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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.
My thanks to a certified nursing assistant (CNA) for sharing the following information regarding her very personal (on the job), experience as a nursing home employee. As a CNA, she is truly on the front line of providing care to residents. If her story doesn’t make you angry or concerned or whatever-enough to do something about the problem of nursing home UNDERstaffing, I don’t know what will motivate you. Our anonymous CNA writes…
“I got my CNA license three months ago from a local certification program. Then I got my very first CNA job two weeks ago (August 2011) at a nursing home. I’m here to say that I am appalled at the conditions there in my new place of employment. I’m told by by co-workers that this situation is “normal.” As you read this information, try to imagine if your mother were a nursing home. My post here is a cry for help!
There are 35 residents on my floor, and during the 3-11 shift (my shift) we have only 4 CNA’a. One of the residents on our floor is paralyzed, requiring mechanical lifts –that means she cannot be lifted out of bed or out of a chair without the use of a sophisticated mechanical lift known as a “Hoyer Lift.” And the law mandates that whenever a mechanical lift is prescribed, such a resident gets designated as a “2-person assist” which means that resident will always require 2 CNA’s to lift him or her for whatever reason (showering, toileting, etc). The “2-person assist” is a serious designation! Major legalities apply here!
Meanwhile, another resident is permanently bedridden. Whenever he needs to use the bed pan (about 5 times a day) it likewise takes two people to toilet him there at the bedside. Another resident is semi-paralyzed, so she’s a 2-person assist to get her on and off of the 3-in-1 shower chair (portable comode) where she gets toileted. Another resident is moderately overweight, but is about 90 years old and has no strength in her legs, so she requires a different type of mechanical lift (a Vander Lift) when she needs to toilet. Once again that requires 2 people. That right there means four residents on our floor are designated as needing “2-person assistance.” And more than 80% of the remaining residents (26 of those other 31 residents) are classified as needing “1-person assistance,” which means 1 CNA must help them sit and stand and transfer from their beds to their wheelchairs to toilets, etc. The most frequent need of the 1-person assist residents is the need to be walked to the toilet.
Every time a CNA helps a “1-person assist” resident to toilet herself, that’s a time expenditure of no less than three minutes. An awful lot of tragic things can happen with the 34 other residents in three minutes. (Would you leave a young child alone for 3 minutes? If your answer is no, then why on Earth would you leave an 82-year-old alone for that long?) Every time two CNA’s help with a “2-person assist” resident, it ties them up for no less than 5 to 9 minutes, and only if they are very fast and very skilled. Trying to get an incapacitated person into a Hoyer Lift is VERY dangerous and time-consuming, but it MUST be done, and you don’t cut corners with a Hoyer! That’s 9 whole minutes. What if a pair of CNA’s are mid-way through a Hoyer Lift procedure right when 3 of the 1-assist residents on the same floor all ring their call bells at once because they each just happen to need to go pee at the exact same time? It happens. I have seen five call bells at once go off, but there are only four CNA’s on the floor, and half the time two of those CNA’s are tied up with a 2-person assist resident … for up to nine minutes.
So what do you imagine will happen if a 73-year-old lady needs to pee but no one answers her call bell? The answer is either a) she’ll pee in her pants, or b) she’ll try to walk to the bathroom on her own. The first answer is bad because peeing her pants can set her up for things like urinary tract infections and bed sores, not to mention that it’s just a horrible degrading thing to pee oneself. The second answer is worse because she might fall. If she falls she’ll likely break or even shatter a bone, and then that CNA is in a world of trouble and she could easily lose her license.
Does any of this sound fair to you? Is this fair to the resident? Is it fair to the CNA?
Helpless is helpless, no matter how old. I see many great strides take on behalf of childcare standards, but so little is done for elder-care standards.
A CNA will get in major trouble (as in get suspended or fired) for leaving a resident unattended in a Hoyer Lift. So once that CNA has a resident in a Hoyer, she cannot leave that Hoyer Lift resident for the sake of answering a call bell. Meanwhile, at the other end of the you’re-going-to-get-in-huge-trouble scale, a CNA will also get burned for not answering a call bell quickly enough. The call bells have timers, so as soon as a call bell gets activated, a computer records how many seconds (or minutes or hours) pass by before the bell gets answered. The facility can calculate the overall average of how long it takes for call bells on a given shift to get answered. So a CNA could get fired and lose her license for having a terrible average in her call bell response times.
