New Accreditation Rule May Give Some Residents More Access to Care

Many of the country’s nursing homes are about to open their doors wider to patients and visitors – as part of a new federal rule that is met with some praise and others concern.

From New Hampshire to California, local nursing homes are cooperating with the new rules, which took effect last week. But some fear they could be sued if they make modifications that could conflict with the rules.

Among the changes, local nursing homes have to provide physical and occupational therapy and mental health services to patients, including music and art therapy, in addition to their daily food and medication. Residents will also be able to spend the night at their home as long as they’re not injured or incapacitated by the home’s activities.

“There are certain areas we have to follow,” said public affairs director Peggy Hernandez of Maine Medical Center, “but you also have to look at the patient as well. They have the right to, as a resident, express their needs and wants. So, we will certainly make sure they get what they need.”

The new rule requires the home to allow family members to eat with patients, for example, even if the home doesn’t have a designated meal service area. That could put the home at risk of a lawsuit if the nurse or food service supervisor goes off duty during the meal.

Medicare may also sue, according to the rule, if nursing homes won’t meet the new requirements.

“The Affordable Care Act is trying to move the country toward more community-based care, more cost savings, and quality care,” Hernandez said. “So it seems to be in the best interest of the patient to open up the facility and be able to meet those needs.”

In addition to Maine Medical Center, Maine Recovery Health Care in Lewiston allows guests to stay overnight and even dine together as a group, she said. It will also require residents to have a physical therapist visit every other week.

Boston Pilgrim has also implemented the rules and makes it mandatory for residents to have a physical therapist visit three times a week.

“With almost all of the clients of ours being either still in nursing homes or not having been discharged into the community, we see so many residents that need a physical therapist, they need a mental health therapist, they need speech therapists, occupational therapists,” said Sarah Larocco, manager of quality and patient experience. “We see so many employees at the center that need the same types of people.”

Roger Weeden, the chairman of the board of directors of the National Residents Campaign, which advocates for the needs of nursing home residents, said there are concerns with the new rule. For example, the new rule could potentially force the home to deny physical, occupational and speech therapy to an Alzheimer’s patient, he said.

“These individuals are placed in a facility that has a right to provide those services and need those services,” he said. “We’ve seen that a lot of nursing homes have denied physical, occupational and speech therapy to Alzheimer’s patients that are requiring those services.”

In addition, the rule requires local home managers to spend one day per month with their staff to review their rules. And the homes must meet federal requirements to certify that all written procedures they use for emergency situations are consistent with the new rules. The length of the certification process will vary from facility to facility.

Although some believe it’s a good idea for residents to be able to come and go as they please, there are still questions about whether it will get the greatest benefit, they said.

“They’re not discussing the impact on efficiency and safety of nursing homes and services,” Weeden said. “For many residents, that may mean they’ll have the greatest access to services, the greatest access to the most people at the lowest cost.”

The Associated Press contributed to this report.

Copyright MSNBC

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