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Nursing home payments changed

October 23, 2009
Times Leader
OHIO’s STATE budget included changes in how nursing homes are reimbursed for services to residents receiving Medicaid assistance. While most of the state’s nearly 1,000 skilled nursing homes continue to provide excellent care for their residents, some have said that they will need to merge or close and many will be forced to make layoffs, which could affect the level of care residents receive. In such an environment, it is essential that nursing home residents and their families know their rights and how to stand up for them, should the need arise.
Since the 1970s, Ohio has had a model Resident Bill of Rights in state law and the federal nursing home reform law of 1987 reinforced those rights to information, choice, safety and quality care. Anyone who lives in a long-term care facility needs to know that while they are no longer in their own homes, they have not given up the right to independence. They have the same rights they’ve always had, plus a few more. Nursing facility resident rights must be provided upon admission and posted prominently in the home. Facility staff should supply copies upon request.
Residents have the right to information, to make decisions, to have visitors of their own choosing in private, to be free from discrimination and restraints and to stay in the facility or, if they wish, receive services in another setting that meets their needs.
Nursing home residents have the right to be treated with dignity and respect at all times. They have the right to decide how they want to spend their days. They get to choose how to spend their money, when to visit with family and friends and when to participate in activities inside and outside the facility. Residents also are assured privacy - in communication by mail, phone or visits; while receiving personal care and medical treatment and for all personal and medical records.
Nursing home residents have the right to know their medical conditions, participate in care planning and decisions about treatment alternatives, as well as available services and costs. They get to choose their doctors, other health care providers and their care and treatment. They also have the right to know how to apply for Medicaid and to receive all the care they agreed to in their plan of care.
If a long-term care facility tells any of its residents they are being discharged and must move, it is required to tell the residents in writing the reason for the discharge. There are only a few reasons that a nursing home may legally use to discharge a resident against their wishes. The facility also must inform the resident and their sponsor how to appeal the discharge and let them know that they do not have to leave until the appeal has been heard. The 30-day written notice must contain contact information for the Long-Term Care Ombudsman who can assist with the appeal. The facility also is responsible for arranging an alternative care setting that meets the residents’ needs.
Residents and their families sometimes hesitate to make complaints because they are afraid of retaliation - subtle changes in staff attitudes or more blatant abuse, neglect or even being forced to move out of the facility.
That’s where the Office of the State Long-term Care Ombudsman comes in.
Ohio’s ombudsmen advocate for people receiving long-term care in any setting from home care to nursing homes. They work with providers, consumers, their families and other representatives to resolve problems and concerns. Ombudsmen link residents with services or agencies, inform consumers about their rights, offer help in selecting long-term care providers and provide information and assistance with benefits and insurance. They can also provide information about Ohio’s volunteer ombudsman program and tell you how you can get involved. Call 1-800-282-1206 for more information.
Another important right of residents and their families is access to information about their facility and other nursing homes. The Ohio Long-term Care Consumer Guide is an interactive resource that includes information about nursing homes and residential care facilities in Ohio, such as size, location, services offered, customer satisfaction, regulatory compliance, performance measures and more. Information about alternatives to facility-based care is also available on the site.
Senior independence means you control the effects of aging on your life and you have a say about the adaptations necessary to deal with those effects.
Independence is everyone’s right - no matter your age.


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