Then there’s the threat of “decubitus ulcers,” — that’s the official medical term for “bed sores” (a/k/a “pressure sores”). Bed sores tend to form most often on the coccyx (tailbone), and sometimes on the elbows, knees, shoulders, anywhere on the spine, and even on the heels and the soles of the feet. Boney areas are the key here for figuring out where they’ll form. If you are lying around all day long, or sitting for 12 hours straight in a wheelchair all day, the constant pressure and lack of circulation start to degrade the tissues of those areas –and in a battle between bone and muscle, bone usually wins. The muscle and skin tissue slowly break down (that’s the beginning of a sore) and then the bone eventually starts to poke through. As any dentist can tell you “Bone CANNOT touch air!” Bed sores are very dangerous, prone to rapid infection, and can easily kill you. Once a bed sore is detected, the CNA’s and nurses MUST go on the offensive to combat that sore with a vengeance to prevent it from getting any bigger. Then they embark on the long, arduous process of healing it. Google for “decubitus ulcers” to see horrible photos of such sores. They can range in size from a few millimeters to over a foot in diameter. The big ones can maim and disfigure you for life. They can even kill you in mere weeks.
The way to prevent a decubitus ulcer from even happening is to engage in frequent and regular “reposition” an unmoving resident. Repositioning is done once every 2 hours. This relieves pressure, allows circulation to flow again, and the tissues that were being squashed can start breathing again. I was told during training: “It takes four hours for a bed sore to form and four weeks for it to heal.” The task of repositioning is a very straightforward one, sometimes requiring two people and about 1 to 2 minutes of their time. I have NEVER seen it done this fast at the nursing home where I work. Meanwhile we are supposed to fill out forms at the end of our shift where we record every instance of having repositioned someone. We all have to fill in the forms every night where we CLAIM that we did repositioning every 2 hours for every last one of our assigned residents. But we didn’t. None of us did. So those documents get falsified every time, every shift. I wish I had the time to do all these repositions during every shift.
I wish I had the time to do a thorough skin examination of each resident assigned to my care during every shift. But I do not. None of us do. I accidentally discovered a blank form last week called a “CNA Skin Sheet.” I’d never seen it before (no one showed it to me during my training period). The form has a simple drawing of a naked human body, front and back, on which we CNA’s are supposed to record places we see skin problems on a resident. It’s kind of like “mapping” their skin anomalies. The other CNA’s said “No one does those anymore.” (Because no one does skin checks anymore.) So now I’m waiting for the day when we all get the memo that a resident came down with a massive decubitus ulcer. The best I can hope for is that maybe the other shifts have time to do checks. But I doubt it.
It breaks my heart to know I’ve no time to care for the residents the way they should be. It kills me whenever I see a call bell go unanswered for almost 15 minutes.
Every time a CNA in my facility clocks-in at the start of her shift, she’s taking the risk that something will happen where someone might get injured or killed, and she herself might lose her license. Meanwhile, the other CNA’s likewise hate this insipid reality we have to deal with, but they’ve been here a long time and tell me it’ll never get any better. They’ve all developed a dark, jaded attitude. “You’ll learn” they mutter.
Nursing home understaffing is considered by many to be “normal” — as long as facilities can continue to get away with it. It all comes down to money. Why have six CNA’s on the clock when you can get away with just four?
Meanwhile, if there’s an MBA-trained number-cruncher reading this — the kind of 26-year-old snot-nosed kid who wears a suit and never once had the privilege to put on a latex glove, and who does nothing but look at PowerPoint graphs of employee cost analysis — YOU are to blame here! YOU are the most culpable party in this whole shameful debacle! If you are one of those MBA-holding snobs who stands smugly behind your laptop, pointing at a screen while saying: “According to the parameters of this particular matrix, which is a fine chart laid out by the American Nurses Association, 4 CNA’s should be enough,” then this is on your head –4 CNA’s is NOT enough to handle 35 people, especially when 4 of them are 2-assists, 26 of them are 1-assists, and three of them are chronic wanderers!
If there are any journalists or politicians reading this, you NEED to take notice of this crisis–and it IS a crisis. It’s a risk-management crisis akin to the BP Gulf of Mexico disaster of 2010. BP had a reputation for decades in the oil industry as being one of the worst offenders of safety violations out there. But they got away with it for so long because of lax oversight, extreme cost-cutting, and 7-digit bonuses for the suits at the head office if they could squeeze an extra basis point out of each quarter. This situation with too few CNA’s in American nursing homes is exactly the same. Different industry, same problem.
