Monday, February 23, 2009

When Family Care Homes go bad: citizen s w/ mental health issues live in PRISON are HOMELESS or in FAMILY CARE HOMES LIKE THIS

This is all public information now. I'm namin' names.


Marsha V. Hammond, PhD: Clinical & Health Psychology: Licensed Psychologist, NC Lic # 2748
E mail: cell: 404 964 5338 fax: 828 254 2013

February 23, 2009

Formal Complaint on WNC Homes

Dear Sarah Tarpey, Adult Protective Services Buncombe County DSS:

I am making a formal complaint on WNC Homes, Leicester, Country Time Circle. Their mailing address is in your files, I believe. Please consider this e mail as outlining that complaint.

I was seeing my client, ----, in Hse # 12, Country Time Circle, Leicester, NC at 1900 hours in agreement w/ their schedules and mine when the Supervisor in Charge (SIC) attempted to call me to the phone, interrupting our session, in order to speak to someone from administration of WNC Homes. As you may recall, I asked Jeff Clifton , administrator for WNC Homes in a US Post delivered letter to fax to me information from the WNC Homes Policy and Procedures manual any information as associated with ‘visiting hours.’ He did not fax that to me. Neither did he send this to me or have posted on any of the walls of the WNC Leicester Homes information which is demanded by law to be posted as re: visiting hours.

In any case, as WNC administration have insisted on berating me on the phone in the past several weeks, I refused to speak to the person on the phone; the SIC stated that the sheriff’s department was being called upon which I advised her that I was calling the Emergency Worker on call for DSS Buncombe. I spoke briefly at 1910 w/ Joann Amato, the emergency on call person for Buncombe DSS. Shortly, I stated to her that there were three sheriff’s cars on the premises. She advised me to call her if necessary after I left. I called back at 2215 in order to obtain her name.

Jeff Clifton, one of the administrators w/ WNC Homes, was present when the Buncombe Sheriff’s department arrived @ approximately 1930. Arriving were: Deputy Hannah and Deputy Ernst. Their supervisor that evening was Sgt. Styles. He was not present. Their contact information is: 828 250 4496. The case number is: 2009-001831. There was no report filed, Deputy Hannah, stated to me. The sheriff’s department sided w/ the administrator, Jeff Clifton, and told me I had to leave immediately as it was the property of WNC Homes and he stated that I could no longer see clients which I intended to do for about thirty more minutes. The sheriff’s department stated that I was forbidden, in keeping w/ administrator’s request, from coming onto the property any more or I would be arrested. The administrator indicated that he ‘owned’ the property. The clients were given no opportunity to express their desires though it is my understanding that it is ‘their home.’

So, my complaint, issuing from Subchapter 3G-Licensing of Family Care Homes is below. Please consider this a formal complaint. I await your ruling on this matter prior to filing it with the Division of Health Service Regulation. I want to know what the trajectory of this complaint is and what I can expect in terms of a timetable. I will accordingly advise my clients living at WNC Homes Leicester, NC.

These are the specific items of my complaint:

Item 1: 10A NCAC 13G .0208 Renewal of License : “All applications for license renewal shall disclose the names of individuals who are co-owners, partners, or shareholders holding an ownership or controlling interest of 5% of more of the applicant entity.”
I would like to know who the owners, co-owners, partners, or shareholders or those holding an ownership or controlling interest of 5% of more are as re: WNC Homes.

