedom from abuse, neglect, exploitation, and misappropriation of property
Freedom from physical or chemical restraints
Quality of life is maintained or improved
Exercise rights without interference, coercion, discrimination, or reprisal
Provide a homelike environment, and use of personal belongings when permitted
Security of possessions

Right to Self-Determination

Reasonable accommodation of needs and preferences
Organize and participate in resident and family groups
Request, refuse, and/or discontinue treatment
Choice of activities, schedules, health care, and providers, including attending physician
Participate in developing and implementing a person-centered plan of care that incorporates personal and cultural preferences
Choice of designating a representative to exercise his or her rights

Right to be Fully Informed Of

Rules and regulations, including a written copy of residents’ rights
The type of care to be provided, and risks and benefits of proposed treatments
Contact information for the long-term care ombudsman program and that state survey agency
Changes to the plan of care, or in medical or health status
State survey reports and the nursing facility’s plan of correction
Written notice before a change in room or roommate
Notices and information in a language or manner he or she understands (Spanish, Braille, etc.)

Right to Raise Grievances

Present grievances without discrimination or retaliation, or the fear of it
Prompt efforts by the facility to resolve grievances, and provide a written decision upon request
To file a complaint with the long-term care ombudsman program or state survey agency

Right of Access to

Individuals, services, community members, and activities inside and outside the facility
Assistance if sensory impairments exist
Visitors of his or her choosing, at any time, and the right to refuse visitors
Personal and medical records
His/her personal physician and representatives from the state survey agency and long-term care ombudsman program
Participate in social, religious, and community activities

Rights Regarding Financial Affairs

Manage his/her financial affairs
Information about available services and charges for each service
Personal funds of more than $100 ($50 for residents whose care is funded by Medicaid) deposited by the facility in a separate interest-bearing account, and financial statements quarterly or upon request
Not be charged for services covered by Medicaid or Medicare

Right to Privacy

Private and unrestricted communication with any person of their choice
Regarding personal, financial, and medical affairs
During treatment and care of personal needs

Rights During Discharge/Transfer

Preparation and orientation to ensure safe and orderly transfer or discharge
Right to appeal the proposed transfer or discharge and not be discharged while an appeal is pending
Receive 30-day written notice of discharge or transfer that include: the reason; the effective date; the location going to; appeal rights and process for filing an appeal; and the name and contact information for the long-term care ombudsman
Notice of the right to return to the facility after hospitalization or therapeutic leave

Dinizulu Law Group: Illinois Nursing Home Abuse and Neglect Attorney’s

If you or your loved one has been subjected to poor treatment while in a nursing home facility, our attorneys can help find the answers for you. Contact our skilled legal team at Dinizulu Law Group to discuss your concerns. Call us at (312) 384-1920 for a free consultation or visit our website for more information.

How to Choose a Nursing Home in 2020

October 15, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – Nearly 1.3 million residents live in nursing home facilities across the United States. Nursing homes should offer a safe place for your loved one who needs guided rehabilitation or a senior care facility their future residency. It’s normal to have questions and concerns about these facilities as a quarter of all residents will experience during their residency. The coronavirus pandemic has targeted the elderly nursing home population more than any other demographic.

When you begin to research, be sure to schedule a virtual tour of a facility. Ask to talk to the administrator and staff members and ask questions to learn about the nursing home’s staffing, training, environment, and infectious disease outbreaks.

Make sure to consider asking the following questions:

Facility Type:

Is the nursing home Medicare certified?
Is the nursing home Medicaid certified?
Are both the nursing home and current administrator licensed by my state?
Is rehabilitation care offered?
Does the nursing home offer specialized care, such as dementia?
Is there an arbitration agreement requested to be signed?
Will the nursing home create a care plan for my loved one?
Will the nursing home provide in writing to me their polices and procedures, services, charges, and fees before I move my love one into the facility?

Staffing:

Are you currently facing staffing challenges due to COVID-19?
Do staff wear masks and seem equipped with person protection equipment to protect against COVID?
How often is staff tested for COVID?
What is your staff to resident ratio?
Has there been a turnover in administration staff, such as the director of nurses, within the last year?
How long do nurses and aides spend with residents each day?
Do staff knock before entering a resident’s room?
Does the nursing home offer training and continued education for all staff?
How does the facility ensure they don’t hire staff members who have been found guilty of abuse, neglect, or mistreatment?

