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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!
Over the past several weeks I’ve begun to keep a much closer eye on news media coverage of the many aspects of the nursing home industry. Information I’ve discovered points to a disturbing pattern involving massive fraud and deception by numerous players in the industry!
It is abundantly clear that HUNDREDS OF MILLIONS of dollars in government funding given to nursing homes with the expectation that the monies would be used to increase staffing levels and improve other aspects of resident care have instead gone to significantly increase the profit margins of many for-profit nursing home owners. This problem may involve facilities in nearly 30 states (including Kentucky, Indiana and California) and can be traced as far back as 2003, when individual states (thanks to pressure from the wealthy nursing home industry) began offering financial incentives with the intention that the funding would improve the quality of nursing home care. Not surprising to those of us who have had loved ones living in nursing homes over the past decade, the quality of resident care has actually significantly declined!
For-profit nursing homes guilty of fraud and deception involving government money? Say it ain’t so! Then again, over the past few weeks we’ve also uncovered many news reports that tell the tale of entire nursing home corporations — from Georgia to Ohio — being indicted for deceptively over-billing Medicare and other insurance providers.
Yes, friends. Stealing, lying and other forms of deception are all-too-common within the nursing home industry. When it comes to dealing with nursing facilities on a personal level (regarding the care of a loved one) you are wise to be cynical and to closely examine every claim made by the pathological liars that are all-too-present within the nursing home industry!
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. |
My thanks to “J”, a certified nurses aide (CNA) who works at a nursing home in central Indiana, for sharing the following thoughts about her experience as it relates to the problem of understaffing and other issues of concern (like a lack of adequate training for CNAs, etc.). Her identity is not being revealed in order to protect her from retaliation from management (although if “Stuart R.” reads this, he might be paranoid enough to fire every CNA who works in his chain of nursing homes who’s first name starts with “J”. Wait, what if “J” were actually a male?) 
I’m a new CNA. I don’t feel that I received adequate training in school or upon hiring. I’m feeling shattered and overwhelmed. I’ve just landed my first-ever CNA job (at an Indiana nursing home). I found out during training that I love the residents and the very nature of this work. My teacher predicted I would fall in love. And I did.
I love my residents. I understand they probably ran circles around me when they were my age. Unlike them, I don’t know how to make apple pie from scratch, stay married to the same person for 50 years, raise eight cloth-diapered children, harvest 10 acres each of corn and wheat, or milk six cows and collect the eggs from 2 dozen hens before sunrise and then butcher, pluck, and fry one of these aforementioned hens for Sunday dinner! I’m fond of them, I care about them and I respect them.
My facility pays exceptionally well (to make up for being chronically understaffed, perhaps?). I’m inexperienced and slow and flying by the seat of my pants. I’m honestly doing the best I can and still I don’t feel I’m doing right by any of them and I don’t know what to do about it. My assignment for the past two shifts has been 29 residents, the majority of whom I haven’t had time to become familiar with. This boils down to roughly 15 minutes of individual care per resident spread out over eight hours. Two minutes per resident is shaved off due to reasons that could have been avoided by a little forethought on the part of those in authority. Stupid reasons, such as having to chase down rubber gloves, wipes, clean linens and briefs, or read 20 charts because I’m in charge of the health and safety of people I know nothing about and any uninformed decision or action on my part has the potential to kill someone.
A few of the 29 residents I care for are pretty self-sufficient, while the rest of them require and DESERVE way more than the remaining 13 minutes of hands-on care. These are people’s mothers and fathers. They could be my parents. The quality of care I have time to give each resident is inadequate, and certainly far below that which I would expect if they were my own parents. I feel like they’re being neglected. Neglected by me, despite that I don’t have an idle moment and usually end up working off the clock.
When I finally fall asleep after I get home, I have nightmares. I don’t believe that even the most experienced and proficient of aides can provide *adequate* care to that many residents singlehandedly. I’m probably going to get fired for not charting. Because I can’t bring myself to ignore a call light and humiliate one of my beloved residents into soiling herself so that I can go make a note that someone else “eliminated” and how much and whether or not it was in a brief or in the toilet, while someone is begging *right now* to be taken to the toilet to eliminate like the adult that she is.
