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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!

Some recent comments this blog has received from individuals who are employed as nursing home administrators lead me to believe that I’ve offended some of these folks, let alone possibly hurt some feelings.  Perhaps an explanation and disclaimer are needed at this point.

First, let me be clear that I do not “hate” nursing home administrators.  However because of my experience with several administrators during the time my mother lived in various nursing homes, I must also state that I ended up being very disappointed by the vast majority of them and would have a very hard time trusting an administrator any time soon!  When you are lied to, when your loved one’s rights are violated, when you are screamed at and threatened in retaliation for going to the state with concerns, when you told that your going to the state has created a “hostile working environment” and when problems with your loved one’s care aren’t really fixed (or aren’t fixed for more than a few days at a time)…Well, I think it only appropriate and good self-care to be slowwwww to administrators ever again.

Do I think that all nursing home administrators are “bad people” or “more bad than most other people”?  I’ll let God answer these kinds of questions, on an individual basis, as I believe God is the ultimate judge of people’s hearts and intentions. All I know is that of the nursing home administrators I’ve personally dealt with, most seem to lack integrity — let alone compassion — for the residents they serve and the family members they deal with.

At the same time I will offer a word of compassion for nursing home administrators as it seems that many of them are clearly under enormous pressure as they deal with residents, family members, owners, state regulations and state inspectors (a/k/a “surveyors”) and employees.  Probably many of them work enough hours each week and are under such a mountain of stress that they likely deserve every penny they earn.  I have a feeling that some administrators would do a much better job if the nursing home owners would stop trying to micromanage them and let them do their job!

Speaking of “pennies that are earned”, the people who seem to me to be most deserving of a raise are the certified nurese’s aides — truly these people are the front line caregiver in a nursing home setting — yet they are typically the lowest paid of all nursing home employees.  This isn’t just!  They deserve to earn more money (while being held accountable for their job performance) and nurses should treat their CNAs with more respect than I’ve seen them treated with.

Let me begin this journal entry by admitting the obvious: I’m not only telling my story here, but I’m also telling the story of a wonderful woman, my mother: Joann G. Poland.  She passed away on January 1, 2009 and I believe that the cause of her death was directly related to nursing home neglect.

My mother died as the result of complications caused by aspiration pneumonia.  On the Monday before her death (she died on a Thursday), she vommitted almost non-stop for nearly 10 1/2 hours!!!  What caused the vomiting that lead to the aspiration pneumonia?  SEVERE BOWEL IMPACTION!!!  What caused the impaction?  Nursing home staff that (for reasons of laziness and/or malice, I don’t know which) failed to properly chart her bowel movements for likely nearly two months! Make no mistake: Tracking bowels movements is one of the most basic things a nursing home is required by law to do on a daily basis! To not do so is clearly criminal!

My wonderful, courageous mother: Joann Gay Maria Morris Poland

R.I.P.: Joann Gay Maria Morris Poland December 9, 1929 - January 1, 2009.

I write this journal entry on Tuesday, December 8, 2009.  Tomorrow (December 9) would be my momma’s 80th birthday if nursing home neglect hadn’t claimed her life.  She is survived by me, as well as her twin brother, a sister-in-law and a niece.  I would loved for my momma to have lived at least long enough to celebrate her 80th birthday with my wonderful Uncle Joe.

Momma, I love you with all my heart and I miss you more than you  could ever know!

Your memory continues to be an inspiration to me. What nursing homes did to you was criminal and in your memory — as I promised you the day before you died — I pledge to continue to work and pray to make positive changes take place within the nursing home industry so that NO other nursing home resident need ever suffer like you did because of unsepakable nursing home neglect and abuse.

The following post submitted by a registered nurse currently working in a nursing home setting offers a pointed reminder of the seriousness of what happens when corporate greed is allowed to dictate minimum staffing standards…

I am an RN in a nursing home licensed for just over 200 residents that offers skilled, intermediate and personal care. This facility has four nurses stations/units. I work on a unit with 38 residents. Many of these individuals have dementia.

My unit is allowed four nurses aides and an LPN on day shift, 3 nurses aides and an LPN on evenings, 1 – 2 aides and an LPN on nights.

