Rights not enforced are rights denied

Local nursing home residents are learning a sad truth: rights are not really rights if the state is unable or unwilling to enforce them.

Case in point: A resident of a Santa Cruz County skilled nursing facility (SNF) recently went to the hospital because she was experiencing pain. She only needed to be there for a couple of hours to be assessed and then was ready to go back to her home at the nursing home. But when hospital staff called to facilitate the return, the nursing home management said they would not take the resident back and would not participate in finding a new placement.

The hospital staffers were versed in the rights of nursing home residents. They knew that nursing home’s action was a violation of federal and state regulations and they referred the case to the Long Term Care Ombudsman. At the resident’s request our office filed a protest before a state hearing officer.

A hearing was held at which both sides presented their cases. The hearing officer ruled the nursing home had, in deed, violated the regulations and issued a legal order for the nursing home to readmit the resident.

A happy ending, right? Well, not so fast.

The nursing home continues to refuse to allow the resident to return to her home. The resident went to the hospital on April 19. The hearing officer’s decision was issued on May 4. As I write this post on May 11, the resident is still at the hospital, taking up a bed that could be used by a patient that truly needs services of an acute facility.

A reasonable reader would wonder why the nursing home could get away with ignoring an order from a hearing officer that is empowered by state law to interpret state regulations. That is because there is no branch of state government that admits to having the authority (or the willingness) to enforce the order to readmit.

That’s correct. Residents have rights, but state agencies refuse to enforce them.

More on this later.

Unfortunately, the local case is a symptom of a national problem. The issue is noted in a recent Associated Press article that appeared in the Washington Post and other newspapers and was outlined in a National Public Radio story.

Skilled nursing facilities around the country are dumping their least profitable residents at hospitals. Why are they doing this? Resident advocates believe there  is a dollars and cents answer. Short stay Medicare residents are more profitable than the long term Medicaid (we call it Medi-Cal in California) residents who often have complicated medical issues.

Given the state’s inability or unwillingness to enforce the law the corporations that own nursing homes find it is more profitable to kick out residents who require more expensive care .

There is an attempt to bring some measure of justice to nursing home residents. The California Advocates for Nursing Home reform has filed a legal action against the California Department of Public Health to get the department to enforce the regs. You can find information on the suit at CANHR v. Dooley.

If you are outraged about the way some nursing homes — and by its inaction, the state —  are treating dependent elders, congratulations!; you ought to be outraged. If you are not outraged — why not? The victims of hospital dumping are those least able to help themselves: the poor, the medically fragile, the residents with few options.

The Long Term Care Ombudsman Program of Santa Cruz and San Benito Counties is here to fight for resident rights. We will continue to fight this case for as long as the resident wants our help.

Join the fight. Call your Legislative representatives. Tell them that the state has a responsibility to make sure the rights of nursing home residents are protected.

Call me (429-1913) if you need to know who to call.

“FUND”amentals of advocacy

Ahhh, Spring! The flowers are starting to bloom, my beloved San Francisco Giants are preparing for the start of the baseball season. And our non-profit agency starts making its pitch to city, county, and state government for funding for the new fiscal year.

This is the time of the year when, in addition to advocating for residents, we develop a budget and talk to the elected officials who primarily fund our efforts. We could use your help in this effort. I explain how in a little bit.

Long Term Care Ombudsman programs have a unique funding model. Although we are mandated by state and federal law, we draw our resources from a variety of sources. Some federal dollars are routed through the state who contracts with local Area Agency on Aging bodies to determine how Ombudsman services will be provided in their jurisdiction.

But federal and state dollars are not enough to support a robust program to protect resident rights. So we ask for aid from cities, counties, and philanthropic groups.

We have been blessed to be supported by nearly all of the cities in our service area plus the governments of Santa Cruz and San Benito Counties. We also get assistance from the United Ways of each county plus$20,000 from the Monterey Peninsula Foundation. I am proud to say that we get a yearly donation from the Aromas Eagles, a service organization in my hometown.

Put that patchwork together and add some private donations and you have our funding model. That’s a lot of work for only barely enough money to keep the doors open.

When the Ombudsman program was created by federal law back in the 1970s, it was designed to be a partnership of federal and local resources. In fact, there are mechanisms that encourage programs to seek local support and not simply rely on Washington. The founding notion was that protecting the rights of facility-bound residents is a mission that should be shared by the entire community. Having an active cadre of volunteer Ombudsman is one manifestation of the push for shared responsibility.

Our financial support was hit hard during the Great Recession. We now have a smaller staff then we did when I became an Ombudsman 11 years ago. In 2008, all state general fund support for local programs was taken out of the state budget. Just last year, a fraction of that funding was restored.

City and county leaders want to be responsible stewards of local funds. They need to know the money is being used wisely and that expenditures are supported by citizens.

That’s where you come in. If you are a resident of a long-term care facility, or you have had a loved one in a facility, you most likely have witnessed the work of the Ombudsman. You know that we identify and work to resolve quality of care issues. You know the Ombudsman is often the only voice advocating for resident rights. You know how important our work is to the daily lives of residents.

We need you to tell others. In the coming days, weeks, and months, we will be asking you to contact local and state leaders and ask them to financially support the work of the Ombudsman. Please answer the calls to action. If you want to talk about how you can help spread the word about the public value of Ombudsman services, give me a call (831-429-1913 in Santa Cruz, 831-636-1638 in San Benito) and we will work out an action plan.

Advocating for quality care and protections of rights takes all of us.

Time Is Best Gift

My grandmother was a generous woman, but as a woman with limited means she had to find creative ways to express her generosity. She learned an important lesson and I’m privileged that she passed it on to me.

