New senior’s legislation gets mixed reviews

Kim Smith

Thursday, Feb. 10, 2000 | 10:13 a.m.

A new state law that requires licenses for companies that refer seniors to nursing homes, assisted living facilities and group care homes is drawing mixed reactions.

Lisa Jones, a state health facilities surveyor, said of the 12 such companies in the state, only four have applied for licenses. The law took effect Jan. 1.

"The intent was to give a little more oversight to the process so we could avoid people being inappropriately placed," Jones said. "Moving into a nursing home or group home is already a traumatic event, and our goal is to see people ideally placed the first time and save them the hassle."

Patients with unusual problems were being placed in group care homes that were ill-equipped to handle them. Patients, therefore, were constantly being shuffled from group home to group home, a situation the state found perturbing.

By requiring such agencies to have someone on staff who is qualified to assess a patient's needs, such as a registered nurse, doctor or social worker, the chances of someone being placed in a home ill-equipped to handle their set of problems is diminished, Jones said.

In addition, the nursing homes and group homes were paying the referral agencies instead of the patients themselves, Jones said. Typically, the referral agencies would get 40 to 50 percent of the first month's rent from each facility, and each time a patient was moved, they would get the same amount from each new facility, Jones said.

The new law prohibits the agencies from accepting fees from anyone other than the patient and the patient's family. "The idea of selling a person to the highest bidder had become a concern," Jones said.

Las Vegas resident Rick Smith, who owns Senior Connections, a group home management and consulting group, and the director of Senior Connectors, a licensed referral agency, supports the new law.

"I think it was a very smart move. Other referring agencies were making inappropriate placements, and the legislators are saying if you're going to refer people, you've got to do it the right way," Smith said.

"These agencies might place someone with dementia into a regular assisted living place and then one to two weeks later, when the facility realizes they can't take care of them, they move them out. It's traumatic for the patient, and it's traumatic for the family."

Jones said that in order for a referral agency to become licensed the state must make sure the license application, which includes employee qualifications and business history, is filled out in full. In addition, an on-site inspection is conducted during which record keeping, policies and procedures and assessment plans are verified.

If no deficiencies are noted, a recommendation is made to license the agency, and if problems are found, the bureau will work to rectify them.

Inspections will probably take place every year, unless complaints are filed, Jones said.

Virgil Payawal, owner of AAAA Adult Rest Home Referrals, is debating whether he wants to apply for a license. It would cost him $3,000 a year for insurance, the $750 license fee and the salary of the registered nurse or doctor he'd have to put on retainer.

"I'm a licensed group home administrator and as such I'm allowed to assess patients, but as a referral agency owner, I'm not," Payawal complained.

Payawal said he believes legislators buckled under the political pressure brought to bear by large assisted living and nursing home corporations that wanted to run off their competition -- the smaller "mom and pop" group homes.

"The mom and pop group homes rely on referral agencies" and if there are no referral agencies, many will go under, Payawal said.

"Now if there are no small group homes and no referral agencies, all of the old folks will have no choice, they'll have to go to the large facilities," Payawal said. "And, if you talk to them, they don't want a nursing home environment, they're too noisy."

Smith, however, disagrees. "Certainly, some of the legislation has been because of the larger facilities, but that doesn't necessarily mean it's bad legislation," Smith said. "I think the law can really bring more quality and professionalism to the industry and those that don't want that will get out."