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As I’ve written many times over the years, the comments made by readers who currently or previously worked in nursing homes are some of the most powerful indictments of serious problems within the greedy nursing home industry! Along with family members and loved ones, these folks know all too well that the system is broken badly and is desperately in need of fixing!
A comment left earlier today by one such reader, a CNA with many year’s experience of caring for nursing home residents, points out the dangers and stresses caused by understaffing. Understaffing is caused by? Corporate greed. The CNA wrote:
“I’ve been a CNA for a while now and I’m exhausted. Today I alone was responsible for 16 residents with nine of the 16 being total care and 11 of the 16 requiring assistance by a minimum of two staff members. It’s impossible!!! Unfortunately those total care residents were only changed once because of the lack of time during day shift.
Inadequate staffing creates a situation that is incredibly hard – mentally and physically – because I care and love my residents. Something has got to change. Our residents are suffering!
No wonder there are so many issues with skin tears. Some CNAs get in such a hurry to get everyone done in time or they’ll get in trouble for running late or if they clock out even one minute late they get their attendance bonus taken away. But let the administrator come out of their office and out of their plush leather desk chair once a week and throw afit because the closets are a mess or there’s a lift in the hallway or some other unimportant bullcrap! They don’t worry about the CNA whose back is broke, with sweat running down their face, or that there are 10 more residents to lay down and change before the end of the shift.”
I believe this comment from a certified nurses aide points out that short-staffing, which is directly related to corporate greed, is the source of suffering for both nursing home residents and nursing staff. I have no doubt the emotional toll is especially heavy for the nurses and CNAs who truly love and care for their residents. The best and brightest staff get burned out and worn out because of inadequate staffing.
The suffering caused by short staffing clearly harms nursing home residents. Everything from medication errors to bedsores can be traced to short staffing. My observation is that inadequate staffing is the single largest cause of nursing home resident neglect leading to illness and death.
When a nursing home CEO (as many do) earn mutliple million dollar annual salaries and the front line caregivers (CNAs) barely earn above minimum wage and often lack health insurance or other benefits, something is seriously wrong with the nursing home industry!
As a resident of Kentucky committed to nursing home reform, I was thrilled when our 2013 legislative session ended a few weeks ago without passing Senate Bill 9. The bill’s intention was to make it much more difficult to sue nursing homes by mandating that a panel of three physicians would have to, by majority vote, approve of the merits of a lawsuit against a nursing home before it could tried in court.
Most nursing homes in Kentucky are owned by for-profit corporations. Most hospitals in Kentucky and owned by non-profit corporations. Kentucky’s hospitals have never sought such protection. So it’s obvious what this dysfunctional bill was all about: protecting nursing home profits. With a smaller profit margin nursing home bosses like Kindred President & CEO Paul Diaz might not be able to make an obscenely huge salary of over $6.4 MILLION like he did during 2012. This is all the more an obscene situation when you consider how cheaply Kindred and other nursing home giants run their facilities — meaning they don’t provide adequate staffing to care for their residents and the front-line caregivers are woefully underpaid, many not even having health insurance as part of their compensation.
While Senate Bill 9 passed in the Kentucky Senate, thankfully it never received a hearing in the House Health & Welfare Committee, so it couldn’t up for a vote by the House. While the fact that this bill was able to pass in the Senate is disturbing, yet it points out a reality that the nursing home industry needs to face: No matter how much money they spend to buy legislator’s votes to support such a bill and to run deceptive commercials to promote their agenda to the public, they do NOT have the truth or decency on their side. Thankfully, so far at least when it comes to Senate Bill 9, all of their money and lies could not force their hideous agenda on nursing home residents. Truth won. Greed lost. Amen.
I want to offer a few reminders about this blog…
– As I’ve mentioned before, I’m very familiar with how nursing homes operate in Kentucky and Indiana, due to my late mother’s experiences in facilities located in both of these states. But I never claimed to be knowledgeable about nursing home rules and regulations in any other states.
