What state agency is responsible for nursing homes in Arizona?

Running a nursing home is an immense responsibility. Those in charge must ensure patients who are vulnerable, frail, or elderly are safe at all times, while also meeting their medical needs.

This article explains which agencies are responsible for care homes in Arizona and how they do this. It also details care home residents’ legal rights and what to do if you fear your relative is the victim of abuse.

Who is responsible for nursing homes in Arizona?

In Arizona, The Office of Long-Term Care Licensing, which is part of the Arizona Department of Health, is responsible for nursing homes.

The Office issues licenses and it’s also there to monitor if nursing homes are abiding by state and federal regulations. The department does this through:

• Surveys
• Investigating complaints
• Carrying out inspections
• Ensuring the buildings are safe and comply with fire regulations

Other bodies involved in nursing home regulation

Another body that plays a crucial role in Arizona’s nursing home safety is the Certified Ombudsman office.

The role was established through the Arizona Revised Statute 46-452.02 Long Term Care Ombudsman. This formed the Arizona Long Term Care Ombudsman Law of 1989.

Ombudsmen work to build relationships with residents and staff, and facilitate the resolution of disputes. They also:

• visit homes to assess patient welfare
• act as advocates and educators to residents and staff
• ensure patient rights are held

In addition, the Ombudsman will suggest solutions to complaints that are raised and continue to work with the resident to ensure ongoing compliance, and seek legal remedies if necessary.

Each state has its own Ombudsman office to oversee care homes and their role in nursing home quality is extensive. Typical duties include:

• Acting as an advocate: This means working with the resident and the home to resolve problems.
• Mediation: The ombudsman will act as a spokesperson for the resident
• Acting as a broker: If an ombudsman feels another agency is best suited to manage the complaint, they’ll refer the resident.
• Working as an educator: Ensuring all parties understand their rights.

Every resident can access an Ombudsman both prior to and during their nursing home stay. If you have a complaint or concerns over the level of care received, you can file a complaint with the Ombudsman office yourself.

You can call them at (602) 277-7292 or 800 (872) 2879 or you can file a complaint online. If you need help navigating the Ombudsman process, a lawyer can help.

Medicare and Medicaid run nursing homes

The Centers for Medicare and Medicaid (CMS) oversees nursing homes. These nursing homes must have a Certificate of Compliance, which is CMS issued.

To qualify for Medicaid or Medicare payments, nursing homes must meet the standards set out in Nursing Home Residents Bill of Rights. Failure to do so can result in:

• fines
• removal of funding
• additional monitoring
• state takeover

There are extensive rules governing state-run care homes. You can read more about them on the CMS website.

State nursing home agencies and CMS

State agencies and CMS work together to ensure Medicare and Medicaid funded nursing homes comply with federal guidelines.

The state agency’s role is to investigate complaints on behalf of the CMS. The agencies then investigate complaints according to established protocols.

Every year, CMS will review state agencies to check investigation procedures comply with State Performance Standards. A review found some of these agencies lacking in the past, which resulted in the CMS making recommendations for improvements.

Nursing home rights

The same rights apply to nursing home residents  as any other United States citizen. These rights cover every major aspect of the person’s life and the standard of care they can reasonably expect.

The Office of Long-term Care also details the rights that nursing home patients have under federal and state regulation. This covers:

• Pre-admission rights
• Admission rights
• Basic rights
• Privacy and confidentiality
• Quality of Life
• Living accommodation
• Medical care
• Freedom from restraints and abuse
• Transfer and discharge rights

The full details of these rights are available online.

If you or a loved one feel these rights aren’t adhered to, you can file a complaint with the Office of State Long Term Care Ombudsman or to The Arizona Department of Health Services, Office of Long Term Care.

Alternatively, if you’re seeking help and guidance, a lawyer can assist.

Listening to nursing home complaints

If a member of your family or a friend starts voicing concerns about their care, be sure to listen to them.

It may just be part of the settling in stage, or if they’ve been in the home for a while, perhaps they’ll find the confinements distressing.