“The greatest gift you can give someone,” she said, “is to give them some of your own time.”

She was right, of course. The most expensive present can’t really compare to having people care for us when we are helpless or speak up for us when we are voiceless.

We are blessed at Advocacy, Inc. to have a dedicated group of volunteer Ombudsmen who generously give the gift of their own time to advocate for residents of long term care facilities in Santa Cruz and San Benito Counties. Our volunteers have busy lives with jobs, activities, families — including grandchildren — but somehow they manage to find the time to make sure that complaints are addressed and rights are protected.

Our volunteers work varying schedules. Some can only work 5-6 hours per week. Others are able to donate much more time. All of their contributions are important and invaluable.

Our volunteers are full-fledged, certified Ombudsmen. They complete 36 hours of classroom training plus an internship. Once they earn their certification, volunteers have the same authority as paid staff. We couldn’t meet the needs of facility-placed elders without their contributions.

We hold training about once a year. We hope to be able to schedule a session in the first half of 2016. If you are interested in applying, give me a call at (831) 429-1913.

My grandmother would have loved our band of volunteers. She would have marveled at their dedication. And she would have thanked them for the important work they are doing.

I hope you are having a joyous holiday season. I pray for peace in the New Year.

Sharing our gifts

This is the time of year dedicated to being grateful for all of the gifts we have been given. The fortunate among us can be glad that we have shelter, food security, the love of family and a place in our community. I am certainly blessed by  these things.

But it is also a season to consider that there are many who are not so fortunate.

In our work here at Advocacy-inc., we see residents of long-term care and mental health facilities that struggle to be seen as the people they are; people who have rich and diverse experiences; who are fathers, daughters, workers, executives, artists, and business owners. They struggle to give voice to their human need to be both cared for and to be cared about.

The work we do here at Advocacy-inc is richly rewarding — even if we wish that the work didn’t need  to be done. We understand that caring for the fragile and vulnerable among us is not a task meant for even the most dedicated individual — it takes a community.

I believe that the best judge of a community is how well it takes care of those who can’t readily take care of themselves.

The men and women of Advocacy-inc and our group of dedicated volunteers could use your help. Please consider Advocacy-inc as you make decisions on your holiday giving. You gifts will help us give voice to the voiceless and advocate that all of us have a basic right to be treated with dignity and respect.

It’s easy to support our work. There is a DONATE button on our homepage. Checks can be sent to our office, 5274 Scotts Valley Dr., Suite 203, Scotts Valley, CA, 95066. For information call (831) 429-1913.

Thank you. Happy Holidays!

Annual Fund Drive – YOU Can Help!


Dear Friends of Advocacy,

What time did you get up this morning? Did you have breakfast before bathing or did you exercise first?  Who decided?  That may seem like an odd question – of course YOU make those decisions!

But life changes when one experiences a significant health event – stroke, traumatic brain injury, a diagnosis of dementia or a major mental illness. Many end up in long-term residential or skilled nursing care where strangers care for the most basic physical needs – eating, bathing and toileting. In this situation it seems that facility staff, family and friends all know what’s best for the resident, but who represents the resident’s point of view?

The staff and volunteers of Advocacy, Inc. work to protect the rights of long-term care facility residents and mental health clients, so that they may have the quality of life and appropriate care they deserve. Both programs provide complaint resolution, abuse prevention and intervention, rights protection and advocacy for quality care. We are also a vital source of training and information to the community.

Although our work is mandated by state and federal law, funding from those sources falls far short of the actual cost. To provide these necessary services we rely on foundation grants and donations from friends and supporters like you.

Your tax deductible contribution helps support our work for elder and dependent adults in long-term care, and mental health clients in Santa Cruz and San Benito Counties. Please consider donating now by clicking here: DONATE NOW

On behalf of those we serve, thank you!
Gary Signature
Gary Edwards
Executive Director – Advocacy, Inc.

Choosing long-term care? We can help!

I had the pleasure of speaking to a lovely and lively group of people the other day. It was a fun time even if the topic – How To Choose A Nursing Home – wasn’t the most pleasant.

I was invited to speak at the monthly Seniors Pot Luck Luncheon at the Aromas Bible Church. This group gets together once a month to share a meal and socialize. Pastor Kevin Stottrup asked me to share about the work I do as a Long Term Care Ombudsman.

Aromas is where I’ve made my home since 1985. It is the place my daughter, Casey, grew up. And it is the first home of my granddaughter, Lily. The community’s location at the intersection of Santa Cruz, San Benito, and Monterey counties has influenced an ethic of taking care of one another because there are few governmental services available to us rural folk. Family is a big deal in Aromas. It isn’t easy to acknowledge that we might need a little help caring for our loved ones.

I told them it is not an admission of defeat when our elders enter a nursing home or assisted living facility. The truth is that sometimes the need for care or the needed resources – whether physical, financial or emotional – are just more than we can provide.

Sometimes the greatest gift of love we can give is to acknowledge our own limitations. Besides, it often isn’t our decision anyway. The choice about going into a facility and choosing a facility is the elder’s to make – not ours.

We have resources at Advocacy, Inc. to help with the transition. We have lists of all of the long-term care facilities in Santa Cruz and San Benito counties. The lists and other useful information are available on the Ombudsman Page of our website. You can also call me or the other Ombudsman at (831) 429-1913 or (831) 636-1638 in San Benito County.

Breaking bread with the seniors in Aromas reminded me that we are all neighbors and that it is OK to ask neighbors for help. Have any questions, concerns or just need to talk about the subject? Call me.