Safety, Infectious Disease & Care:

How are residents and staff screened for fevers and respiratory diseases?
What is your COVID outbreak history?
What is your COVID testing plan and response strategy?
Can residents still see their personal doctors?
Does the nursing home’s inspection report show the quality of care problems or other deficiencies?
Has the nursing home corrected all deficiencies?
Can I see the most recent health and fire inspection report?

Food:

Can the nursing home provide a special dietary need?
Do residents have a choice of food items at each meal?
Can residents eat when they want?
Does staff help residents eat and drink at mealtimes, if needed?

Residents Rooms:

Can residents have personal belongings in their room?
Does each resident have a storage space, such as a closet and drawers, in their room?
Does each resident’s room have a window in it?
Can a resident leave their room if showing signs of any illness? How do you minimize resident’s exposure to others who may be sick of tested positive for coronavirus?
Do residents have access to the internet, personal phone, television, and computer?

Hallways, Stairs, Common Areas, & Bathrooms:

What types of spaces do residents share?
How often are common areas cleaned and disinfected?
Are common areas, hallways, resident rooms, and doorways designed for wheelchair accessibility?
Are handrails appropriately placed in hallways and bathrooms?

Activities:

What types of activities are offered to residents, including those who are unable to leave their rooms, allowed to participate in?
Does the nursing home have outdoor areas for resident use?
When does the nursing home allow visitors? Are visits outside?
What disruptions has COVID-19 caused in group activities?

Use of Antipsychotic Drugs:

What percentage of residents who are diagnosed with dementia are prescribed antipsychotic medication?
Does the nursing home have specific policies and procedures related to the care of individuals with dementia?
What is the current rate of antipsychotic medication use within the facility?

Both state and federal laws protect the right of residents in nursing homes; however, each year nearly 5 million elders fall victim to abuse and neglect. Often times, negligence occurs because of understaffing and insufficiently trained to care for residents in long-term settings. When facilities do not comply with safety standards and employ adequate staff, residents may suffer from malnutrition, bedsores, dehydration, fatal falls, medication errors, come into contact with an infectious disease, or fall victim to abuse.

Resources for Nursing Home Abuse

The Centers for Medicare & Medicaid Services (CMS) has announced it is now easier for consumers to identify nursing homes and long-term facilities with instances of non-compliance related to abuse on their website. CMS is rolling out a warning icon strategy to highlight facilities that meet the following criteria:

Facilities cited for abuse where residents were found to be harms on the most recent standard survey, or on a complaint survey within the past 12 months;

Facilities cited for abuse where residents were found to be potentially harmed on the most standard survey or a complain survey within the past 12 months and on the previous standard survey or on a complain survey in the prior 12 months

The icon is designed a bright red “STOP” hand, which may negatively shift a provider’s overall federal quality rating, but the change is welcomed by elder abuse advocates after years of systematically being non-compliant with unexplained inconsistencies in quality measures. Consumers will now have access to more information about nursing facility’s history of abuse, neglect or exploitation citations when visiting the CMS’s Five-Star Quality Rating System through the Nursing Home Compare Website.

Contact Nursing Home Abuse and Neglect Attorneys in Illinois

If you suspect your loved one is being abused or neglected in a nursing home in Illinois, contact the attorney’s of Dinizulu Law Group, Ltd. Our attorney’s have extensive knowledge and resources in this area of law and offer a personalized service by working closely with clients throughout every step of the process. Call our office today for a free consultation at (312) 384-1920 or visit our website for more information.

CMS Clarifies Quality Reporting Rules After COVID Pause, Nursing Home Compare Frozen Until 2022

October 12, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The federal government waived several reporting requirements for nursing homes during the COVID-19 pandemic. Although they have been reinstated, the temporary pause will continue to have ripple effects on public data for years to come.

The Centers for Medicare & Medicaid Service (CMS) released an updated tip sheet explaining how the agency’s including data on the Nursing Home Compare website.

