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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!
A visitor to this blog shared the following comment a few days ago. I think her comment speaks directly to the issue of corporate greed and that leads to both the neglect of nursing home residents as well as mistreatment of nursing staff. A nurse wrote:
“At one time I worked in a nursing home that was so understaffed that I dreaded work every day. I provided care to 24 residents at one time (on a unit with a total of 48 residents). On my shift there were just two CNAs and two nurses for 48 residents.
One time I was forced to work while having the flu and a 102 degree fever. Management told me that I would be fired if I didn’t report to work and they would demand the state revoke my licence for abandonment. It is really sad what happens in these nursing homes.”
Many important issues are touched on here.
- Clearly nursing home management had NO regard for the residents by insisting that a staff member with a fever of 102 and a diagnosis of the flu report to work — or else! True, most all nursing home residents are given a flu vaccine shot each year, but that is NO guarantee of protection from every strain of the flu. Given the severe health problems most nursing home residents have in the first place, the last thing that needs to happen is for them to be exposed to the flu! The flu can be deadly for elderly persons and others who suffer from serious health problems.
- Clearly nursing home management had NO respect for their staff member in this case. Someone sick with the flu, without question, should be allowed to stay home from work. Nurses and all caregivers have a RIGHT to take care of themselves and their health!
- Clearly nursing home management ignored their option to bring out one (or more, if needed) temporary employee(s) to cover the shift(s) of the nurse sick with the flu — assuming no other qualified staff members were available to cover her shift(s). Oh wait, temporary employment agencies charge for providing staff. Which means that would be a threat to the bottom line for the nursing home involved in this situation! We certainly have greed taking priority over respecting the health of residents and treating their nursing staff with dignity! Indeed GREED MUST ALWAYS rule the day with the nursing home industry! Sad. Truly sad.
- One nurse and one CNA per shift for 24 nursing home residents. Do the math: how many minutes PER RESIDENT can the nursing staff provide EACH resident over the course of an 8 hour shift? When I do the math it comes out to 20 minutes per resident/per staff member. Generous? Hardly! Especially considering how much time is spent by both nurses and CNAs to do things like clean up messes caused by sick residents (including helping a resident change out of soiled clothing and changing bed clothing), taking infirm residents to and from the bathroom, giving showers, serving food and feeding infirm residents, preparing medications, etc. — on top of doing all of the paperwork required to document resident care!
- One nurse and CNA per 12 residents would be able to provide a lot better quality of care than one each per 48 residents, don’t you think? Remember most CNAs barely earn above minimum wage and many don’t work enough hours to qualify for health insurance or other company benefits! So nursing homes can’t afford to hire more CNAs yet the owners, administrators and other management people (who never — or hardly ever — provide direct resident care make five, six-or-more-figure annual salaries! It isn’t fair. It isn’t just. The priorities regarding financial compensation for staff are all wrong!
Some people who read this blog assume that I am against nurses and CNAs who care for nursing home residents. I have no respect or use for staff who abuse and/or neglect the residents charged to their care. At the same time, I would never assume that most or all nurses abuse of neglect their residents. No, the real evil here clearly goes back to ownership and management. The fault for corporate greed begins and ends with them.
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!
Several weeks ago hundreds of us nursing home reform advocates were delighted to learn that Extendicare (known to some of us as “Pretend-I-Care”), one of the worst-of-the-worst for-profit nursing home corporations, planned to sell all 21 of the facilities they owned within the Commonwealth of Kentucky. They are leaving Kentucky for the same reason they exited Florida several years ago: they couldn’t force our state’s legislators to support legislation that would make it more difficult to sue nursing homes for negligence. They didn’t have their way during the 2012 Kentucky legislative session, despite the hundreds of thousands of dollars Extendicare and other nursing home owners have spent over the past year to bribe (I’m sorry, I mean “influence”) lawmakers with the hope of making it more difficult to sue nursing homes for providing negligent care.
Extendicare is truly one of the greediest companies you will ever encounter! Greedy to the point that the management of one of their southern Indiana nursing homes treated their kitchen staff to a nice dinner party in appreciation for them figuring how to feed their residents three meals and two snacks per day for less than 75 cents! More money is spent feeding dogs and cats each day than is spent by Extedicare to feed their (human) residents. That’s pathetic enough, but then to “celebrate” this new low point in resident care with a dinner party? That’s just plain evil. Greed should be a source of shame, not celebration.
When a Kentucky-based law firm that takes on cases of nursing home neglect published a “So glad to see y’all leave!” press release following Extendicare’s exit announcement, Tim Lukenda (Extendicare’s President and CEO), attempted to defend his outfit’s badly battered reputation. One of the statistics Likenda cited as something he is proud of is something that sane people would cite as a point of shame. He noted that within the year prior to the announcement that Extendicare was pulling out of the Commonwealth, “14% of our Kentucky [nursing homes] have received deficiency-free surveys.”
