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My thanks to a CNA from Arkansas who shared following about the overwhelming burden of nursing home work. We applaud her courage for speaking out and sharing her story! Out of a sense of social justice, changes must come to the nursing home industry. The voices of persons who, like this CNA, know from the inside about the problems within the nursing home industry, can help lead to significant changes when their story is shared. We are glad to share her story, as painful as it is (on many levels)…

“I’m a Certified Nursing Assistant (CNA) with 10 years of experience. I love helping people and that is why I picked this career.

I’ve only worked in nursing homes and have to say everyone of them had staffing problems. I’m always exhausted by the end of my shift and yet I’m not even 30 years old. Many days I feel like I’m one of the older people I take care of. This job has worn me down: I have chronic lower back pain along with arthritis in my back.

I’m a struggling single mom with hopefully many years ahead of me. But when anyone tells me they are thinking of being a CAN, I tell them don’t do it! The nursing homes don’t care about how they work the CNAs and the nurses seem to only know how to put more work on you. This is a bad business to get into if you value your back and knees, not to mention the employment benefits are almost non-existent. After a decade of working as a CNA in Arkansas I only make $9.00 a hour!

Arkansas desperately needs to change state regulations regarding nursing home staffing levels! If things don’t change in a big way and soon there will be no CNAs to take care of anyone because most of us are injured or just plain worn out! The past generations of CNAs just took the crap, while this generation knows change has to be made. I can’t keep quiet and do my job anymore it is literally killing me from the inside out.”

A CNA (most of them are females) in Arkansas who has a decade of experience is making $9.00 per hour, while the CEO’s of many for-profit nursing home corporations (many of which are men) are easily earning over $1 million per year! This is criminal, not to mention obscene. Oh yeah, and more than a little bit sexist!

I get a laugh from the thankfully fairly small percentage of comments readers of this blog leave that include an observation like, “Not all nursing homes are bad. The ones I’m familiar with provide excellent care.” My response to these comments is, “So? Just because you aren’t familiar with pathetically bad nursing homes doesn’t mean they don’t exist.” The other thing I want to tell these nursing home apologists is, “WHERE does this blog even suggest that all nursing homes are bad?” Since NursingHomeReality doesn’t make such a claim these comments are little more than a smoke screen used to deflect the reality that nursing home care in many facilities located within the USA is a major embarrassment and a pathetic sham.

Don’t believe the claims I make about nursing home neglect and abuse of residents, let alone the problem of corporate greed within the nursing home industry? Then look on the left side of every page of this blog. That’s where you’ll find my Twitter feed. Most of my “Tweets” include links to news articles that focus on the serious problems with many nursing homes in this country! Disagree with me all you like, but now your disagreeing with professional journalists? Please. Get a grip on reality!

Don’t believe the details posted on this blog that highlight short staffing and other problems caused by corporate greed and deception? That’s belief is really pathetic. You see many of the serious complaints about nursing home care posted on this blog were written by current and former nursing home employees. Insiders and whistleblowers know much more than any outsider about the many serious problems with nursing home care.

The fact is, was and sadly will continue to be that the problems discussed on this blog are very real. To deny otherwise is beyond ridiculous.

agendaNearly every state’s legislature begins their 2014 session this month. So January is the appropriate month to offer my five point agenda for nursing home reform. I believe 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 (commonly referred to 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 most states a minimum of 10% of nursing home annual 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 staffing levels are usually at their lowest and when management isn’t present to see for themselves what’s going on.

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. 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 would not be allowed by either the state inspectors 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 at times other than when management is in the building? Residents with dementia are likely incapable of reporting such problems. Family members can’t stay with their loved one 24’7 non-stop to monitor the situations. Placement of a “Granny Cam” inside the room is incapable of documenting problems that take place outside of the resident’s rooms (example: 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 (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 do I believe this issue requires a legislative intervention? Because calling in off-duty nursing staff during an inspection or even bringing 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 devising schemes to make it look appear that we are the bad guy, thus justifying prohibiting (or at least limiting) our 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 facilityStrongly 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!