Just like BP, nursing homes suffer from all of the following: deficient safety standards, poor oversight, bonuses for “the suits” for cutting staff to the bone, and a false security found in the sheer luck of having not yet had an accident severe enough to garner worldwide attention.
Just one fall. Just one overlooked laceration. Just one accidental strangulation. Just one covertly executed suicide attempt. Any one of these can easily happen in the span of just three minutes while some poor overworked CNA is helping an old lady use a toilet.
The nurses in nursing homes are in just as bad a situation because they also are overworked and understaffed. Their liability is twice that of the CNA. But in a nursing home setting, the CNA is the true point-person when it comes to providing adequate one-on-one care (in a hospital setting it’s the nurses who are the key).
I MUST tender my resignation. I can’t in good conscience continue to take part in this horrible management-spawned scandal of neglect and fraud. I have had nightmares about my place of work and I’ve only been there since August 24th. Perhaps I will go into private duty. There are no benefits to private duty, but at least I will be able to sleep at night. This decision to resign is my own effort at risk-analysis here –I am weighing out the risk between A) staying at this place with benefits where I am undermining my heath and running the daily risk of losing my license, vs. B) going into a more rational work environment with no job security and benefits. I’ll take the latter.
I hope to see reform in the industry soon, and if it comes, I’ll gladly return to nursing home work. But I hope it won’t take a world-famous BP-style tragedy to trigger such reform. However, I fear that’s the ONLY thing that can bring it about. The politics of American policy-making has always tended toward a reactionary mindset, never a proscriptive one.
I hope someone with even a small modicum of power can read this thread and help to bring about the changes needed. I am a ………
Shocked & Awed CNA (Massachusetts)”
Every 24 hours I receive links to news articles posted on the Internet pertaining to the nursing home industry. I have an average of 40 news articles to shift trough every day. That makes for a lot of reading and lots of tough decisions about what I should post about on this blog. Additionally, your e-mail messages provide me with more excellent topics to write about. At any given time I probably have at least two dozen news articles or topics to write about. If there were only enough hours in the day to devote to this blog and attend to the other things that demand my attention!
Easily the number one topic in the news these past few months – which is the time of the year that various state’s legislatures have been in session – has to do with the near hysterical responses of the nursing home industry about proposed cuts to state Medicaid funding. Nursing homes happen to be the largest recipients of Medicaid funds, so it is understandable that the industry would have strong emotions when it comes to their income stream being threatened. Strong emotions I can understand. But the near hysteria that has been coming from industry spokespersons is, at best, over the top and should be taken with a huge grain of salt.
If you’ve spent any serious amount of time reading this blog, then you know my position is that FOR-profit nursing homes have a clear history of MISspending their income (e.g., spending it on things OTHER than resident care), while NON-profit nursing homes not only spend their money where it truly belongs (e.g., spending it on nothing but those things that directly impact resident care).
So when the paid mouthpieces of the for-profit nursing homes get hysterical about proposed Medicaid spending cuts, I gotta’ ask what is their response REALLY all about? Their hysteria is cleraly influenced by….
- For-profit CEOs who might have to take a cut in pay (many make is excess of $1 Million per year, while nurse’s aides barely make above minimum wage). Maybe their Rolls Royce will be replaced by a BMW? What, no more heated indoor swimming pools in their multi-million dollar homes?
- Stockholders, since cuts to Medicaid reimbursement will likely reduce the growth of of profits and therefore mean smaller dividend checks.
- Nursing home administrators, who might have to take a pay cut? I certainly don’t feel sorry for them since the average base salary for administrators of for-profit nursing homes is believed to be in excess of $80,000. Will they have to trade-in their BMW for a Chevy or Ford?
- Corrupt politicians, since the for-profit nursing home industry might have to reduce the money it spends on buying their votes.
Less money to buy luxury homes built on multi-acres of land, smaller stock dividend checks and fewer dollars to influence legislators…maybe even less income to spend buying up more nursing homes. Make no mistake: these are the things that are REALLY “at risk” if Medicaid reimbursement is decreased. Moreover, these things are NOT in any way, shape or form related to providing nursing home resident care! Instead they are hallmarks of a greedy, whoring industry that has a clear track record of wasting your tax money – our tax money – to feed its out-of-control appetite.