– Since I’m not an attorney, nor am I employed by any government agency that regulates nursing homes I ask that you do not contact me for help resolving a problem with any nursing home, especially if they aren’t located in either Kentucky or Indiana. Instead, I urge you to focus on contacting either your local long-term care ombudsman and/or the agency that regulates nursing home in your state (the agency name varies from state to state, but this is information you can find at your local library or from your state legislators). These are the people you need to contact. With access to Google and other Internet search engines, you can likely find their contact information quite easily. If you can’t find the information online, then (as mentioned previously) contact your local library and/or state legislator for this information. In both Kentucky and Indiana all nursing homes MUST (as a matter of law and/or regulation) provide anyone who asks (resident, family member or friend) for their
– While I do publish from time to time comments readers leave on this blog having to do with nursing home problems they’ve experienced, please remember that I reserve the right to edit your comments. I edit these comments to protect the identity of the nursing home resident, the author of the comment and I never include the name of the facility involved. Given the tendency for nursing homes to retaliate against residents and their friends and families, it should be obvious why this information is omitted. I also don’t feel comfortable naming a nursing home accused of neglect or abuse of their residents unless this is a matter of public record (e.g., it involves a situation that has been the subject of a lawsuit).
Please DO keep share your story with me and with our readers! I believe it is therapeutic to share the horror of one’s stories with others and it is helpful for others to be reminded they are not alone and that others have faced the same nursing home crap they have!
Remember: Truth Won. Greed Lost. If it can happen in Kentucky (and it did during our 2013 legislative session) it can also happen in your corner of the world!
We know that abuse and neglect of nursing home residents is all too common. Make no mistake that nursing home management and ownership routinely psychologically abuse both the residents and family members of residents who confront abuse, neglect and other problems (including fraudulent billing) that takes place!
One such family member of a nursing home resident who has visited this blog wrote the following earlier today, “I just got a copy of a bill submitted to Medicare for $8,000 worth of therapies never done for my father by nursing home staff. Their fraudulent billing was so bold as to list therapies done on CHRISTMAS, a day when he was asleep 95% of the day!” When confronted by the family member, what did the nursing home’s administrator do? The family member continues, “When I disputed the bill, the administrator told me perhaps it was time to move my father!”
THIS TYPE OF PSYCHOLOGICAL RETALIATION MUST STOP!!! It is NOT a crime or a bad thing to confront fraudulent nursing home billing! It is NOT fair to retaliate against a nursing home resident because their family member points out a legitimate problem! It is NEVER wrong to point out possible insurance fraud!
How is suggesting moving a family member to another nursing home a type of “psychological retaliation”? Because it is NOT in any way, shape or form an appropriate suggestion. Claims of possible fraudulent billing by a family member (or resident) isn’t something that should cause a nursing home administrator to even suggest a resident should be moved. The problem is the FRAUD committed by the facility and NOT reporting the possible fraud! The “sub-text” of this type of “suggestion” is actually a THREAT to involuntarily FORCE a resident to be moved as a way to punish the person concerned about fraudulent billing. Involuntary discharge from a nursing home because a resident or their family member reports possible fraud is ILLEGAL. Nursing homes are masterful in how they can cook up FALSE reasons (through lies and false charting of resident information) to make it appear that involuntary discharge is for legal reasons. Think of the stress inflicted upon the resident and/or family member to have to defend themselves against false claims. Think of the stress caused a family member when a nursing home resident, for no good reason, is forced to move to a different facility — some residents end up being moved literally hundreds of miles from their family member in order to find a facility that takes Medicare payment that will accept the resident. It isn’t easy to place a resident when the discharging facility has falsely documented problems about the resident in order to justify kicking them out.
If possible insurance fraud involves Medicare, as in the case of this reader, the official Medicare website (www.medicare.gov) offers the following information about how to report fraud…
First, if you even suspect that Medicare is being charged for a service or supply that wasn’t provided your loved one (or a friend, or yourself), call toll-free 1-800-MEDICARE.
It will help to have the following information handy at the time you report fraud:
- The provider’s name and any identifying number you may have.
- The service or item you’re questioning.
- The date the service or item was supposedly given or delivered.
- The payment amount approved and paid by Medicare.
- The name and Medicare number of the person the service or supplies were alegedly provided to.
- The reason you think Medicare shouldn’t have paid.
- Any other information you have showing why Medicare shouldn’t have paid for a service or item
Under certain circumstances fighting Medicare fraud can pay up to $1,000! You may be eligible for a reward of up to $1,000 if all of these 5 conditions are met:
- You report the suspected Medicare fraud. The allegation must be specific, not general.
- The suspected Medicare fraud you report must be confirmed as potential fraud by the Program Safeguard Contractor, the Zone Program Integrity Contractor, or the Medicare Drug Integrity Contractor (the Medicare contractors responsible for investigating potential fraud and abuse) and formally referred as part of a case by one of the contractors to the Office of Inspector General for further investigation.
