Does a Hospital have the Right to Ban the Legal Representative Of the Patient?

[hatemalpractice]

What is the name of your state? Nevada

I have a question regarding the law as it applies in this state, to Hospitals and the Legal Guardian/POA right to see his family and loved one who is interned as a patient. My grandmother is a 78 old bed bound individual whose currently under the care of a local "long term acute hospital." We have had numerous issues not only with the lack of care provided by Hospital Nursing staff but the apathy and incompetence of the Hospitalist Doctor noted as her Primary Physician and the covering Doctors he has sent to handle her care. We have complained of various issues to Administration and they have decided that it is better to go to war with the family then to reprimand and discipline the deficiencys in the quality of care found at their institution. We have had 2 meetings with the full house of Administration at this Hospital and have put most problems in writing and they have failed to make amends other than to Ban one member of the family who is one of the Legal Representative and advocate of the patient. The daughter who is the next kin has been put under notice that their staff feels "intimidated and scared" of us and that they will call METRO (police) if they feel remotely threatened. Administration has done all they can to try to bury legitimate issues by trying to intimidate and drive off the family which are the only advocates this non speaking grandmother has in the area. So without writing pages with specific details that justify a Lawsuit against the Physicans and the Hospital, I would like a Legal Response. DOES THE HOSPITAL HAVE THE RIGHT TO BAN THE LEGAL REPRESENTATIVE OR REPRESENTATIVES FROM VISITING THE PATIENT?

When I say "legal representative" I mean those empowered by Durable Power Of Attorney Over Finances & Healthcare Matters including the power by the main power of attorney (daughter) to fully empower any other she so chooses to assist with the administration of her affairs.

Thank you in advance for your caring helpful and detailed responses!

 

[lya]

Yes; the hospital has the right to ban any person considered to be a threat or interfering with the staff's ability to render care.

You stated that the daughter is "one of the legal representatives". The hospital has identified one legal representative, who happens to be the patient's next of kin, and is allowing visits and is interacting with that one person. The hospital can ban the rest of you from the hospital's property and have police escort you off the property with or without placing you under arrest.

A longterm acute-care hospital is usually funded by Medicare and Medicaid. An ombudsman should be available for you to contact and to investigate any complaint(s) that you have.

You may file complaints through the websites for Medicare and Medicaid, or at least start the process of filing of a complaint via the website(s).

If the facility is JCAHO certified, you may file a complaint through JCAHO's website.

You may report your concerns to the state's hospital licensing board, the state's licensing board of physicians, and the state's licensing board of nursing.

You may also contact the US Senator and US Representative for that area and ask for their assistance. Each US Congressperson has staff members who assist constituants with such concerns and problems.

Your State Senator and State Representative may be of some assistance but usually do not have the resources to be of as much assistance as can the US Senators and US Representatives.

Whatever you and your family members do, my advice is to leave the hospital staff, including administrators and physicians, alone. Do not antagonize them any further; not, if you wish to be taken seriously by those who can help you the most. Be on your best behavior and do not say one derogatory thing while you are in the hospital.

If you are not keeping a diary of events, start one now and describe events and timelines to the best of your recollection. Keep it current with daily entries of observations; do not include your opinion of events, simply write down what happened and who did it or failed to do it.

 

[longsally111]

Be Careful

YES. lya is right. If I had family that was unhappy with the care I was rendering and they were "in my face" to the point I felt threatened personally, yes, I would ask that they be banned to allow me to do my job. I suggest you guys behave yourselves while at the hospital. Assault of a health care worker is now a felony!!!!!

 

[barry1817]

care for elderly

I guess this is just a general response.

I am concerned that when people can't provide proper care, there is often an attempt to limit those that can see and complain about such care. There have been numerous posts to that effect.

What exactly is a threat to the care givers. Do what is right or I will complain, or is it a physical threat to do harm.

I do hope that situations are documented and can get to an ombudsman in a proper manner.

But a frail elderly person is in no place to advocate for themselves and often gets lost in the shuffle. Sad bud true.

 

[hatemalpractice]

I guess this is just a general response.

I am concerned that when people can't provide proper care, there is often an attempt to limit those that can see and complain about such care. There have been numerous posts to that effect.

What exactly is a threat to the care givers. Do what is right or I will complain, or is it a physical threat to do harm.

I do hope that situations are documented and can get to an ombudsman in a proper manner.

