Some good advice from HealthCare Review- New England Edition.

What difference would it make in your health care facility if morale was even better, if all departments treated each other as valued internal customers, if labor and management saw each other as equals and allies, and if everyone had a “how can I help out?” mindset?

This is valuable for CNA’s…who tend to bicker and banter more than others who work in nursing homes…

What can you do to spread goodwill?
Regardless of whether you are a frontline worker or manager, you can:
• Look for opportunities to give people compliments.
• Look for opportunities to show appreciation. Think of all the people who help you do your job or make your life a bit easier.
• If you have a disagreement with someone, rather than trying to prove them wrong, focus on first understanding their perspective.
• If you’re experiencing ongoing conflict with someone, rather than engaging in “payback” behavior or holding a grudge, make the first move to get things out in the open and resolve them.
• If you believe you’re getting bad internal customer service from another department, rather than responding with antagonism and resentment, try to engage them in productive conversation.
• If someone who has a history of not being helpful to you asks you for help, rather than pay them back by refusing, model helpfulness to them, and perhaps let them know in a low-key but direct way that you would appreciate their helpfulness in the future.
• If you’re upset with something your supervisor did, rather than holding a grudge and talking behind his or her back, talk to your supervisor directly.

I know it won’t work for every problem, every co-worker, but isn’t it worth a try???

The Concord (NH) Monitor has an editorial about the recent NH nursing home problem:

Belknap County Nursing Home has an excellent reputation, but last month, state inspectors found so many deficiencies in patient care that the home was told it was in “immediate jeopardy” of losing its Medicaid eligibility. Since 2002, the state has issued 18 “immediate jeopardy”warnings affecting 16 of New Hampshire’s 82 nursing homes.

Many of Belknap’s problems stemmed from poor record-keeping, but others were more serious. Too often, patients were not given their medicine on schedule. Some missed doses or got the wrong medicine. Bedsores went unreported or did not receive proper treatment. Fire codes in some areas weren’t followed, nor were dietary recommendations.

The nursing home is correcting the deficiencies, and its “immediate jeopardy” status has been lifted. But how did a good facility go bad so fast? There’s no single answer, but high turnover and a lack of leadership appear to be responsible.

Most nursing homes have three priority positions: administrator, nursing supervisor and director of social services. Belknap had changes in all three positions in rapid succession and a long vacancy between one nursing supervisor and the next.

Regular use of fill-in nurses contributed to the poor care. Unlike staff nurses, they know neither the patient nor the practices and culture of the home. They are also expensive. The difference in patient care is great enough that the marketing materials of some nursing homes boast that they are “agency free.”

Yeah…but not too many nursing homes can say they are “agency free” now. There is a HUGE problem with staffing- both nurses and aides. The pay isn’t great for aides and nurses in LTC make far less than nurses who work in a hospital setting.

Read the rest of this editorial—>

Two reports from Ohio- nursing homes under investigation.

Nursing home was scene of fatal beating
A Toledo man who, police said, had a mental disorder and dementia was arrested yesterday for allegedly beating an Alzheimer’s patient with a bathroom towel bar in a nursing home, causing the victim’s death.

Sharon John Hawkins, 62, is charged with murder in the death Friday of Norbert Konwin, 77. He was arrested at 12:30 p.m. at a treatment facility at 2051 Collingwood Blvd. and is being held without bond in the Lucas County jail pending arraignment today in Toledo Municipal Court.

What good does it do to arrest a person with Alzheimer’s disease/dementia? It’s not like they have too much control over themselves and it’s not like they have good judgement. Or memory. The only real crime here is the patient mix at this facility. Everyone who works with dementia residents knows they often go through a period of violent behaviors during the decline process. I also think if facilities are going house residents who are violent, more staff is needed to supervise. Plain and simple. Arresting the demented does nothing except waste tax payers dollars.

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The second article:

HIGHLAND HEIGHTS — The state investigation into the operations of Lakeside Heights Nursing Center is continuing, but no date has been set for when it will be finished.

“We are reviewing files seized,” said Corey Bellamy, assistant communications director of admin services in the state Attorney General’s office.