- You aren’t an “excluded individual.” (Example: You didn’t participate in the fraud offense being reported. Or, there isn’t another reward that you qualify for under another government program).
- The person or organization you’re reporting isn’t already under investigation by law enforcement.
- Your report leads directly to the recovery of at least $100 of Medicare money. The incentive reward can’t exceed 10% of the overpayments recovered in the case or $1,000, whichever is less. If multiple individuals qualify for a reward, the reward is shared among them.
If you want to know more about Medicare’s Incentive Reward Program, call toll-free 1-800-MEDICARE.
My prayer is that nursing home residents and their family members may never again be subjected to psychological abuse in retaliation for telling the truth.
Nearly every state’s legislature will begin their 2013 session this month. So January is the appropriate month to offer my five point agenda for nursing home reform. My hope is that state nursing home reform groups and individuals concerned with nursing home problems will lobby their legislators about these matters. My belief is that these five points can, at a reasonable cost to taxpayers and to nursing homes, help improve the quality of the care provided to residents.
Suggestion #1: Have each state mandate an INCREASE in the percentage of inspections (more frequently known as “surveys’) that MUST take place outside of regular business hours on weekdays. This standard should apply to both annual inspections (inspections the state conducts approximately once each year at all licensed nursing homes) as well as to surprise inspections (these are inspections that take place in response to complaints the state receives about a particular nursing home.
In many states at least 10% of nursing home inspections must begin at night or on the weekend. That means that 90% of inspections are likely done during 23% of time that accounts for regular weekday business hours. I believe that if state law would mandate a minimum of 25% – 33% of inspections begin on weekends and during hours when administrators are not normally at work the inspectors would get a more accurate view of the low quality of care that goes on in nursing homes on weekends, 2nd and 3rd shift and on holidays — the times when administrators are rarely on the job. As a family member of a nursing home resident, it was “after hours” that my mother experienced the worst neglect by her caregivers. These are the hours when the staffing levels are usually at their lowest and when management isn’t present to see for themselves what’s going on.
Inspections that take place during weekday first shift hours get a skewed picture of the care being offered. When nursing home owners and management get the message that the state CAN and WILL be showing up UNexpectedly more often, then I believe we’ll see improved staffing levels on second and third shift and on weekends and holidays.
Suggestion #2: Require management personnel to work staggered shits ALL THE TIME, not just when state inspectors are in their building. In large facilities that have an Assistant Administrator (or equivalent position), the state should mandate that the Administrator and their assistant must not be allowed to work identical shifts. In fact, I believe the state should require that the shifts for management can not overlap more than four hours per day (Example: Administrator works 8:00am – 4:30pm, while the Assistant Administrator is scheduled to work 12:30pm – 9:00pm).
The majority of nursing homes are too small to be able to afford an Assistant Administrator. Yet even these facilities MUST have a full-time Director of Nursing on staff. In these nursing homes the same “staggered shifts” rule should be in place for the Administrator and Director of Nursing.
Why suggest this legislative mandate? For much of the same reason that I made my first suggestion: after management is out of the building the quality of care given often suffers. As the cliche goes, “When the cat is away, the mouse will play!” And “play” they often do (e.g., taking excessive smoke breaks, ignoring call lights, talking on their personal cell phone instead of checking on or responding to their residents). One third shift nursing staff member at an Indiana facility where my mother lived admitted to me that she “preferred” to work overnight so “the big shots” couldn’t get in her way of doing her job the way she wanted to do it. Scary! One of CNAs who worked with this individual on third shift shared with me that this nurse took an average of seven (7) smoke breaks, OFF THE UNIT, per hour! This clearly wouldn’t be allowed by either the state or sane nursing home management — but how could the state or management know this was problem existed if they aren’t in the building at night? Residents with dementia likely aren’t capable of reporting such problems. Family members can’t stay with their loved one 24’7 non-stop to monitor this. Placement of a “Granny Cam” inside the room is incapable of documenting problems that take place outside of the resident’s rooms (as in documenting a lack of staffing at the nurse’s station caused by staff taking an excessive number of smoke breaks).
If it is impossible to have management in the building 24/7, then the state should mandate their presence a minimum of 12 hours per day on non-holiday weekdays and 4 hours (or more) per day on holidays and weekends.
