Analysis of Regulations in Long-Term Care - Essay Example

Analysis of Regulations in Long-Term Care Through the years, the conditions of health and safety for people internationally have been alternated; different priorities exist in medical institutions (either of the public or the private sector) within the international community; the financial status of patients is considered to be of high importance defining the quality of medical services offered to the person involved. Toward this direction, the development of appropriate legal framework for the regulation of various aspects of long term care has been considered as necessary under the influence of the continuous changes in social conditions around the world; people that are severely ill or elders – usually the teams that need the long – term care – have to be given the appropriate treatment in order for their health to be kept at specific levels. On the other hand, it should be noticed that the regulations related with the long term care are not the same internationally; they rather follow the social and cultural standards of the country or region involved – despite the fact that they may be specific characteristics of long term care that are common globally (e.g. the development of insurance services covering the cost of long term care – under specific terms and conditions). In order to understand the structure of these regulations and the procedure followed for their application, it would be useful to refer to specific examples (i.e. to long term care regulations that are applied on specific countries/ regions around the world). An indicative example is the Section/Title 28 of the Pennsylvania Code. In this article the general aspects of long term care services offered in the specific state are analytically described. In the above Section of the Pennsylvania Code the following chapters regulate the various aspects of long term care services provided in institutions across this state: 201, 203, 205, 207, 209 and 211 (see also the website of Department of Health, Pennsylvania, 2008). The application of the above provisions in Pennsylvania is enforced mostly by relevant governmental authorities who can intervene to a relevant dispute after such a claim is made by the relatives/ supervisors of the patient. In this context, consumers in Pennsylvania are given the right to seek for advice and support on various issues related with the long term care to the Ombudsman while it is made clear that they have a series of rights (but also of obligations) regarding the provision of them of long term care services, like the right to be appropriately informed by the service provider or the right to use a legal guardian when communicating with arranging all the issues related with the provision of the long term care by a service provider (Long term care in Pennsylvania, 2008). In other states or countries internationally different approaches could be used when regulating the various aspects of long term care. The local social and cultural characteristics are likely to influence the provision of the above services in a specific country/ region. The governmental policies regarding the long term services provided to the public by institutions of the public or the private sector are also considered as having a crucial role in the forms and the requirements of these services in countries internationally. Also, it is possible that changes are made in the existing legal framework related with the provision of long term care services in a specific country in case that the conditions under which these services are provided across the country have been changed – in this context, the laws governing these services should be also changed in order to respond to the needs of patients but also the rights of the practitioners in the specific sector. An indicative example is the case of Virginia where the regulations related with the provision of Nursing home facilities have been revised in May 14, 2008. The new regulations, having the number 18VAC95-20-10 et seq. are related with the article § 54.1-2400 and Chapter 31 of Title 54.1 (Code of Virginia, 2008). These regulations set a series of requirements/ standards for all home nurse administrators; in this context, in accordance with the section V of these regulations the board can refuse to accept a candidate if he has been found that he is guilty of ‘1. Conducting the practice of nursing home administration in such a manner as to constitute a danger to the health, safety, and well-being of the residents, staff, or public…’ (18VAC95-20-10 et seq., regulations, Virginia Board of Long Term Administrators, 2008). It should be noticed that the application of the above regulations is supervised by the Enforcement Division of the specific Department. The specific division makes regular inspections regarding the application of the above rules; however it is possible that a case is examined under the relevant complaint of a patient (or his/ her relatives/ supervisors, see also Virginia Board of Long Term Administrators, 2008). Apart from the governmental bodies described above, private institutions or communities are also likely to be involved actively in the provision of long term care services in a specific region. In this case, the application of the relevant rules (established by the state) will be supervised by specific persons that will propose the necessary actions for the protection of patients against the possible violation of their rights. An indicative example is the Long Term Care Community Coalition based in New York. The priority of this body is to protect the rights of its members ensuring that patients or elderly that need a long term care support are being offered the appropriate services (in terms both of quality and of duration, see the Long Term Care Community Coalition website, 2008); the issue of cost of these services and the potential participation of this body to their payment can be also examined under specific circumstances. As for the enforcement methods used by the above body regarding the application of the rules related with the provision of Long term care services, there is no reference to specific measures; through the relevant website it is made clear that an extensive effort is made in order for the patients/ elderly to be appropriately informed on their rights regarding the specific issue; the enforcement of the relevant rules seems to be left to the state – which can be only informed by the above body on existing cases of violation of the patients’/ elderly people’s rights. In other states specific departments have been developed regarding the protection of elderly/ severely ill or disabled people against the potential violation of their rights. An indicative example is the case of Minnesota (USA) where the Office of Ombudsman ensures the appropriate application of all relevant rules. This department is described as ‘a program of the Minnesota Board on Aging, the Office advocates for person-directed living, throughout the health care continuum, which respects individual values and preferences and preserves individual rights’ (see also Minnesota Board Aging, 2008). The effectiveness of the regulations related with the long term care services as well as the methods used for the enforcement of the relevant rules have been examined in practice through a study in which 19 OECD countries (including Spain, Germany and Mexico) are being monitored as of their practices in the above mentioned sectors. The findings of this study led to the following conclusions: ‘the quality of long-term care services for older persons in many cases does not meet the expectations of the public, the users of services and their families, - more so for institutional care than for home care’ (Kim et al., 2004, 21). The above findings can also lead to the assumption that the role of the state in the enforcement of the relevant rules is not the required one – taking into account the conditions of modern life internationally. A more effective network of rules regulating the various aspects of long term care around the world should be developed; appropriate bodies should be also established regarding the monitoring of the application of these rules asking for the intervention of the state in cases that the violation of the rights of patients/ elderly is proved to exist. References Department of Health, Pennsylvania (2008), available at http://www.dsf.health.state.pa.us/health/cwp/view.asp?A=188&Q=200735 Kim, H., Hennessy, P. (2004) Monitoring and Improving the Quality of Long-Term Care: A Comparison of 19 Countries. Academy Health Meeting, 21 Long term care in Pennsylvania (2008) online report, available at http://www.aging.state.pa.us/longtermcare/cwp/view.asp?a=489&Q=243988&longtermcareNav=| Long Term Care Community Coalition (2008) available at http://www.ltccc.org/ Minnesota Board Aging (2008) available at http://www.mnaging.org/admin/ooom.htm Virginia Board of Long Term Administrators (2008) available at http://www.dhp.virginia.gov/nha/nha_laws_regs.htm Read More