This week’s question comes from Jared S. in San Francisco, who asks:
Q: “My mother’s health is declining. My siblings and I don’t have the bandwidth to provide her the care we need ourselves. We’ve started to look at nursing homes. Any advice on selecting a nursing home? What should we know and/or watch out for?”
A: Jared, selecting a nursing home can be a difficult and emotionally taxing process. First and foremost, you need to be sure that the medical needs of your mother are being met. You should consult with your mother’s physicians to determine the level of assistance that she may need.
Type of care facility
While many people refer to assisted living facilities as nursing home, California actually has several licensing and certification categories. These include Skilled Nursing Facilities, Distinct Part/Skilled Nursing Facility, Intermediate Care Facilities, Residential Care Facilities for the Elderly, and Continuing Care Retirement Communities. Within each license type there can be further subcategories that allow for treatment of specific conditions.
Know your rights
In recognition of the vulnerability of elders and dependent adults in the state, the legislature has ensured that all nursing home residents must be provided a written policy, entitled “Nursing Home Resident’s Bill of Rights.” If this policy has not been provided to you or your mother, you should insist on the care facility providing it, if not strongly consider moving your mother to another facility.
The Resident’s Bill of Rights codifies that residents are entitled to privacy, dignity and respect and that they can choose their own physician, possess personal property, plan medical care, manage their own finances, determine which visitors they may receive and be discharged or transferred only for medical reasons.
Just because your mother needs additional assistance does not mean she should lose her independence. Your mother’s independence, while reduced by her medical condition, is a very important part of her self-worth and protecting this independence allows for your mother to spend her remaining years in a dignified manner.
Be wary of arbitration clauses
In a searing three-part series earlier this year, The New York Times addressed the ubiquity of mandatory nursing agreements in consumer contract throughout the U.S. When signing the admissions documents for your mother, You should not sign an arbitration agreement. As described by The Times, arbitration clauses have “deprived Americans of one of their most fundamental constitutional rights: their day in court.”
In regard to nursing homes in California, an arbitration clause must be on a form separate from the admission agreement, cannot be used to waive a resident’s right to sue and can be rescinded by written notice within 30 days of the original signature. Most importantly, a nursing home cannot require applicants or residents to sign an arbitration agreement as a condition of admission or medical treatment.
Compare nursing homes
Research potential nursing homes online. Two great resources are Nursing Home Compare offered by Medicare and CalQualityCare, which is run by UCSF and California HealthCare Foundation. CalQualityCare will provide a grade of superior, above average, average, below average or poor. Using these grades can help ensure that your mother is going to a reputable facility that can adequately meet her needs.
Free booklet on elder abuse
For a more in-depth review of the Resident’s Bill of Rights and how to identify and stop elder abuse and neglect, I have published a booklet on this topic. Everyone is welcome to download the booklet at www.dolanlawfirm.com/elder-abuse free of charge, or call my office at (415) 421-2800 and we will mail a copy, again, free of charge.