Kentucky Attorney General Greg Stumbo executed search warrants for the facility on Monday, April 3 after Medicaid and Medicare funding was pulled from the home because of numerous regulatory violations, including 12 that posed immediate threat to the health, welfare and safety of residents.

The two-day search warranted thousands of files for review.

“We’re going to move as quickly as possible. However, to just say it’s going to take a specific amount of time I cannot say,” Bellamy said.

According to Kentucky statues, a nursing home license can be revoked when there is “substantial failure to comply with the provisions” set forth by the state Health and Family Services Cabinet. The cabinet would notify the home by certified mail and include the reason for the action.

At that point the facility would have the option to appeal to the Franklin County Circuit Court.

According to the statutes “an appeal may be taken by filing a petition for review in the Franklin Circuit Court within 30 days after notice of the final decision.”

Beth Crace, public information officer for the cabinet, said if Lakeside Heights looses its license, it would be the first revocation under the current Inspector General Robert J. Benvenuti III.

“He’s been here about two years,” she said. She said she was unsure when the last Kentucky nursing home license was pulled.

In addition to loss of its operating license, the facility operators could face felony charges. Kentucky state law says knowing or wanton abuse or neglect of vulnerable adults are felonies. If investigators find residents were neglected and claims for Medicaid payments were filed, it is considered a felony fraud offense.

Lakeside Heights administrators did not return a phone call seeking comment.

Nursing Home Magazine, February Edition, has an excellent write up about empowering CNA’s…

Some excerpts:

Have you ever wished that there were enough resources and personnel to improve some of the services that your facility offers? Wouldn’t you like to make mandatory in-services more interesting or present policies in a new way? Unfortunately, head nurses are overwhelmed, department heads have no time, and staff nurses say they have too much to do. But these goals can be achieved if your direct-care staff are willing and able to help. How about involving the nursing assistants?

At Broadway House for Continuing Care in Newark, New Jersey (an affiliate of the University of Medicine and Dentistry of New Jersey), we’ve taken a fresh look at nursing assistants as a long-term care resource. Outside the workplace, direct caregivers take on various roles. They run households, maintain budgets, hold positions in civic organizations, participate in church activities, and serve on school PTAs. They have a multitude of skills that we have not accessed. Right in our midst are valuable unpolished jewels waiting to sparkle.

Caregivers Against Pain
In this program, nursing assistants conduct in-services on pain management and the CNA’s role. The presenters have received certificates from New Jersey’s ombudsman for their work in this field.

Infection Control CNAs
Selected direct caregivers assist the infection-control coordinator in presenting in-services on handwashing and the proper use of personal protective equipment. And we’ve spread the word: An article about keeping residents safe from the flu was in the September 2005 issue of Nursing Assistant Monthly and featured Broadway House Infection Control CNA Gladys McKinnis.

Dancercise Program
CNAs interested in exercise therapy work with the physical therapist to help lower-functioning residents have fun while doing low-impact exercises. In addition, the CNAs conduct a program for staff entitled “Women in Red,” the American Heart Association’s Healthy Heart Program.

There’s lot more…go read…

Darn. This guy sounds like a real sicko. Course he’s innocent until proven guilty.

PROVO — A man accused of sexually abusing elderly patients in a Utah County nursing home has a new attorney, pushing future court proceedings back another two weeks.

Jesus Partida, 33, is charged with 11 counts of forcible sex abuse, a second-degree felony, and four counts of forcible sodomy, a first-degree felony.

Attorney Shelden Carter had been representing Partida but said Thursday that he was told by Partida’s family members that they had hired someone else.

He said they wanted someone who was going to approach the case in a different way.

Partida, who was working as a certified nursing assistant, is accused of abusing eleven elderly women at the Heritage Care Center in American Fork over the last two years.

All of the women had either dementia or Alzheimer’s disease and were unaware of the abuse, according to court documents.

All but two of the victims have since passed away.

