Nursing homes in the private sector should be allowed, while limiting the number of older people who can be accommodated there. On February 10, such a proposal was made by the director of the department for supervision and preventive work of the Ministry of Emergency Situations, Rinat Enikeev, at a meeting in the State Duma on improving legislation in the field of regulating the activities of private boarding houses. The deputies are ready to develop, together with the Government, legislative norms that would define clear rules for nursing homes and bring them out of the shadows, Svetlana Bessarab, a member of the State Duma Committee on Labor, Social Policy and Veterans Affairs, told Parliamentary Newspaper.
Hut for five
According to the Ministry of Emergency Situations, there are 689 facilities in Russia that by all indications can be called nursing homes, although they are not registered anywhere and are located in private housing. “For the most part, these are St. Petersburg, Moscow, Altai, Krasnoyarsk, Sverdlovsk, Moscow, Leningrad, Chelyabinsk regions,” Rinat Enikeev cited the geography of such boarding houses.
The Social Committee of the State Duma conducted their own small study – they went to the websites of private nursing homes in different regions. Often, apart from bright advertising, there was no information on their pages – neither about registration, nor about licenses for medical services, although people were promised medical support. Sometimes there was not even an address – only a phone number, on which they refused to provide specific data and offered to meet first, said Svetlana Bessarab. According to her, 22 such boarding houses were found in Krasnodar, 80 in Moscow, 30 in Yekaterinburg and 27 in Rostov.
What goes on behind their closed doors remains unknown. “After all, they are located on plots for individual housing construction, and law enforcement agencies, supervisory authorities cannot enter the dwelling. Often, entrepreneurs who are in the shadows work dishonestly and do not provide the elderly with proper care,” Bessarab said.
As one of the options for control, the deputy proposed introducing compulsory licensing of all organizations that care for elderly citizens with residence. She sent such a bill to the Government for consideration. “It is puzzling why we can license circuses and zoos, but not nursing homes where our citizens live,” she said. True, this is only one of the options for how to regulate the activities of nursing homes. You can choose another one – the main thing is to finally bring them out of the shadows, the parliamentarian added.
According to Rinat Enikeev, the Ministry of Emergency Situations and the Ministry of Labor are considering a proposal for licensing, but they believe that this is not the best option. “It won’t solve the problem. We need to regulate this area in a different way,” he said. Thus, it is possible to allow people to provide social services in residential buildings, observing certain norms. “Let’s say you can keep no more than two sedentary and three mobile people in a separate house. If you want to keep five bedridden, there must be two exits in an individual residential building, and staff must be present around the clock. But a nursing home, where there will be 20-30 people, on lands intended for individual residential construction, is unacceptable,” he said.
Svetlana Bessarab noted in a conversation with Parliamentary Newspaper that the deputies are ready to work on this option as well. But it is high time to start working on a bill that would somehow regulate this area. “Usually people start talking about nursing homes when another tragedy occurs – due to a fire, poor care, poor quality services. And if nothing is done, new incidents cannot be avoided,” she believes. According to her, it will be necessary to work out additional measures to support private traders who honestly do their job, including subsidies.
But the idea of licensing should not be buried yet, says the CEO of the National Association of Social Service Participants Sergey Zaitsev. It would be good, for example, because it would not allow illegal nursing homes to freely advertise their services.
• Refusal to let the inspector in may result in a fine of 100,000
Not in the registry – turn off work
There is another option, simpler than licensing. It is possible to oblige all nursing homes to be registered in the register of social service providers, considers a member of the public council under the Ministry of Labor, authorized under the governor of the Vologda Oblast to protect the rights of veterans and pensioners Olga Danilova. So far boarding houses are included in the register voluntarily. In this case, they receive benefits and at the same time are in the field of view of the state, the expert added.
The idea of regulation with the help of the register was supported by the Deputy Head of the Department of Sanitary Welfare of the Population of Rospotrebnadzor Andrey Guskov. This path has already been taken in other areas, he recalled: “The Government Decree approves the rules for inclusion in the register, and indicates that it is impossible to carry out activities without being included in it.” For example, no tour operator has the right to work if it is not on the federal list of such companies.
But no matter which method of regulation is chosen, it is necessary to rank the requirements for nursing homes depending on the volume of services, the number of guests, says Aleksey Guskov, head of the department for organizing state control of the quality of medical care for the population of Roszdravnadzor. The rules cannot be the same for a boarding house with ten grandparents and a nursing home with eight hundred people.
A differentiated approach to different organizations is a compromise path, says First Deputy Chairman of the State Duma Committee on Labour, Social Policy and Veterans Affairs Elena Tsunaeva. “Apparently, this is the path we will move on,” she said.
And they will start by defining in the legislation what a residential care service for the elderly is, said Svetlana Bessarab. She supported the proposal of Ramaz Akhmeteli, chairman of the board of the National Association of Social Service Participants. Otherwise, everything will end before it starts – the owners of underground boarding houses will simply say that they do not provide social services, and will not respond to the call of the authorities to come out of the shadows.