Ideas on Overseeing the Care in a Nursing Home When You Can’t Enter the Building

Advocating for our clients in nursing homes during this pandemic has been uniquely difficult, but we continue to utilize whatever tools are at our disposal to help the family members oversee the delivery of care to their loved ones. Many rights are guaranteed, and right now much creativity is needed to protect those rights. Care plan conferences with the treatment team (nursing, dietary, recreation, physical therapy, medical) can be set up in which the family member/ health care representative/ POA (and the attorney, if desired) are on a conference call. Dietary staff can communicate with family about menu selections at the start of the week, using scans or faxes + emails.  It is important to monitor diet because the lack of communal eating and snacking may be causing significant weight loss in residents.

Arrangements can be made for the resident to be brought down to the Lobby so that the concerned health care proxy/involved family member can actually see them through the glass windows or doors. Arrangements can be made for nursing staff to call the family at scheduled times with a report from the shift.  As the weather warms, facilities should be scheduling outdoor visits with family on a regular basis.

Access to the medical record can be arranged, and state law requires the facility to provide access to records to the resident and their authorized requester. Ordinarily, a patient’s advocate/family member who has HIPAA authorization can review the chart during their visit to the nursing facility, in order to stay up to date with the care that’s being delivered, how the resident is functioning, whether there were any incidents and what medications the person is taking. Right now, no third parties are allowed on the premises of the skilled nursing facilities. Since the facility is obligated to keep the families informed about the condition of the resident, creativity and cooperation are needed. Have a discussion with the administrator about a reasonably convenient way that the facility can send this information out – perhaps once a week via fax or scan.

Updates on the COVID-19 situation as it affects seniors and those who care for them can be found here and here.  Many towns have put special programs in place to provide support for frail and housebound community members who are suffering due to the pandemic. The local Aging & Disability Resource Centers can also be useful as an access point for information and services, even though service delivery is not swift during these times.

For help with your unique senior care legal problems, call us at … 732-382-6070

Update on Care and Emergency Directives Affecting Residents of Nursing Homes

Governor Murphy this week signed into law S2333/A3910, an Act granting civil immunities to health care workers and facilities for actions taken in good faith during the declared state of emergency. The act also waives certain professional licensing restrictions and requirements on health care personnel to quickly expand the health care work force in an effort to ease the traumatic staffing shortages that are being caused by the high rate of sickness among health care personnel.

The new law embodies essentially what was included in Executive Order 112 issued by Governor Murphy on April 1st. EO-112 easing licensing restrictions for health workers.  This EO enables certain categories of health care professionals to enter the field temporarily or to practice more broadly than the current limitations on their licenses, with streamlined procedures. Retired licensed health care professionals or those whose licenses lapsed due to nonpayment of annual fees during the past 5 years can temporarily re-activate their license and re-enter practice by a streamlined process through the NJ Division of Consumer Affairs (DCA). The DCA issues licenses to physicians, nurses and nursing assistants, physicians assistants, dentists, chiropractors, acupuncturists, and others. Physicians licensed overseas can be issued temporary licenses by the DCA. The scope of practice of Advance Practice Nurses and Physicians’ Assistants is expanded temporarily. Supervisory responsibilities placed on physicians over certain other physicians or physicians’ assistants is suspended temporarily. Practitioners who have received temporary licenses from the DCA and have prescribing authority as part of that license,  can register with the Prescription Monitoring Program (N.J.S.A. 45:1-46) without first obtaining a NJ controlled dangerous substance registration as long as they hold a who hold a valid US  DEA  registration to prescribe Controlled Dangerous Substances (CDS)

Section 6 pertains to pre-made funeral contracts: “For the duration of the State of Emergency or Public Health Emergency, whichever is longer, the written signature requirements of N.J.S.A. 45:7-85 and N.J.S.A. 45:7-95, pertaining to prepaid
funeral agreements and authorization to commence funeral services,
can be met by the provision of electronic signatures.”

Paragraphs 7, 8 and 9 contain certain immunities to the above professionals and to health care facilities  for acts taken in good faith that do not constitute a “crime, actual fraud, actual malice, gross negligence or willful misconduct.”

Here is a compendium chart of the Executive orders issued by the nation’s governors concerning the public health crisis caused by COVID-19. All of the NJ Department of Health orders are HERE.

We will continue to monitor developments that affect the delivery of crucial health care to our clients in skilled nursing facilities. If you have concerns or a problem, call for a telephone consultation with one of our attorneys…. 732-382-6070