Choosing a Quality Nursing Home Could Become Easier for Hospital Patients Under New Rule

Under current federal law, “[H]ospital[s] must not specify or otherwise limit the qualified providers that are available to [a] patient” who is being discharged, as a nursing home abuse lawyer in Philadelphia, PA knows.  Intended to ensure plentiful care options for patients, this law has had an unintended consequence: in order to avoid unintentionally restricting patients’ choices, hospitals provide patients with minimal information about nursing home facilities.  As a result, many patients unwittingly choose to enter facilities with troubling histories of abuse, neglect, and serious health violations.  However, that may be changing in the near future.  Philadelphia nursing home abuse attorney Brent Wieand investigates.

Woman Dies After Hospital Refers Her to Poor Quality Nursing Home

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At age 88, Elizabeth Fee was admitted to California Pacific Medical Center, a hospital in San Francisco, for treatment of a pelvic fracture.  When Fee was ready to be discharged, the hospital provided her family with a list of options for continuing care.  Heading the list was the hospital’s own nursing home.

“They handed me a piece of paper with a list of the different facilities on it, and theirs were at top of the page,” said Fee’s daughter, Laura Rees.  “They kept pointing to their facility, and I was relying on their expertise and, of course, the reputation of the hospital.”

Seeing no reason to mistrust the information – which, after all, was supplied by a team of medical professionals – the family decided to place Fee into the hospital nursing home, where she developed an undiagnosed bowel obstruction and died in February 2012.

“I feel we were misled,” said Rees, “because we believed that Mom was going to a facility that would have given her excellent care.  And what she got was not even close to that, it was like night and day.”

Fee’s family filed a lawsuit against the hospital, whose nursing home facility received a one-star rating – the lowest score possible – from Medicare Compare, a government-run database that compiles reports on violations and quality issues at nursing homes throughout the country.  According to court documents, the hospital is denying the family’s claims that Elizabeth Fee received improper care.

Under New Rule, Hospital Patients Would Receive More Information About Nursing Facility Violations

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Hopefully, justice will be served for the Fee family.  However, this tragic ordeal could have been avoided altogether had more information about the options for nursing home care been made available.

“Generally, hospitals don’t tell patients or their families much about any kind of patterns of neglect or abuse.  Even the worst nursing homes are nearly full because hospitals keep sending patients to them,” says Michael Connors, who works for a San Francisco-based nonprofit organization called California Advocates for Nursing Home Reform.

“Hospitals are not sure enough that it would be seen as appropriate, and so they don’t want to take the chance that some surveyor will come around to cite them,” says Nancy Foster, vice president of quality and patient safety at the American Hospital Association.  Foster is referring to 42 CFR § 482.43(c)(7), which states that hospitals “must, when possible, respect patient and family preferences when they are expressed.”  The rule also bans hospitals from “specify[ing] or otherwise limit[ing] the qualified providers that are available to the patient.”

Last October, the Centers for Medicare & Medicaid Services (CMS) announced a plan to rewrite the rule for increased transparency.  According to an October 2015 press release, the update would ensure that patients “would be better prepared to select a high quality post-acute care provider, since hospitals… would be required to use and share data, including data on quality and resource use measures.”

As of December 2016, the Obama administration has not announced a finalization date for the rule.  And, with the White House presently in a state of transition, the fate of the rule – and the extent to which it will be prioritized over the coming months – is uncertain.

However, some hospitals have already implemented a more transparent system, such as Partners Healthcare in Massachusetts, which operates two of Harvard University Medical School’s teaching hospitals.  Despite endorsing nearly 70 Massachusetts nursing homes, Partners Healthcare says its system does not violate 42 CFR § 482.43(c)(7) because all patients receive a full list of options.  The list, however, indicates which facilities have received endorsements.

Brian Fuller, an executive with consulting firm NaviHealth, anticipates that systems like Partners’ will become more and more common.

“The whole idea of preferred provider networks is really going to escalate in the future,” he says.

Worried About Elder Abuse? Contact a Philadelphia Nursing Home Neglect Attorney

If you suspect that your parent or grandparent has been a victim of neglect or abuse at a nursing home in New Jersey or Pennsylvania, your family needs aggressive representation by a skillful, compassionate, and experienced PA nursing home lawyers from a PA nursing home law firm.  As founder of the Wieand Law Firm, LLC, nursing home lawyer in Philadelphia, PA Brent Wieand handles personal injury and wrongful death claims in Pennsylvania and New Jersey on behalf of injured nursing home residents and their loved ones, including:

To discuss your concerns about your loved one’s nursing home in a free and confidential legal consultation, call the Wieand Law Firm, LLC at (888) 789-3161 right away.

*Disclaimer: This article is for informational purposes.  It is not legal advice and should not be used as legal advice.  The Wieand Law Firm, LLC is based in Philadelphia, PA, and proud to serve clients throughout Pennsylvania and New Jersey.*

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