But a frail elderly person is in no place to advocate for themselves and often gets lost in the shuffle. Sad bud true.

Barry you are exactly right atrocities against patients particularly the elderly and those who cannot advocate for themselves are committed all the times even at the so called "finest hospitals or medical facilities." It is the tendency of Administration to bury legitimate complaints particularly of the family members. The situation here are very real and very legitimate and are grounds for a lawsuit which is going to be a soon coming move. The talk about "Feeling threatened" and people being "in their faces" are gross inaccuracies, just lies made up by a staff of ignorant no compassion having fools who dare to claim that they are "medical professionals." The situation is that they are upset to find that there are people out there that are passionate about the level of care their loved ones receive and outright despise whistle blowers because they are used to their own little routine of mediocre care that they cunningly embolster to the public as 5 star service, all hogwash. I have been prohibited from coming to visit my grandmother because I have been discriminated against, we speak forcefully but we DO NOT "get in peoples faces" and much less display any physical gestures as if to say I intend to assault or cause bodily harm. I happen to be tall and large and the huge majority of the staff here are short skiny individuals and though my mother is my grandmothers Legal Next Of Kin and Main POA she is also under threat of the possible involvement of the police if their "wondeful staff feels threatened." We been maintaining a log since day 1 it is humongous and if I were to state it here it would consume many pages. Suffice it for me to say the level of care being provided does NOT meet my grandmothers needs and is atrocious for a long term hospital purported to offer the best care.

Here at this Hospital we find the most incompetent and ignorant Nurses we have ever seen in any Medical Facility. They want the Doctor to hold their hands and guide them through their day with clear instruction on what to do, how to do it and when to do it. The Nurses act as if they bought their degrees online from non reputable companies that will sell you even a PHD over night if you have the right amount of cash, forget about actual study or hands on training! The Admitting Physician and all of his "covering partners" and "non-associate covering doctors" are all related and coverup the gross negligence and mistakes committed by each other. The latest trend ever since the discovery that they have NOT been managing the patients PTINR level which was recently found to be at 1.0 a disturbing trend has commenced. Now that the patient has become less responsive even to the family and has stopped moving both of her arms these unethical horrid excuses for Doctors come into the room to tell the family members that she is "suffering from Advanced Dementia, Alzheimers, Breast, Pacreatic, Colon and Lung Cancer, Fibromyalgia, late development of "PMS" like symptoms and other outrageous FASLE DIAGNOSIS that are hardly ever heard of.

This is a 78 year old woman that is bed bound as a result of prior strokes. It is very probable that while under the care of these unprofessional and negligent individuals she could have suffered another stroke. All we had been told from the beginning was that she was receiving Fragmin via IV but two days ago another one of the Admitting Doctor "mery-go-round of coverup bafoons" said he was increasing her dosage to 7.5mg of Coumadin and lied that she had been receiving it all along. The family has been at the hospital night and day since day 1 and we know for a fact they were NOT giving Coumadin nor performing the Protyme tests often enough. This Doctor goes on to say he is going to request a Cardiology Consult because "due of her atrial fibralation this can be very dangerous possibly leading to a stroke but at same time she may bleed." Hmmm wow this guy thinks hes a real Einstein but we have known that for years because under the care of the family at home her PTINR readings ranged in the 2-3 range consistently under coumadin therapy and we had no incidents of bleeding or easy bruising for over 3 years. The Doctors have clearly dropped the ball and the only person suffering is my grandmother! The hospital administration has gone so far as to even roadblock her discharge home because they claim "they are also responsible for her wellbeing." However, last I checked, and feel free to correct me on this, the holder or holders of the Durable Power Of Atorneys over Financial and Health Care matters had the final say so as the legal representatives/ advocates for said individual and have the power to DEMAND IMMEDIATE DISCHARGE of the patient to RETURN HOME or to TRANSFER to ANOTHER FACILITY. The care being provided her at this Hospital Facility has been 90% horrid and the Administrations position is that it is wise to go to WAR with the family and coverup the mistakes of its staff.

