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elliemae   ignore (0)   2009 Feb 7, 4:44am   ↑ like (0)   ↓ dislike (1)     quote        

You may call the Bureau of Healthcare or the number for the state agency for complaints that are listed on information boards in the nursing home. Your concerns are serious, and you should report them. They will be investigated, although they may never tell you the outcome. Be sure to have specific instances that can be investigated.

According to Medicare.gov, this facility received deficiencies during their last state audit. For further information, the nursing home has to provide the actual findings to residents and visitors in the form of a 2567 form; you should be able to find them without asking but they must be provided when you ask.

I agree with Patrick, many times people ask for help or are constantly ringing their call lights. That doesn't mean they shouldn't be answered.

elliemae   ignore (0)   2009 Feb 7, 4:57am   ↑ like (0)   ↓ dislike (1)     quote        

This is a response to the following comment:
"First, get a letter addressed to the Social Security Administration
giving you authority to have the bills and information regarding the
premiums for Medicare sent to you. If this is not done you will lose
Medicare parts B and D, and any drug benefit will be lost. I was not
aware of this when my mom went in to a nursing home and wound up
paying for all of her drugs out of pocket. I could not get her to
sign the letter before dementia set in and any legal recourse was more
expensive than her meds."

There is no letter that the SSA will honor - a Durable Power of Attorney for Healthcare from the patient, completed while they are competent, will suffice. If the patient is not competent, a family member can intercede on the patient's behalf. The nursing home has a Social Worker whose job it is to help with such an issue - but Parts D (drug plan) and B (medical) shouldn't be jeopardized by the patient's inability to participate in his/her decisions.

elliemae   ignore (0)   2009 Feb 8, 12:49am   ↑ like (0)   ↓ dislike (0)     quote        

I work for a SNF, and am proud to say that I do. I would say that there are more good places than bad, but those bad ones certainly taint the industry. Congrats on working for a quality care provider

elliemae   ignore (0)   2009 Feb 8, 1:00am   ↑ like (0)   ↓ dislike (1)     quote        

Birdie:
Report, report, report. You can report any issues you found to the state bureau that investigates nursing home abuse, or can find the info listed under Adult Protective Services in your phone book. Your complaints are serious and if they can be substantiated during a surprise visit, the place will have to address them or can be closed down.

The system works; I personally witnessed abuse in a nursing home in which I worked and reported the abuse; it nearly ruined my career but it was the right, and only, thing to do. The state is obligated to respond. In my case, the abusers were removed and the abuse stopped. Don't stop with your complaints because your family member is gone from there - please.

You can search the information about the nursing home you refer to on the Medicare.gov website, search nursing home compare and follow the prompts to look at the healthcare deficiencies. Unfortunately, they don't have the same rules for Assisted Livings and there are some out there that need an overhaul to say the least. Family diligence is important for anyone who has a family member living in a NH or Assisted Living.

elliemae   ignore (0)   2009 Feb 13, 1:06am   ↑ like (0)   ↓ dislike (1)     quote        

“We have a lot of experiences with nursing homes who load somebody up in an ambulance on a Friday night. … They do it on a Friday, I think, because advocates go home,” said Vicki Elting, the regional ombudsman in King County. By Monday morning, hospitals are struggling with a discharged patient with nowhere to go."

Unfortunately there are nursing homes that dump patients out - if the patient is admitted to a hospital it's possible that the nursing home isn't legally required to take them back. Most hospitals won't admit patients unless they have a medical need, and the nursing home has to accept the patient back if he isn't admitted to the hospital.

Many nursing homes are ethically run; those that dump patients lose credibility in the community and often are the place of last resort for hospital discharge planners. Complaints are investigated by Nursing Home Ombudsmen - the federal government requires that each state have these workers to protect the rights of patients in nursing homes and assisted livings, but the states don't recieve federal funding for thse positions. This means a higher caseload, and less protection for the residents - with the economy tanking, they are needed now more than ever.

