After an investigation into Colorado’s care for people with disabilities who reside in nursing homes, the Department of Justice (DOJ) concluded that the state unnecessarily segregates people with physical disabilities in nursing facilities. The unnecessary segregation is in violation of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C.
The DOJ’s investigation concluded that many of Colorado’s Medicaid funded nursing facility residents would like to transition to community-based settings, and are likely appropriate for this with some additional support. The investigation determined that many of these residents are unaware of the services that are available to them to assist with this transition, which creates a barrier to a successful discharge to a community-based setting.
The ADA and the Olmstead ruling require state and local governments to make services available to people with disabilities in the most integrated setting appropriate to their needs. These available services should be regardless of the person’s age or physical disability. The investigation’s conclusion is that individuals with physical disabilities in Colorado are denied a meaningful choice to receive services that may be required to meet their needs so they can live in their own homes or the community.
Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division stated, “People with disabilities have too often been unlawfully segregated in institutions like nursing facilities. The Civil Rights Division will vigorously enforce the rights of people with physical disabilities, including older adults, to access the community-based services they need to age in place and thrive at home.”
Issue:
A discharge discussion should begin quickly after a resident is admitted to a facility. Resources that are available in the community should be included in this discussion. A resident’s desire to be discharge back to their home or a community setting should always be considered when developing the plan of care for a safe discharge. Not providing education regarding community resources could be seen as a violation of ADA requirements and could result in citations, fines, and other sanctions.
Discussion Points:
- Review your policies and procedures on discharge planning. Update as necessary.
- Train appropriate staff on your safe discharge planning policy, and provide education on resources that are available in your community for care services that could enable a resident to live successfully in his or her own home or in a community setting. Document that these trainings occurred, and file each signed document in the employee’s education folder.
- Periodically audit to ensure that residents are receiving information on available community resources. Interview residents to ensure that all safe discharge planning needs have been met.