In March, CMS announced that the fourth quarter 2019 data for the Skilled Nursing Facility Quality Reporting Program (QRP) and the Value-Based Purchasing Program (SNF VBP) would be optional. This does not require submissions for the first and second quarters of 2020. The agency positioned the move as an emergency measure to allow health care providers to focus on the early days of the COVID-19 pandemic.

CMS Administrator Seema Verma stated the exceptions and extensions that were grant allows for CMS to support clinicians fighting coronavirus on the front lines.

The waived expired on July 1 with quality and Minimum Data Set (MDS) reporting resuming as usual. However, because of how much of CMS’s public data lags the present by several quarters, the pause will have a long-lasting ripple impact on Nursing Home Compare.

The missing data for quarter one and two of 2020 will impact what is displayed on the Nursing Home Compare too; however, CMS claims they have developed a strategy to accommodate these quarters of data.

Enough providers were able to voluntarily report quarter four 2019 data to include that information in the October refresh, which will also unveil six new quality measures. These include:

Changes in skin integrity post-acute care: pressure ulcer/injury
Drug regiment review conducted with follow-up for identified issues
Application of IRF function outcome measure: change in self-care
Application of IRF functional outcome measure: change in mobility
Application of IRF functional outcome measure: discharge self-care score
Application of IRF functional outcome measure: discharge mobility score

October 2020 data will remain constant until public reporting resumes in January 2022, with the next normal Nursing Home Compare refresh which is scheduled for April 2022.

If CMS should change the methodology for calculating measures before January 2022, the agency will follow normal rulemaking procedures with notice and comment periods, according to Skilled Nursing News.

CMS acknowledged the resumption of data reporting requirements on July 1 may have created data mismatches. For example, a resident who does not have an admission record in the MDS because it occurred during the pause.

The agency stated they will make adjustments on their end to accommodate any records that may have missing admissions. The mismatched sets of records will not be counted or included in SNF data calculations for Nursing Home Compare.

Illinois lawmakers seek hearings after failure to investigate nursing home complaints

September 15, 2020/in Blog/by Yao Dinizulu

CHICAGO, IL – The Illinois Department of Public Health has hired a former U.S. Attorney to review the department’s failure to investigate complaints of nursing home abuse and neglect in long-term care facilities for more than three months over the course of the pandemic.

Last month, Deputy State Long-Term Care Ombudsman Chuck Miller said he and others could not properly advocate for residents they represent due to COVID-19 restrictions. “I’ll just say our program has had difficulties because we’re not regulators,” he said.

The department said that for more than 15 weeks during the COVID-19 shutdown, the Bureau of Long-Term Care was not properly processing or investigating claims.

Illinois law requires abuse and neglect complaints to be reviewed within certain time frames was not suspended. IDPH personnel did not complete reviews of allegations of abuse and neglect in a timely manner between March 15 and June 30.

According to the Washington Examiner, the department has more than 272 allegations of abuse and neglect from that period and substantiated the factual circumstances of 17 of those complaints.

To ensure findings are thorough and accurate, IDPH has hired former U.S. Attorney Cox to conduct a thorough review of the complaints that IDPH found to be unsubstantiated.

What Are a Nursing Home Resident’s Financial Rights?

August 7, 2020/in Blog/by Yao Dinizulu

When you think of a nursing home, you probably imagine many elderly individuals living there who rely on staff members to help them with their everyday tasks. While it is true that most do require around the clock assistance, there are plenty of residents who still act independently and are able to manage certain areas of their life. Take finances, for instance. A large portion of residents living in a nursing home in Illinois still have the mental capacity to make financial decisions and even handle their own money. According to The Consumer Voice, some of the financial rights a nursing home resident has include:

They have the right to handle their own bank accounts and money.
They have access to their funds on weekdays during business hours.
They are able to withdraw as much of their own money as they choose.
They can keep their spending habits private.
They can receive an itemized account of their monthly bill.
They can appoint a person to handle their finances.