Write your congressional and senate representatives and ask for more protection for the elderly in these difficult times - ask them to fund Nursing Home Ombudsmen and set a reasonable caseload for them so that they can fully investigate complaints.

elliemae   ignore (0)   2009 Feb 18, 11:15pm   ↑ like (0)   ↓ dislike (1)     quote        

You asked "is this ethical?" Honestly, I don't have enough info to say yes or no. But a dementia unit is traditionally a unit that is locked so that patients who wander won't be in danger of leaving the building and hurting themselves. If your relative needed help with her ADL's (activities of daily living such as bathing, meal prep & eating, dressing, etc), she would be probably be appropriate for the nursing facility. However, many times dementia patients in the beginning phases can be better served in a more homelike environment that can ensure their safety without being as institutional as a nursing unit. Remember that facilities are in the business of making money - they received several (9?) months of payment for the apartment, Medicare rehab monies plus co-payments, and room & board in the dementia unit. They would have continued to receive $ for her nursing home placement - so of course their recommendation would be for her to remain in their facility as long as possible. Did they give you the option of moving her to other facilities that were less restrictive?
(I'm a social worker with 20 years of experience in working with the elderly).

elliemae   ignore (0)   2009 Mar 6, 11:36am   ↑ like (0)   ↓ dislike (1)     quote        

Would it be possible for you to give me more information?

elliemae   ignore (0)   2009 Mar 14, 12:25am   ↑ like (0)   ↓ dislike (1)     quote        

You'll need to contact them directly.

elliemae   ignore (0)   2009 Mar 15, 12:05pm   ↑ like (0)   ↓ dislike (1)     quote        

Good point. I'd like to see funding for programs that help people stay in their homes, or with family, rather than having to go to nursing homes because Medicaid pays there. Waiver programs are woefully underfunded, and mismanaged in that they don't save money by the time the monies are spread amongst the different agencies administering and providing oversight for the programs.

elliemae   ignore (0)   2009 Mar 23, 2:02pm   ↑ like (0)   ↓ dislike (2)     quote        

Most facilities don't have doctors who are on staff, they usually only visit their own patients. If you believe that there is a problem with the facility you can report it to the state ombudsman (address should be clearly posted in the facility, or you can search the state website).

elliemae   ignore (0)   2009 Mar 24, 2:21pm   ↑ like (0)   ↓ dislike (1)     quote        

If they throw any further roadblocks, ask them for a copy of the Resident's Bill of Rights and call the Long Term Care Ombudsman. I would recommend writing your MD and telling him your concerns. LifeCare is a national company and you should write a letter to their corporate office describing your issues and including the names of the employees who attempted to interfere.

elliemae   ignore (0)   2009 Apr 1, 11:26pm   ↑ like (0)   ↓ dislike (1)     quote        

I was speaking with an Assisted Living Administrator, who told me that a board like this is dangerous because people can say anything that they want to. I pointed out that he loves Wikipedia, and that there's no difference in the theory. This forum, and each page, provides the rare & unique opportunity to give feedback - both good and bad - about nursing homes. It also allows people to ask all those questions and receive the answers from other "normal" people, not someone who works for a facility.

elliemae   ignore (0)   2009 Apr 9, 1:34pm   ↑ like (0)   ↓ dislike (1)     quote        

According to the Smoking Gun:

http://www.thesmokinggun.com/archive/years/2009/0122091nursing1.html
"JANUARY 22--Meet Brianna Broitzman and Ashton Larson. The Minnesota women, both 19, were arraigned yesterday on charges that they sexually humiliated, spanked, groped, and spat on nursing home residents suffering from Alzheimer's disease and dementia."

Examples such as these are why Ombudsmen are so necessary to nursing homes - to investigate reports of abuse & neglect.

elliemae   ignore (0)   2009 Apr 9, 1:41pm   ↑ like (0)   ↓ dislike (1)     quote        

http://www.consumeraffairs.com/nursing_homes/ny_tietz.html

From Consumer Affairs.com:
"Lisa of Fresh Meadows NY (03/09/09)
This is directly from the letter sent by me to this nursing facility regarding my father's stay there.

I want to thank you, Margaret Tietz Nursing and Rehabilitation Center, for robbing my father of his dignity in his final days.

