Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, September 5, 1993 TAG: 9309050242
SECTION: VIRGINIA PAGE: B6 EDITION: METRO
SOURCE: CAROLYN CLICK STAFF WRITER
DATELINE: LENGTH: Long
Some callers to the advocacy agency, formerly known as the League of Older Americans, feared for the health of relatives at the Avante at Roanoke Health Care Center. Others wanted more information about the nature of the deficiencies. Still others worried about the reputation of other area nursing homes that housed their relatives or friends.
Turning over the care of an elderly relative to an institution can be a difficult decision. Choosing a suitable facility can be even more baffling, especially when a sudden, debilitating illness or discharge from the hospital demands a quick decision.
Along with determining what medical services are provided and whether facilities are certified to participate in federal Medicaid and Medicare programs, there is the nagging question of quality of care.
Is the environment pleasant? Are caregivers genuinely concerned about performing their jobs well? Do residents have the opportunity to improve their physical and mental conditions? Are they treated with dignity?
Consumers can turn to agencies like the LOA, an arm of the Virginia Department for the Aging, and the state Health Department for some answers.
The Health Department licenses the state's 257 nursing homes, and conducts federal-certification reviews for facilities designated to accept Medicaid and Medicare patients. All but 18 nursing homes in the state are certified to participate in Medicare and Medicaid.
Each facility is inspected annually to ensure it remains in compliance with state and federal requirements. If violations of state licensing regulations or federal certification requirements are noted during that visit, the facility must file a "plan of correction" and take steps to bring the home back into compliance.
"Technically, we are supposed to do a follow-up when we cite a deficiency," said Connie Kane, director of long term care services for the Office of Health Facilities Regulation. "If they had a deficiency during the annual review, they are subject to a follow-up."
Once an investigation is completed, those surveys and follow-up reports are public documents and may be obtained by calling the Health Department's Office of Health Facilities Regulation at (804) 367-2100 or writing to: Office of Health Facilities Regulation, 3600 Centre - Suite 216, 3600 W. Broad St., Richmond 23230. Copying charges may be assessed.
The Virginia Long-Term Care Ombudsman Program, mandated by federal law and operated locally through the League of Older Americans office, can provide information about the nature and outcome of complaints made against nursing homes, adult care homes and community-based programs.
Those complaints may come from a variety of sources - family members, staff members, patients, and the administrators.
"We can outline the complaints," said Laura Pollack, an LOA case manager. "We can't say who the complaint was made by, whether it was a resident or staff."
The agency can comment only on cases that have been investigated and resolved, so consumers cannot obtain information about ongoing investigations. Ombudsmen cannot recommend a particular facility over another.
The main office of The League of Older Americans is at 706 Campbell Ave. in Roanoke, 345-0451. Satellite offices are located in Botetourt County, 884-2303; Craig County, 864-6031; and the Alleghany Highlands (703) 962-0465.
Beyond obtaining information from state reports and aging agencies, advocates suggest conducting your own inquiry before signing a contract.
Reputable nursing homes are generally happy to provide tours of the facility to visitors.
Tell the administrator you plan to return and check out the daily routine during further unscheduled visits. Then go at different times of the day, perhaps in the morning as the staff prepares residents for the day, at mealtime, and again in the evening.
"Use all your senses," Pollack said. Note the condition of the building, whether the premises, including individual rooms, are well-maintained and if the facility is free of offensive odors.
Pay attention to how the staff treats the residents, particularly interaction with residents who may suffer from Alzheimer's disease or other impairments that may make it difficult to communicate. Are there restrictions on use of restraints?
Determine if a physician is available during emergencies and whether other medical services are available.
Talk to the residents themselves and ask them about their impressions of the facility. Are they dressed neatly and appropriately? How often are they provided a full bath or shower? Are there programs that enrich their lives or are they apathetic to their surroundings? Do they have access to the outdoors?
Sample the food and determine if mealtimes are pleasant experiences. Check to see if bedridden patients are provided nutritious meals, if their individual food preferences are considered, and if they are allowed enough time to eat them.
Ask about the facility's reputation in the community.
Locally, the League of Older Americans publishes a "Long-Term Care Guide" that provides information about nursing homes, adult homes and home health agencies in the region.
The U.S. Department of Health and Human Services publishes a "Guide to Choosing a Nursing Home." It may be obtained by writing the Health Care Financing Administration, 6325 Security Boulevard, Baltimore, Md. 21207-5187.
by CNB