Suggestion #3: When the state shows up for an any type of inspection (annual or in response to a complaint) the inspectors (a/k/a “surveyors”) should IMMEDIATELY seize payroll data to (before it can be altered) to verify staffing levels for the 14 continuous days immediately prior to the inspection. With this information in hand, inspectors should have the legal authority to insist that while they are in the building that the staffing level can NOT exceed the average staffing level for the previous 14 days.
Why would I suggest this issue requires a legislative intervention? Because calling in off-duty nursing staff during an inspection or even bring in temporary employees is one of the biggest (and most deceptive) things nursing home management does to make it appear that resident needs are being taken care of in a timely and appropriate manner — when the reality is that they aren’t being responded to in either a timely and/or appropriate manner when the state inspectors are not around. “Putting on a show” for state inspectors should be against the law! Inspectors should see and judge the quality of care based on the REALITY of ACTUAL staffing levels.
Suggestion #4: Pass legislation that prohibits nursing homes from either outright banning or limiting visits of residents by their family and friends. Once nursing home staff identify a resident’s family member(s) or friend(s) as a “trouble maker” (e.g., that we really have the courage to report their facility to the state, as is our LEGAL RIGHT AND MORAL RESPONSIBILITY TO DO) then you can count on the facility to begin setting traps (coming up with schemes) to make it look like we are the bad guy), thus justifying prohibiting (or at least limiting) visits. Some facilities have even limited visits from family and friends from taking place on the unit where the resident resides — allowing, for instance, visits to only take place in the lobby. This way family and friends can’t observe the substandard care the resident is receiving, thus preventing them from being able to observe (and thus report to the state) problems with care.
Attempts to prevent family and friends from visiting nursing home residents (when no harm is being caused to the resident as the result of the visit and when the resident wants to receive visits from such individuals) is clearly a violation of nursing home resident’s civil rights! We activists must get through to these corrupt nursing home owners and managers that their facility is the HOME of the resident and therefore the SAME rights of visitation residents had at their house, apartment on condo apply inside the nursing home facility! Strongly worded legislation is clearly the only hope we have to prevent nursing homes from taking their residents hostage!
Suggestion #5: We need legislation that will mandate increased fines against nursing homes that are found guilty of abusing resident’s rights, especially with regard to forcing residents to move to another facility. Many nursing home residents find themselves being forced out of their facility as retaliation against the resident or their family for sticking up for their rights. This type of abuse of resident’s rights must stop! It is truly a twisted, dysfunctional way of thinking when a nursing home’s only way of handling it’s problems is to punish their residents (or the resident’s family) by forcing the resident to leave their facility. How many residents must suffer “eviction” before a facility is finally forced to look inside itself and make the changes needed to resolve their real problems?
How can you help to make these five changes happen within the state where you reside? Contacting your state legislators would be a good start. Also request the support of your local or state Long-Term Care Ombudsman to help promote this reform agenda. If your area or state doesn’t have a nursing home reform organization then start one! I’ll be glad to help you start and promote such an organization.
I believe that together we CAN make meaningful, important and positive changes take place within the nursing home industry. While the industry clearly has the big bucks to spend on maintaining the status quo, we have more than enough individuals on our side to make change HAPPEN!
I’ve had it with folks who defend the nursing home industry and it’s employees as if some really serious problems don’t exist that threaten the well-being of residents. REAL problems — including some very serious ones — DO exist and I’m not going to be silenced about these issues by the toxic apologists of the nursing home industry! Yes, some very wonderful individuals have (and are) working in the industry, but some very evil people have (and still are) causing real harm to nursing home residents and SILENCE ABOUT THOSE INDIVIDUALS IS NOT ACCEPTABLE!!!
You don’t believe what I just wrote? Really. How can you deny the abuse of an Oklahoma nursing home resident that is featured in the news video below? The video does NOT lie! This video shows the resident shown being abused by two of her certified nurses aides — in her nursing home room! Make no mistake: this once incident is just the tip of the iceberg!
Please click on the follow link to view a video clip, courtesy of News9 in Oklahoma City, that shows the horrible abuse of a 95 year old nursing home resident:
Please note that near the end of the video clip it was mentioned that it is estimated between 24,000 to 63.000 acts of physical abuse of nursing home residents by nursing home staff take place every year! This estimate refers JUST in OKLAHOMA! Multiply that shocking estimate by 50 states and the District of Columbia! This situation is a national tragedy and truly a source of shame!
