Mother's hip fx in nrsg home

[CaliNurse]

PappyRN,

I CAN'T BELIEVE THIS !!!! I AM FLOORED!!! IF I WERE THERE I WOULD BE SPITTING FIRE FROM MY MOUTH !!!

There are very clearly SEVERAL issues here. Of course the first one that sticks out with neon lights is NEGLECT AND PHYSICAL ABUSE.

We all know what that is. However did you know that medicaid PAYS the LTC facility for a 7 day bedhold whenever the patient goes out to the acute facility ?????? Medicare doesn't but Medicaid/Medical DOES. WHY DID THEY CHARGE YOU? Get you money back.

I am sorry but when I was done with this facility I would probly own it !

Forget the other owner. He may have found out he was indirectly involved with this LTC facility.

CALL the Ombudsman. This is their specialty !!!!!

Everyone there IS a MANDATORY abuse reporter. Don't take pitty on them for the place they have put themselves in. In California if an Administrator has failed to report abuse or has prevented anyone from reporting abuse it is a CRIME punishable by 6 months in jail and $500.00.

The bitc_y RN who is no longer working there is not off the hook. She is also a mandatory reporter. The CNA, everyone who has been involved with her care and has not reported it.

You have to find the strength from somewher and make these people answer for what they have put your mother thru.

When abuse results in great bodily injury the fines and jail time go up.

In my facility if the patient needs eyeglasses, hearing aids, splints, dental work, whatever we eat it as we only get a set fee for their admission. THEY MUST PURCHASE THE HEARING AMPLIFYER.

Stop approaching this facility to correct these active deficiencies. DOCUMENT, DOCUMENT, DOCUMENT, DOCUMENT, everything, everyname, every detail. Don't worry about the statue of limitation you have time. Get the Ombusdman involved. They are not there for the facility. They are in a way an extention of a survey team. I would also take pictures of your mom with these bitc_es in the background. This way you can identify them easily to others if needed.

You mother deserves the be turned, to have her teeth brushed, the have thick it proportioned correctly. Hey, thick it.... has anyone read the label lately ??? Our supplier has the consistency proportions RIGHT ON THE CAN ....... I guess that was for stupid people so they don't have to guess. A fracture .. physical abuse. Did they even call you to inform you or did they let you find out when you came in ...... F tag 157 "notification of change of condition" Did they notify the doctor, family and resident of each and EVERY change of condition.

To leave her alone is an act of neglect. To shut the door even know she is toileting can be isolation since she is unable to move on her own. Not providing basic care ... neglect. Not giving her the appropriate pain releif ..... neglect! Even if they are medicating to the max of what was ordered they have the responsibility to call the doctor and get the appropriate pain relief meds. Pain the 5th vital sign!!!!!!! Regarding her lost ROM - In her quarterly MDS they should be measuring the joints each and everyone of them. How can they state if there has been a decline or improvement of ROM???? New pressure areas = neglect !!! Not following a physicians order for the amplifyer is a delay in treatment which is neglect.

I would get the ombudsman there pronto. They are patient advocates!!!!!! not facility advocates !

Call the numbers given to you here by the other people who posted messages. They are right on target. Call the newspapers, radio stations, tv news programs, ombudsman, state licensing, medicare, medicaid - (double billing for a bedhold to you and medicaid is also fudiciary abuse and fraud), JCAHO, Adult protective services, and anyone else who can help you.

That place will shatter to the ground when they get these people in to survey them at the same time.

In California I can look up the facilities and see how many deficiencies that had on their surveys. Do this --- you can see what their bad habits are.

If you have health problems now you may end up in this place one day. If your family has responsibilities that prevent them from being able to care for you it could happen. You have more than one reason for doing this.

Please sound the alarms !!!! In order to recieve Medicare each facility must adhere to responsibilities in the Medicare contract. The same applies to Medicaid. This is what gives the surveyors the right to come in and survey us.

They should feel like your mom is contributing to their paycheck and retirement. They are lucky that I am not there.

I am usually a very calm, cool headed person. NOTHING FIRES ME UP LIKE ABUSE DOES. This summer in California we were sent an inservice from the department of justice, office of attorney general. The topic was "Your legal Duty - Reporting Elder and Dependent Adult Abuse". Some of the examples of abuse given are actually things you stated happened to your mom. Even not providing your mom with the correct consistency of fluids is abuse. I know what I am talking about. Since June I have given approx 20 inservices on this. The class is one and a half hours long. It was very simple and straight forward. Abuse is illegal and will be prosecuted. I would also call your district attorney. Print out your posting to use as part of documentation. You have it all there.

I am so upset that I can't think straight, And it is late here. Please keep up informed as I am sure we are all astonished by this. This gives us all a bad name to think there are nurses out there who are capable of this.

good luck and check back anytime you need more moral support we are here for you and your family.