Item 2: 10A NCAC 13G .0209 Conditions for License Renewal: “In determining whether to renew a license under G.S. 131D-2 (b) (6), the Department shall take into consideration at least the following……
(3) the extent to which the conduct of a related facility is likely to affect the quality of care at the applicant facility….”
I am filing this complaint as I maintain that the noxious inability to cooperate with case manager and other professional providers offering services to the clients living at WNC Homes Country Time Circle Leicester NC affects adversely the quality of care at the applicant facility. Specifically, these are the matters which impact the ability to care for these residents:

a. the residents’ charts and medical information inclusive of medications is not available to this clinical psychologist who informs the physician in care of the resident. Residents with chronic pain conditions cannot be assessed without the current medication or difficulties or documented side effects of the medication. Residents taking psychotropic medications cannot be assessed as per behavioral difficulties or side effects which could assist the physician in dosing or choice of medications. WNC administration has stated that this psychologist can have no access to client medical records.

b. the residents’ financial information which impacts their mental health as associated w/ no spending money and thus limited ability to interface w/ the community, is not available to this psychologist.

c. the curtailment of hours available to see the clients which is determined solely by the WNC Homes administration is impacting the ability to care for these residents as per psychological therapy and additionally, Community Support Services, provided by a private Endorsed Provider Company.

Item 3: 10A NCAC 13G .0213 Appeal of Licensure Action: (a) In accordance with G.S. 150B-2(2), any person may request a determination of his legal rights, privileges, or duties as they relate to laws or rules administered by the Department of Human Resources. All requests must be in writing and contain a statement of facts prompting the request sufficient to allow for appropriate processing by the Department of Health and Human Services.”

I am formally asking Buncombe DSS, and by default, the Department of Health and Human Services as to my rights, privileges, or duties, to see clients during a reasonable hour, at a time of client and psychologist mutual choosing.

Item 4: "10A NCAC 13G .0216 Administrative Penalty Determination Process (a) The county department of social services of the Division of Health Service Regulation shall identify areas of non compliance resulting from a complaint investigation or monitoring or survey visit which may be violations of residents’ rights contained in G.S. 131D 21 or rules contained in this Subchapter. "

I am asking the Buncombe County of Social Services to determine and identify areas of non compliance as associated with actions taken by WNC Homes County Time Circle Leicester NC as pertaining to residents’ rights to health care delivered by a licensed mental health professional at reasonable hours and hours of their mutual choice. I want to know if this is a Type A or Type B violation.

Item 5: 10A NCAC 13G .0704 Resident Contract and Information on Home The administrator or supervisor in charge shall furnish and review with the resident or his responsible person information on the family care home upon admission and when changes are made to that information. A statement indicating that this information has been received upon admission or amendment as required of the home’s resident contract specifying rates for resident services and accommodations, including the cost of different levels of service, if applicable, any other charges or fees by this Rule shall be signed and dated by each person to whom it is given. The statement shall be retained in the resident’s record in the home. The information shall include:

(1) a copy of the home’s resident contract specifying rates for resident services and accommodations, including the cost of different levels of service, if applicable, any other charges or fees…..

(2) a written copy of any house rules, including the conditions for the discharge and transfer of residents, the refund policies, and the home’s policies……

(3) a copy of the Declaration of Residents’ Rights as found in G.S. 131D-21

(4) a copy of the home’s grievance procedures which shall indicate how the resident is to present complaints and make suggestions as to the home’s policies and services on behalf of self or others….”

I am asking that the rates for resident services and accommodations be made available in writing for the residents in keeping with the law; I am asking that a copy of the home’s grievance procedures be made available to the residents (no it is not sufficient to have the telephone number of the ombudsman on the wall) ; I am asking that the hours associated w/ visitations with professional providers be posted for the residents.