Some of the hysterical remarks from the for-profit nursing home industry involve threaten to reduce staffing levels to compensate for reduced Medicaid reimbursement. The TRUTH is that for-profit nursing homes are staffed at a LOWER level than comparable non-profit facilities. So don’t believe the lie that the nursing home staffing levels have to be reduced. The only thing that should be “reduced” is the degree of greed that the industry has been getting away with for the past 20 years!
Kudos to Ohio Goveror John Kasich! During his recent State of the State speech he used very blunt language to confront the greedy nursing home industry (and this from a Republican!).
Kaisch pledged to rein in the powerful nursing home industry, whose lobbyists and campaign contributions have helped it preserve a big piece of his state’s Medicaid budget. “If your mom and dad want to stay home instead of going to a nursing home, we should help make that happen,” he said. “Taxpayers will save a bundle of money. This has been discussed for decades. It’s time to get this done.”
Amen, Governor Kaisch!
As taxpayers, let us unite our voicers in DEMANDING that our legislators stop “enabling” the insanity of the “addict” known as the for-profit nursing home industry!
Today (January 1, 2011) is the second anniversary of my mother’s death. Without a doubt, nursing home neglect contributed to her death (e.g., the CNAs weren’t accurately charting her bowel movements — maybe not even taking her to the restroom regular, which lead to bowel impaction, that lead to 10 1/2 hours of near-non-stop vomiting, that resulted in aspiration pneumonia, which caused her death…sure, this is gross to discuss…and it is also totally true!).
The day before my mother passed away, I promised that I would work to promote nursing home reform in her memory so that no other nursing home resident need every suffer like she did because of abuse and neglect of the kind she was subjected to. Working on this blog, promoting the nursing home reform message through contacting my state and federal legislators and even my own city councilwoman, supporting the work of Kentuckians for Nursing Home Reform, and regularly praying for the protection of nursing home residents and nursing home reform are the major ways that I’m continuing to fulfill this pledge to my momma.
I’m not writing about any of my actions in order to brag about myself. Instead I’m posting this information as a wake-up call to you (and you and you and you…indeed every reader of this blog that isn’t employed by the nursing home industry spin doctors) to DO (not just “think about doing”) something — anything — to advance the cause of nursing home reform in the new year.
You and I have a precious duty to be part of the solution. The problem is the greed that drives the for-profit nursing home industry in this country.
First, if you are comfortable with praying, begin praying regularly for nursing home reform. Don’t know what to specifically pray for? See the page elsewhere on this blog that offers many suggestions for situations that you can be in prayer about.
Second, get in touch with and support the work of the nursing home reform organization that is working for positive change within the nursing home industry in you state (in Kentucky we have Kentuckians for Nursing Home Reform, in Indiana United Senior Action is doing a great job promoting our agenda, etc.) Nearly every state has such an organization — if you don’t find a link to it on this blog then do a Google search to find one. If you don’t have a state organization, then please contact the National Citizen’s Coalition for Nursing Home Reform (also known as Consumer Voice). Links to websites for these organizations are located on the left side of every page of this blog.
While the nursing home industry has what at times seems to be a Mafia-like control on legislator$ in order to facilitate gridlock to prevent reform from happening, we have the numbers — and thus the ultimate power — to break the industry’s stranglehold on progress and thus make meanginful change happen! I believe that if we — all of us — aren’t actively working for nursing home reform then we are being little more than enablers of the corporate greed that is responsible for the senseless harm and thousands of deaths annually of nursing home residents.
Why care about the tens-of-thousands of nursing home residents who can’t advocate on behalf of themselves? Because you (yes, you!) or someone you love might be a nursing home resident someday! Or perhaps you, like me, have a loved one’s memory you wish to honor by doing the right thing on behalf of those who have suffered and are suffering to this day.
Also, nearly every state legislature here in the USA will be in session (or is already in session) during the first part o the new year. So find out what nursing home reform legislation is up for a vote and respectfully ask your state representatives to support it!
Not sure what to do? to create positive change? Feel free to contact me by leaving a comment and I’ll be in touch with lots of suggestions for ways you can help advane the reoform agenda.
This journal entry, like every other entry on this blog, is lovingly dedicated by me in memory of my mother, Joann G. Poland.
Now that the 2010 general election is history, I call your attention to a piece of proposed federal legislation that deserves the support of all persons concerned with the quality of care offered to nursing home residents. All partisanship aside, I waited to bring up H.R. 6261 until I knew the sponsoring legislator would be around for another term to help make her bill a reality. I’m pleased that Congresswoman Lucille Roybal-Allard easily won re-election this past Tuesday (she won by a margin of over 50%!) We need many more champions for nursing home reform like this lady!