May God help our nation and world when both this kind of abuse goes on and when non-abusers are silent about the abuse!
Some recent comments sent to me by readers of this blog, as well as attempts to abuse this blog by “spammers”, lead me to address some issues. What I’m about to share is very important, so I hope you’ll take the time to read it carefully.
For family members who request my assistance: I regularly hear from family members and even friends of nursing home residents who clearly have serious and very valid concerns about the lack of quality care being received by the resident. The phrase “lack of care” doesn’t really do justice to the very serious situations reported to me!
The problem is that some folks assume that either I have some sort of legal authority or can magically intervene to resolve their nursing home related concern(s). Make no mistake: I can (and will be glad to) share my thoughts and offer suggestions to those who write me based on my experience as a family member of a nursing home resident. But other than pray for your sitaution that is ALL I can do. I wish I could do more, but that simply isn’t possible. I’m NOT an attorney, judge, Ombudsman or employee of any government agency charged with regulating nursing homes
I will tell you all up front that if you have a problem with a nursing home that you can’t result after confronting the facility directly, you need to contact your local long-term care Ombudsman. EVERY part of the United States has one or more Ombudsman who lookd after the legal rights and concerns of nursing home residents. Most of these are paid to do their job, while many are unpaid volunteers. All of them are responsibile for a very large number of nursing home residents in their region, so you need to be patient and give a reasonable amount of time to respond to your concerns.
If you have a concern about a nursing home resident that you consider to be a crisis or involves a situation where the life and/or safety of a nursing home resident is involved, then I would urge you to consider taking one or more than one of the following actions: contact the state agency responsible for regulating nursing homes in your state, contact a local Crisis Hotline and/or call 911 to get request an intervention by police, Adult Protection Services or other government agency/agencies who respond to nursing home situations that need outside intervention.
Remember that I’m located in Louisville, Kentucky. If you aren’t within 75 miles of where I live, please consult someone other than me to find the contact information for your local Ombudsman, state nursing home regulatory agency or other authority. Usually a simple search using Google or some other search engine will help you find the contact information you need. If you want to discuss your situation with me, that’s fine. But when it comes to expect me to know the phone numbers you need outside of the immediate where I’m located, you need to be responsible for doing that.
Remember that ALL nursing homes are LEGALLY required to give anyone who asks (especially family members and friends of their residents) the phone number for the local Ombudsman and state agency that regulates that particular nursing home. For any nursing home to refuse to provide this information, when requested, would be a most serious matter! Retaliation against nursing home residents, their family members and others for reporting problems related to the care of a nursing home resident is most illegal and should always be reported immediately to the state regulatory agency (e.g., In Indiana that agency is the Indiana Board of Health, in Kentucky the agency is known as the Office of Inspector General, etc.). AGAIN: Every local area has an Ombudsman and every state has a nursing home regulatory agency.
For spammers and others who attempt to abuse this website and my Twitter feed: Y’all might as well cut it out! I regularly review the list of persons who are following my Twitter feed and IMMEDIATELY DELETE those who are in any way selling merchandise and/or have a commercial (e.g. for-profit) motive to contact my readers. Whatever you are selling you aren’t going to sell it through this website or my Twitter account.
The same goes to spammers who leave comments on this website that really have nothing to do with what they appear to be commenting on, but include a link to some sort of business-related website. Your comments will NEVER be approved, therefore you links will never be seen on this website.
Other than that, I’m a really nice guy who cares deeply about the well-being of nursing home residents!
Earlier this afternoon I received a very important reminder from an individual who inspects (a/k/a surveys) nursing homes. Each state has a “survey agency” that is in charge of inspecting nursing homes. The name of the agency is different in each state (in Kentucky this agency works through the Office of Inspector General, while in Indiana and many other states this agency is part of the state Board of Health). Whatever they call this agency in your state, these folks need to hear from family members of nursing home residents and nursing home staff regarding unsafe staffing level and any other care concerns. Your calls to your state agency (and regional Long-Term Care Ombudsman) are essential in order for problems to be identified and corrective action to be taken! The state survey manager who contacted me wrote,
“When you (and this goes for both families of nursing home residents and nursing home staff) have concerns about the care of a resident or unsafe staffing levels, be sure to CALL your state survey agency! Their number is REQUIRED to be posted in all Medicare / Medicaid-certified nursing homes. We surveyors (inspectors) are here to protect the residents of nursing homes and assure they are getting quality care.
