License to care

Kim Smith

Thursday, Feb. 10, 2000 | 11:07 a.m.

When Deneice Peters realized she wasn't going to be able to care for her ailing mother any longer, she felt blessed to find a homey, comfortable and safe environment for her.

The individual group home Peters found was the exact opposite of the sterile, smelly, impersonal nursing homes where she had visited her grandmother.

But six months after placing her mother into the home, she deeply regretted her decision. Instead of being the only resident, her mother soon became one of six, despite the fact the home had registered with the state as a one-resident home.

"In the beginning it was fine because she was their only resident, but gradually to me it seemed like they wanted to see how many more people they could get in there and how much more money could they get," Peters said. "She no longer had the individualized care. She was just part of a schedule. It was, 'Oh, it's her turn for a bath' or 'It's her turn for medication.' "

So when Peters heard that as of Jan. 1, group homes that care for one or two patients have to be licensed and inspected by the state, she was thrilled.

"I think it's good they're making everyone be licensed, because I don't think just any Joe or Jane Doe off the street should be able to say, 'OK, I want to run a group home' just so they can make some money," Peters said.

As of Jan. 1 people who operate homes for individual residential care must be licensed and inspected by the state's Bureau of Licensure and Certification. Before then, the operators who provide care for one or two patients had to only register with the state.

Lisa Jones, a state health facilities surveyor, said legislators wanted to give the bureau a way to monitor the smaller group homes. Laws were already in effect for group homes with more than three patients, but the state could not investigate anything short of criminal abuse, neglect or exploitation in the smaller homes.

Nor could the state do anything about those homes that were trying to take care of patients whose needs far exceeded their level of expertise, Jones said.

While pleased with the new law, Jones is somewhat concerned, because so far fewer than 75 of the 300-plus care homes registered last year have completed a license application.

It's not that elderly patients at these homes are necessarily more at risk than at a licensed facility, it's just that these homes are supposed to be licensed, Jones said.

"We have gotten a lot of formal responses from people who are saying they are getting out of it," Jones said. "They've said that it worked fine for them as long as they didn't have to deal with the paperwork side of things, but now that they have to, they don't want to."

People who continue to operate care homes without licenses can be fined up to $10,000, Jones said. They would also be prevented from applying for a license for six months and required to move their patients at their cost.

The $200 licensing fee appears to be a problem for some operators, and others are upset at having to have a high school diploma or its equivalency, Jones said.

Sharon Leffingwell is one of the 75 who has applied for a license. The former nursing home activities director has been operating Almost Home Group Care for three years.

"I'm in favor of the law. I think people have to be accountable for the lives of others and for their well being," Leffingwell said.

While not thrilled with the amount of paperwork required by the state, Leffingwell said she understands its importance and was actually documenting everything before the state stepped in.

"The paperwork is terrible, but it needs to be done," Leffingwell said. "By keeping paperwork, you can see if your patients' eating habits have declined or if their moods have been changing. Mood swings could be an indication of illness."

Peters appreciates Leffingwell's meticulous ways. She placed her Aunt Lila with Leffingwell two years ago. She wishes she had known about Almost Home Group Care when she was looking for a place for her mother, who died last year. As it turned out, she transferred her mother to Leffingwell's home only two weeks before she died.

"We wanted her to have a family environment and loving care, and I honestly believe she made it longer at Sharon's than if she would have been in a hospital or nursing home, which was where the doctors wanted me to put her," Peters said.

As for the $200 licensing fee, Leffingwell said she paid it with few qualms.

"I've got to pay for the people who are going to come out to survey me and it lends credibility to my business," Leffingwell said. "My thinking is that there is a problem that needs to be fixed or else the state wouldn't be doing this. We need to get a fix on the problems that are out there."

Although the surveyors will only be visiting her house once every three years, Leffingwell said that should be enough of a threat to keep operators in line.

"You never know when they're going to come in and so we've got to take care of everything like they'll walk in tomorrow," Leffingwell said.

Rick Smith, a Las Vegas registered nurse, agreed that the new law will help the state crack down on those people who take on more patients than they are licensed for or those patients whose needs are better served by someone with additional training.

Smith owns Senior Connections, a group home management and consulting company. He is also the director of Senior Connectors, a licensed referral agency.

"I think that legislation came about because some of these registered homes weren't doing what they should've been doing," Smith said.

Judging from the lack of new customers asking for referrals, however, Smith said he believes many of the smaller group homes are risking it and operating without a license.

"But since I can't refer to an unlicensed home, that may shut down some of these places," Smith said.