After the conducted inspections the substantiated conclusion could be drawn that in many homes medical care is a provided at lowered standards – both in quantitative and qualitative terms. It is neglected and is reduced to routine manipulations without actually engaging employees with the health conditions of the customers. There is no coordination between the specialists in the home in terms of health care. This is evidenced by the fact that in the HEPMD – Razdol, for example, papers that had been filled out by different specialists concerning one and the same individuals some discrepancies in terms of their health status had been registered. In some individual health care plans the diagnosis are not even recorded in its full extent when examined by medical experts and included in personal medical records of the patients. These are referred to as “underlying diseases” and targeted research and consultation with specialists to administer adequate treatment for them have not been made, i.e. the adequate diagnostic and therapeutic steps had not been taken in compliance with the rules of good medical practice. In the same home during the interviews with staff it was found that the GP provides patients with the necessary directions by phone and comes in the home only when needed. To the patients who are given medicines fully or partially paid by the NHIF, the GP writes out prescriptions on a monthly basis and submit them to the pharmacy at the village of Mikrevo and the pharmacy staff takes medicines and delivers them in the home. All this happens without the general practitioner to see the patient. Under the current regulations medicines can not be prescribed without a medical examination of the patient. Also, in reviewing the documents of M.C., who died in the HEPMD – Razdol, it was found that the death certificate recorded as a cause of death „acute cardiac and vascular disease.” In none of the medical records of the above person there is no evidence of any somatic medical condition. Even in her individual plan prepared several months before her death, it is recorded that there are no any abnormalities in the condition of the lung and cardiovascular system. In this case, without prior disease and signs of health problems, the fact that the patient had been buried in the cemetery of the home without pathological examination necessary in such cases for more accurately determination of the pathogenesis of death is puzzling. Thus, the NPM team noticed that the practice in homes providing this type of social services, in case of death of a customer the notice of death is made by the GP and no pathological examination of the deceased is made. The NPM emphasizes that it is important a post-mortem examination to be carried out in any case of death of a person who uses the appropriate social service. In this way are avoided both suspected neglect of the customers’ health of customers and is a way to identify potential medical errors. In addition to the above matter, the NPM team has been informed by officials in various institutions, that there is a serious problem related to refusal by emergency units and hospitals to admit customers for treatment. In other cases, admittance of a patient to a medical institution requires compulsory attendance of companion which impedes the work of the staff of the home (e.g. the HEPMR in the village of Butan). 41 Annual Report of the National Preventive Mechanism | OMBUDSMAN OF THE REPUBLIC OF BULGARIA