Thank you for taking two hours to bring a bedpan to his room, and then letting him sit in filth for two hours before taking it away.

Thank you for switching shifts and having gaps in your coverage, and for being extremely insensitive when patients are in need during that time. The diaper he was wearing was too tight, he had accumulated fluid around his middle. Nurses could see the patient was in distress, and when I begged one of them (Livingston) to come to his aid, she said, We're switching shifts now. I asked how long it would take, and she said (while calmly rinsing a bowl in the kitchen), We'll get to it when we get to it.

Another nurse told me to administer the medication to my father myself because she was apparently offended that I was standing nearby. She handed me the cup and walked away. I could name others, but that will come in another forum, at another time.

Thank you, physical therapy area, for yelling at my father when he could not stand up, or walk, and for not understanding enough about a patient's medical condition to realize that he truly couldn't.

Thank you for contributing to my father's last days by making them a living hell, and one that I'll truly remember for the rest of my life.

One thing is for certain, I will never, ever send another loved one to your horrible place, and I will let the world know how awful your facility is.

I believe Margaret Tietz would be turning over in her grave if she knew how you were treating the patients who have entrusted you with their care.

But finally, I recommend you show a little respect to the family when a loved one dies in your care. When my father died, I was greeted by a happy, giddy nurse and two aides, who were telling jokes over his body as they did their preparations.

I reserve the right to take up this matter with additional people in the future, including, but not limited to, local legislators."

elliemae   ignore (0)   2009 Apr 9, 1:50pm   ↑ like (0)   ↓ dislike (1)     quote        

Let's hope it's taken more seriously than a normal assault against a competent person.

elliemae   ignore (0)   2009 Apr 15, 7:01am   ↑ like (0)   ↓ dislike (2)     quote        

Property in free fall - Las Vegas property purchased at $775k in November 2005; according to Zillow it's lost $60k in the last month. It's $485k off peak prices. Wow.

http://www.zillow.com/homedetails/charts/66844273_zpid,5years_chartDuration/

elliemae   ignore (0)   2009 Apr 15, 1:47pm   ↑ like (0)   ↓ dislike (1)     quote        

http://www.dailymail.co.uk/news/article-1170269/Whistleblower-nurse-filmed-elderly-patient-neglect-guilty-misconduct-Panorama-expos.html

Yet another example of abuse in a nursing home - not only on the part of the provider, but also the nurse who recorded the abuse. Unfortunately, with cuts in Adult Protective Services and Ombudsmen programs across the country, there will soon be no one to investigate these incidents.

elliemae   ignore (0)   2009 May 3, 3:06pm   ↑ like (0)   ↓ dislike (1)     quote        

Tiqstuff:
If the AL portion is separate from the Skilled Nursing, they can continue to charge for that room - if it's not paid, they will rent it to someone else. AL requirements are that patients be independent - if they require nursing care, they're not appropriate to return to AL. The rules vary from state-to-state; you should be able to research the rules for assisted living on the state of New Mexico website.

You don't have to keep her there - you can find another facility for her and have her transferred but Montebello probably won't take her back. If she's competent to sign the paperwork they have no choice and if she's not, the power of attorney or next of kin according to state law can make the decision.

Patrick has Advanced Directive laws by state on the nursing home page, it may address next of kin. If your mother knows who she is, where she is, the general date and the situation, she can probably make a decision. If you decide to get counsel, see an attorney who specializes in elder law. However, from what you describe, Montebello is following the rules.

It's unfortunate that the police were called and your mother was upset, but if the facility believes that you are going to take your mother out without being able to care for her, they are obligated by law to call the police and possibly adult protective services.

elliemae   ignore (0)   2009 May 4, 11:46am   ↑ like (0)   ↓ dislike (1)     quote        

If this other person is a power of attorney, there's not a lot that you can do. However, if you are the closest relative you might be able to move her from the facility. I would suggest you see an attorney if that's what you think needs to happen.

Unfortunately, your mother is in the middle. This conversation shouldn't have happened in front of your mother.

elliemae   ignore (0)   2009 May 9, 6:23am   ↑ like (0)   ↓ dislike (1)     quote        

Unfortunately, the medical profession protects its own. Your complaints might be viewed as a nuisance - and not taken seriously.

