ElderWeb

Consumers who are choosing a new physician for themselves or a family member often are unsure how to tell if the physician they are selecting is reputable. There are databases available to insurance companies and healthcare providers that will tell you if a physician has been disciplined by a state medical or osteopathic board, or federal regulatory agencies like the Department of Health and Human Services or the Drug Enforcement Agency, but there have been few options available to individuals who want to find this information out. The Federation of State Medical Boards has just created a new service to make this information available to the public. For a fee of $9.75 per physician record, the FSMB will provide a report on disciplinary actions taken and reported against physicians by regulatory and licensing entities throughout the United States and a growing number of international locations. The report is available immediately online if you provide credit card information through a secure server, otherwise the report is available within 7-10 working days.

New York Gov. George Pataki signed legislation that gives New Yorkers easier access to information about malpractice cases and disciplinary actions involving their physicians. The Medical Society of the State of New York (MSSNY) supports the right of consumers to access valid information on physicians in New York State, but expressed concern that malpractice actions have not demonstrated correlation to a physician's professional ability.

Under the provisions of the new law, patients will be able to use the Internet or a toll-free telephone line to review physician profiles that will include:

- Criminal convictions within the last 10 years;
- Office for Professional Misconduct (OPMC) final actions taken against licensee (currently available on the OPMC Web site);
- Current limitations of licensee to a specified area, type, scope or condition of practice;
- Any loss or involuntary restriction of hospital privileges within the last 10 years for reasons related to the quality of patient care delivered;
- All medical malpractice judgments made within the past 10 years; and
- All medical malpractice settlements if the physician has three or more within 10 years, or any individual settlement if the New York Department of Health (DOH) Commissioner deems disclosure is warranted.

Due to the complexity in coordinating all of the profiling information, New York DOH officials said the information will take some time before it is available for the public to access.

The first annual National Summit on Medical Errors and Patient Safety Research was held on September 11, 2000 in Washington, DC. to investigate causes and cures for medical errors. This summit is an outcome of a report issued late last year by the Institute of Medicine (IOM) which said that 44,000-98,000 deaths each year are caused by medical errors, and that deaths from medical errors may be the 8th leading cause of death, ahead of deaths from motor vehicle accidents. The cost of these errors are estimated to be between $17 and $29 billion. Summit participants suggested areas which need research, such as the effectiveness of automated prescription drug entry systems and the impact on errors of long hours worked by interns and other medical personnel.

The Assisted Living Federation of America (ALFA) has announced the creation of an accreditation program for assisted living industry professionals as part of its continuing effort to encourage professional training and development within the industry. The program is offered under the auspices of ALFA University, the training arm of ALFA. The national Assisted Living Administrators Certification Program is available for executive directors, assisted living administrators and industry professionals seeking to prepare for administrative positions.

The program is based on ALFA?s "Management Library for Assisted Living Administrators and Executive Directors". It is self-study and self-paced culminating with a final examination. The program has been approved for 47 CEU credit hours through the NAB (National Association of Board of Examiners).

Initial response to the program has been overwhelming, reflecting the commitment of industry professionals to on-going training and development. Within the first few weeks, over 250 administrators signed up for the certification program.

One of the problems in selecting and evaluating assisted living facilities has been the lack of any consistent standards or regular survey process across the country. There are no standards for assisted living at the federal level, and many states have only recently set licensing standards for this level of care. Worse still, most do not have any process in place for the regular and recurring surveys of these facilities which would provide data which could be used to evaluate quality of care.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has stepped into this void by publishing its first-ever standards for assisted living. JCAHO has long operated as an accreditation program for hospitals and nursing homes, but the development of an accreditation program for assisted living is a new endeavor. The JCAHO accreditation process is a voluntary program, as opposed to the mandatory state survey processes. To qualify for a JCAHO accreditation, the facility must pay a fee and undergo an initial survey, with follow-up surveys every three years.

To be eligible for accreditation, an assisted living community would need to provide or coordinate personal services, 24-hour supervision and assistance, activities and health-related services. The assisted living community would need to operate under the philosophy that it is in the best interest of the resident to offer and design services to minimize the need to move; accommodate individual resident changing needs and preferences; maximize residents? dignity, autonomy, privacy, independence, choice, and safety; and encourage family and community involvement.

The standards include: Consumer Protection, Rights, and Assisted Living Community Ethics; Continuity of Services; Assessment and Reassessment; Resident Services; Resident Education; Health and Wellness Promotion; Improving Performance; Leadership; Managing the Environment of Care; Managing of Human Resources; Managing Information; and Prevention and Control of Infections. The standards will be effective in June of 2000, and the first surveys are expected to be conducted by January 2001.

The only other national accreditation program for assisted living was developed by the Commission on Accreditation of Rehabilitation Facilities (CARF). The CARF assisted living accreditation program is also new, and was just unveiled in February of this year. CARF is a private, not-for-profit organization that accredits programs and services in Adult Day Services, Assisted Living, Behavioral Health, Employment and Community Services, and Medical Rehabilitation.