This is interesting: Nursing-home records closed off - Health & Science - News & Observer

After Maggie Gibson, in pain, took an ambulance ride to the hospital from a Durham nursing home, family members were stunned to learn that doctors had found a hip fracture.

No one at Carver Living Center had said anything to them about an accident.

With persistence, Gibson's daughter was able to get to the bottom of what happened to her mother in the 2006 incident. But a recent Bush administration change in federal rules on nursing home inspections makes it nearly impossible for others to do the same, say opponents of the federal action.

Put into effect in October with little notice and without a public comment period, the federal move is getting sharp criticism locally and nationally for closing off what advocates call crucial information.

"It's an extremely troubling development -- it puts a lot of information related to nursing-home inspections off-limits," said Eric Carlson, director of the Long-Term Care Project of the National Senior Citizens Law Center, a California-based nonprofit group funded in part by the federal Administration on Aging.

"I think it's certainly bad for consumers and the folks who represent them."

Officials of the Department of Health and Human Services said employees have been too burdened by requests for information. Under the rule change, state employees who inspect nursing homes for the federal government are reclassified as federal employees who aren't allowed to provide "privileged" information or documents to the public without approval from the head of the Centers for Medicare and Medicaid Services.

"Although any specific request for testimony or documents may not be unduly burdensome, the requests divert employees from their federal survey, certification, and enforcement responsibilities," Michael Leavitt, secretary of the Department of Health and Human Services, said in announcing the change.

"The cumulative effect of these requests can impede these activities."

Raleigh resident Valerie Thomas, Gibson's daughter, learned what happened only by reviewing follow-up reports from state inspectors -- documents that under the new rules can't be released without specific approval from the chief of the giant federal agency that oversees Medicare and Medicaid.

The reports that Thomas got from state regulators said a nurse's aide had allowed her mother to fall. She then got other aides to help prop up Gibson in a chair without reporting the incident to a supervising nurse as required, the state report said.

More than two weeks passed before Gibson, now 81, who has dementia, got treatment for the break. She lost her ability to walk as a consequence, her daughter said.

"How can I trust my loved ones to someplace and I can't even find out what's going on?" said Thomas, 41."There ought to be an open policy where I can find out what's going on with my relatives."

Anne Marie Regan, a public-interest lawyer in Louisville, Ky., said the new rule has already slowed to a crawl her efforts to represent a resident of a Pine Knot, Ky., nursing home in a suit that charges he was illegally discharged.

"This totally goes against the normal rules that apply in a lawsuit," Regan said. "It's interfering with our ability to get the information we need to prove our case."

Anne Duvoisin, a Raleigh attorney, is representing Thomas in a claim against Carver Living Center. Being able to get detailed survey reports is important not only for lawyers, but also for family members, potential residents or policy makers -- anyone who wants direct knowledge of how well nursing homes are doing their jobs, Duvoisin said.