About MemberoftheFamily.net
In 1996, during a routine visit to one of his patients in a Maryland nursing home, Dr. Edward C. “Terry” Watters noticed that her sight-threatening condition had worsened since his last visit. He discovered that his orders for treatment had not been followed, and as he noted this in the patient’s chart, a staff member asked him not to do so because that would “cause problems” for the home—financially and with state reporting agencies. The staff member exhibited no sympathy for any pain the patient might be experiencing because of the failure to follow the treatment regimen.
During several visits, Terry noted in the chart additional times when the prescribed regimen hadn't been followed and confronted the staff about the problem. The last straw came when a staff member informed Terry that his notes had been removed from the chart because they would be a "red flag" to state auditors. (Dr. Watters subsequently learned that another patient in the home had recently died and that some of the evidence also suggested falsification of records, in this case regarding the details of the death.)
Dr. Watters knew that the standards of care had been violated, and the patients had suffered dramatically because of this. He drew up a plan of action to help reduce the likelihood of such incidents in the future. He and a partner, Dennis Steele, learned how to petition for government reports about nursing homes—among them the federal Online Survey Certification and Reporting (OSCAR) 3 and 4 data—and how to read them. As they assembled the facts and ran statistical analyses, a bleak picture emerged of understaffing, physical abuse, untreated bedsores, and coldhearted decision-making by home operators and state officials charged with monitoring facilities.
MemberoftheFamily.net first made its data available to the Veterans Administration in Washington, D.C, and North Carolina, analyzing the agency government reports about nursing homes in which veterans reside. Now 22 Veterans Administration offices across the country subscribe to our service. Since 1999, we have researched more than 16,000 nursing homes available to the general public, providing easy-to-understand information from state and federal government reports.
One of the site's most valuable sections is the National Watch List of all the nursing homes in the country that have been cited in government reports for causing "Actual Harm," Severity Code "G" or higher. We have also added a Registry of U.S. Nursing Homes, which lists all the Medicare-and Medicaid-certified nursing homes in the country.
Durable POA PDF Forms
We have a separate section for fillable and editable PDF forms. These templates include state-specific durable power of attorney forms.
The Texas Durable Power of Attorney grants the designated agent broad authority to manage the principal’s financial affairs, even if the principal becomes incapacitated. This form is legally recognized in Texas and allows for comprehensive financial decisions, including managing property, paying bills, and handling banking transactions.
The California Durable Power of Attorney provides a legal mechanism for appointing an agent to make financial decisions on behalf of the principal. This authority continues even if the principal becomes incapacitated, ensuring that important financial matters are handled according to the principal’s wishes under California law.
A Florida Durable POA is a legal form that allows the principal to appoint someone to make financial and legal decisions on their behalf. Unlike some other states, Florida law requires that the powers granted take effect immediately, and the agent’s authority remains valid even if the principal becomes incapacitated.
The Power of Attorney Form in Georgia enables a principal to delegate authority to an agent to manage specific or broad financial and legal matters. The form becomes durable, meaning it remains in effect if the principal loses the capacity to make decisions independently.
With the Financial Durable General Power of Attorney Arizona, a principal can appoint an agent to handle various financial tasks, from managing bank accounts to real estate transactions. This durable form remains effective even if the principal becomes incapacitated, safeguarding the principal’s financial interests under Arizona law.
The North Carolina Durable POA Form allows a principal to appoint a trusted agent to manage financial and legal matters. This form stays in effect even if the principal becomes incapacitated, ensuring continuity in decision-making for financial affairs.
The Durable Power of Attorney Washington State form authorizes the agent to act on behalf of the principal in managing financial matters. It ensures the agent’s authority remains intact should the principal become incapacitated, in accordance with Washington state laws.
The Durable POA in Missouri gives an appointed agent the authority to handle the principal’s financial and legal affairs, even in cases of incapacitation. This form is legally recognized in Missouri and provides essential protections for managing finances and property when the principal is unable to do so.
