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Archive for Thursday, January 30, 2003

Elder care inspections under fire

Opponents object to facility officials joining KDHE on tours

January 30, 2003

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— Advocates for the elderly are worried recent changes in the way the state inspects assisted-living facilities will help the industry more than it does the people in its care.

"This, I think, is an example of the state's being far too sensitive to the concerns of the industry and not nearly sensitive enough to the concerns of the residents," said Margaret Farley, a Lawrence attorney and past executive director at Kansas Advocates for Better Care, an association that monitors conditions in the state's nursing homes and assisted-living facilities.

"Assisted-living facilities are barely regulated to start with, and (the state's) enforcement hasn't been all that strong," Farley said.

Under the new arrangement, which started last fall, officials at assisted-living facilities are no longer kept at arm's length. Instead, they're free to accompany inspectors on their rounds, seeing what they see, hearing what they hear.

Advocates worry that the arrangement will lead to coercion or collusion between inspectors and facility managers.

But lobbyists for assisted-living facilities say the new arrangement works great.

"Kansas is on the verge of stepping out and being a leader in the regulation of assisted living," said Marla Lopeman, national vice president of sales and marketing for Alterra Healthcare, one of the nation's largest assisted-living companies.

Lopeman testified Wednesday before the Senate Public Health and Welfare Committee.

Sharon Watson, a spokeswoman for KDHE, said the new arrangement was meant to increase industry officials' understanding of the survey process.

"Rather than a surveyor writing up a report, turning it in and saying, 'Here's where you went wrong,' the process will be explained as it goes along," Watson said.

"This isn't about not being written up; it's about understanding why you were written up. The regulations are still there; they've not been changed," she said.

Since the change, facilities' annual surveys are more efficient, Lopeman says, and when problems arise, they are dealt with quicker.

"The survey process is not more lenient. It just got quicker and more collaborative," she said.

She said the assisted-living industry and KDHE still were trying to figure out how best to notify the media when the state takes action against a facility.

"The media likes to portray us with the tobacco industry," Lopeman said.

She said KDHE often notified the media of enforcement action weeks after the problem has already been cleared.

Alterra serves about 850 patients in Kansas with 28 assisted-living residences, including four for Alzheimer's disease patients.

Last year, Kansas Department of Health and Environment banned admissions at Alterra facilities in Overland Park, Junction City, Abilene and Wichita after the facilities failed inspections.

In 2001, bans were imposed at Alterra facilities in Salina (two), Olathe (two), Abilene and Junction City.

The company recently filed for Chapter 11 bankruptcy protection.

Lopeman said the bankruptcy was "the final step in the company's restructuring, which has been going on for two years. We are still a sound company."

Brian Wood, a Salina attorney who represented several clients in lawsuits filed against assisted-living facilities, said he's willing to give the new arrangement a chance.

"As long KDHE surveyors remain truly free and independent, I don't have a problem with it," he said. "But I wouldn't want the facility directing the survey in any way, shape or form -- that would concern me."

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