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Marianne:
I'd either go to the faciliy and read the actual survey results, or obtain a copy from the state agency (below). The Dept of Health site indicated 26 deficiencies in 2010 - and that's alot. Remember, something that sounds serious might not be horrible so take it all with a grain of salt. On the other hand, there also seems like a lot of complaints, some of which were substantiated.

http://hfcis.cdph.ca.gov/LongTermCare/Facility.aspx?fac=090000076

Year: 2010
7 Complaints
2 Entity Reported Incidents
0 State Enforcement Actions
26 Survey Deficiencies

San Diego North District Office
7575 Metropolitan Drive, Suite 104
San Diego, CA 92108-4402
District Administrator: Carol Littler

Phone: (619) 278-3700
Toll Free: (800) 824-0613
FAX: (619) 278-3725

Counties Served
(Parts of) Imperial, San Diego North County

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San Diego South District Office
7575 Metropolitan Drive, Suite 211
San Diego, CA 92108-4402
District Administrator: Donna Loza

Phone: (619) 688-6190
Toll Free: (866) 706-0759
FAX: (619) 688-6444

Counties Served
Imperial, San Diego (cities south of Interstate 8)

Thanks Ellie Mae!

My Mom went there for a 10 day IV fluid follow up after an ER visit for a UTI.

She also contracted the following infections while there:

C Diff
Scabies
A second UTI
A wound on her backside

So after being there 2 months and being discharged she is back in the hospital being treated for:
Scabies
UTI
Wound They discharged her in that condition! Unbelievable!

And now the hospital wants to discharged her to another SNF.

Only this time she will be paying out of pocket because of the 60 day eligibility rule...

Does anybody know where the info online is for daily costs of SNF? She might have to stay 1 or 2 weeks and I am going to make sure that I look at the SNF ratings before I choose one.

The hospital is trying to rush me.

Normally, she lives at an Assisted Living Residential Care Home, and I am looking into finding a better one for her because this one has deteriorated in the level of care they provide this past year.

Your mother should be able to go to a snf and pay the daily private rate - whatever that is - and supplies only. If she has a wound vac, that could be expensive (and perhaps not necessary), and all this might be confusing for your mother since she has been in/out of facilities and moved around in the recent past. Are there smaller group homes (2-3 residents) that can provide a higher level of care and be supplemented by a home health nurse under Medicare hhc benefit?

Marianne, it seems to me that you need some help - actual consultation with someone to develop a plan of care for your mother. Have you heard of private case managers who can help you figure this out? There's a fairly new field called Geriatric Care Management, where you hire someone to guide you in making decisions for your mother.

Here are a couple in your area I pulled off the interwebs:

http://www.seniorcaremanagement.com/
This one employs Social Workers, which is my personal bias. I believe that SW's are more well-rounded than RN's when it comes to these issues. Once again - my personal bias. I'm sure these other agencies can help just as well:

http://www.innovativehc.com/about.html
http://www.jfssd.org/site/PageServer

All are based in San Diego. You'll want to call them asap. The hospital will rush you because your mother doesn't have an acute need and she's racking up thousands of dollars per day in billed charges for which they'll never get paid.

I should have mentioned GCM's sooner - didn't think about it. Let me know how it goes - and tell 'em about my book. :)

Thank you Ellie Mae!

My Mom just had to switch insurance plans this year due to her former employer switching from Calpers to save money on costs. She had a choice between Kaiser Senior Advantage or Anthem Blue Cross Senior Secure HMO. I chose the latter for her.

It is a very large group plan, which medicare is secondary. I believe it is a managed plan.

All very confusing, but overall a very good plan. She is in UCSD hospital now, however I changed her group to Sharp due to personal reasons (Dr's stopped her Aricept without my consent; she moved from ER to one floor to a different floor and I did give them the med list, but somehow they decided to stop it or got mixed up.)

Anyways, tomorrow is my day off, I will call up a few of these Geriatric Managers.

Her Residential Care Home really is not set up for wound care, and has become mediocre over this past year, high caregiver turnover...

I have contacted a service to look to see what is out there for my Mom to move from that place.

Thanks again!

marianne says

It is a very large group plan, which medicare is secondary. I believe it is a managed plan.

If your mother has a Part C Advantage Plan, their rules are different. She must go to a contracted provider SNF in order to receive any covered services. Their pharmacy rules might be different too - most nursing homes order meds from a commercial pharmacy and it's only after you get slammed with a huge bill that you find out they're not contracted providers for your insurance plan. I'd have to know a bit more - but if she's managed care the rules change a bit. I'm sure the Care Manager you choose can help you understand all this - and she might be able to help you locate a new place for your mom.

It's crazy - all the ins & outs of the insurance and nursing home biz. Even tho it's my job security, it's so complicated that even professionals don't completely understand it. I wish you luck.

Is part C Advantage Medicare? She has A and B only.

I think her Anthem is a managed care plan.

Her coverage for ambulance is 0 copay.

Her coverage for Er/Hospital is $50.00 admit/$50.00 discharge.

So, essentially, she could stay there a few more days while I figure things out, she has a wound so they cannot just discharge her.
They are turning her for wound care too,anf giving her antibiotics for the UTI for follow up treatment.

I am her Health POA, but I did not sign for her either.

Thanks to you, Ellie Mae!

marianne says

Is part C Advantage Medicare? She has A and B only.
I think her Anthem is a managed care plan.
Her coverage for ambulance is 0 copay.
Her coverage for Er/Hospital is $50.00 admit/$50.00 discharge.

She has A&B - but her medical benefits have been assigned to a Med C advantage plan. She pays a monthly premium (or doesn't depending upon the plan she's on) and her part D drug plan is bundled in there. The part A/B copays for ER is higher than the amount you listed, which verifies she's managed care and her choices are severely limited. You've got an insurance case manager who will be forcing you to move her, or the wrath of the plan shall fall upon you.

Time is of the essence. They'll move her with, or without your permission.

Yes, they actually can just discharge her to a lower level of care, part of the managed care agreement she signed onto. Her needs aren't acute, they're sub-acute and can be managed in a snf or at home with home health assistance. Even the antibiotics (abx) can be administered in a snf or acute rehab if it's IV abx.

Good luck.