Village Shalom, a Jewish-based independent living and nursing facility located in Overland Park for the past 20 years, is embroiled in controversy over its recent decision to involuntarily discharge one of its patients. It was The Chronicle’s overture to request officials there be interviewed and recorded to help clarify issues raised in a Feb. 23 Kansas City Star article on this discharge. The following are excerpts from that interview edited only for brevity and clarity. Comments made were verbatim.
Participants in the interview from The Chronicle included Stephen Rose, publisher; Meryl Feld, editor; and Barbara Bayer; senior consultant and editor until her recent retirement. Village Shalom was represented by longtime CEO of Village Shalom’s facility Matt Lewis, current board chair Frank Lipsman and former board chairs Joseph Hiersteiner and James Klein. We all agreed to the ground rules that privacy of both the resident and staff be protected under Kansas privacy laws, a violation of which can be a felony.
A Village Shalom resident for many years, Norman Bresel, and his daughter Aliza Katz have actively protested the involuntary discharge decision by Village Shalom.
The surveyor concluded Village Shalom did not meet the necessary state requirements to involuntarily discharge the patient. However, she did not have access to personnel records due to privacy concerns. The resident has appealed to an administrative law judge, who is scheduled to hear the case next week. The judge is the only official outside of Village Shalom with full access to all medical and personnel records. The decision will be binding. Questions below are from The Chronicle staff; answers are from Village Shalom officials.
Q. In the time Village Shalom moved to the Overland Park campus 20 years ago, is there any knowledge of a resident being involuntarily discharged from the facility?
A. This is the first one.
Q. To be clear, you are saying that Village Shalom campus (and without knowledge of facilities preceding over more than 100 years) that there has never been an involuntary discharge for any reason, even if the resident was not able to pay?
A. Yes. That is something we are very proud of.
Q. Why has Village Shalom never chosen to involuntarily discharge a resident?
A. Typically, reasonable minds can come to a compromise and we are able to work with families on a variety of different issues.
Q. What is the procedure if Village Shalom is heading toward the ultimate conclusion — discharge?
Village Shalom’s Campus
A. We will have a conversation if the resident is competent. Then, we will talk with the families or those responsible. Our clinical team — which includes our medical director, nursing director, and social services — is involved. The pharmacist will also look at prescribed medications.
Q. It was intimated that perhaps too much medication was prescribed.
A. That is not accurate. A physician has to prescribe all medications. We would never ask a physician to sedate an individual; our contracted physician is a gerontology expert.
Q. The surveyor who assessed this particular case at Village Shalom concluded there was no documentation to back up an involuntary discharge. Is that accurate?
A. The documents the state surveyor reviewed did not include the personnel records due to privacy concerns. Comprehensive detail has been provided to the administrative law judge who is expected to make a ruling soon. The bulk of these details that we are not permitted to disclose, are contained in the personnel records. These entire records will be assessed by the administrative law judge.
Q. How often do you communicate with a resident’s family?
A. We talk regularly, if not daily, with residents or families. Care conferences are frequent but held at least every three months with the interdisciplinary care team.
Q. In this case, when your contact with the family was more frequent, and you had reached the decision to involuntarily discharge the resident, was this a surprise to the family?
A. It should not have been a surprise to the family, but no formal warning was given. However, the family and resident were notified of the involuntary discharge prior to Village Shalom filing the paperwork.
Q. What are some kinds of behaviors that constitute an involuntary discharge?
A. Due to privacy and confidentiality, we cannot disclose the specific behaviors involved in this matter. But generally, behaviors that may prompt an involuntary discharge focus on the safety of residents, staff, families and the community. Often, these issues are resolved and stay resolved. The reason there has never been a situation like this is because the issues did not stay resolved.
Q. By moving forward with this involuntary discharge, Village Shalom has been accused of not handling things in an ethically Jewish way.
A. Village Shalom has gone to unbelievable efforts to resolve this situation in some other manner. As we reach out to other facilities, we would take note of an existing Jewish population. But there are other factors. If the administrative law judge determines the discharge is valid, no resident can leave until an appropriate safe facility has been located.