Wow. Comments from Nursing Home Industry apologists to this blog never cease to amaze me. Their denial (or outright deception) is pathetic. Their comments do seek to spin our (yours and mine) personal experience and news headlines to make it sound as if nursing home living is overwhelmingly a positive experience. These writers acknowledge that “maybe” a “few” bad persons are employed by nursing homes, but the majority are outstanding care givers. Depicting the nursing home industry as having a “few bad apples” and/or a “few problems” is like saying the Titanic “only has a little hole in the bottom of it.” Talk about denial! Talk about deception.

Who are they trying to convince?

This blog has NEVER claimed that ALL nursing home caregivers are bad, evil or lazy. NEVER. We don’t paint in broad stokes to make our point. No need to. We cite specific cases of abuse and neglect of nursing home residents. These reports (found in blog entries like this one and in Twitter Tweets on the left side of your monitor) come from mainstream news media — not from Nursing Home Industry prostitutes…I mean, paid spokespersons. While other damning allegations featured on this blog come from current and former nursing home administrators, nurses and certified nurses aides.

NursingHomeReality also receives reports of abuse and neglect of nursing home residents from physical therapists, speech therapists and other professionals who work in nursing homes.

It is not as if we family members and friends of nursing home residents need any confirmation of what we’ve experienced with our own eyes. We know the suffering of our loved ones and we know the deception and denial of a well-financed industry that will lie and spin at any cost to cover it’s huge corporate butt. SHAMEFUL!!!

This blog will not back down and you should never give up praying and working for nursing home reform. Together we can make a difference for the better!

Yesterday I received a comment about this blog from a person self-identified as a “Licensed Nursing Home Administrator”. I knew her overall comment would irritate me when I read just the first two (of the many) sentences she wrote, “Yes, there are nursing homes that could improve the quality of care they provide. I find the articles here to represent the misinformation out there about nursing homes.” 

Here are my thoughts in response to two sentences clearly written with the intention to promote DENIAL of nursing home REALITY.

To say that “there are nursing homes that could improve the quality of the care they provide” is a gross understatement of REALITY. An accurate statement would have begun with something to the effect that “It is a national embarrassment and disgrace that MOST nursing homes provide substandard care of their residents — primarily caused by a culture of corporate greed that insists on dangerously low staffing of nurses and nurses aides.” There. Much better. If you are the family member of a nursing home resident (let alone a nursing home resident yourself) you know this is the truth. To state anything less is spin. Oops…to state anything less is dishonest. Really now…to state anything less is a lie.

When I first read that the nursing home administrator believes “the articles” (actually they are more like essays, along with news and commentary through my related Twitter feed that’s posted on the left side of each page) on NursingHomeReality represents “the misinformation out there about nursing homes” I laughed out loud! Your Attention Please: The name of this blog is Nursing Home REALITY, not Nursing Home Spin or Nursing Home Deception or Nursing Home Public Relations-Generated Lies! You see, as it’s name implies, this blog is dedicated to telling the TRUTH about the REALITY of nursing homes.

TRUTH about the neglect, abuse and criminal harm done to nursing home residents by their caregivers and management. TRUTH about the abusive treatment suffered by family members and friends when they dare confront (let alone report) the REALITY of their loved one’s nursing home nightmare.

“Nursing Home Apologists” can spin all they want. But the TRUTH is that the REALITY they are actively trying to deny WILL be found out eventually and REFORM of the nursing home industry WILL take place. The liars have nowhere to hide. Denial of reality is toxic and will come to an end.

Those who have read this blog many times over the past few years know that I’ve never portrayed all nursing home staff members as being abusive, neglectful or dishonest. Those, like the “Licensed Nursing Home Administrator” this post is responding to, would have you believe that this blog portrays everyone involved in the nursing home industry as being evil. Many are to be sure (just look at the NEWS HEADLINES in my Twitter feed!). While others are loving, caring and give 110% to the nursing home residents entrusted to them. Claiming that we have published otherwise is just another LIE designed to confuse you about our mission and content. Interestingly some of the most critical comments about nursing homes published here were NOT written by me, but rather were penned by actual nurses, nurses aides and administrators (and other staff) who have worked in the industry and know personally what shameful things take place in nursing homes.

As I’ve written many times over the years, the comments made by readers who currently or previously worked in nursing homes are some of the most powerful indictments of serious problems within the greedy nursing home industry! Along with family members and loved ones, these folks know all too well that the system is broken badly and is desperately in need of fixing!

