Substandard care in asst living

Nurses General Nursing

Published

Hello to all...Hope you all have had a better day that me. Where to begin, I am a Homecare r.n. and have this one facility that I must go in. The place has never been good since I first walked into it 4 months ago. The patients I am there to see are for the most part decubitus of buttocks due to incontinence and poor care . One patient who is diabetic would be found in a wheelchair leaning out of it, I would support her back up with pillows and after I would leave, she would end up back in a severe lean position. P.T was ordered and I finally got them to get her out of that chair and even eggcrate placed behind her. The point is, way before I started seeing her, she would sit for hours in this chair crooked, a wound to her scapula was created. It cannot heal because of her poorly controlled diabetes. They write down they test her 4 times a day, but I have gone it at 11am and they were just getting her up to breakfast. I told them the late breakfast is not good for a diabetic...Then I see them take ppl totally soaked in urine and put another dirty shirt on them never even washing their backs off. Fungus under breast and groins...AND ALOT MORE...AND YOU CAN BE SURE I EDUCATE WITH EVERY VISIT AND DOCUMENT! The other patient I have there has almost 7 decubes, she is never clean when i see her, duoderm is never on when I change and clean her, Its like impossible to heal her. She sits in a hard chair, she refuses to keep her legs up or sit in another chair, of course these folks have dementia.Then at this same place where the aides spend more time outside smoking than doing anything, they get a resident with a trach, which of course I have because he is new and they have no nursing there but homecare. Sure enough, someone dipped into his percocets over the weekend, but I only know this because I overheard it. The pharmacist called when I was there and said he sent 50 out last week and will not refill them yet. So today was the big day, I told work at case conference this is abuse and neglect and they knew about the care here for years, but they keep taking the money...MONEY MONEY MONEY. So to my surprise our administrator sent up a nurse who knows the ppl who own and run this place and warned them that anytime we see substandard care we will fill out a paper writing about what we found(on any pt, not just who I am there to tx), keeping a copy for ourselves, and if things don't change we are outa there. This is all good but really, will this place ever change??? And of course, I being the nurse who visits the most will now be looked upon as trouble. Its a mess...what do you folks think???? thanks for listening:) ann

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Shoot, no responses yet:( Also, forgot to mention this place was reported to the state several times just in the last year, I heard mostly by disgruntled employees, and they passed all inspection, of course they knew when they would be in. Wondering why a red flag has not gone up high enough to warrent a surprise inspection????

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Specializes in Critical Care/ICU.

You might try posting this in the LTC/Geriatric nursing forum.

Just a thought.

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OH thats a good idea...thanks for answering :)

You might try posting this in the LTC/Geriatric nursing forum.

Just a thought.

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good for u for your excellent nursing. I am sure the people who work there will be angry, but don't let them get to u. They have been neglectful and shouldn't be working. write them up for all the "smoke-breaks."

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Did you report to Ombudsman?

I cannot imagine how they are passing inspections.

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That is horrible. In my state they are cracking down on assisted living/ personal care homes. These places are licensed by the state and should be inspected. An annon call to the state or ombudsman could help. What about the families...are they aware? I know we have to notify families with every little change in status. These people are totally not appropriate for Asssisted living...they are LTC/ skilled residents.

As far as the Percocets missing..you definalty would/ should get a response from reporting it to the state or DEA. Yep....the DEA gets involved in these type of cases...or even the BON might help.

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Thanks michelle for your input....I have not heard anything about the missing percs, appearently the administrator called the police even. I walked in there today to see 4 patients and here is how my day went down.....first I was greeted by the nurses aide who tells me my one pt(the one who had the percocets stolen) is now claiming he was beaten at 3am by a nurses aide on midnight, and locked in the elevator. He even wrote up a letter and signed it. Upon assessing him, sure enough he was in need off xrays. Although there wasn't a witness, he states this all happened and more. Including unable to catch his breath( he has a trach on 10L ) SO, had to go down and see what they were going to do about this. Pretty much told they are taking it very seriously and already reported it to area on aging along with calling employee.