The Durable Power of Attorney PA form is used in Pennsylvania to grant an agent authority over financial decisions for the principal. It is considered durable, meaning it remains in force even if the principal is incapacitated, ensuring that their financial matters are managed effectively.
A Durable POA Ohio form allows the principal to designate an agent who can manage financial and legal matters on their behalf. The form remains valid and enforceable even if the principal becomes incapacitated.
The Virginia Durable Power of Attorney enables the principal to appoint someone to manage their financial affairs, such as paying bills or managing property, even if they become incapacitated. This durable power of attorney is a vital legal tool for financial management under Virginia law.
The Montana Durable POA form grants the appointed agent authority to manage the principal’s financial and legal affairs. This form remains in effect even if the principal becomes incapacitated, providing ongoing protection for the principal’s financial interests under Montana law.
Registry of U.S. Nursing Homes
Survey Ratings, Complaint Information, and Reports of Repeat Violations
The Registry lists 16,000 homes by state. Click on the state whose homes you want to check. (Files for larger states such as Texas, California, and Pennsylvania may take a couple of minutes to download.) The homes for each state are listed alphabetically. You will see the results of the past three government surveys for each home. If a home also appears on our National Watch List, there will be a link to that information. Homes on the National Watch List have had recent survey violations or substantiated complaints of actual harm or immediate jeopardy.
National Nursing Home Watch List
Nursing homes with recent survey violations or substantiated complaints for "actual harm" or immediate jeopardy." Click on a state to see homes cited for these problems.
Definitions
The Centers for Medicare/Medicaid Services (CMS) has defined the following terms in its Survey Protocol for Long-Term Care Facilities, which is based on 42 CFR Part 483:
Guidance on Severity Levels. There are four severity levels. Level 1, no actual harm with potential for minimal harm; Level 2, no actual harm with potential for more than minimal harm that is not immediate jeopardy; Level 3, actual harm that is not immediate jeopardy; Level 4, immediate jeopardy to resident health or safety. These four levels are defined accordingly:
- Level 1 is a deficiency that has the potential to cause no more than a minor negative impact on the resident(s).
- Level 2 is noncompliance that results in minimal physical, mental, and psychosocial discomfort to the resident and has the potential (not yet realized) to compromise the resident's ability to maintain and/or reach their highest practicable physical, mental, and/or psychosocial well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services.
- Level 3 is noncompliance that results in a negative outcome that has compromised the resident's ability to maintain and/or reach their highest practicable physical, mental and psychosocial well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services. This does not include a deficient practice with little consequences for the resident and would be included in levels 2 or 1.
- Level 4 is immediate jeopardy, a situation in which immediate corrective action is necessary because the facility's noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident receiving care in a facility.
Danger Zone
Unlock the Secrets of Nursing Home Medical Records and Protect Your Loved One
You must play the watchdog to provide your loved one with the best care. This book shows you some tricks nursing homes play to keep you—and government regulators—less than fully informed about patient care. You’ll also learn some tips for outmaneuvering such attempts to keep you in the dark. And we’ll teach you the handy method of using three-by-five cards to document what you observe. For patients requiring more extensive documentation, we supply worksheets in the back of the book that breaks down the areas and items you need to monitor and have included charts you can use to do so.
Here’s what sets this book apart from others that provide advice about nursing home care: most other authors believe that if you get involved, work through the system, and play nice, you’ll be okay. We certainly believe in getting involved, and playing nice may work at some facilities—there’s no sense in taking an aggressive approach if the staff is generally cooperative. But the truth is that you’ll just get eaten alive playing nice at many facilities, and you’ll only be playing into the administrators. Especially in for-profit nursing homes, everything boils down to money. The business model is simple: every expense the facility can avoid means more dollars to the bottom line. If you don’t challenge the staff about lapses in care—or don’t know how to—the home will have won the game, and your loved one could wind up in the danger zone of long-term care in America. This book will help you level the playing field.
By Dennis R. Steele and Edward C. Watters III, M.D. A MemberoftheFamily.net LifeGuide®