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A patient in a North Carolina nursing home was allowed to fall by a nurse aide. The aide and her friends/coworkers covered it up and for two weeks the patient was untreated for a hip fracture. She was eventually taken to a hospital and there it was found she had a broken hip. Shocked by the news, the family eventually was able to find out what happened. The resident’s family learned what happened only by reviewing follow-up reports from state inspectors.

As we know, rules and regulations get through “channels” and many times they do so without anyone noticing. That has happened again. A recent change in federal rules on nursing home inspections makes it nearly impossible for families to get the information they need to protect their loved ones.

According to the associated press, the changes were put into effect in October 2008 with little notice and without a public comment period. The change is getting sharp criticism for closing off critically important information. Under the new rules, the state inspector follow-up reports can’t be released without specific approval from the chief of CMS.

“It’s an extremely troubling development – it puts a lot of information related to nursing-home inspections off-limits,” said Eric Carlson, director of the Long-Term Care Project of the National Senior Citizens Law Center, a California-based nonprofit group funded in part by the federal Administration on Aging. “I think it’s certainly bad for consumers and the folks who represent them.”

The change bars nursing home surveyors from releasing privileged information to the public without approval from the Director of the Centers for Medicare and Medicaid Services. State employees (the nursing home and hospital surveyors) who perform inspections for the federal government have been reclassified as federal employees as part of the revision. This reclassification is only for this purpose, and not for wages/benefits or other purposes. The surveyors are still state employees. They contract to the Federal government to perform the surey and certification work and as such are required to follow federal standards and procedures, and in this case, are required to follow the federal procedures for the release or non-release of privileged resident/patient information.

Officials at the Department of Health and Human Services said employees have been too burdened by requests for information. Under the rule change, state employees who inspect nursing homes for the federal government are reclassified as federal employees who aren’t allowed to provide “privileged” information or documents to the public without approval from the head of the Centers for Medicare and Medicaid Services.

Requests were diverting employees from certification responsibilities, Michael Leavitt, secretary of the Department of Health and Human Services, said in announcing the change.

Lawyers are now finding out that the new rule has already slowed efforts to represent their clients. It is slowing down the process to get the information they need.

How does this affect you, the consumer? – You can see, it is putting a wall in your path to ensuring your loved ones are getting safe care.

What about those of you who are administrators and staff of nursing homes – now is it affecting you? You might think at first, that it is a good thing, but really, getting information out to the public about both GOOD and BAD state inspections is beneficial to the facility and to those who are wanting to look at where to place their loved ones.  I would think even those who administer nursing homes find the change in rules, without a public comment period, to be a poor decision.

Then look at who has to give the permission – the head of CMS – the head of a federal agency is going to review and provide permission for the hundreds of requests in every state? That sounds like an impossible task, the permission is either going to be given or withheld willy-nilly. What determines who gets permission to see the documents and who doesn’t? Will there be criteria? Who is developing that criteria? What patient rights are being stepped on here?

 

JL

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4 Responses to “Nursing Home and Hospital Surveyors no Longer Allowed to Provide Information Without the Permission of the Head of CMS!”

  1. Stephen M. Beckwith MHCA Says:

    For the record, there used to be a website that listed every nursing home and their inspection reports. The reports specified violations in Nursing Homes from Inspectors and plans of Correction. The reports also issued the level of severity of the deficiency. Having worked in a Nursing Home I know that Administrative rounds should be conducted daily to address the issues before they become serious. Unfortunately as was previously mentioned in the fall that happens a lot. A facility should have a fall report handy and documented accordingly. There also should be a form that documents wound care or any skin tears that occur. Working in a Nursing home is a tough job and I applaud anyone who works in a Nursing home.

  2. admin Says:

    Thank You for your comment. Yes, and families can still look at the nursing home compare site to find reports. Unfortunately these don’t have the complaint and other investigations outside of the routine survey. Working in a Nursing Home is hard hard work, I’ve been there, and totally understand the difficulties. It is hard when the administration tries its best to hire competent and loyal staff and yet things like this happen. I’ve had to give my share of deficiencies over something with similar types of circumstances.

    It still is unbelievable, though, that permission has to be gotten from the head of CMS in order for state survey staff to give patients/residents, and loved ones information from the state records and files. It is one more road block to the public having all the iformation they need about the care their loved ones are recieing in facilities.

    Again, I applaud all the hard work of the loyal nursing home and hospital staff and hope they have the systems in place to encourage the proper reporting of accidents and incidents.

    JL

  3. Deborah Montgomery, RN Says:

    My comment goes to the issue of Bush making every surveyor a Federal employee. Do you have a rule number or someway that I can locate this information to read it for myself? I am a surveyor employed by a state and I am very concerned about my employment status changing as I am unionized. I am wondering also if this is another final swipe Bush could take at unions.

  4. admin Says:

    The news story I shared was obatined from this site: http://www.newsobserver.com/news/story/1344803.html .
    I also found the information here:
    http://www.cjonline.com/stories/123008/opi_372296952.shtml .

    I have not had the opportunity to find and look for the rule myself, but I will attempt to do so and report back here, either in this comment or on the blog itself.

    JL

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