How to Mess Up a Complaint – Part 2

When an elderly loved one is living in a long-term care facility and you see something that needs to be corrected, issuing a complaint is often the right thing to do. How can you make sure your complaints are heard? How can you make sure they are resolved? We posed these questions to Linda Anderson, a Certified Elder Law Attorney and the founder of Anderson Elder Law, a Life Care Planning Law Firm in Media, Pennsylvania. In the first article in this series, Linda explained how lack of documentation, misguided expectations, and choosing the wrong family spokesperson and lead to trouble.

In this article, we look at three more ways family caregivers mess up when trying to complain.

Choosing the Wrong Professional Advocate

Another common mistake involves involving the big guns (aka the lawyers) too soon in the complaint process. Though some people may believe that the threat of litigation will resolve problems faster, intimidation tactics can make things worse.

Linda recommends working with an elder-care coordinator in a Life Care Planning Law Firm to resolve problems with facilities. “It’s more of a peer-based approach,” she said. It’s less threatening, less lawyerly, less intimidating, and more likely to get the results you want.”

She maintains that the use of non-legal advocates to resolve care problems is one of the reasons why the Life Care Planning model is so successful. “When you send in your elder care coordinator to complain, it's a very different setup than when you send a lawyer in to complain,” Linda explained. “You’re sending in someone who is basically at the same level, who speaks the same language, and understands the providers’ pain points. Our goal is a win-win-win for the family, for us, and the facility. When you have professionals who know how to have those hard conversations successfully, that’s where the magic happens. Elder care coordinators are the secret sauce.”

Complaining to the Wrong Person

In any organization, especially in long-term care facilities, there’s a chain of command. Families who ignore the chain of command or think they’ll get better results if they skip steps set themselves up for problems. “It’s important to find out what the steps are to submit a complaint, and then follow those steps,” Linda advised. “Going straight to the top may seem like a way to expedite the process, but it often causes problems.”

Trusting the Wrong Sources

The final mistake involves knowing when—and when not—to trust the Internet to help you identify a problem that needs to be resolved. You can’t trust everything you see on online, but there is a tremendous amount of good information there. “The Center for Medicare Advocacy has self-help packets that are excellent,” Linda said. “This is a great resource for some of those issues that don’t rise to the level of paying a lawyer to fix.”

Another problem Linda sees quite frequently involves disputes about how long Medicare will pay for a patient’s therapy. One of the most common complaints arises when a family caregiver is told that an elderly loved one’s therapy is no longer being covered by insurance because the patient has plateaued or there's no potential for improvement. “The actual law says that therapy is covered if it is being used to maintain or improve a person’s condition,” Linda added. “How do you appeal those determinations by a skilled nursing facility or an insurance company? You start by getting great advice from the internet. In Pennsylvania, there’s the Center for Medicare Advocacy and the Pennsylvania Health Law Project. Nationwide, there is Justice in Aging and many nonprofits that are built for the mission of supporting family caregivers. The key is knowing how to tell the good advice from the bad, and that’s another way an elder care coordinator working in a Life Care Planning Law Firm can help.

Find a Life Care Planning Law Firm near you.