By Steve Moran
This is a story about leadership courage!
At the California Assisted Living Association Conference in Palm Springs, they have a session called “Ask The Attorneys”, something they do at each conference and is always fascinating. Almost every time someone asks a question where I go . . . “I hadn’t really thought about it that way”. This was one of those questions:
“I am the executive director in an assisted living community and we started a prospect’s admission process. When the physician sent in the required physician’s report it says dementia, which means we can’t take the resident. The family says, ‘Whoa . . . we will go back to the doctor and get this fixed.’”
“What do I do?”
The Temptation Is High
The temptation to think “cool another resident” is very high particularly when your occupancy is not where you want it to be. It is even higher if it means being called on the carpet by your leadership. It is easy to rationalize, in most assisted living communities many residents have some level of cognitive decline and so if you think about it, this is just a question of degrees.
In Fairness
In fairness, it is possible that a physician in haste will completely get it wrong, and if that happens, then getting it fixed or getting a second opinion is the right thing to do, the only thing to do.
But Beware
Joel Goldman’s recommended response to the families’ offers to get it “fixed” or to get a new physician report, is to unequivocally refuse to accept the resident and tell the family, “I am not admitting your mom because of you.”
From a lawyer’s perspective, which makes sense to me, having a family who is willing to manipulate the situation is a huge red flag that they will do and say whatever they want to get what they want. That they would be willing to lie, steal, or cheat to take advantage of you. They could even put your license and your livelihood at risk.
Imagine for a moment that this resident is in fact cognitively impaired and goes out of your building on their own. Your staff sees them exit just like she has done 50 other times, always without a problem. Then something happens and the resident dies or gets hurt or even has a medical condition.
You think to yourself, “no problem, we have our physicians report showing this resident is fine. No dementia, completely able to leave the community.” You are sad for the incident but not worried legally. Imagine your surprise when licensing shows up with that original physician report showing “you knew” there was dementia and did nothing to protect the resident.
This is your risk.
I am a CCRC resident who left my first CCRC experience in my rear view mirror. I am now ensconced in my second CCRC, in a different state. Per our friends we left behind, they got a new Exec Dir who was arrested by the local sheriff’s department on a warrant out of California. It seems this detained individual, according to the grapevine, was part of the management of a care facility that “took in” a dementia patient when the facility was not licensed to do so. There had been some elopements, then finally, a fatal one….. this “resident” went out onto a busy highway and was hit. I do not know what the legal charges were in the warrant.
What admissions person would want to take the legal risks mentioned above, let alone put the resident’s life at extreme risk?
Steve, I would imagine you heard about this incident since it wasn’t too far from you.