Please comment on this more recent display of malpractice. A covering physicain for the admitting doctor recently was requesting the replacmeent of her PICC LINE. When he was asked about the matter he said it is because a new "blood borne infection" had been detected on a preliminary culture. We asked him to state the name of the bacteria he didnot know and said he would call an Infectious Disease Consult. The Infectious Doctor appears on the seen and put alot of pressure on my mother to sign the consent form to replace the PICC LINE and sold the idea as if he was a salesman assuring us that "this infection only comes from the PICC LINE." We were hesitant upto that point btut she agreed. We both read the consent form in detail that was filled out by this Infectious Doctor himself. The exact wording stipulated that the procedure would be performed by the Doctor "whose name was noted on the form or by any associate doctor of his choosing." What happened the following day was that the this hospital called in an outside Third Party to come in and insert the PICC LINE and there was 2 (yes TWO) PICC LINES inserted one through the Left Arm and one through the Right Arm). My grandmother has a Cardiac Pacemaker and we were told many times before by various Doctors that you DONOT stick a PICC LINE in on the same side as a pace maker because it may conflict with the wiring of the pacemaker among other things. The hospital was made aware since before the transfer to its facility that she had a cardiac pacemaker installed. Upon discovering this my mother the POA demanded the PICC LINE through the Left Arm be REMOVED IMMEDIATELY because my grandmother was in alot of pain complaining. The Administrative contact was advised and they called in a Charge Nurse that was supossedly trained in PICC LINES and REMOVED it. After that my grandmother began calming down and a Tylenol Suppository was given her to help her rest. Incidentally as of yesterday January 7, 2008 it has been 92 hours and the result of the Culture of the FIRST PICC LINE ahs been "NEGATIVE 0 GROWTH."Another major problem that came out of this however, was that now BOTH of her Arms are FULLY EXTENDED, whereas for a few years they both had contractions ESPECIALLY on the RIGHT ARM. Post the day of this procedure the ARMS are fully extended and she has not been moving them. We have demanded from Administration that they Order XRAYS for BOTH ARMS and quite frankly a Catscan due of the PTINR reading of 1.0. The administrative contact assured my mother she would contact the Absentee Doctor and make the arrangements to have these things are done.

Please provide any further advise you can think of. It appears this institution and the Doctors themselves are headed for a Medical Malpractice lawsuit that will expose the real quality of care afforded patients like my grandmother at Kindred.

 

[lya]

The patient's legal representative may certainly move this patient to another facility and considering the level of dissatisfaction elaborated upon by the original poster, it seems more than appropriate for the patient to have been moved long ago.

HOWEVER--the question asked was if a hospital can legally ban family members and legal representatives and the answer is "yes".

I read the description of events and wonder where the poster has met nurses who bought degrees online and thereby enabled him to compare the hospital's nurses to those who bought their degrees. Just wondering, too, if the poster is aware that a "bought" degree does not come with a passing grade on the NCLEX exam, which licenses the nurse to practice.

There is so much in this post that indicates the poster does not understand the patient's condition. Someone, somewhere failed to recognize an emotional response as indication of lack of understanding.

Lab values do not mean the same from one lab to another. PT/INR values vary from one specific test to another specific test. One can't compare a value from one healthcare provider to another healthcare provider or an acceptable INR for one condition to the acceptable INR for another condition.

Contracted extremeties do not suddenly "un-contract". The muscle is shortened and without the muscle's being severed, it isn't going to stretch.

PICC lines do not always extend above mid-arm and therefore, not all PICC lines have the potential to interfere with a pacemaker.

All of the diagnoses that the OP listed are most likely correct, I'm sure, and fall into the category of dying, system by system, including the deterioration of mental function and neurological function. The patient presented with an impaired cardiovascular system and impaired CNS and impaired muscle system. Even in a completely healthy person, deonditioning of the body takes very little time to occur. This patient has been bedbound far too long to recover without a true miracle.

Obviously, the family does not want grandmother to die, despite her best attempts to depart this earth. None of us want to lose our family members to death. None of us want to suffer the loss of that person. Yet, none of us are spared the experience of such a loss unless we die before anyone else in our family or in our circle of friends. And, yes; I know the loss of my closest family member and I lost my grandparents, too. Death has not excluded my family or circle of friends.

The biggest fault I see from the healthcare provider is not having someone sit down with this family and explain that the grandmother is not going to recover and continuing treatment is only prolonging her suffering in many way by many means.

There are options to aggressive care, options that allow maximum functioning in the least restrictive environment, options that allow the family members and the patient to derive the most of every bit of the time the patient has left.

In other and fewer words, what I see in this post is the anger stage of grief. The family's behavior has resulted in the loss of the grandmother before her actual death. Someone needs to intervene on everyone's behalf before the grandmother dies and these family members never make it through the grief process and impact the rest of their lives with this anger.