Calvary Hospital like any other Nursing home, offers a very cost effective means of enabling patients with severe illnesses, injuries, or other postoperative care requirements to recuperate in an institution away from a hospital. In this regard, Calvary hospital is a care facility licensed to provide round the clock room, board and other health care services among them; both basic and skilled nursing care, therapies, treatments, rehabilitation among other programs. After being referred for care under the Medicare Hospice Benefit, it becomes the responsibility of the hospice to provide professional management of various services to the resident. Delivering of the end-of-life care falls within the dual regulations of the nursing home and the hospice through a plan of care must based on the assessment of the patient’s needs and specific living arrangement including the resident’s current physical, psychosocial, spiritual and medical needs. In addition to this, it must allocate the type of care and to be provided in order to meet the patient’s needs.

Calvary hospital as a nursing home is bound by law to provide a standard of care that is reasonably expected to be provided in similar institutions. Since different homes provide different care, they are expected to provide high level care to its residents. Nursing home’s legal liability can be said to be based on two principles, the general standard of care applicable to nursing homes and nursing home staff members and the liability arising from various state and federal laws and regulations. Different state and federal laws to a larger extent regulate the nursing homes and as long as these laws relates to resident safety, any breach can amount to negligence on the part of the nursing home (Carlson, Lim & Meier, 2011). These regulations in particular cover licensing as well as maintenance and general operations of a nursing home.

In this regard therefore, there are several legal responsibilities that each nursing home must fulfill as well as the care requirement provided for by the U.S. Code of Federal Regulation (42 CFR Part 483). To begin with, they must admit a specific number of residents which it believes it can provide nursing care for safely and adequately without straining their facility. This means that they can only admit more residents if they have enough CNAs or nurses at their disposal and in case of applicants who were denied admission, the home must give reasons for their denial in writing. In addition, the nursing home is supposed to ensure that drugs and medications are used in quantities that do not interfere with a resident’s normal living activities. It is therefore against the law for a nursing home to use medications for convenience of its staff, or use them for punishment.

On the same note, the nursing home is expected to comply with all the other state and federal laws while at the same time providing the residents with spiritual needs. Further, the home must ensure that its residents are not subjected to restraints of any kind except with written orders from an attending physician which to be applicable for a specified period of time aimed at protecting such residents from injuring others or themselves.  The regulation of nursing homes in America is to some extent fragmented where different agencies share different functions as well as oversight roles. These functions are dived among various stakeholders (in no order of priority) such as Centers for Medicare and Medicaid Services, state survey agencies, researchers, consumer groups, nursing home providers, and independent governmental evaluators (Madhusoodanan et.al, 2014).

The regulation is three fold whereby, even though the main responsibility rests with CMS, it is shared among central agencies and their respective regional offices who deal with development of regulations and laying down guidance for the state survey agencies on one side and regulations enforcement on the other. The second fold involves sharing of responsibilities between CMS and the state survey agencies. This relationship, the CMS takes up the duty of setting out state’s operations manual that details the roles of the state agencies while at the same time allocating resources to them. This makes the state agencies to have a dual accountability to both the CMS and their specific state government. In this kind of relationship, CMS is mandated with the oversight role over the state agencies. Thirdly, there is a fragmented responsibility of certification and licensing where the former is handled by the federal government while the latter is left to the state government.

From the foregoing statement, it is evident therefore that the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) is mandate to offer accreditation to all nursing homes through a program of long term care accreditation which was established in 1966. The main role for this body is to ensure that all nursing homes improve the quality of care they offer to their residents through periodical surveys. After the accreditation, nursing homes are certified by either Medicare or Medicaid if it convincingly meets their criteria (Rodriquez, 2014). With reference to Calvary hospital, New York State conducts inspection after every 15 months and where the nursing home fails to meet the set requirements; the state may fine or penalize the nursing home (Allen, 2011). In conclusion, even though this kind of fragmentation of responsibilities may cause complexities, there is the need not to compromise clarity and priority of the mission. Finally, it is important to balance between nursing home independence and accountability.

References

Allen, J. E. (2011). Nursing home administration. New York: Springer Pub

Carlson, M. D., Lim, B., & Meier, D. E. (January 01, 2011). Strategies and innovative

models for delivering palliative care in nursing homes. Journal of the American Medical Directors Association, 12, 2, 91-8.

Madhusoodanan, S., Nwedo, S. A., Brenner, R., & Mirza, O. (January 01, 2014).

Preadmission Screening and Resident Review (PASRR) regulation and its implications for patients, hospitals, nursing homes, and the taxpayers. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, 26, 2, 83-7.

Rodriquez, J. (2014). Labors of love: Nursing homes and the structures of care work.

 
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