We surveyors (inspectors) are on the side of the residents and staff. Although we are constantly lied to by facility staff and Administrators, we can get to the truth.
In addition to contacting your state survey agency, be sure to get the Ombudsmen involved too! They can be a great resource.
The bottom line is that if we (regulators) don’t know about your concerns, we may not be able to pick up on these issues. Complain to your State survey agency to get your issues investigated and also help prevent others from receiving poor care!”
Some nursing homes have signs posted that ask family members to speak to the facilities administrator when they have concerns (I’ve seen one such sign that practically begged family members to NOT call the state survey agency before talking to the administrator). While this is an appropriate action to take in most circumstances, I believe the state survey agency and Ombudsman should be contacted FIRST when resident safety and well-being is at risk. If speaking to the nursing home’s administrator doesn’t resolve your concern, then by all means call the state agency and Ombudsman!
I finally figured out how to add “Tweets” to this blog, thanks to the technology of the Twitter website. To “Tweet” means that I’ll now be able to provide you with links to news article and commentary about the Nursing Home industry authored and/or published by news media organizations.
Among the hateful comments I’ve received from readers of this blog, occasionally someone will question my analysis of the nursing home industry and the accuracy of what I write. In addition to continuing to attack my own blog entries, now (thanks to my Twitter feeds) my haters will have mainstream journalists to falsely accuse (like they already do me). Bring it! Discredit me as a nursing home activist all you like. But when the nursing home big shots go on the attack against news organizations, investigative journalists and scientific researchers? Well how’s that working for them in terms of building their credibility with the public? Probably not very well. I mention scientific research because it is constantly being conducted on various aspects of the nursing home industry. Virtually all of these studies both get press coverage and — not surprisingly — point to greed and other problems within the nursing home industry.
You’ll find my Tweets on the left side of your monitor, underneath the heading NURSING HOME NEWS WATCH, near the top of whichever page you are viewing within my blog.
NursingHomeReality now with Twitter “Tweets”…another tool to expose the frighting truth about the greedy nursing home industry!
I’m always amazed when I get comments from individuals who defend the evil of corporate greed as it exists within the nursing home industry. Corporate greed is truly evil wherever it manifests itself. It is an extreme form of evil when (as it does within the nursing home industry) it jeopardizes, compromises and outright prevents quality care from being provided to nursing home residents. “Care” and “for-profit” don’t belong in the same sentence.
Corporate greed is the culprit behind under-staffing of nursing homes. It is the underlying cause of nursing homes lacking essential supplies to properly care for their residents. It is the reason “corporate bean counters”, instead of nursing professionals, are allowed to determine the quality (or lack thereof) of care given to nursing home residents.
One person who sent me a message a few months ago blew off the problem of corporate greed by claiming if it was a problem in a particular nursing facility that the nursing home would “not be around for long”. Yet anyone who knows anything about how states regulate nursing homes is aware that it can be very difficult for state surveyors (inspectors) to catch even the most serious problems within a facility — let alone document those issues to the point that the nursing home is fined, let alone has it’s license revoked. Nursing home executives are experts at spinning (e.g., lying) to the state, to their employees, to their residents and their resident’s families…anything to avoid being caught doing the wrong thing. Anything to avoid from being found out to be comprising resident safety and care because the pursuit of financial profit comes before providing quality resident care.
Now an example of something written by a person who really does not understand the harm caused by corporate greed within the nursing home industry. The anonymous comment claimed, “Saying for-profit is bad means you would have to make every for-profit business bad. So don’t eat at any restaurant since every one of them are for-profit.”
My response is that being for-profit in and of itself isn’t the real issue. Corporate greed is the problem. Within the past six months two research reports have been released that prove that a much higher percentage of for-profit nursing homes have lower resident-to-staff ratios than non-profit facilities. Inadequate staffing levels are clearly the number one cause for inadequate care. Non-profit facilities, staffed at higher levels than their for-profit counterpart, consistently provided better quality care than for-profit nursing homes.
I would love it if every nursing home on this planet were non-profit. But until that day comes (and I don’t see it happening ever), then we in the Nursing Home Reform movement must continue to put pressure on state nursing home regulators to do a better job of catching and penalizing nursing homes for providing inadequate care — realizing that is most often corporate greed that creates the crisis of substandard care in the first place.
