Stuck in the Hospital “Let Me Return Home” 2017 Consumer Voice Annual Conference Cheryl Hennen MN State Long Term Care Ombudsman November 6, 2017

Refusal to re-admit on the increase (aka: “dumping”) Analysis of federal data from Long-Term Care Ombudsman. Associated Press - complaints about discharges and evictions are up 57% since 2000. Top reported complaint in 2014 – 11,331 complaints logged by Ombudsman (Associated Press 2016) MN data – steady increase, at least 45% of current complaint work.

What does it mean? Not allowing residents to return to their homes after an acute stay in a hospital . Includes nursing homes and other residential adult living arrangements. Residents of Nursing Homes have rights under federal and state laws with regard to transfer and discharge. Not allowing a resident of a nursing home to return after an acute stay in a hospital is an involuntary discharge.

MN Example Woman 87 years old; diagnosis advanced Alzheimer's Disease, congestive heart failure, and renal failure. Resident of a nursing home Son under investigation of financial exploitation Facility issued involuntary discharge notice (2) location of discharge to son’s home. Transported to hospital Facility refuses to allow resident back – transferred to a facility 30 miles away. Passes away 2 weeks later

MN Response: Development of training curriculum for hospital discharge planners. In response to numerous calls from hospitals concerned about refusing to allow residents back home. Project began in 2006 Overwhelming interest and request for training Revisions in response to new regulation Working to complete curriculum specific to tenants who reside in other adult residential facilities and receive home care services.

“Let Me Return Home” PowerPoint Presentation excerpts Role of the Long-Term Care Ombudsman Focus on advocating and protecting residents rights to be free of abuse and exploitation. To empower residents and resident councils to feel confident and speak out. Protect residents right to decision making and residents self-determination. Assist in making referrals to proper agencies Ombudsman Federal mandate to advocate for changes in the systems that provide or regulate long-term care services

Resource Materials Consumer Voice , Justice In Aging, Center for Medicare Advocacy: Issue Brief - A Closer Look at the Revised Nursing Facility Regulations: Return to Facility After Hospitalization http://www.justiceinaging.org/wp-content/uploads/2017/04/Revised-Nursing-Facility- Regulations_Return-to-Facility-After-Hospitalization.pdf Involuntary Transfer Discharge http://theconsumervoice.org/uploads/files/issues/Revised_Nursing_Facility_Regulations_I nvoluntary_Transfer_and_Discharge.pdf

MN Resource Materials: MN Department of Health in Collaboration with MN Ombudsman Program http://www.health.state.mn.us/divs/fpc/profinfo/061917callfile4.pdf MN Depart. Of Health Bulletin: Nursing Home Discharge/Transfer Notices (Pending revision with updates and corrections) Involuntary Discharge Checklist

THANK YOU Cheryl Hennen MN State Long-Term Care Ombudsman