By Kayla Matthews, HealthIT writer and technology enthusiast, Tech Blog
Twitter:Â @ProductiBytes
Long-term care health facilities, like most other entities that deal with interactions between people, have to determine the best ways to navigate the common legalities to the industry.
It’s often difficult for the facilities at large or the people working in them to spot issues and deal with them, but knowledge of their existence is a fundamental aspect that leads to improvements.
Here are two tricky legalities that long-term care workers should be aware of this year.
Injuries and Deaths Occurring in Long-Term Care Facilities
Injuries and deaths can both occur in health facilities that administer long-term care even when all parties involved follow best practices for ensuring patients’ safety and well-being. Deaths will realistically occur in centers that deal with older individuals who are a higher likelihood of passing away from natural causes. And, concerning injuries, they could happen because of circumstances outside of a facility’s control.
But, in the time immediately following injuries or deaths, the emotions of loved ones run high, and they may look for people to blame. That’s why it’s crucial for people at long-term care facilities to proactively monitor patient care to minimize liability.
One of the primary duties of a facility’s medical director is to oversee all the clinicians providing care in the facility and make sure they meet minimum standards of adequate care, whether they come from the outside to meet short-term needs or are regular staff members. There are also regulations surrounding attending physician visits.
More specifically, patients receive them every 30 days for the first 90 days following admission, and at least once every 60 days thereafter. During each of those appointments, the physician must review the person’s complete care plan, including all prescribed medications. Those periodic visits can help prevent problems, but medical directors must address physicians who are delinquent in their duties as well as any other providers who fall short.
They can do that by regularly reviewing records and intervening when necessary. Additionally, all parties involved in patient care must consistently document all interactions and accurately record what happened. Proper record keeping protects caregivers, plus helps facility managers recognize when things might be amiss.
It’s also crucial for long-term care facilities to hire lawyers who act as points of contact for anyone such as a patient’s physician outside of the nursing home or a loved one. Then, an individual or the care facility itself can bring any matters of concern to the legal representative.
Patient Disputes With Appointed Guardians
Guardians get appointed when patients are not capable of making their own decisions. This situation is common when adults have dementia, for example. Certain things can make it evident that it’s time to appoint a guardian, such as when an individual needs to sell a home or other investments and does not have the mental capabilities to handle it, or when the person refuses to go into long-term care.
States have slightly different rules about the types of guardianship and what power guardians have. Regardless of those specifics, a judge decides whether to grant guardianship, often examining documents such as a physician’s statement that asserts why that medical professional believes the person needs a guardian.
All physicians, whether they work inside the long-term care facility or not, need to know if a patient has a guardian, all medical decisions likely get approved by that person. However, in cases of partial guardianship — often granted to people with disabilities — the patient can still make some choices, including medical ones.
Ideally, legal guardians look for the best interests of the patients. But, disputes can still arise, and they may affect the respective care facilities. The National Guardianship Association publishes standards of practice that collectively give a framework for how guardians should behave, but problems still happen.
Resolving disagreements between patients and guardians often happens through hearings in the court system, but mediation could be an option, too. Disputes can also crop up when care facilities apply for guardianship. Some states allow that, such as in cases when a facility needs to collect debts. In such cases, the facilities should let their lawyers communicate with aggrieved parties.
Moreover, long-term care facility staff members must keep accurate records that inform everyone involved when patients have guardians. Without such documentation, it could be too easy to mistakenly give a patient decision-making ability over an aspect of care rather than the guardian, leaving the facility liable. In some states, long-term care facilities are legally obligated to request guardianship court orders in effect for their patients.
Being Alert for Issues Prevents Problems
These two legalities remain prominent for long-term care facilities and will for the foreseeable future. But, staying aware of issues and promptly responding to them can help keep things under control.