Cali :)

[jnette, ASN, EMT-I]

Pappy..

As the others have already stated, reading your posts was heartbreaking. It is truly a nightmare. I see it so many places and it has always infuriated me beyond words. It simply makes my blood boil. I just don't understand how these people can live with themselves, much less sleep at night. Do they not know that they, too, may someday end up in the same place? Would they want to receive the same LACK of care, respect, concern and tx.?

I'd better leave it alone...I could ramble on about this for weeks.. has always been my pet peeve. Such injustices are beyond my ability to comprehend.....totally inhumane. I just don't understand.

:o ((( ))) to you, your sis, your mom.

:kiss

[VivaLasViejas, ASN, RN]

Pappy: I'm a resident care manager in an Oregon LTC facility who would be THRILLED to have your mother in my unit!! Since that's theoretically impossible, however, I would advise you to contact a geriatric care manager in your area to help you find an alternate placement. You MUST get your mom out of that snake-pit of a nursing home, and the company that owns it must be forced to fix it or shut it down.

These are some of the most egregious violations I've ever heard of in this day & age, and if you'd had decent legal representation you could've probably OWNED that place by now. Just because your family isn't filthy rich, does not mean that you have to "let them win". Please, don't give up!! You can get help from your state Legal Aid, the Ombudsman's Office, and if they aren't helpful, you can write to your state Governor and legislators. Your mother's right to live out her final season of life with dignity and loving care MUST be respected---all state and federal regulations are designed with that in mind. Use them!!

[pappyRN]

Hello all and thank you for your suggestions. The situation at present is better than what it was before.

To make a very long story as short as possible, my sister and I have now spoken with 2 law firms who handle elder abuse cases. They have both declined to take the case due to Medicaid and the fact that it would have to be reimbursed for all care. They said they did the math and that it wouldn't be worth the little amount of money that would be left. I also did the math and my calculations come up - greed on the part of the attorneys. For now, we will not even consider legal action because it really upset my Mom and she is afraid of repercussions.

I took the advice given and I contacted the state Ombudsman office. After explaining the entire situation the lady got me all fired up about the 'violations of your mother's rights'. This recent call came as a result of my Mom getting moved from her room which was a Medicaid/Medicare swing bed to a regular Medicaid bed with a nightmare roommate. I was told that she should have been asked if she wanted to move and if she said no it was a violation. Also, there were some CMT issues such as why was my Mom wearing THREE nitro patches at one time? This happened at a time when her doc had just ordered Duragesic patches for pain from her hip fx. Any surprises that her bp plummetted? I removed two of the patches and gave them to the evening supervisor. She promised to take care of it and SHE did. A few days after that I went to visit at 12:50pm and her patch was just then being applied for the day. It is a nitro patch scheduled for 8am application!

So, to get to the crux of the whole story. The ombudsman lady agreed to talk to the admin. with my sister and I. I was prepared to do battle as she had told us of so many violations. Well, this was a bust. The entire time the ombudsman stood up for the ADMINISTRATOR even at times telling my sister and I to be quiet and to let the other lady talk. We never did get to discuss the entire matter because we were being silenced. I passed a note to my sister at that time and told her I was finished and was going to leave. She agreed.

We have reached the point that we will put this in God's hands. We had the opportunity several weeks ago to discuss our concerns with the nurses on evenings. They have absolutely been wonderful to Mom and to us. I feel so much better that they are looking out for her. They even apologized for going along with the previous b_ _ _ _h who left the facility. They have done a complete turnaround. There is a new GN, correction RN, she just got word of passing her boards yesterday, that has been wonderful. She is compassionate and such an advocate. She puts my Mom to bed in the evening HERSELF instead of the CNA. They have made every attempt to correct and prevent the wrongs.

As far as the Ombudsman is concerned- that was a complete waste of time. She was clearly biased in favor of the home. In fact, she did a complete turnaround from what she told me on the phone. My sister and I felt completely abandoned like sitting ducks. Sis was so p_ _ _ _ d about the Ombudsman that she told the Administrator EVERYTHING the woman had said to me on the phone. Including the words " I don't ususally do this but I am going to supply you with the names and numbers of threee really good elder abuse attorneys". We are in the process of writing a complaint to the director of the State ombudsman program. She was worthless and I will never call her or Ombudsman again- no matter what.

It is clear to us that the legal route will not pan out. In fact, we have given up on it. As far as the state surveyors- what a joke. They always seem to know when they are coming. They just had their annual review. It was almost funny. I happened to be there when the surveyors walked in. You wouldn't believe the action that took place before the surveyors even put their things down in the conference room.

To be honest, I have very little faith in the system from what I've seen. When I reported a previous nursing home for 37 allegations they were only cited for 3-4. Do you think that they sat around and talked openly about my Mom when the surveyors were there? Of course not. They aren't that stupid to do that with the surveyor sitting at the same nurses station. The point is that many of the allegations were things that they knew they were supposed to be doing but didn't bother to- UNTIL the surveyors were there. They knew immediately which patient the call was generated about. My Mom's bathroom and patient room were shining before they even got down the hall. They must have a secret 'red alert' when the state arrives!

