More protection needed for vulnerable adults

November 19, 2012 

As a long-term care provider, I believe our state’s strong Abuse of Vulnerable Adults Act is commendable. Indeed, it should be enforced more broadly.

Any caregiver working for me is a “mandatory reporter.” He or she must report to the state any reasonable suspicion of abandonment, abuse, financial exploitation or neglect.

In fact, many state investigations in facilities are just follow-ups on self-reporting.

Further, any resident, family member, or volunteer who witnesses something questionable can call 800-363-4276. This reporting applies to in-home care just as it does to facility-based care.

I support this law, yet wish the state applied it to family members of vulnerable adults who too often fail to pay for care, as they are entrusted to do under guardianship or power of attorney.

Family members often withhold resources from a resident’s care – either to preserve an inheritance or steal, unnoticed, from someone whose frailty has led to mental decline.

And under state law such family members cannot be obligated in facility admission agreements.

Deadbeat family members bet facilities will not discharge a resident for nonpayment – either because of “check is in the mail” reassurances, because punishing the resident for family failings seems immoral or because state law makes it almost impossible to discharge residents.

Even if a facility wants to discharge a resident for nonpayment, it cannot without at least a 30-day notice.

That only adds to the injury – negligent family members treat it as another free month of care.

In many sad cases the resident has died by the time it becomes clear no payment will be made. Yet, in a Catch-22, it’s only upon discharge for nonpayment that the legal grounds for “abandonment” or “neglect” would be established against the irresponsible family member under the Abuse of Vulnerable Adults Act.

Similarly, family members often fail to pursue private insurance claims for an insured resident’s care. Given the time-honored practice of insurers in delaying, or denying, claims, this creates another hardship. The care provider, as a third party, has no direct standing relative to the insurer to force payment.

Two reforms are in order.

First, the state should sanction negligent family members, or other resident surrogates, for “financial exploitation” which includes the “withholding of the property, income, resources, or trust funds of the vulnerable adult.”

The state should feel a special obligation to ensure private payments are made because its own Medicaid payments for the medically-indigent fall so short of covering care costs.

Second, as insurance is state-regulated, the state should grant care providers standing in pursuing insurance claims that those acting in the place of a vulnerable adult may fail to follow up on.

Building on its success with the Insurance Fair Conduct Act, which applies to property and casualty insurance claims, the state should also require prompt payment of long-term care claims. After all, who’s more vulnerable – someone whose property was damaged or a nursing home patient? It’s grotesque to think repairing a car is more important than protecting seniors.

These modest reforms would help care providers beset with an age wave and the constant threat of bankrupting Medicaid and Medicare cuts.

Craig LeVee is the owner and administrator of Roo-Lan Health Care Center and Lodge in Lacey.

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