Have you reviewed the Medicare.gov site for the facility to see if it has a good record?

You have the right to complain at any time about the treatment to the State office - but you'll need names/dates, etc.

elliemae   ignore (0)   2009 May 26, 10:21pm   ↑ like (0)   ↓ dislike (1)     quote        

It's so easy to see how it's worth $89,500:

- It's a view lot (probably overlooks a feed lot)
- Mature landscaping (look at the shrubbery, a structural landscaping element in that it holds up the structure)
- Like the Leaning Tower of Pisa, it provides a local tourist attraction
- Fenced lot
- Custom screened porch
- Power supply on property
- Plenty of parking

I'm practicing to be a realtor. How'm I doing?

elliemae   ignore (0)   2009 May 27, 2:30pm   ↑ like (1)   ↓ dislike (2)     quote        

For the cost, you did well. I'm actually a little jealous of the trees. Mine are babies. :(

elliemae   ignore (0)   2009 May 29, 2:57pm   ↑ like (0)   ↓ dislike (1)     quote        

Let me guess - you work there? It's good to take pride in your work. :)

elliemae   ignore (0)   2009 May 31, 1:26am   ↑ like (0)   ↓ dislike (1)     quote        

If you can refi, it's always a good idea to get your fixed costs down. But if you can't, you'll lose a chunk if you sell. Of course, you could lose more if property values go down and you are forced to sell due to an unforeseen event.

Try to keep a cushion if at all possible. I know mine might not be a popular opinion, but one life-altering event (medical bills, disability, new baby, etc) can drastically change your circumstances.

elliemae   ignore (0)   2009 May 31, 11:28am   ↑ like (1)   ↓ dislike (2)     quote        

Now it shows as 7493 Proud Meadows St. LV 89131 Don't know why the change.

It was $455k on April 15th, today it's $431k.

elliemae   ignore (0)   2009 May 31, 3:39pm   ↑ like (0)   ↓ dislike (1)     quote        

You mentioned several issues:
1- it's common for Administrators to refuse to give out cell phone numbers. She should have called you back, or the Director of Nurses (aka Director of Nursing Services) should have done so. I would schedule a meeting with both of them, and bring a witness along. It doesn't have to be an adversarial meeting, but if it goes bad you'll have back-up.

2- There should be no reason that you have to drive 30 minutes to check on a prescription. The floor nurses should have been able to tell you if it was filled. Depending upon the pharmacy the nursing home uses (or your father uses, if the insurance requires), you should have access to the pharmacy to ask any questions about the prescription. Please be aware that most nursing homes have delivery of prescriptions twice a day - am/pm and unless its an emergency the pharmacy won't deviate from the schedule.

3- Regardless of whether your father is self-pay or a Medicaid recipient, you and he deserve to be treated well and your questions answered in a timely manner. If you have a problem that the facility can't resolve, you can get the number of the Ombudsman and/or state agency that oversees your facility from a bulletin board in the facility. You can also call the Area Agency on Aging (http://www.dads.state.tx.us/contact/aaa.cfm) for the ombudsman that serves the area where your father lives.

I hope this was helpful.

Elliemae

elliemae   ignore (0)   2009 Jun 1, 1:50pm   ↑ like (0)   ↓ dislike (1)     quote        

So.... who is the pic of? Just curious.

elliemae   ignore (0)   2009 Jun 2, 2:08pm   ↑ like (0)   ↓ dislike (1)     quote        

http://www.ccld.ca.gov/PG477.htm is the website that will give you information about RCFE's in California (residential care facilities for the elderly). Laws vary from state to state as to the requirements for staffing, certification, etc.

There are franchises for RCFE's in different states - it's possible that your wife might not have to start from scratch by purchasing a franchise - info that the state office might have for you.