Item 6: 10A NCAC 13G .0902 Health Care (b) The facility shall assure referral and follow up to meet the routine and acute health care needs of residents. ….(c) The facility shall assure documentation of the following in the resident’s record: (2) all visits of the resident to or from the resident’s physician, physician service of other licensed health professional, including mental health professional, of which the facility is aware (3) written procedures, treatments or orders from a physician or other licensed health professional, and (4) implementation of procedures, treatments or orders specified in Subparagraph c3 of this Rule. Moreover, as per 10A NCAC 13G .0906 Other Resident Services: “(a) Transportation. The administrator must assure the provision of transportation for the residents to necessary resources and activities, including transportation to the nearest appropriate health facilities, social services agencies, shopping and recreational facilities, and religious activities of the resident’s choice. The resident is not to be charged any additional fee for this service. Sources of transportation may include community resources, public systems volunteer programs, family members as well as facility vehicles. I am asking that WNC Homes Leicester, NC provide transportation to all appointments w/ myself, Dr. Hammond, at my office at: -------Biltmore Avenue, Suite 313, Asheville, NC 28801, as agreed upon by this psychologist and the client. I am documenting that WNC Homes Country Time Lane, Leicester, NC did not provide services to client ---, Hse 13, on 1.26.09: “I waited for over an hour after the Supervisor in charge indicated she would rendezvous w/ me and bring Mr. -------- so he could go with me to the SSA but apparently she talked to her boss who forbid it. I therefore contacted DSS Buncombe and will be speaking to them re: the client’s rights re: living in a personal care home.” I am asking DSS Buncombe vis a vis the Administrative Penalty Process to render a verdict re: residents’ right to health care as per that event.

Additionally, in that WNC Homes Country Time Lane Leicester, NC has declared that all Community Support Services must cease by 5 pm every day and in that residents have events which are not constrained by this e..g, AA meetings, etc., and in that this psychologist signed off the medical necessity matter assuring Community Support Services----which makes possible said services-----I am asking DSS Buncombe to require that WNC Homes make available transportation for residents to events which are associated with their healthcare e.g., AA meetings, support groups meetings after 5 pm in that WNC Homes has stated that no CSS activities may take place after 5 pm any day of the week. There is no bus service to this residence which is 30 minutes outside Asheville, NC.

Additionally, I am asking that DSS Buncombe demand that current medications list of residents is carried w/ the residents to meetings with Dr. Hammond in accord with: “10A NCAC 13G .1201 Resident Records: When a resident leaves the facility for a medical evaluation, records necessary for that medical evaluation such as Items 1,4,5,6,7 above may be sent with the resident” (those items include “ orders or written treatments or procedures from a physician or other licensed health professional and their implementation”

Item 7: 10A NCAC 13G .0906 (f) Visiting (2) There must be at least 10 hours each day for visitation in the home by persons from the community. If a home has established visiting hours or any restrictions on visitation, information about the hours and any restrictions must be included in the house rules given to each resident at the time of admission and posted conspicuously in the house." I am asking that the hours associated w/ professional services and Community Support Services be posted conspicuously in the homes so that clients may know what the administration of WNC Homes demands.

Item 8: "10A NCAC 13G .0908 Cooperation with Case Managers The administrator shall cooperate with and assure the cooperation of facility staff with case mangers in their provision of case management services to the appropriate residents."

Let it be known that I am filing a formal complaint on the inability of the WNC Homes management to cooperate with this mental health provider as pertaining to therapy sessions for WNC Homes residents. Moreover, I wish to underline this complaint with the fact that several residents prefer not to go off the property of the home as associated with diagnoses. Specifically, client ------, Hse # 11, with a diagnosis of Avoidant Personality Disorder, prefers to not go off of the campus (though Community Support Services is working with her as re: this matter); client -----, Hse 10, has Irritable Bowel Syndrome which causes him to have to use the bathroom frequently; and, client -----, Hse # 13, also has gastrointestinal difficulties which cause him to stay close to home---as documented in his medical records. Instead of being supported for providing services close to home, and in the community, this mental health provider, since WNC Homes took over the management of these Family Care Homes in August, 2008, has been harangued particularly as re: questions prompted by the clients pertaining to their personal funds whenever I have asked questions and attempted to find out what personal funds they were to be accessed.

Thank you for considering these matters and I would like to have a timeline as to when these matters will be resolved.

Marsha V. Hammond, PhD
Cc: ---------------(Endorsed Provider company)


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