Life as a resident in a skilled nursing facility can be a challenging experience both for the resident and their family. A resident is dependent 24/7 for all their needs on the care provided by the facility and its employees. Such dependency presents difficulties both for the resident and the facility. Nonetheless certain standards of care do apply. Unfortunately, in some instances the environment in the facility and/or the quality of its employees and administrators may fall short of the standard of care that a resident is entitled to receive.

Anyone who visits a resident in a California nursing facility can see a laminated copy of the Patient’s Bill of Rights posted on a wall in each resident’s room. Resident rights, however, can be violated as confirmed by the substantiated complaints filed with the Center for Health Care Quality’s (CHCQ) Licensing and Certification Program (which investigates and substantiates complaints against nursing facilities).

Residents are often unable to advocate for themselves and so depend on others to do so, such as the resident’s agent under an Advanced Health Care Directive. A resident’s family should, therefore, be aware that the resident has, “a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility, … [the Nursing Home Reform Act §483.10) and also California regulations].

An important resource in addressing any concerns and grievances is the Ombudsman’s Office. Each county has an Ombudsman Office that assigns an ombudsman to each facility. “The Ombudsman program advocates on behalf of residents in long-term care facilities, working to protect residents’ rights, investigating and resolving complaints made by or for residents, addressing quality of care/quality of life issues, providing training, education and technical assistance, monitoring rules, regulations and legislation.” (www.lakecountyca.gov/771/Long-Term-Care-Ombudsman)

Each resident is entitled to an “individual care plan” that is developed, and reviewed and (as needed) modified annually, by the skilled nursing facility and the resident or his/her legal representative. The care plan is the cornerstone to the relationship between the facility and the resident. A resident’s health care agent is entitled, and well advised, to participate in such care planning. It is an opportunity to address concerns and, in the case of an annual review meeting, to revisit any unresolved grievances. A resident’s representative may request the Ombudsman to be present.

Family visits to the facility are important to the resident on multiple levels: It is reassuring to a resident to interact with their family and be connected to loved ones; it is also important for the family see how well the resident is doing and raise any concerns with the facility’s administration or nursing staff. Each facility also has a social worker who speaks to the family about concerns and directs them within the facility.

Any concerns, disputes and/or agreements with the facility are best documented by the resident’s representative by written communications to the facility’s administrator. Anything important that is said is best documented. Do not simply take it for granted that what is said by the facility will necessarily be honored in practice. Get it in writing and see that the practice is actually implemented. If there is a problem, discuss it with the Ombudsman’s Office. For more consumer rights information and for a legal referral consider the California Advocates for Nursing Home Reform, www.canhr.org.

If all efforts to redress a serious resident welfare problem directly with the facility and through the Ombudsman’s Office prove futile, and a valid grievance still exists, then a complaint may be mailed, faxed or filed on-line with the California Health Facilities Information Database (Cal Health Find) www.cdph.ca.gov/Programs.

A filed complaint is investigated by the state regulatory agency, often through an onsite investigation at the facility. The investigation will either substantiate the complaint’s allegations or not, as the investigator’s report recommends. Lastly, legal representatives of residents may use court proceedings to redress serious resident rights violations.

The foregoing is not legal advice. Anyone confronting the issues addressed should consult with a qualified attorney. Dennis A. Fordham, attorney, is a State Bar-Certified Specialist in estate planning, probate and trust law. His office is at 870 S. Main St., Lakeport, Calif. He can be reached at Dennis@DennisFordhamLaw.com and 707-263-3235.

“Serving Lake and Mendocino Counties for nineteen years, the Law Office of Dennis Fordham focuses on legacy and estate planning, trust and probate administration, and special needs planning. We are here for you. 870 South Main Street Lakeport, California 95453-4801. Phone: 707-263-3235.”