Let me break that down for you: only 3 of the 21 nursing homes owned by Extendicare in Kentucky were not cited for deficiencies by state inspectors. 14% (3 nursing homes out of 21) had excellent inspection reports. Wow. Impressive? Hardly! Pretty sad actually. What other corporation would be proud to point out that 86% of their facilities were doing a sub-standard job? Not many.
So here’s hoping that the Texas-based nursing home chain that Extendicare has sold all of their 21 Kentucky nursing homes to will provide a much higher level of care than their previous owners ever did. Sadly, it wouldn’t take much for the new owners to do a better job than Exitendicare.
Excuse me, but it is a widely known fact this it is EXTREMELY DANGEROUS for a person to smoke while hooked up to oxygen! I would certainly hope that every nursing home staff member would be aware that smoking while tethered to oxygen could (likely would) lead to an explosion! Yet according to a report posted on the Illinois Nursing Home Abuse Blog (http://blog.levinperconti.com) a nursing home located in Illinois – Charleston Rehab & Health Care Center — was fined $12,500.00 because staff failed to ensure that the facility was free of accident hazards and that each resident received proper supervision to prevent accidents.
According to a state inspection report issued in late 2011, a resident of the facility who had smoking privileges was not served well by staff members who failed to remove a liquid oxygen tank and cannula from the gentleman before allowing him to smoke. It is absolutely essential that all nursing home staff members protect residents from serious risks at all times. In the case of this situation, staff allowed a 64 year old resident to act out with this behavior, which lead to the resident suffering second and third degree burns on his face and right hand! After the oxygen ignited, the man was rushed to a local hospital where he was treated and is expected to recover from his injuries.
Many vulnerable individuals are placed in the care of nursing homes specifically because there are too many safety risks present for them to safely live alone. Close observation is required to ensure that those risks are guarded against and seniors are allowed to live free of serious harm. You can not have “close observation” when corporate greed overrules common decency and leads to under-staffing in nursing homes.
I don’t believe that any form of “special training” was needed to prevent the resident mentioned above from being burned. Rather common sense and close observation was all that was needed by nursing staff.
Am I claiming that most nursing home staff members lack common sense? Not all all. MOST would never have allowed this situation to occur. Never. Because some nursing home staff members appear to not have common sense, this is why inspections of nursing homes — along with reports to the state by family members and friends who observe inappropriate behavior by staff — are absolutely essential to prevent residents from experiencing senseless harm.
Nursing home administrators and owners frequently insist that government regulations are somehow harming the industry — allegedly making it “less profitable” for for-profit facilities to operate. Yet the reality is that without regulations, let alone the presence of persons who have integrity to conduct frequent inspections, nursing homes simply can not be trusted to protect their residents from harm.
Make no mistake, the lobbyists for the nursing home industry in every corner of our nation are constantly pressuring state and federal legislators to lessen the regulations they have to follow. This is another reason Nursing Home Reform advocates like you and me are needed to protect the safety of residents from an industry lacking anything close to decent ethics.
The study linked below, published by researchers at the highly respected University of California at San Francisco, proves a point that I’ve made many times on this blog: for-profit nursing homes do NOT need more money from Medicaid or from their residents in order to improve the quality of resident care. Indeed it is the NON-profit facilities who overall provide a higher quality of care than the for-profit, greed-driven facilities!
So when the nursing home industry whines about needing more money to care from residents, make no mistake they are already earning enough money to provide a higher quality of care. The reality is that the executives and stock holders of these faccilities are (morally speaking) stealing from their residents by paying themselves handsomely and using their nursing home profits to fund other business investments.
Please click on the following link and learn the truth about the horrible impact of corporate greed on for-profit nursing homes: Low Staffing and Poor Quality of Care at Nation’s For-Profit Nursing Homes | www.ucsf.edu.
As the research study poinds out, “The 10 largest for-profit (nursing home) chains were cited for 36 percent more deficiencies and 41 percent more serious deficiencies than the best facilities. Deficiencies include failure to prevent pressure sores, resident weight loss, falls, infections, resident mistreatment, poor sanitary conditions, and other problems that could seriously harm residents.” The 10 largest for-profit chains in 2008 were:
- HCR Manor Care,
- Golden Living,
- Life Care Centers of America,
- Kindred Healthcare,
- Genesis HealthCare Corporation,
- Sun Health Care Group, Inc.,
- SavaSeniorCare LLC,
- Extendicare Health Services, Inc.,
- National Health Care Corporation and
- Skilled HealthCare, LLC.
Note that the study clearly makes a connection between inadequate staffing levels among the largest for-profit nursing home chains and a higher incidence of state-issued citations for insufficient care: “From 2003 to 2008, these chains had fewer nurse ‘staffing hours’ than non-profit and government nursing homes when controlling for other factors. Together, these companies had the sickest residents, but their total nursing hours were 30 percent lower than non-profit and government nursing homes. Moreover, the top chains were well below the national average for RN and total nurse staffing, and below the minimum nurse staffing recommended by experts.”
