Should Residents of “Personal Care” Homes Have Rights to Appeal an Involuntary Discharge?

A 90-year-old resident apparently wanted “out” of her personal care home in Pennsylvania — but being kicked out probably wasn’t the outcome her family wanted to see for their restless matriarch.  The personal care home issued a discharge notice on safety grounds, due to her “continued exit-seeking from the building.” 

On January 9, 2015, the Commonwealth Court of Pennsylvania, an intermediate court, ruled that a core right recognized in state and federal law for residents of “long-term care nursing facilities” — the right to seek third-party review when the resident or family disagree with a facility’s involuntary discharge or transfer decision — does not apply to “personal care homes” under the state licensing and regulatory system.  See Bouman v. Department of Public Welfare, Case No. 1262 C.D. 2014, decided November 14, 2014. 

Perhaps a new facility was the best decision, but at age 90, the woman’s options for settling into a new place may be very limited.  The short opinion does not reveal whether other approaches, including behavioral “distraction” techniques that often are effective for those with dementia, were explored.  And without an appeal right, families may have no effective way of advocating for those approaches.

The Bouman decision is a reminder that the “Bill of Resident Rights” that accompanied hard-fought reforms for the nation’s nursing homes in the 1980s may not exist for residents of “other” forms of senior housing.  Federal law provides that residents of nursing homes must be provided with acceptable reasons plus an explanation that the resident has a “right to appeal” the discharge or transfer action to a state authority.  See e.g., 42 C.F.R. Section 483.12.  But with the push in every state to avoid the higher costs of nursing homes, elderly individuals needing care may be residing in so-called assisted living, memory care, or personal care facilities.  It is becoming increasingly apparent that what can sometimes seem like senior hoursing “name games” are anything but child’s play.  As Shakespeare wrote, “What’s in a name? That which we call a rose by any other name would smell as sweet.” Or not….