The next patient was covered in urine from her head to her feet. I knew she had this outfit on friday and notified the adm about this also. She was on the phone calling another aide about doing poor work on nights.

The next patient , who I was told they just got her up and changed need a new duoderm on, of course she was full of bm, didn't look to be new.

Last but not least was one of my favorites. She is the one who I caught them feeding her breakfast at 11am, then taking her plate and setting lunch in front of her, she has NIDDM. Now that I have them understanding the importance of regular meel times, I noticed gaurding, sure enough, looks like another...YES another fracture of her shoulder.

I called my company to report all this. I was so sick in my stomach I could just vomit. They told me that I should not worry about anything, I got all the xrays ord, did all I could do. But yet, I feel so sorry for these ppl . The owner of this dump has not been in, he has just moved into his million dollar home. How he can sleep at night I will never know. These families of these ppl seem to turn the cheek. They seem to be all residents that are just dumped off. OH and one more, the one patient I seen needs fed, a hospice nurse told me she seen this ones son go crazy sat, he is actually one that cares. Would you believe he walked in his mothers room and found the aide sleeping on her bed while she was sitting in the chair(she is blind) waiting to be fed......NO ONE KNOWS HOW TERRIBLE IT IS TO SEE THIS UNLESS THEY HAVE BEEN THERE :(

That is horrible. In my state they are cracking down on assisted living/ personal care homes. These places are licensed by the state and should be inspected. An annon call to the state or ombudsman could help. What about the families...are they aware? I know we have to notify families with every little change in status. These people are totally not appropriate for Asssisted living...they are LTC/ skilled residents.

As far as the Percocets missing..you definalty would/ should get a response from reporting it to the state or DEA. Yep....the DEA gets involved in these type of cases...or even the BON might help.

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Specializes in Vents, Telemetry, Home Care, Home infusion.
Pretty much told they are taking it very seriously and already reported it to area on aging along with calling employee.

In PA part of our state practice act requires each RN to report suspected abuse to DHS for children and state area of aging for adults over 65. Those between age 21-65 are in limbo unless facility is getting medicaid funds.

Please discuss with your supervisor tomorrow as YOU should also be reporting exactly what you stated above.

I've been an ombudsman in my county and only after 1-2 years of reports, failure of facility to take corrective action, reinspection etc was several facilities in my area closed. Finally after several years of one owners' different facilities being reported MEDICARE took action and striped owner of any ablity to own or be involved in Medicare system.

Good luck to you. Keep us updated.

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Thank you karen....What they told me was if things did not improve we would pull out of there and my adm from homecare would report them. I just feel that this has gone on long enough. Did you read where the last inspection they had , they have reported that they found ZERO violations...How can this happen??? Do they not read the charts and see all the decubitus wounds ect.... but thank you very much , its good to know someone is listening and understands what I am seeing.

In PA part of our state practice act requires each RN to report suspected abuse to DHS for children and state area of aging for adults over 65. Those between age 21-65 are in limbo unless facility is getting medicaid funds.

Please discuss with your supervisor tomorrow as YOU should also be reporting exactly what you stated above.

I've been an ombudsman in my county and only after 1-2 years of reports, failure of facility to take corrective action, reinspection etc was several facilities in my area closed. Finally after several years of one owners' different facilities being reported MEDICARE took action and striped owner of any ablity to own or be involved in Medicare system.

Good luck to you. Keep us updated.

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Oh my goodness, I feel so bad for you but even more so for those poor residents. I agree with Karen this is something you MUST report YOURSELF. Each of us is responsible for what we see. I can not believe your agency is doing nothing but threatening to "pull out". For heavens sake these folks are in immediate danger. Something needs done NOW. I am glad these folks have someone like you who cares enough to want to do something about this situation. Good Luck to you.

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steelcityRN, I also visited a facility that was abusive and neglectful to its residents. The owner was a man in his 30's that was very wealthy, he opened another facility in a nearby town that was as bad as the first. After repeated reports were made to the state and Adult protective services, both facilities were shut down and his ability to license anymore was taken away also.

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