A comment left earlier today by one such reader, a CNA with many year’s experience of caring for nursing home residents, points out the dangers and stresses caused by understaffing. Understaffing is caused by? Corporate greed. The CNA wrote:

“I’ve been a CNA for a while now and I’m exhausted. Today I alone was responsible for 16 residents with nine of the 16 being total care and 11 of the 16 requiring assistance by a minimum of two staff members. It’s impossible!!! Unfortunately those total care residents were only changed once because of the lack of time during day shift.

Inadequate staffing creates a situation that is incredibly hard — mentally and physically — because I care and love my residents. Something has got to change. Our residents are suffering!

No wonder there are so many issues with skin tears. Some CNAs get in such a hurry to get everyone done in time or they’ll get in trouble for running late or if they clock out even one minute late they get their attendance bonus taken away. But let the administrator come out of their office and out of their plush leather desk chair once a week and throw afit because the closets are a mess or there’s a lift in the hallway or some other unimportant bullcrap! They don’t worry about the CNA whose back is broke, with sweat running down their face, or that there are 10 more residents to lay down and change before the end of the shift.”

I believe this comment from a certified nurses aide points out that short-staffing, which is directly related to corporate greed, is the source of suffering for both nursing home residents and nursing staff. I have no doubt the emotional toll is especially heavy for the nurses and CNAs who truly love and care for their residents. The best and brightest staff get burned out and worn out because of inadequate staffing.

The suffering caused by short staffing clearly harms nursing home residents. Everything from medication errors to bedsores can be traced to short staffing. My observation is that inadequate staffing is the single largest cause of nursing home resident neglect leading to illness and death.

When a nursing home CEO (as many do) earn mutliple million dollar annual salaries and the front line caregivers (CNAs) barely earn above minimum wage and often lack health insurance or other benefits, something is seriously wrong with the nursing home industry!

As a resident of Kentucky committed to nursing home reform, I was thrilled when our 2013 legislative session ended a few weeks ago without passing Senate Bill 9. The bill’s intention was to make it much more difficult to sue nursing homes by mandating that a panel of three physicians would have to, by majority vote, approve of the merits of a lawsuit against a nursing home before it could tried in court.

Most nursing homes in Kentucky are owned by for-profit corporations. Most hospitals in Kentucky and owned by non-profit corporations. Kentucky’s hospitals have never sought such protection. So it’s obvious what this dysfunctional bill was all about: protecting nursing home profits. With a smaller profit margin nursing home bosses like Kindred President & CEO Paul Diaz might not be able to make an obscenely huge salary of over $6.4 MILLION like he did during 2012. This is all the more an obscene situation when you consider how cheaply Kindred and other nursing home giants run their facilities — meaning they don’t provide adequate staffing to care for their residents and the front-line caregivers are woefully underpaid, many not even having health insurance as part of their compensation.

While Senate Bill 9 passed in the Kentucky Senate, thankfully it never received a hearing in the House Health & Welfare Committee, so it couldn’t up for a vote by the House. While the fact that this bill was able to pass in the Senate is disturbing, yet it points out a reality that the nursing home industry needs to face: No matter how much money they spend to buy legislator’s votes to support such a bill and to run deceptive commercials to promote their agenda to the public, they do NOT have the truth or decency on their side. Thankfully, so far at least when it comes to Senate Bill 9, all of their money and lies could not force their hideous agenda on nursing home residents. Truth won. Greed lost. Amen.

I want to offer a few reminders about this blog…

– As I’ve mentioned before, I’m very familiar with how nursing homes operate in Kentucky and Indiana, due to my late mother’s experiences in facilities located in both of these states. But I never claimed to be knowledgeable about nursing home rules and regulations in any other states.

