TOPEKA – The Kansas adult assisted living industry has rejected legislation that creates requirements in state law to notify residents in advance of involuntary resignations or relocation orders and establishes by statute the right of residents to appeal such decisions.
The House bill was developed with the assistance of the Kansas Judicial Council amid evidence that senior citizens were subjected to excruciating involuntary resignations without warning or justification. In some cases, facilities put residents in a hospital and refused to take them back. Offloading vulnerable residents – people with dementia, behavioral issues or considered difficult to date – could have life-or-death consequences.
State long-term care ombudsman Camille Russell, who advocates for the rights of Kansans in nursing facilities, hospital long-term care units, assisted living centers and other residential models, said Thursday during a Hearing from the House Judiciary Committee that it was important that Kansans have rights of appeal etched into state law so that involuntary discharges from adult nursing homes can be independently reviewed.
He said dumping in violation of administrative regulations continued to be one of the most frequent complaints to the ombudsman’s office.
“There are many houses that rarely find reason to issue an involuntary discharge notice. There are also establishments that are ‘serial offenders’, some that do not provide the required written notice at all, while others do not provide an appropriate reason or justification,” Russell said.
‘Tip of the iceberg’
LeadingAge Kansas President Rachel Monger said the Association of Non-Profit and Faith-Based Aging Services believes House Bill 2246 would improperly require residential facilities to care for clients while discharge appeals were pending. outstanding. Administrative appeals could delay the transfer of residents to facilities that are properly equipped and staffed to meet their needs, she said.
“Forcing an assisted living facility to retain a resident whose needs it cannot meet has wide-ranging and seriously adverse effects on the health and safety of residents and the continued accessibility and operation of residential care facilities,” Monger said.
Linda MowBray, president of the Kansas Health Care Association and the Kansas Center for Assisted Living, said it would be a mistake to enact a law that would force state-licensed homes to retain or readmit a resident no longer deemed by trustees to be suitable for that facility.
“The amount of time allowed in HB 2246 for an appeal is just the tip of the iceberg. Call after call could drag on for months. It would be irresponsible with the potential for serious consequences for a community to attempt to care for someone whose needs are clearly outside the services they can provide,” MowBray said.
Shelley Gromer, vice president of Guest Home Estates with 99 residents spread across six properties in Caney, Chanute, Erie, Pittsburg and Garnett, said she manages properties with capacities ranging from 11 to 25 residents. She said it would be unfair for the state to strip operators of the authority to determine who was an appropriate match in each of those locations.
“This could put our tiny homes out of action and cause problems for our staff and residents,” Gromer said.
The fine print
Under the House bill, administrators of assisted living, residential health care, home plus, or pension facilities in Kansas would be required to provide residents with written notice of an involuntary relocation or discharge at least 30 days in advance of the scheduled relocation, unless the resident had an urgent medical need or posed a danger to others. The notice should be forwarded to the resident in person, entered on the person’s record, sent to the resident’s representative, and provided to the state long-term care ombudsman.
Discharge facilities would be required to complete a form stating reasons and evidence to support the involuntary removal. The document would include names and contact information, the effective date of the transfer or termination, and a copy of the notice of appeal.
The care facility administrator would be obligated under the House bill to develop a discharge plan before taking that step.
An appeal should be filed on behalf of a resident within 15 days of receiving a deportation notice. Such an appeal may be requested by a representative of the resident, including the state long-term care ombudsman. A state administrative hearing should take place within 15 days of filing your appeal. The Hearing Officer will issue a decision within 10 days.
During the appeals process, the bill said, the resident would either be allowed to remain in the facility or be allowed to resume residency at the facility.
A comparable system for emergency move orders would be worked out with administrators required to notify the resident 48 hours prior to a move or discharge, with the secretary of the Kansas Department of Aging and Disability Services responsible for defining what constitutes an emergency. An emergency eviction could be appealed within seven days of receiving the notice. The hearing would be within 14 days of the appeal and auditors would have five days to rule.
The Kansas Judicial Council has recommended that a provision in the bill provide some liability protection to facilities from alleged negligence lawsuits if the care facility failed to provide services to an appealing resident “outside the scope of the contract of negotiated service”.
Selective denial of rights
Alexandra English, director of the Kansas Legal Services Seniors Rights Project, participated in the Judiciary Council advisory panel that explored the issue of involuntary discharge. The recommendation on the structure of an appeals process was drawn from concepts adopted in other states, she said.
The Kansas model drew from Alaska’s requirement that assisted living facilities meet informally with a resident to discuss the appropriateness of involuntary discharge before filing an appeal, he said.
“In the end, a majority of the committee determined that House Bill 2246 was the best and most comprehensive plan that balanced the rights of residents to appeal involuntary resignations while also giving assisted living facilities the ability to keep residents safe and preserve their business interests,” English said.
English said Kansas needed a system that could better protect vulnerable residents in assisted living facilities. Existing regulations for assisted living businesses fell short of matching rights held by individuals in nursing homes or tenants of rental units. Homeowners facing foreclosure have broader rights than residents of assisted housing units, she said.
“Kansas regulations require the resident to receive a notice, but do not have any type of appeals process for residents of assisted living facilities,” he said. “Why should this segment, of one of the most vulnerable populations, be left out? Are their rights not as important as others?