Could hospitals be under scrutiny for undue influence?
We spoke with Scott Livingstone, who has held many roles in California Hospitals from Director Case Management, Risk Management & Compliance to Chief Operations Officer. Scott is a Registered Nurse and a graduate of Massachusetts School of Law. Scott shared, “The reason I obtained a law degree was so that I could understand regulations that control healthcare better. Hospitals have to be very careful regarding referrals to outside private paid agencies. We have to balance our due diligence in providing patients and their families with appropriate resources with the time constraints to meet hospital throughput by handling discharges in a safe and timely manner.”
NBH: We are aware that some hospitals refer families and responsible parties to Placement advisors that are advertising that they are FREE of charge, but they actually receive referral fees from the homes that they place the clients. They aren’t always contracted with every community or facility in the area and therefore could potentially be “steering” people in a biased direction. Would that be considered undue influence?”.
Scott: I’m not a lawyer, but I can provide some general information on the concept of undue influence in healthcare settings. Undue influence typically refers to situations where one party exerts significant pressure, coercion, or manipulation over another party to make a decision that is not in their best interest or against their will. In the context of healthcare, this could involve healthcare providers, including hospitals, potentially influencing patients or their families in ways that are not ethical or legal.
In the scenario you’ve described, where hospitals may refer patients or families to placement advisors who receive referral fees from certain facilities, there could be concerns about potential conflicts of interest and whether this constitutes undue influence. Whether or not such actions are considered undue influence would depend on various factors, including the specific laws and regulations in the relevant jurisdiction and the details of the arrangement between the hospital, placement advisors, and the facilities.
Healthcare providers, including hospitals, are generally expected to act in the best interests of their patients and avoid conflicts of interest that could compromise patient care. If there are concerns about potential undue influence or unethical practices, it is important to seek legal advice and potentially report the matter to relevant regulatory authorities for further investigation.
NBH: If a hospital refers potential clients to a senior placement advisor and they steer them to options that are not best matched with a client’s level of need or within a practical budget because it would affect the opportunity for the advisor to obtain a referral fee then could that be considered undue influence?
Scott: If a hospital refers a patient to a senior placement advisor, for example, and that advisor then steers the patient to options that are not the best match for the patient’s level of need or budget solely to obtain a referral fee, it could raise ethical and legal concerns. Whether this constitutes “undue influence” in a legal sense may depend on specific jurisdictional laws and definitions, such actions could certainly be considered unethical and potentially harmful to the clients.
In healthcare, there is an expectation that professionals, including placement advisors, act in the best interests of the patients or clients they serve. Steering clients toward options that are not appropriate for their needs or budget, solely for financial gain, could very likely be seen as a breach of that duty and a violation of ethical standards and honestly, it may rise to a violation of state and or federal regulations.
It’s important to address such concerns and report them to relevant regulatory authorities or professional organizations responsible for overseeing the conduct of placement advisors in your jurisdiction. These authorities may investigate the matter to determine if any laws or ethical guidelines have been violated.
If you or someone you know is in a situation where they suspect unethical practices or potential undue influence, it is advisable to consult with a legal professional or contact relevant regulatory agencies to seek guidance on how to address the issue. The specific actions taken and their legal implications will vary depending on the laws and regulations in your area.
NBH: That’s where we have become the wild wild-west in senior placement. If a senior placement advisor was actually steering a client or there was a conflict of interest where would someone report them? What regulatory agency is monitoring this type of profession that is a service provider for the elderly which is a vulnerable population?
Scott: The regulation of senior placement advisors and similar professions can vary from one jurisdiction to another, and there may not always be a specific regulatory agency dedicated solely to this field. However, you can take several steps to address concerns or report unethical practices:
- Contact Local Authorities: You can start by contacting your local government or state-level agency responsible for senior services or elder affairs. They may be able to provide guidance on where to report concerns about placement advisors or refer you to the appropriate agency.
- State Departments of Aging: Many states have departments or offices dedicated to aging or elder services. These agencies may have oversight or regulatory responsibilities related to senior placement advisors. They can provide information on how to file complaints or report unethical behavior.
- Professional Associations: Some senior placement advisors may be members of professional organizations or associations. These associations often have codes of ethics and standards of practice that members are expected to adhere to. You can contact the relevant association to inquire about filing a complaint against a member.
- Consumer Protection Agencies: You may also consider contacting your state’s consumer protection agency or attorney general’s office. They can investigate consumer-related complaints, including those involving potential fraud or misrepresentation by service providers.
- Elder Abuse Hotlines: If you suspect elder abuse, neglect, or financial exploitation, you can contact your local adult protective services agency or an elder abuse hotline. They can investigate and intervene in cases of abuse or exploitation of vulnerable seniors.
- Local Ombudsman Program: Many areas have Long-Term Care Ombudsman programs that advocate for the rights and well-being of residents in long-term care facilities. They may be able to assist with concerns related to placement advisors.
When reporting concerns or filing complaints, it’s essential to provide as much detail as necessary – keeping in mind patient privacy regulations that control. Like HIPAA and state privacy regulations. Understand that most regulatory bodies have specific information they need and will guide you through the reporting process.
Keep in mind that the regulatory landscape for senior placement advisors may evolve, so it’s a good idea to check with local authorities or elder services agencies for the most up-to-date information on how to address concerns within your jurisdiction.