So there’s this nurse who is counted among THE PEOPLE WHO ARE OFFICIALLY CARING FOR YOUR MOM OR DAD. Because she’s there at the same time as I am, the facility gets to count her as someone who is providing hands-on care. Except all she does is administer medications. She’s “above” doing what she can to make sure your mother isn’t having her skin digested by the enzymes in her diarrhea. She can see that I’m already up to my elbows in seven different cases of diarrhea, yet she’ll sit and chitchat with the other nurse about what’s on sale at K-Mart and still see fit to remind me about all these other call lights that are on, rather than step up herself and care for a resident who is suffering from the caustic germs that’s eating the skin off his nether regions.
I just wanted to propose the possibility that for every aide you encounter who seems jaded and apathetic, there’s another one who wishes she had a button to stop time and make sure absolutely everyone’s every need is met, so that she could go home and rest easy feeling that her best was good enough by her own standards. I don’t know who to hate more, myself for not knowing how not to fail my residents, or the greedy powers that be at the facility for failing all of us. There’s a very high turnover rate for CNAs. I had to become one to understand why.
Please know that it breaks my heart to see you or your mom or your dad suffer and I will do everything in my power to prevent that, but that my power is very, very limited. Please understand that I have to feed my kids and this is the only way I know how to do it. Please keep in mind that the people with the least authority and power are most likely the ones who are the most emotionally invested in your mom’s or dad’s happiness and well-being.
Anyway, I just wanted you to know how much a lot of us care and how much some of us are up against.
May God richly bless every loving, hard working CNA like “J”! May God give them the strength (physically and otherwise) to provide excellent care like “J” obviously provides to her residents. May God provide nurses (unlike the one referred to in “J”‘s comments) who will conscientiously lend a hand to her hard working CNAs (instead of talking on their cell phones at work, or talking about the latest sale at K-Mart, etc.).
My opinion is that, in a more perfect (nursing home) world, CNAs would be paid better, be allowed to be involved in the care planning of their residents (something few facilities currently allow) and be treated with much more respect by the nurses they work with.
I want to take a moment to salute those members of the news media who have the courage to expose the truth about the reality of problems within the nursing home industry! It must be more difficult to buy the silence of the news media (not to mention us blog owners) than it is to come up with enough money to bribe some state politicians!
Recent articles published in the Boston Herald, Louisville Courier-Journal, Lexington (Kentucky) Herald-Leader and Indianapolis Star newspapers have shed much light into the truly frightening reality of many nursing homes. The Indianapolis Star investigative report (published this past Sunday, March 7, 2009) makes clear that (at least when it comes to nursing homes within the state of Indiana, which is the focus of the article) the following equations are clearly at play within the nursing home monopoly:
* Staff-to-resident ratios in for-profit nursing homes are much lower than in non-profit facilites.
* While for-profit facilities claim they can’t afford to hire more nursing staff, their CEO’s make much more money than do executives of non-profit nursing homes.
* The lower the staff-to-resident ratio = the lower the quality of care = increased health problems for nursing home residents.
Ya’ think?!? And to think that some readers wonder why I rail against corporate greed on this blog as often as I do!?! It all goes back to the Biblical expression, “The love of money is the root of all evil.” And evil (as I understand the nature of real evil) is all-too-present within the for-profit sectior (which is by far the largest sector) of the nursing home industry. Nursing home “evil” places the safety and care of residents below the craving for increased earnings by CEOs and COOs who often earn literally millions of dollars per year, while the Certified Nurses Aides (the front line caregivers) barely more than minimum wage!
(Update: Saturday, 3/20/10: I was able to find out the direct website address for The Indianpolis News’ excellent investigative feature that focused on problems with nursing homes in Indiana. You find the link to view Crisis of Care Among State Nursing Homes under the Blogroll feature on the left side of this page.)
For those of you who live in Indiana, please contact your state legislators to ask them to pass minimum staffing regulations for nursing homes within the state! Indiana and Kentucky are among only 13 states that are dumb (or corrupt) enough to not have nursing staff-to-resident minimums in place.