— Since I’m not an attorney, nor am I employed by any government agency that regulates nursing homes I ask that you do not contact me for help resolving a problem with any nursing home, especially if they aren’t located in either Kentucky or Indiana. Instead, I urge you to focus on contacting either your local long-term care ombudsman and/or the agency that regulates nursing home in your state (the agency name varies from state to state, but this is information you can find at your local library or from your state legislators). These are the people you need to contact. With access to Google and other Internet search engines, you can likely find their contact information quite easily. If you can’t find the information online, then (as mentioned previously) contact your local library and/or state legislator for this information. In both Kentucky and Indiana all nursing homes MUST (as a matter of law and/or regulation) provide anyone who asks (resident, family member or friend) for their

– While I do publish from time to time comments readers leave on this blog having to do with nursing home problems they’ve experienced, please remember that I reserve the right to edit your comments. I edit these comments to protect the identity of the nursing home resident, the author of the comment and I never include the name of the facility involved. Given the tendency for nursing homes to retaliate against residents and their friends and families, it should be obvious why this information is omitted. I also don’t feel comfortable naming a nursing home accused of neglect or abuse of their residents unless this is a matter of public record (e.g., it involves a situation that has been the subject of a lawsuit).

Please DO keep share your story with me and with our readers! I believe it is therapeutic to share the horror of one’s stories with others and it is helpful for others to be reminded they are not alone and that others have faced the same nursing home crap they have!

Remember: Truth Won. Greed Lost. If it can happen in Kentucky (and it did during our 2013 legislative session) it can also happen in your corner of the world!

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.

  1. 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.
  2. 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!
  3. 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.
  4. 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!
  5. 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 ( 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:

  1. You report the suspected Medicare fraud. The allegation must be specific, not general.
  2. 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.
  3. 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).
  4. The person or organization you’re reporting isn’t already under investigation by law enforcement.
  5. 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.

Earlier tonight one of my readers shared about a very disturbing thing her mother, a nursing home resident, experienced this weekend. While waiting for one hour for a CNA or nurse to assist her with using a bed pan, the resident eventually soiled herself. To add insult to injury, the CNA who finally responded to the resident’s plea for help made a judgmental comment to the resident — which of course is beyond inappropriate!

The situation with this reader reminded of my own late mother’s many experiences of waiting 15, 30, 60 minutes…even over TWO HOURS for nursing home staff to respond to her call light. She wasn’t able to toilet herself and I wasn’t allowed to assist her. All she could do was remain in her bed, miserable with the urgent need to use the restroom. On many occasions she ended up soiling herself before nursing staff arrived. In many cases I was told by nursing home staff that it was not only OK for my mother to soil herself, but probably this was even a good thing!

“Good” for who? Not my mother. Not for the mother of the reader. Indeed the longer a person sits in their feces and/or urine, the greater the likelihood they will develop BED SORES. Along with being horribly painful, bed sores can even ultimately be deadly!

During the time my mother was a nursing home resident she was taking Lasix, a powerful diuretic medication. And, well duh…Diuretics make a person HAVE TO PEE!  Lasix can make a person HAVE TO PEE every hour for up to six hours after administered to the patient (FYI: “Lasix” is shorthand for “lasts six”, meaning it can make a person HAVE TO PEE for up to six hours after they take it). Yet my mother and myself were repeated verbally berated by nurses and CNAs over the years with comments like, “Well I just took her to the restroom two hours ago!” (What part of “EVERY hour for up to six hours” don’t they understand?)

As if not providing adequate staffing so a nursing home resident can be toileted regularly after being given Lasix isn’t bad enough, all of the nursing homes where my mother resided eventually noted in her chart that she was “incontinent”, inferring she was incapable of controlling her bowel and/or bladder function. Hmmm…Who wouldn’t be INcapable of controlling their bathroom functions if 1) they were given a medication that caused them to need to urinate and/or defecate hourly for several consecutive hours and 2) despite being unable to take themselves to and from the bathroom (for whatever reason) they weren’t given the nursing assistance — in a timely manner — needed to get to (and from) a toilet?!?

Sadly, what often happens to nursing home residents after they’ve been charted as being “incontinent” is this designation makes it more difficult for the resident to be accepted by a different nursing home — if and when the resident needs to move. Not being toileted regularly (let alone as needed) is a very good reason to want move to a different nursing home!

Incontinence is a reality for many persons, nursing home residents and otherwise. But when, as is often the case, incontinence can be PREVENTED by providing adequate staffing to assist residents who need help with toileting…that certainly could be a matter of criminal neglect.

Nursing Home News Watch

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