Getting back to the present situation. We have discussed this with my Mom and she just wants peace. We have installed a phone for her and programmed it to autodial her children. She now calls us when things aren't what they should be. There has been a remarkable turnover in staff. This too has made a difference. A CNA told us she was warned to watch out for us and to do everything right because as they told her the "one that's a nurse is mean and sh'e a b_ _ _ h'. At first that really bothered me. I wouldn't have to confront if they did their jobs. But now, I kind of like it. It keeps everyone on their toes and my Mom is getting very good care. There are still problems but they pale in comparison to what they were. My sister and I visit three times per week. My aunt takes another day, my brother(nerd) takes one day, and my children cover the other two days.

Sis and I visit together because we never know which one will be in any shape to drive. It's a day to day thing regarding driving.

My Mom suffers daily pain as a result of their stupidity but she has decided to forgive them. If she can then we can and should for now. It may be different after she passes. For now and for our health, peace is a better alternative. Chronic pain doesn't lend itself to tolerating conflict as both my sisters and I know.

Each evening when her nurses have supper they wheel my Mom up to the table with them and share their dinners with her. When they order out they let her order out, too. We have given her a stash of money to pay for her food. The food at the home is disgusting and she was starting to skip meals rather than eat. This is a great alternative. We also try to bring in food from home and things she likes. She is a Sicilian Italian and can't get enough tomato sauced items to suit her. They say they have grown to love her and love to interact with her because she is so sassy and feisty. She is one of the few 'with it' patients that are on her division. They have also helped by trying to get her to implement the things that speech therapy has suggested to increase the volume of her voce. It is still hard to hear and understand her but you get used to it and it works out.

The facility has ordered ONE voice amplification system for use by any pt in the facility, stressing it is NOT just for my Mom. It hasn't arrived yet. We'll have to see what they do when two people need it at once. Thie fact that the order for it was written on May 17, 2002 and that it had not yet been implemented was brought out in our mtg with admin and ombuds. The administrator knew we had her at that point- at least on that subject. She ordered the staff to make it a priority. I will say she tried her level best to get out of taking blame to the point of getting frantic because she couldn't reach the speech supervisor. She tried her best to make us look wrong but ti flew up in her face big time. You should have seen her when she couldn't get a response from speech. She actually SCREAMED " I order you to find her and even if she left I order her to return to the facility at once!". Wow,she really lost her cool. The funny thing is she was saying this to the DON. The DON is her DAUGHTER!!!

We realize that we will have to kiss her butt and always make her look powerful and in control. She told us she wants us to come to her personally to handle each situation. So, we have. She's been as nice as pie lately.

I thank each and every one of you who has shared comments and suggestions. In a perfect world this nursing home would have to answer for these things. In the real world at least in my state, it doesn't happen. It is obvious to me that the nursing home industry is one hell of a powerful lobbying group. They have to be or many of these things wouldn't be allowed to happen. It's a big business and my eyes have been opened wide. The system lends itself to so many flaws. Most employess know that the state surveyors are there as they hit the door. Unless they are totally stupid they are not going to engage in behaviour that gets them cited. So, when complaints are made they aren't substantiated in a lot of cases. In one instance in my Mom's case there are FORTY TWO days of nurses notes missing. The explanation I received from one of the day nurses was" well, maybe there wasn't anything to say".

My state didn't even close down or really punish the nursing home that allowed 4-5 residents to roast to death without air conditioning. My complaints look petty in comparison to those poor souls. I am too sick and worn out physically and emotionally to take on something that is just too big to fight.

Warm personal regards and again, many thanks,

PappyRN

[Youda]

PappyRN, you brought tears to my eyes and such a sick feeling in my heart. Having worked in Missouri homes for the last 8 years, I wish I could tell you that you are wrong. But, I can't. Everything you've said is true. I've spent the last 8 years of my life trying to fight this kind of thing. It can't be fixed from the inside, either. God bless you and your family. Especially your Mom. And God help us all if the nursing home industry doesn't get changed.

[renerian, BSN, RN]

This is a good example of why I quit my job to care for my father. No one else can care for your family like you......

Also you just cannot turn off the nurse in you. It is automatic.....

Hugs to you and prayers to your mom,

renerian

[sandyth]

I am a CN at a long term care facility. We dont leave our toileters unattended for a moment! If they fall at all, all ROM are performed and even if I suspect head injury neuros are started immediately. If they complain of any kind of pain neck down, I call the MD and have them sent out for x-rays. The pfacility sounds very negligent!!!!!! I even had a confused ladty fall trying to get out of bed, bad head injury; called MD and sent to ER for CAT scan.