Ick…

REIDSVILLE, N.C. - Three residents of the Avante at Reidsville nursing home have died as the result of Invasive Group A Strep disease, according to the Rockingham County Department of Public Health.

A fourth resident has been diagnosed and is receiving treatment, Rockingham County Health Director Glenn Martin said.

The outbreak was first reported to the county health department on March 6. Both Martin and Avante at Reidsville administrator Scott Alexander said they could not release the names of those who died or the dates they died. However, Alexander did say the three patients diagnosed with the disease were hospitalized at Annie Penn Hospital in Reidsville before they died.

The disease is an invasive form of the bacteria known to cause strep throat and bacterial infections, Martin said. One of the two severe forms of the disease, necrotizing fasciitis, is often known as a “flesh eating disease” because it rapidly destroys muscles, fat and skin tissue.

The other severe form is known as Streptococcal Toxic Shock Syndrome, or STSS, and results in an extreme rapid drop in blood pressure and organ failure. STSS is not related to the toxic shock syndrome associated with tampon usage.

The breakout of the disease is the second of its kind in the state in recent weeks. The Associated Press reported a nursing assistant in Hartnett County died of the invasive form of the bacteria on Feb. 27, three days after accidentally jamming her thumb in a wheelchair while working at a nursing home.

State epidemiologist Dr. Jeff Engel said the disease should not be a huge cause of concern to the general population.

“There is no need for alarm in Rockingham County,” Engel said in a press release. “We have seen clusters in other group care situations, where you have a number of frail, sickly people in a close environment. That’s why we’re working with the local health department to ensure that other residents and employees of this nursing home aren’t affected.”

Alexander said all of the nursing home’s staff and patients have begun prophylactic treatments.

Avante is a 110-bed facility with 156 employees. According to its Web site, the Reidsville facility “excels at short-term rehab” and has a “very aggressive and committed therapy department.”

Martin said the outbreak of this disease is very rare, but has happened before.

“This is the first time I remember having multiple cases, not to say that there hasn’t been isolated cases here or there,” Martin said.

The disease can be especially debilitating to those with weakened body defenses, Martin said.

“Whenever you bring people together in a close environment, especially those with reduced immune systems, you have increased risk with that population,” Martin said.

The bacteria can be spread from person to person through hand-to-hand contact or through air by way of coughing, Martin explained, although he is doubtful the department will ever know exactly how the bacteria found its way into the nursing home.

Martin said with the right opportunity and the right conditions, the disease can spread. It is seasonal, peaking in late winter and early spring.

The director is hoping the prophylactic treatments will resolve the situation, and says Avante is taking the right steps and cooperating fully.

“Obviously, they care deeply about their residents and are absolutely committed to ensuring their safety,” Martin said.

During the last Rockingham County Department of Environmental Health inspections of the facility on March 22, Avante received a score of 93 out of a possible 100. The food services department at the nursing home, inspected on March 6, scored a 95.

TOO many people think assisted living facilities are actual nursing homes. They are not, and therefore they are not covered under the same oversight regulations.

Top dollar should pay for top-notch care in an assisted living facility.

At least that is what Beth Ewell of Lewes thought when she placed her mother in an assisted living center in Rehoboth Beach.

But Ewell says she began to notice that the staff was not what she considers adequate for the number of patients, and the level of care was not what she expected. So she complained to the state agency that regulates nursing homes.

Nothing happened.

A certain heart-wrenching phone call was the breaking point for Ewell.

Ewell said the facility’s director of nursing called to inform her that another resident had sexually molested her mother in the middle of the night.

But after weeks of phone calls and complaints, the state agency for long-term care didn’t seem to respond at all.

When she did receive a response, it seemed more like lip service than a solution to a real problem, Ewell said.

Ewell, who said she paid $4,000 a month for her mother’s placement, is disappointed in the care her mother received. But she’s also disappointed that her efforts to correct the problem went largely ignored by state regulators charged with protecting patients in nursing homes.

AL is regulated but not as tough as nursing homes. It’s unfortunate too, because so many think life in AL is an alternative to the nursing homes. In reality, many AL facilites have become nursing homes with the residents they are admitting.