SALT LAKE CITY — Under current Utah law, if a resident of a nursing home ridicules, swears at or yells at another resident, the operator of the facility is required to submit a report to state human services authorities.
Then, workers in the state's Adult Protective Services agency are required cull through the reports to determine if further action needs to be taken. In the vast majority of those cases, the administrators of the facilities have already rectified the issues and there is no reason for caseworkers to intervene.
Nels Holmgren, director of the state Division of Aging and Adult Services, said the combination of mandatory reporting requirements and an overly broad definition of "emotional abuse" in Utah's Human Services Code is unnecessarily tapping the resources of facility operators and APS workers.
A bill sponsored by Rep. Carol Spackman Moss, D-Salt Lake City, attempts to refine the definition so that only significant incidents of emotional abuse receive appropriate review, so nursing homes and assisted-living centers are not required to report minor events that are readily handled by staff.
"I really could understand this well because my mother is in (a) assisted-living (center) where I've seen that very thing happen, where someone might be acting out over some relatively minor thing," Moss said.
Including "yelling" as part of the definition of emotional abuse is problematic, Moss said, because "some people talk really, really loud because they can't hear."
The amendment also clarifies that emotional abuse does not include the "verbal or nonverbal conduct of a vulnerable adult who lacks the capacity to intentionally or knowingly engage in the conduct."
Moss said requiring facilities to file reports regarding the conduct of people who lack the capacity to knowingly inflict emotional abuse adds to the "stigma of people already struggling with dementia to be the subject of unnecessary reporting," she said.
Holmgren said the majority of facilities overseen by Aging and Adult Services do a good job of protecting residents while taking into consideration the diminished mental capacities of people who may act out on occasion.
"It is truly a handful of cases out of hundreds of referrals that raise to the Adult Protective Services investigating and needing to take action," Holmgren said.
Holmgren said he believes the proposed changes to the law, which were recently reviewed by the Utah Legislature's Administrative Rules Committee, would curb the number of reports that require no action on the part of regulators.
"At the same time, we don't want to create a loophole if someone's in danger they're not getting the help they need. We want to protect people but not make it a burden to the individuals working with these clients," he said.
The bill, as drafted, appears to accomplish those goals, Holmgren said.
"In my opinion, it's a win-win," said Holmgren. "This lets the facilities do their jobs and it lets Adult Protective Services focus on issues where we can do the most good."
Representatives of the Utah Attorney General's Office and the nursing home/assisted-living industry also participated in drafting the amendments, Holmgren said.
Members of the Administrative Rules Committee supported the changes in concept Wednesday but could not take a formal vote to endorse it due to the lack of a quorum.