However, it could also be something more serious. Common complaints include:

• Dietary concerns
• Resident conflicts
• The patient’s needs nor being met
• Items going missing/getting mislaid

Nevertheless, it could be something more serious. Perhaps the level of care isn’t up to standard, or a resident conflict hasn’t been resolved adequately.

Reporting nursing home concerns

There aren’t always physical signs that something is wrong, but if your relative seems distant, depressed, or lacking in appetite, then these may be a sign that there is a problem.

In addition, from your own observations, you may have noticed areas of concern or potential negligence.

If you feel this is the case, the first step should be to approach the manager or administrator of your loved one’s nursing home, they must address your concerns and investigate them.

However, if you find the response unsatisfactory, or your concerns remain, you can then  contact the Ombudsman or The Office of Long-Term Care Licensing. The Ombudsman office work with residents to resolve concerns. They can also act as a mediator and educate residents on their rights.

If these worries persist beyond this, you can then explore any legal recourse by speaking with an experienced lawyer.

Frequently Asked Questions

What are my rights?

1987 legislation called the Nursing Home Reform Law protects nursing home rights under federal law. The law means nursing homes must “promote and protect the rights of each resident”.

The government brought in the Act after the Institute of Medicine discovered some nursing home residents were facing poor care and negligence. The law led to a certification process to monitor nursing homes

In addition, under regulations introduced in 2016, nursing home residents and their relatives can sue federal funding nursing homes if they provide poor care. These rules were introduced by the Centers for Medicare and Medicaid Services.

The regulations mean patients and their families no longer need to rely on arbitration to ensure a resolution at Medicaid and Medicare-funded homes.

How do I know if a nursing home is safe?

Arizona Department of Health has a searchable directory online. Here, you can enter the name of the nursing home and it will bring up a list of any deficiencies in Arizona care homes. Other directories covering the Arizona area include Care Pathways, Medicare.gov, and Nursing Home Inspect.

What federal regulations apply to nursing Homes?

Federal regulations state nursing home residents have “the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion.”

Nursing homes funded by state insurance programs are legally obliged to abide by these regulations.

What should I look for in a good nursing home?

Reviews are a good place to start; you can find these online. It’s also advisable to ask for word-of-mouth recommendations taken from personal experiences. It’s always advisable to visit the nursing home with your relative to ensure they feel at ease in the home.

How do I find the right nursing home?

The facility will be the individual’s home for the foreseeable future, so it needs to be compatible with all their medical, spiritual, and emotional needs. A good starting point is to look at homes that can cater to the specific needs of a patient.

Location is another essential component. Residents making the move to a nursing home will want the reassurance that family and friends are nearby.

If you want further input, there are a host of people who can help guide your decision. They include:

• Medical staff
• Social workers
• Occupational Therapists
• Specialist groups

Once you’ve done this, you can then use one of the comparison sites to narrow down your search. Pre-visits are also a must. They’ll give both you and your relative a chance to get to know the staff better and assess whether the environment seems suitable.

What if something goes wrong?

Most nursing homes deliver a top quality of care, but even the best of them can have accidents or overlook an essential aspect of care.

Should this happen to a relative, you may want to consider your legal options.

What common problems occur in nursing homes?

The problems that may occur in the nursing home include:

• Negligence either from staff or because of poor management procedures
• One on one resident abuse
• Wrongful death
• Staff abuse

How a lawyer can help

Should the worse happen, a lawyer has multiple resources they can use to assist you and your family. This includes:

• Investigating to ensure that the care you or your relative received is consistent with federal and state standards.

• Obtaining records to check the home adhered to patient plans
• Gathering any nursing home records, such as incident reports and investigation,
• Getting copies of medical records
• Notifying the defendant

Contact he Thompson Law Firm

If you need advice about nursing home care, the expert team at the Thompson Law Firm is here for you.

With free consultations available, you have nothing to lose by reaching out to us to find out how we can assist you. We can help throughout any legal process that may follow and secure settlements for:

• help with costs to move to another healthcare setting
• current/ongoing medical bills
• current/ongoing rehabilitation costs
• emotional trauma
• pain and suffering
• burial and funeral expenses in the event of wrongful death

For expert advice combined with compassion and care, contact the Thompson Law Firm today.