Rep. Roybal-Allard is the chief sponsor of the Nursing Home Patient Protection & Standards Act (H.R. 6261). Citing a Government Accountability Report from November 2009, Roybal-Allard argues that nursing home surveyors (inspectors) are pressured by state legislators, nursing home bosses and nursing home industry groups to under-report problems discovered at nursing homes. Roybal-Allard noted that in many instances the entire nursing home inspection process is compromised. We totally agree with her when she says that manipulation of inspectors in order to overlook neglect and other care problems and thus render worthless inspection results “is unacceptable”!
H.R. 6261, which will be considered by the House Ways and Means Committee, also would improve the staffing level for survey teams and establish an advisory committee comprised of nursing home stakeholders to focus on improving the quality of nursing home care.
ACTION ALERT: Please call, send an e-mail message or an old fashioned letter to your U.S. Congressperson and ask them to 1) Co-Sponsor H.R. 6261, 2) Put pressure on House Ways and Means Committee to bring up the bill for debate and vote and 3) Vote in favor of H.R. 6261 when it comes to the floor of the House for a vote.
Do you know how to find the contact information for all of your local, state and federal elected officials? A search by their name through Google, or some other Internet search engine, is probably the easiest way to find this information. A call or visit to your local public library is another way to find this information (every reference librarian worth their salt can easily provide you with this information in just a few minutes).
Rest assured that you do not have to be the most eloquent writer on the planet to be able to write effective messages to your elected representatives! In fact, the more concise (to-the-point) your message, the better. Here’s what I just wrote to my U.S. Congressman, John Yarmuth, through his website regarding H.R. 6261…
“I am writing to ask that you support a piece of legislation that would improve the integrity of nursing home inspections and thus greatly contribute to improving the quality of nursing home care.
Specifically, I ask that you support — and even become a co-sponsor — for H.R. 6261, the Nursing Home Patient Protection & Standards Act, which was recently introduced in the House Ways & Means Committee by California Rep. Lucille Roybal-Allard.
From my own experience as the health care advocate for my late mother, I can assure you that what goes on in many nursing homes in terms of the care offered is not only disgusting – much of what is done and not done to/for nursing residents should be considered criminal! H.R. 6261 will bring about needed improvements to the nursing home inspection (survey) process that will lead to uncovering and ultimately addressing problems that are currently (at best) being under-reported.”
Feel free to “copy and paste” what I wrote above — editing it as you like — as the basis for your message to your U.S. congressperson regarding H.R. 6261.
It is widely known that the for-profit nursing home corporations have very deep pockets. This is clearly evidenced by the obscenely high annual salaries (think: multimillion dollar) they pay their CEOs and CFOs. We know these same corporations are ALSO extremely greedy by the percentage of their income they spend on direct resident care (e.g., the food served in a typical nursing home “meal” in the United States costs around 80 cents) and by the outrageously LOW salaries they pay nurses aides (the front line caregiver in a nursing home setting).
So clearly the big, bad for-profit nursing homes can outspend most of us nursing home activists. But fear not, because you do not have to spend an outrageous sum of money to be an effective activist! We don’t have to have the kind of money the nursing home industry has to buy votes of crooked politicians (like Kentucky’s Julie Denton and Tom Burch) in order to influence public opinion. We can live within our modest financial means and still win the battle, in the classic style of David Vs. Goliath!
Here are just a few ways you can be frugal and effectively spread the message of Nursing Home Reform…
- Self-publish your own bumperstickers. A few weeks ago I spent just $5.30 to print two nursing home reform-focused bumperstickers at a local Cafe Press retail store. It took me about 5 minutes to typeset the stickers using a Cafe Press workstation and 20 minutes for the stickers to be printed. My bumpersticker, which now adorns my minivan, is easily seen by several hundred individuals over the course of an average week. The sticker (see artwork below) looks as if it was professionally produced and cost me less than a value meal at a local fast food restaurant! (NOTE: At my local Cafe Press store, the minimum number of bumper stickers you can print is two and they must be identical. One sticker for you and another for a friend, neighbor or stranger! If you don’t have a Cafe Press retail store near you, contact me and I’ll design your stickers at NO charg. I’ll donate the labor to create them and postage to send them to you, while you pay for the actual printing.)