So here is solid evidence that the greed that runs virtually unchecked in for-profit nursing home corporations — and NOT lack of adequate payment for services — is undoubtly the single biggest factor cuasing a serious crisis in the quality of nursing home care! So when the nursing home industry comes begging for more money from state legislatures in terms of Medicaid reimbursement and telling their sob stories to US Senators and Congressmen as they plead for more money from Medicare, just remember that non-profit nursing homes (including those run by government agencies) are currently doing a BETTER job of providing care (by having higher nursing staffing levels) without a bigger handout from the government.
Take a moment to look over the list of the Top 10 For-Profit Nursing Home Chains listed above — print out the list if you like — and remember that these are nursing homes to be AVOIDED based on their inadequate staffing levels and the resulting increased problems cited with the so-called quality of care they offer. Tell your friends about these corporations and, if possible, don’t allow your loved one to live in one of these facilities!
A reader from central Illinois shared the following nursing home horror story with us. A few details have been removed from the following account in order to protect the resident (the writer’s father) from being involuntarily evicted from the facility. Many nursing homes over the years have falsifed resident’s chart entries and other documentation in order to justify kicking a resident out — this is all done in retaliation for reporting problems to the state, news media and other sources (like this blog) for telling the truth about the shameful abuse, abandonment, neglect and outright negligence that goes on in nursing homes.
My father is in a nursing home in central Illinois. He suffers from several conditions that no longer allows my mother to be his caregiver as she was for many years. Because of repeatedly falling she had no choice but to have him admitted to a nursing home.
The nursing home we chose seemed to have a warm home feeling when we walked in. The administration talked up about how much they would take care of my father. The reality is this sales pitch was a bunch of BS!
My mother CONSTANTLY walks in and his catheter bag is not on right, therefore not draining properly. She constantly finds him with food all down the front of him because he has trouble feeding himself. Today (and several other times recently) he was wet and had urine running down his leg and on his sock and no one apparently was going to do anything about it until my mother said something.
My dad is falling out of bed more and more, so my mother asked if a CNA could stay in his room off and on through the night to make sure his is safe, The Administrator said no: CNA’s will not stay with any residents at night. Further she stated that if we didn’t think he was being properly taken care of that we can take him right on out of there. She appently has NO clue as to the detrimental affects to change the environment it could have on a individual with my father’s diagnoses.
Honestly I just want to yell and screem at nursing home management and ask them, when the day comes that they become a nursing home resident, would they want to sit in their own urine? Do they want to go hungry because their condition prevents them from feeding themselves properly? What if they didn’t know how to use the call button and they crapped in their pants and sat in it for who knows how long! How would they feel?
Government needs to step in and make it mandatory to add more CNA’s and hold nursing homes accountable for the lack of staff, especially on weekends. Nursing home’s should train their staff better before allowing them to care for patients. I can’t tell you how many CNA’s taking care of my father do not know how to properly attach a leg catheter bag. That is pathetic!
Don’t get me wrong, there are several CNA’s that do take care of my dad and do a wonderful job and we praise and thank them every day they are working. I’m just so angry at the Administrator and the government for not putting higher standards in place.
My parents do not qualify for Mediciad and they are paying $148.00/day for my father’s care. We just want him properly taken care of. This is not too much to ask!
A few observations:
– While I don’t know of any nursing home that would provide a CNA to stay in a resident’s room throughout the night in order to make sure the resident is safe from falling (that would be cost prohibitive), nonetheless ALL nursing homes can do one or more of the following things to reduce the risk of resident falls and/or minimize the physical harm caused by falling out of bed:
1) Make sure the resident is attached to or lays on a bed alarm — and make sure it is tested regularly (if it is battery operated) to make sure the battery and alarm are working. These alarms can not prevent falls from taking place, but they can IMMEDIATELY alert staff as to when a resident has fallen or is at risk for falling. Nursing home staff must take seriously their responsibility to respond to bed alarms.
2) Provide the resident with what is commonly referred to as a “high-low bed” — this is a bed that can be lowered when the resident is sleeping so as to minimize the distance between the resident and the floor, thus significantly reducing the amount of physical injury the resident could experience if they do manage to fall out of bed. As always, it takes competent nursing home staff to remember to LOWER the bed when the resident is ready to sleep.
3) In addition to providing a bed alarm and high-low bed, some facilities will also have staff place a type of mattress on the floor next to one or both sides of the bed (next to one side if the bed is placed next to a wall on one side) to also reduce the potential of injury if a resident falls out of bed. However these mattresses are a potential hazard for nursing home staff and others as they can cause falling if they are not noticed. Many a person, CNA and otherwise, has been injured by tripping on these items.
4) If, for any reason, a nursing home resident is incapable of feeding themselves it is the responsibility of the facility to provide staff to assist with feeding. Failure to provide this assistance is criminal!
Above all, I want to encourage this family member to contact the local long-term care Ombudsman to report their concerns and — in the process of making their concerns known — speak to the Administrator to give them formal notice that the problems noted above have been documented by the family and must be addressed. If all else fails, then the family needs to (if they haven’t already) notify the Illinois state agency charged with nursing home regulation.