Because a nursing home resident may still have access to their funds, many individuals, including workers and even family members, will sometimes take advantage of their vulnerability and steal from them. This is referred to as financial abuse or financial exploitation. Because this is a serious issue many aging individuals are faced with today, it is important that if you are considering allowing someone to manage your money, it is someone you can trust.

What are some preventative measures that can be taken to avoid theft in a nursing home?

Aside from financial abuse, nursing home residents also find themselves faced with other issues including having their valuable items taken from them should they choose to bring them when they transition from living in their own home and into a nursing home. Because we understand how important these items may be as they may not only hold value but also a place in your heart, it is important that you take preventative measures to avoid from becoming a victim of theft during your stay. Some preventative measures The Consumer Voice recommends you take include:

Mark all of your personal items, including watches, dentures, eyeglasses, and hearing aids, etc. so that everyone knows who they belong to.
Keep a written inventory checklist of clothing and other valuables, signed by you and a representative from the facility.
Provide your family members with a copy of the inventory checklist as well.
Take pictures of your valuable items.
Keep copies of all receipts for any items taken into the facility.
Place locks on clothing drawers and/or cabinets, where only you and an administrator have a key to open it.

What should I do if I am the victim of financial abuse?

If you or your aging relative has become the victim of financial abuse and you believe an Illinois nursing home employee is inflicting this abuse, you are encouraged to contact the Chicago, IL nursing home abuse lawyers at Dinizulu Law Group, Ltd. Our dedicated team of attorneys can investigate into the matter and gather all the necessary evidence that proves you or your loved one is, in fact, the victim of such abuse. We can then explain what options are available in terms of taking legal action and help you make an informed decision as to which may be the best for you to pursue.

To schedule a consultation to learn more about nursing home financial abuse and how we can serve as an advocate for you and your loved one, contact us today at (312) 384-1920.

Family Sues 87th St. Symphony Beverly Nursing Home for Catastrophic Falls

August 3, 2020/in In the News/by Yao Dinizulu

CHICAGO, IL – The Dinizulu Law Group, Ltd. filed a lawsuit in Chicago on behalf of a Chicago family against Symphony Beverly nursing home, a chain nursing home operating in Illinois, Indiana, Michigan, and Wisconsin. Symphony Beverly is located at 2940 W. 87^th St. in Chicago, IL. In the complaint, the family alleges that Symphony nursing home ignored the warning signs and allowed a wheelchair bound mom to fall twice, resulting in her becoming quadriplegic.

According to the nursing homes own clinical evaluation admission note, it was known Yvette required extensive assistance with limited mobility. It was specifically noted that she could not bear her own weight and must be assisted into a chair, bed, or wheelchair. Yvette made frequent slight jerking motions that changed her body positions. The defendant recognized that Yvette maintained relatively good position in a chair or bed “most of the time,” but occasionally slid down. In other words, Yvette was known as a fall risk. In addition to having a history of falls, Yvette was a high fall risk because the medication she was on induced muscle weakness, numbness, dizziness and drowsiness. These complicated her ability to fully control her body. In addition, she was also on blood thinners which put her at a high risk for hemorrhage if a fall occurred, especially involving her head.

According to Yao Dinizulu, a partner at the Dinizulu Law Group, “When a nursing home takes in a patient, they are saying they are accepting the responsibility for the care of your loved one. In this case, they knew Yvette was a substantial fall risk that could not stay steady in a wheelchair. Despite all of these warning signs, they failed to place her in a wheelchair that fit her condition. The standard of care required that a Broda wheelchair in order to ensure that she did not fall, slip out, or unsettle the wheelchair that would allow her to hurt herself.”

Broda wheelchair

On August 14, 2017, Yvette was placed in a wheelchair that was not non-skid resistant that could allow a non-stable patient like Yvette to fall. As a result, on August 14, she tragically fell resulting in an admission to Christ Hospital and was diagnosed with acute-subacute flaccid paralysis with spinal cord changes and increased intensity for cord compression. While still recovering from her first fall at Symphony Beverly, a CNA attempted to move Yvette alone from her bed despite company policy that mandated two staff members must assist in moving and repositioning her. This resulted in Yvette falling again from her bed, worsening her previous fall. After these falls, her conditions progressively worsened until she passed away six months later.