History and Philosophical Stance

In relation to this blog we are affiliating ourselves with the Wisconsin Board on Aging and Long Term Care who states that long term care consumers have the right to:

· Be treated with respect and dignity;

· Be free from chemical and physical restraints;

· Voice grievances without fear of retaliation;

· Associate and communicate privately with any person of their choice;

· Have personal and medical records kept confidential;

· Apply for state and federal assistance without discrimination;

· Be fully informed of their rights, services available and all charges prior to admission to a facility or enrollment into a program; and

· Be given advance notice of transfer, discharge, disenrollment, termination or changes in services.

The history of long term care in the U.S. has taken some drastic turns; “the number of nursing homes in the United States has declined by over 10% between the years 1999 and 2004¹”. In 1981, the Board of Aging and Long Term Care was created by the Legislature. The Board and other associated programs became in existence to advise the Governor and Legislature on long-term care policy and work directly with and protect the interests of Wisconsin citizens 60 and over³.

Nursing homes are shutting down all over the country due to off the map expenses pushing more and more long-term care customers into under qualified, understaffed facilities. Patti Beilfuss, a former nursing home RN stated; “20 years ago skilled care was not delegated to unskilled providers, the care was provided by skilled, licensed nurses^2.”

Nursing homes have very strict regulations; if someone is falling, it is the nursing homes job to provide that patient with whatever they can to help prevent the falling. An assisted living environment on the other hand, doesn’t have to spend their money on things like an alarm system to notify workers if someone is about to fall.⁴ Instead, assisted living facilities can spend their money on making their facility look nice so people in the community will want to send their family member there. One of our team members works as a CNA at an assisted living in her home town and shared with us that when a resident at her facility wants to use their call button they are charged to do so. That right there is exactly what is wrong with long term care!

Today it seems there isn’t much care that can’t be provided in an assisted living environment; which of course is more cost effective. People can pay a fee and a few weeks later pass a class to become a Certified Nursing Assistant (CNA), providing care that only Registered Nurses used to be able to do. Just because a CNA knows how to pass meds, doesn’t mean they know what signs and symptoms to watch for after giving their resident the medication. Patti Beilfuss, who now works for Care Wisconsin (a Managed Care Organization that provides Family Care) also stated; “It is not uncommon for Family Care members that reside in assisted living environments to be sent to the emergency room by ambulance and require hospitalization for reasons that could have been prevented had they been receiving skilled care².”

Assisted living facilities are finding ways around the little regulations they have. Many of these facilities are ‘for profit’; and only interested in making money. Too many facilities have minimum staff to resident ratios, this may be saving the facility money, but the residents are not receiving the proper care and supervision they need and deserve.

The term Ombudsman is becoming more and more popular to family members of residents who have been transferred from nursing homes to assisted living environments. An Ombudsman advocates for and protects the rights of long term care consumers⁵. Ombudsman work with families and providers to achieve individualized quality care and quality of life for long term care residents. Ombudsman’s authority has been recently extended to tenants of Residential Care Apartment Complexes (RCACs), due to the fact that the typical resident living in such facilities did not require as much assistance or supervision as they do now. The original long term care Ombudsman program had only a handful of regional staff. Today there are fourteen regional Ombudsmen in Wisconsin alone³.

After learning the pathetic truths behind long-term care, our group decided our reform proposals needed to be focused on the three legged stool the health care system revolves around; affordable costs, accessible facilities for everyone, and much better quality of care!

References

1. Shi, L., & Singh, D. A. (2008). Delivering health care in America: A systems approach (4^thed.). Boston: Jones and Bartlett.

2.P. Beilfuss, personal communication, February 16, 2011

3. Board on aging and long term care (n.d.). History. Retrieved February 16, 2011, from http://longtermcare.wi.gov/subcategory.asp?linksubcatid=3001&linkcatid=1953&linkid=1014&locid=123

4 4. U.S. department of health and human services. (2011). Centers for Medicare and Medicaid services, nursing homes. Retrieved February 19, 2011 from https://www.cms.gov/CertificationandComplianc/12_NHs.asp

5. State of Wisconsin board on aging and long term care (n.d.). The long term care Ombudsman. retrieved February 16 2011, from https://docs.google.com/a/uwlax.edu/viewer?a=v&pid=gmail&attid=0.1&thid=12e2ee50ea975459&mt=application/pdf&url=https://mail.google.com/a/uwlax.edu/?ui%3D2%26ik%3D1384f453c6%26view%3Datt%26th%3D12e2ee50ea975459%26attid%3D0.1%26disp%3Dattd%26zw&sig=AHIEtbQXHbzMuW6njlRFossBtaQBVBX1gg