While I try hard to understand the “budget” for staffing on my unit, my repeated requests for additional help has been ignored. In August I had eight (8) resident falls on my unit and they all happened on evening shift. My unit’s LPNs are frequently out of time compliance on distributing medications.

I would like to see mandatory staffing based not only on the number of residentts, but also on their needs. This is especially important on a unit that has residents with many needs.

On a recent Saturday evening, after spending several hours visiting my mother who now lives in a nursing home located in south-central Indiana, I discovered a sight that was quite disturbing. If what I’m about to share doesn’t upset you, it really should!

Standing outside the main entrance to the nursing facility were ALL THREE of the nurses aides who were on duty at that time. They were standing outside taking their smoke break together! Inside was JUST ONE nurse, in the middle of distributing medications, responsible for a unit with approximately 35 residents! Only one caregiver for 35 residents is, to my way of thinking, a case of neglect. For the nearly three dozen residents what I observed is (at best) a serious injury just waiting to happen!

At worst the situation I’ve described is a potentially (harmful or even fatal) medication error waiting to happen. Besides it certainly seems totally unfair to expect JUST ONE nurse to be responsible for responding to all wheelchair alarms, bed alarms and patient call lights — while distributing medication to the residents.

And obviously this situation was unfair to my mother and the nursing home residents.

Is it “unfair” to demand that smokers take their smoke breatks outside the building? After all it hasn’t been all that long ago that smoking employees were allowed to smoke inside nursing homes (not to mention hospitals). Because of the risk associated with second-hand smoke, I don’t find it unfair to require all smokers (both staff and residents) to smoke outside the building.

This incident that took place in June 2008 was NOT the first time that I’ve witnessed first hand this kind of criminal neglect in a nursing facility. EVERY long-term care facility where my mother has lived over the past four-plus years  (e.g., 5 nursing homes and one assisted living facility) have had employees who smok that have left their residents with inadequate staffing levels for several minutes at a time!

One nursing home unit where my mother lived had a nurse who averaged three smoke breaks per HOUR (per the observation of a newly-hired nurses aid)! Many of the times this particular nurse was on duty (night shift: 7:00pm – 7:00am), she was the ONLY staff member on what was a “locked unit” — meaning that if a resident’s alarm were to sound, NO other staff member in the building could have heard it, let alone responded to it!

If I didn’t know any better, I’d think that the caregivers in question (both nurses and nurses aids) think that they are PAID TO SMOKE (OUTSIDE the building), rather than take care of residents (who live INSIDE the building).

I’ve also witnessed many of these same caregivers answering PERSONAL (non-emergency) cell phone calls while caring for my mother (including while they were supposed to be “transfering” my mother from her wheelchair to the toilet, which is NO time to risk a resident’s safety!).

I’ve also personally witnessed still other nursing staff members act as if they are paid to do nothing but sit on their butt and gossip with co-workers! Can they not gossip on their own personal time?

As of this writing my mother has lived in long-term care facilities in two states: Kentucky and Indiana. These are two of the 17 states that have not yet mandated a minimum staffing level to care for nursing home residents. Indiana and Kentucky leave it up to each facility to interpret the wrecklessly-written federal regulation that reguires these facilities to provide an “adequate” staffing level to care for their residents.

Does ONE caregiver for 35 residents sound “adequate” to you? I hope not!

Whatever happened to a decent work ethic? Whatever happened to to having (and ENFORCING) a rule for smokers that ONLY ONE staff member can be outside the building (for any reason) at any given time? Oh wait, ALL of the nursing homes where this smoking concern has been observed already HAVE such a rule in place. The problem: either most supervisors are themselves smokers (who breat the rule themselves) OR don’t want to anger their smoking employees by enforcing an UNpopular rule.

It seems to me that nursing homes should have a policy to NOT hire management who smoke and/or hire non-smokers only. While these might sound like radical concepts, until the day comes when the legislators of Indiana and Kentucky grow a spine and require sensible minimum staffing levels, nursing homes should become part of the growing number of businesses that LEGALLY discriminate against smokers.

Which is more ethical: discriminating in hiring against a smoker or allowing inadequate staffing levels that endanger nursing home residents?

Nursing Home News Watch

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