- Self-publish a magnetic sign for your vehicle. Go to your nearest Kinko’s or other sign store and talk to them about different options to produce affordable signage, including the ever-popular magnetic signs. These signs are usually priced based on their size and producing one is fairly quick and affordable. I’ve designed a magnetic sign to honor my mother’s memory while promoting nursing home reform that reads:
- You have a right and a duty to inform your state and federal legislators about your support of nursing home reform! It doesn’t take any money, just an investment of your time, to contact your elected representatives. I urge you to pick up the phone and call your legislators, or go online and send them an e-mail message. Call your local library Reference Desk if you need to find their phone numbers and other contact information.
- Not into calling or sending e-mail messages? Then for the cost of paper, printing and postage, write and mail letters to your state and federal representatives and senators. In less than 15 minutes you can write, print and mail a letter than can help advance the nursing home reform agenda.
I hope you will join me in refusing to be intimidated, let alone silenced, by the well-financed nursing home industry. Our side needs all the volunteer activists we can get! I take great comfort in knowing that those of us who promote reform have the truth on our side. The truth of our message easily trumps the propaganda spewed out of the mouths of the high paid professional lobbyist liars that represent the nursing home industry. Truth conquers lies every time.
The following comment was written by a nurse who describes herself as being at the “breaking point” due to the daily stress caused by understaffing in the facility where she’s worked the day shift for approximately three years. We feel the stress this nurse is experiencing and ask you to join us in praying for this person and all compassionate, hard working nurses and nurse’s aides that God will grant them the strength to do all they can for the resident’s entrusted into their care.
The nurse that wrote the following comment works the day shift at a nursing home located in Indiana, which is one of 13 states where the nursing home industry has such an overwhelming control of state legislators that no minimum staffing standards are in place.
I love building a relationship with my nursing home residents. I live for making their day a little better. Yet more and more I feel like I am going to have a breakdown. I don’t think I can do it anymore. The demands made by administrators are unattainable because there are too few people on the floor working.
I work day shift — when management is in the facility — despite being clearly short staffed, they act like its not a big deal. Then they leave and the staffing levels on second and third shift are even worse! IF they failed to staff enough people they will threaten us if we leave with charges of abadonment instead of taking the floor themselves.
I want to take quality care of my residents. I used to think it was my fault and that if I just tried harder and harder all would be well. Now I see more and more its them (management)! I stay over late hours nearly every night. I don’t take lunch breaks but maybe once a week. I feel by staying in this job I’m condoning the poor care. I pray every morning before I go in for God to give me the strength to be the best I can be to provide for my residents.
I have to find a new job. I cant condone this any longer. The facility where I work wasn’t always like this. But then new management took over a few years ago.
This morning I had to wait until 9:00am to pass morning medications because there was no one to feed residents who must have assistance with eating. So I feed them the best I could, but there should have been two additional staff on duty to take care of this important need!
I hate not revealing the WHOLE truth to familys, but the WHOLE truth is too ugly.
Speaking of prayer, we also need to be praying for God to move upon the hearts and minds of all for-profit nursing home owners, administrators and stock holders — these people are responsible for the insanity and inhumanity of understaffing. Their greed has created and intensified the problem in Indiana and elsewhere.
| Breakingnurse | |
| none@aim.com | |
| Comment | I am day shift nurse in an Indiana LTC faciltiy I have been doing this for the past three years @ the same place. I love building a realtionship with the residents, I live for making their day a little better. And more and more I feel like I am going to have a break down .I dont think I can do it anymore. The demands made by administrators are unattainable becasue there are just too few people on the floor working. I work day shift, and management is there, we will be short on the floor and they act like its not a big deal. Then they leave and 2nd and 3rd shift are staffed even worse. IF they failed to staff enough people they will threaten us if we leave with charges of abadonment instead of taking the floor themselves. I want to take quality care of people, I used to think it was my fault that if I just tried harder and harder and now I see more and more its them! I stay over late hours nearly everynight, I dont take lunch breaks but maybe once a week. I feel like if stay I will be condoning the poor care that is available.I pray every morning before i go in for God to give me the strenght to be the best I can be to provide for my residents. I have to find a new job, I cant condone this. The facilty wasnt always like this, then we got new management a few years ago. This morning I had to wait until 9am to pass am meds because there was no one to feed people in assistive eating, so i feed them the best I could but there should have been 2 people. I hate not revealing the WHOLE truth to familys, but the WHOLE truth is too ugly and I now there isnt a better long term care facilty. |
