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Discussion

falsifying documentation?

Wondering your thoughts on this issue.

Resident is at a nursing home, while the resident is on the toilet, I notice a rash with old crusted over blisters and fresh fluid filled blisters. You know working in the healthcare field, it is shingles and it has been there for at least a few days. However, the documentation from the few days prior say the resient's skin is clean.

Something is not right here...

Old crusted over blisters in addition to new ones is not equal to this happening over night.

The meeting with the Director of Nursing goes no where because the documentation from the few days prior to me reporting the shingles, say his skin is clean, and that is what they have to go by.

The meeting with the DOH came up as unsubstantial" because there is no way to prove the shingles was there from a few days prior. Even know there are the old crusted over blisters. The nursing home falsified their patient assessment on the resident, and that is not acceptable anywhere, let alone in the health care field.

The meeting with the Nursing Home and the DOH is a dead end.

Wondering your thoughts on this problem as well as being a pt. advocate

Featured Replies

My first question...are you a nurse asking about care for a patient or are you a family member of a patient? Did you contact the DOH on this issue but still aren't satisfied with the outcome?

  • Experts

Seems any discrepancies in charting issues were handled one way or the other by the DON/ADON where I have worked. I always thought that one of their responsibilities was to see that things got rectified, to the best of everyone's ability.

  • Experts
The meeting with the DOH came up as unsubstantial" because there is no way to prove the shingles was there from a few days prior. Even know there are the old crusted over blisters. The nursing home falsified their patient assessment on the resident, and that is not acceptable anywhere, let alone in the health care field.
I think you may have intended to say that the DOH investigators determined that the complaint you made was 'unsubstantiated' due to lack of evidence. That's the regulatory lingo used in the nursing home industry.

You've done what you could already, and did your 'bit' for advocating for this gentleman.

I'd agree with you that crusty shingles blisters do not suddenly appear from one day to the next. That's pretty obvious.

What you might NOT realize is with all this investigation, that certain individual nurses/caregivers are on the major hot seat IN SPITE of the DOH et al calling it all 'insubstantial evidence'.

There's a difference between legal ramifications (which your case didn't prove) and real-life ramifications, which are meted out by the Director of nursing on those staff who didn't check this gentleman's skin but charted that they did. You DID make a difference, just not a 'legal' one. Does that make sense? Not getting a 'legal' declaration of falsified charting doesn't mean you didn't get what this patient needed, which is for his nurses/aides to look more closely and not 'pretend' his skin is clear because the previous staff charted it to be so.

This isn't a terribly uncommon thing in long term care, unfortunately. I lay blame as much on administration who staffs their facility so poorly as much as the nurses and aides.

  • Author

Yep, family member. The DOH hand's are tied since they have to by the documentation vs the pictures I've shown to them.

Where I work, I've seen some chicken pox, nonspecific cellulitis, and as far as leishmaniasis.

I've asked multiple physician's their opinion on this skin outbreak & they agree that this could not of happened over 24hrs.

Emotions aside since it is my family member, a failed physical exam resulting in false documentation caused an extreme delay in antiviral treatment. It's unacceptable...plus seeing how the DOH cant do anything, gives me not much inspirit for the future of quality assurance.

  • Author
You've done what you could already, and did your 'bit' for advocating for this gentleman.

I'd agree with you that crusty shingles blisters do not suddenly appear from one day to the next. That's pretty obvious.

What you might NOT realize is with all this investigation, that certain individual nurses/caregivers are on the major hot seat IN SPITE of the DOH et al calling it all 'insubstantial evidence'.

There's a difference between legal ramifications (which your case didn't prove) and real-life ramifications, which are meted out by the Director of nursing on those staff who didn't check this gentleman's skin but charted that they did. You DID make a difference, just not a 'legal' one. Does that make sense? Not getting a 'legal' declaration of falsified charting doesn't mean you didn't get what this patient needed, which is for his nurses/aides to look more closely and not 'pretend' his skin is clear because the previous staff charted it to be so.

This isn't a terribly uncommon thing in long term care, unfortunately. I lay blame as much on administration who staffs their facility so poorly as much as the nurses and aides.

Thanks for your time in replying. It means a lot to know that there are some people out there who can get their heads out of all the charting and actually understand the real life outcome of what's physically in their presence.

  • Guides

I just want to say I'm sorry this happened to you. It may have been that they just didn't look closely at his skin and assumed based on prior assessments and perhaps he didn't complain of pain. In any case there is no excuse for it. You certainly advocated for him and I am certain made sure the staff there will be much more vigilant as a result. Best wishes to you and your family member.

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