It can be rewarding to provide 24-hour care for the elderly, but it's also a lot of work. I wish you and her the best of luck.

elliemae   ignore (0)   2009 Jun 2, 4:05pm   ↑ like (0)   ↓ dislike (2)     quote        

Assisted Living Facilities, both large & small, offer options to people beyond traditional nursing home placement or in-home care. But you're well aware, as you represent an ALF company yourself. :)

elliemae   ignore (0)   2009 Jun 3, 2:18pm   ↑ like (1)   ↓ dislike (1)     quote        

I'm sorry if you volunteer in a home that leaves the "smell of death" on your clothing. You may want to rethink your community service options.

elliemae   ignore (0)   2009 Jun 4, 11:15pm   ↑ like (0)   ↓ dislike (1)     quote        

He doesn't have the live like us little people. He'll get a bail-out from a rich friend.

elliemae   ignore (0)   2009 Jun 5, 12:38pm   ↑ like (0)   ↓ dislike (1)     quote        

Angie97 asked:
Ellie, are you seriously afriad of being replaced by a middle schooler?

Why, are you looking for a job?

elliemae   ignore (0)   2009 Jun 5, 1:33pm   ↑ like (0)   ↓ dislike (1)     quote        

You might be waiting awhile...

elliemae   ignore (0)   2009 Jun 5, 11:42pm   ↑ like (0)   ↓ dislike (1)     quote        

Radio talk show hosts (and television, and internet...) all know what they're talking about. They're provided with top-secret crystal balls that are never wrong. Well, almost never wrong. Well, usually never wrong.

Do I, or zillions of Patrick.net readers, think that the bottom is near? Based on what I've read, I'd say no. But it's up to you whether or not you buy now.

The important thing is that you don't blame everyone else if you become upside down. Personally, I'd wait if the prices are still out of whack.

elliemae   ignore (0)   2009 Jun 6, 3:25am   ↑ like (0)   ↓ dislike (0)     quote        

They don't do anything. "marketing professionals" my ass.

elliemae   ignore (0)   2009 Jun 6, 3:27am   ↑ like (0)   ↓ dislike (1)     quote        

Perhaps he'll have to rent a place in downtown D.C. and live like the people he's representing...

elliemae   ignore (0)   2009 Jun 6, 5:24am   ↑ like (0)   ↓ dislike (1)     quote        

Stuff is found various different orifices all the time - when it can't be taken out people go to the ER.

How's about a huge (and I mean huge) sausage that had to be surgically removed? Glass/plastic bottles. Vibrators that are still humming along that were too deep to remove. Trailer hitch. Seriously, the ball on a trailer hitch. Hot dogs, bananas, etc.

elliemae   ignore (0)   2009 Jun 7, 2:41am   ↑ like (0)   ↓ dislike (1)     quote        

I refinanced in January (and dropped my rate 2%, whoppee!). The bank loan officer told me that she didn't know who would appraise my house, that another department in the bank will send someone out to appraise and that she isn't allowed to speak with the appraiser at all (before/during/after the refi). I liked that.

There's a Realtor in my neighborhood who walked down our street this week, was telling me that houses are still selling briskly around here and gave me an estimate of what she thought I'd get (urged me to sign a six month listing). Her "estimate" was $50k over the appraisal I received in January - and she told me that the repo across the street that's in tear-down condition didn't change my home value. She was the one who approached me, and had similar conversations with my neighbors.

What a crock.

elliemae   ignore (0)   2009 Jun 7, 3:51am   ↑ like (0)   ↓ dislike (1)     quote        

Wish he'd been able to hang on a bit longer, tho. It seems to me that he didn't realize how precious life is - one minute you're hanging in a closet with ropes around your neck & genitals with your hands bound behind your back, the next minute you're dead.

Seriously, there are people who are into many different types of sexual experiences and as long as it doesn't hurt anyone (unless they want to be), it's their business. But I do wonder how he was able to bind his own hands behind his back if it was an auto-erotic adventure. I don't think we'll ever get to know the full story.

This raises the question - if someone was with him, even though he was a willing participant, since he died are they responsible for his death?

elliemae   ignore (0)   2009 Jun 7, 4:56am   ↑ like (0)   ↓ dislike (1)     quote        

What the realtor meant was, "I will be homeless" if the house doesn't appraise for anything less than asking price.

Boycott realtors. They're high priced prostitutes and leeches on society.