I read this, and even knowing what LTC facilities are like, even I am shocked, and that is saying something.
I work for a 911 dispatch center for EMS in Florida. Last night a recieved a call from and assisted living facility. The person on the phone was asking for lifting assistance for a patient that had fallen on the floor. I then asked if there was a nurse on duty that could come in and help the patient up off the floor. The man told me there was no staff on duty. This was around midnight. Assuming it was the patients roomate suffering from dementia, I called the main line number to the ALF. The same man answered the phone and told me he was the only one there. Of course we sent out an engine to assist the woman and when they got onscene they said there actually was NO staff on duty! The man who answered the phone was a maintenence man.
We promptly sent a deputy over there to see what was going on. The maintenence man explained to him that he was CPR certified and had been authorized to watch the pts for a full two hours every night when there was no staff on duty. The deputy wrote an information report and called us back saying he didnt know enough about nursing home laws to make any criminal charges.
So my question is, is this legal?? Do assisted living facilities have seperate laws than nursing homes do? Is this something I should report? I know if that was my mother and there was no qualified staff on duty for any amount of time at any hour I would be outraged.
Just another note, the deputy was told by the maintenence man that the patients he was supervising were "independent livers" and at low risk of injury during the night. The deputy told me the lady who fell out of bed was 98 years old. And who knows how long she was on the floor. Can she really be an "independent liver" if she was on the floor unable to get herself up?
A great resource to obtain information about the licensing laws in your state is to contact your local Area Agency on Aging. Every county in the US has one. Sometimes they go by the title Area Agency on Aging and at other times they may be listed as Department on Aging, Commission on Aging etc. Whatever the title, they all have a Senior Information and Referral line which is listed in the Blue Pages section of your phone book.
Specializes in Education, Acute, Med/Surg, Tele, etc.
"Families are told specifically what they can expect, so let's not paint the facilities as being the bad guys here."
This is very very true..outlined and signed...but the probelm is they don't GET IT! People still assume grandma or grandpa has a 24 hour nurse caring for them...nope! I have enough time in a day to do my cbgs, b12 shots, clean out O2 concentrators, skin treatment (but must admit my facility is the BEST with skin care..no decubes in our facility! YEAH one good point..LOL!), and chart it all...one emergent situation and I am at a serious loss for time! Caregivers must give the direct patient care and nurses handle acute situations, injections, and complex dressings, take in orders and get them to pharmacy, MAR entries, Med room/cart audits, TB and HEP shots for staff and residents, and still have time to answer tons of questions from Caregivers about meds.
One very nice thing is hospice and home health involvement in our facility! We do illicit folks to have one check in with their residents when there is a change of condition or hospice qualification. And they really do help! Our staff is trained to work closely with them, and communicate almost daily, and they are required to chart daily with VS to keep them in tuned :). Boy they are really a help in our facility, and I think it should be mandatory that all residents that have a certain amount of dependance on staff should have one come in weekly or even bi monthly if there is no real change of condition and are stable.
Yeah, I am not sold on these places yet, but I must say I truely believe that without the hard working staff where I work...most of these people would still be at home with no one to help them (I live in a very rural area)...possibly dead from not going to the MD, or taking their meds right..or even forgetting to turn off the stove...forgetting to eat...not taking their cbg's or insulin..you name it. SO I stick with it for now, because I believe that with me as a part of the crew, these people have a good gal on their side...even if my help is limited at times.
I just can't wait till they get a nurse so I can quit being a floor nurse (I was hired for education/paperwork/QA/Chart audits/etc) and get back to doing much more education for the staff! I have a ton of ideas of course...but my latest endevor are about recognizing skin issues before they happen, ways to spot spousal abuse with the elderly, before and now...emmotional struggles of the elderly, blending in to your new home, and Diabetes..it is more than sugar!
HOWEVER...I really really appreciated this question!!!!!! People don't quite know what "assisted living" is all about....and it is rather nice to point it out. I had NO CLUE what it was...thought it was a fancy word for "rest home"..but no, very different. So clearing some misconceptions..and hearing other peoples concerns about it is very good for me..since I have the exact same concerns! My facility, despite staffing issues and admin allowing residents they really SHOULDN'T into the facilty..it is really top notch, but I like to think I can help to make it better somehow before I go (which I will once my house is built and I can find a job with the same pay...I get awesome pay where I work, which is not typical of assisted living!).
And heck yes...have like 20/20 do a news report on the differences of assisted living vs nursing homes! Not a 'lets tear them up deal' per say..but more of an informative look at what they really are, and what you should consider before choosing one or the other. And what to look out for when applying...the people that get residents to live in these places are salespeople for the company just like selling a used car...I have seen them at work, and I have a hard time not shaking my head..they do embellish a bit (like simply saying 24 nursing staff...okay that means in their policy CNA's and a nurse..but they don't tell you it is ONE nurse [LPN or RN] for the ENTIRE facility, and CNA's doing everything else! What sounds better??? That or '24 hour nursing staff'???). I am all for it...maybe it will start a trend of getting patients that can handle assisted living in, and keep higher medical need and dependance towards facilites aimed and staffed for that type of care!
Ross1
112 Posts
A great resource to obtain information about the licensing laws in your state is to contact your local Area Agency on Aging. Every county in the US has one. Sometimes they go by the title Area Agency on Aging and at other times they may be listed as Department on Aging, Commission on Aging etc. Whatever the title, they all have a Senior Information and Referral line which is listed in the Blue Pages section of your phone book.