Long Term Care, Part 3



The numerous complaints called into a state office is usually held until survey time unless there has been harm or potential harm to the patient.  One or more surveyors will go to a facility and pick a number of residents including the one the complaint
was about.  Trying to prove a complaint can be very difficult.  Let’s say mom told you they are not changing her at night and she is laying in a wet bed all night long.   First thought  you have is, how dare they do that to my mother.

You go to the Director of Nurses and you tell her the staff is not changing your mother at night.  She then tells you it will be
taken care of.  She instructs her staff in checking and changing the patient’s every two hours.  It is well documented in the patient record.  You go back in a few days and mom tells you the very same thing.  This time you are livid, and you will take care of it, so you call the state and complain.  Unless the patient has a bedsore, the state will probably hold that complaint until the next survey and then look into it.

So now you are frustrated because you think the state doesn’t care and is just blowing it off.  Finally the survey happens and someone from the state calls you and tells you that your complaint is unsubstantiated.  You just can’t understand this at all because you know they are not changing mom at night.

Let me explain a little to you about what has to be looked at, and what has to be there in order to prove your allegation.

1.      Mom’sinitial and subsequent evaluations has your mom coded as incontinent.

2        Does your mom have any skin break down.  Has she had previous breakdown and if so did it heal properly.

3.    Has your mom had any urinary tract infections.  Females tend to develop UTI’s more frequently if not changed.

4.    What is your mothers mental status.  If the evaluation the facility has completed, has her sometimes confused, then that can be one of the factors that will cause a complaint to be unsubstantiated.

5.     What documentation does the facility show on her record.  They have shown the patient is checked every two hours and dried when necessary.  The argument can be, it is not our fault we go in to change her and she is not wet, and then after we have gone she wets on herself.

Unless you can prove beyond doubt that care was not provided.  You can’t substantiate the complaint. On the other hand let’s say mom developed a really deep bed sore from lack of care.  The facility can be given a deficiency.  They would be required to fix the problem for the person named in the complaint, and anyone else who could be affected.  They would have to devise a plan to make sure it doesn’t happen again and who will be monitoring do make sure it doesn’t happen again.  This is all put on a form on sent to the state and the federal government.  Usually within thirty to sixty days someone will go back in and make sure the plan was put into place and everything is done appropriately.  If it is not corrected then fines can be put in place by the government.

If it is never corrected to the satisfaction of the state, then the facility can go into the process of being shut down.  Sometimes, facilities will sell and the name will change and all of the previous problems will be wiped clean.  The new facility will have an opportunity to go through the whole process from start to finish.  If they took care of it, then all is well.

The Nursing Home Association has a very powerful lobby in Washington DC.  They keep a lot of rules and regulations from passing they feel could harm the industry.  As you can probably surmise, the care of our geriatric population is very omplicated.
It is overrun with many problems and it’s a constant struggle.

I don’t want anyone to misunderstand my feelings here.  I know there are some very good facilities in this country that take excellent care of their residents.  They have loving caring staff that does what it takes to provide the needed care.  I also know they are facilities I would not let take care of my dog, much less one of my loved ones.

I am fortunate in that I have a family of nurses and care givers and my parents or one of my immediate family will not go to a nursing facility.  I know everyone does not have that choice.

Be planning ahead, and if you have to find a facility then  look at it very seriously.  The years previous survey has to be posted for public view, that is law.  Look at the survey, go at different times of the day and observe what they are being served at meal time.  If you enter the facility at 9:00 in the morning what does it smell like.  You are always going to have some odor on the hall just because of someone being changed at any given time.  It should not remain in the air consistently.  How clean is the facility kept?  Are people sitting around in wheelchairs parked in front of the nurses’ station?  What type of activities do they have going
on.  Are they appropriate for the mental and physical abilities of the patients.

This is only the tip of the iceberg, and I hope and I have give you some information you can use, as well as educate you a bit.  We have some major problems to overcome, when it comes to the care of our geriatric age group.  It takes a very special person to go into long term care and stay.  We have to do our best and keep striving to make things better for those who can no longer
care for themselves.






About shirleymclain930

I'm a retired RN enjoying my retirement to the fullest. I liked adventure and travel and making friends. I have 6 dogs and 1 cat. They are like having a house full of three years olds. Now for the rest of the story. My Granddaughter and her husband now live with us and they have 4 dogs and 4 cats along with a giant Flemish Rabbit. My Granddaughter has now added beautiful, Olivia to our household. My fourth Great Grandchild. They are a large part of my life and I can't imagine them not being around. I spend most of my time sitting in front of my computer working on my latest book or talking about Essential Oils. On the personal side, I'm married to a wonderful man who spoils me and I love it. I am very much a country girl. I love living on our 5 acres on Pole Cat Creek watching the deer and other animals occasionally stick their​ heads out of the trees. It's a fun life.