I received the following comment a few days ago written by a recently licensed nurse who, after barely four months, has had her fill of the cheapness and dysfunctionality of for-profit nursing homes. The nurse writes…
“I graduated from nursing school during the summer of 2011. I started my professional career full of excitement — looking forward to start working in a field that is not only a passion of mine but one that I believed would be fulfilling as well.
When I first started in this (for-profit) nursing home, working third shift, I saw a lot of problems that needed to be addressed. So with much energy I went about fixing them every shift that I worked. I did baths. I changed filthy linens. I gave everyone the meds they needed and also for pain in between so they could sleep.
I met with the aides and other staff members about fall and abuse prevention, ulcer prevention, and care for special needs. I left letters and notes to the Director of Nursing (DON) and the administrator so things would get done. In my mind, they system was broken but I was going to do everything in my power to fix it.
Fast forward several months later…A resident known to have unstable diabetes cannot be given orange juice or food because the kitchenette is locked, so his blood sugar drops into the 50′s. No point in looking in the medication room for a glucagon shot or sugar pills in my cart, since this facility refuses to order emergency supplies for diabetics! It turns out that management considers an”unnecessary expense”. So for this resident who had the dangerously low blood sugar I went to a nearby store on my lunch break and bought him a soda and rushed back to the facility as fast as I could.
The very next week another nurse gives a scheduled insulin shot to one of her residents and comes to me scared out of her mind because we have no test strips to test blood sugar in the building, so she had to guess as to whether this resident’s blood sugar was stable enough for insulin. This for-profit nursing home went without any test strips for an entire week! During this same period of time two residents were sent to the ER due to shock/coma from hypoglycemia because nurses had no way of guessing their blood sugar.
At the facility where I work we have have 80 or more residents. It is quite normal for several aides to call in sick or not be scheduled by management for their shift. On some shifts we end up having only two aides for 80 or more residents! This means that 40 residents have one person to clean them, answer their lights and help them. Two nights ago, only one aide came to work. For 80 residents! Everyone was called, including the adminstrator, at midnight. He said, and I quote, “this topic doesn’t come up when state inspectors are in the building! One aide is adequate – the nurses will pitch in (they already do the aide’s work as well as treatments, meds, and anything else) –and stop threatening the aides with a write-up or termination for not coming in, because we don’t want to anger them which will cause them to not show up for work even more often!”
Yes, we do have some excellent CNAs. I found one aide in tears in a linen closet last week because she had run out of wipes, toilet paper, diapers, chuck pads, and trash bag liners. She went to change a resident, and found him soiled all the way to the mattress. She used a shirt out of his closet, to wipe him clean, and laid him back down on the feces encrusted mattress to sleep. The shirt was left on the floor because laundry locked the housekeeping door and the linen garbage was overflowing with urine soaked laundry.
This is just a sampling of my experience in nursing home care. I could share much, much more.
I pray as I punch in the clock at night that nobody would fall and hit their heads because it could be hours before somebody would notice. I pray for patience, not for the horrors of my job, but for the restraint not to find the administrator and punch him in the face. I’m not a nurse where I work, I’m a faceless pair of legs. And the faster I walk, the bigger corporate’s wallets grow.
I’ve become incredibly discouraged and have contemplated turning in my resignation and walking off the floor. For all those of you facing the difficult situation of putting a parent in a care facility, please, please consider a not-for profit…and NOT a for-profit nursing home! Even if you must move out of state, find a way, any way, to keep your loved ones from places like these. Trust me, you will find it to the best answer.”
There you have it. Another first-person account of the harm caused by outrageous corporate greed within the for-profit nursing home industry! No test strips. No emergency supplies to respond to the needs of insulin-dependent diabetics. No clean linens available so a resident wont have to sleep in their own urine and feces!!! This intentional refusal to meet the basic needs of nursing home residents is beyond disgusting — it is in every sense of the word CRIMINAL!!!
As I’ve stated many times on this blog, do NOT believe the for-profit nursing home spin that they need Medicare and Medicaid to INCREASE the amount they pay for nursing home care. This is a LIE! As documented by a scholarly study conducted by the University of California at San Francisco — released in late 2011 — the quality of care offered by non-profit nursing homes almost always exceeds the quality of the care offered by for-profit facilities! Non-profits invest a larger percentage of their income in providing resident care than do for-profit nursing home corporations. For pr0fit facilities use their profits to line the pockets of stockholders and private investors instead of putting the money back where it belongs.
“For profit” and “care” can not co-exist. “For profit” always means that the nursing home residents will suffer.