The much anticipated Commission on Health Care Facilities in the 21st Century has made it’s recommendations public now. NY state is reacting to this now.

The recommendations by the Commission on Health Care Facilities in the 21st Century go far beyond the nine hospital closings and downsizings that state officials reported late Monday, after being briefed by the commission. Several other hospitals would cease to exist through mergers or conversion to new uses, and more could be eliminated if they refuse to merge.

In addition, the commission reached deep into the particular operations of many individual institutions, ordering them to eliminate specific numbers of beds, telling some to eliminate psychiatric, substance abuse or maternity wards, and in some cases directing others to take on those functions.
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In all, the plan would reduce the number of hospital beds statewide by at least 4,200, or 7 percent. It would also close and downsize several nursing homes, mostly upstate, eliminating 3,000 beds, or 2.6 percent of the total.

The report’s release rippled across New York State yesterday, as cities and towns grappled with the possible closings of some of their most dependable employers. From Long Island to Niagara Falls, hospital executives and elected officials denounced the commission’s plan and vowed to fight it in the Legislature and in court.

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State Panel Recommendations Threaten Public Health Care

Did she do the right thing??

Most of the hands-on care in a nursing home is provided by nurse aides. When a resident has a health problem, it’s usually protocol for the aide to report the concern to an administrator or licensed nurse. But what if no one helps? What if the patient gets worse? And what if the aide then decides to go directly to the patient’s family with the concerns?

The aide might be fired.

That’s what happened to Connie Rust. She was fired after telling the daughter of a resident that her mother was ill and not being properly cared for at Ravenwood Nursing and Rehabilitation Center in Waterloo.

One evening, 89-year-old Maizie Bickley told Rust she was experiencing pain, dizziness and cramps. Rust asked a licensed nurse to check on the woman, but Bickley said she still hadn’t been seen by the nurse the following morning. The next night, Bickley’s condition had worsened. Finally, Rust called the sick woman’s daughter.

Should CNA’s do this? Are there other avenues this aide should have taken? Could she have gone to her charge nurse’s supervisor or the DON, or even the administrator first?

As reported by the Register’s Clark Kauffman, apparently Rust violated corporate policies prohibiting sharing of confidential patient information (in this case, with Bickley’s daughter) and forbidding employees from engaging in conduct “that results in serious negative public relations.” During an unemployment hearing, a judge sided with the nursing home, saying Rust made “highly inflammatory remarks” that “could result in legal liability for the home.”

Uh huh…And what about the negative publicity from a potential lawsuit from the family here? And, were the nurses involved here disciplined in any way, for not assessing this woman at the CNA’s request? I’m sure the aide had a lot of bad things to say- they usually do when they’re ticked off. It’s all about the love for the residents though and not some personal vendetta against the nursing home.

The worry is that this story will send the wrong message to those who care for Iowa’s most vulnerable population: Keep quiet when the health of a resident is at stake.

As mandatory reporters, caregivers have an obligation to report abuse and neglect. They should voice concern to higher-ups. They also can make anonymous reports to the state.

But those options don’t cover every situation. What if higher-ups don’t act, or what if aides face a life-threatening emergency? What should they do?

I wouldn’t keep my mouth shut. If no one was listening to me- and I mean NO ONE, as in nothing was getting done to make my patient better- then I would call the state before I would call the family. I would call the ombudsman’s office. IF the family came in to visit I would probably mention to them my concerns. Medical concerns only- I would not bash the nurses, management ect.

This is a tough situation and I believe many of us have been in Connie’s shoes. We have to stand up and protect our residents and sometimes that means upsetting the higher ups.

How should CNA’s handle this??

A group home in Missouri has burned down, killing 10 residents and one staff…24 have been injured. The home did not have sprinklers.

ANDERSON, Mo. (AP) - A man who worked at a southwest Missouri group home with his wife was among 10 people killed in a fire that gutted the building, the state patrol said Tuesday.

Rain fell on investigators working in the day-old ruins of the home for the mentally ill and elderly, where two dozen others, including the man’s wife, were injured in Monday’s blaze.

State and federal authorities were treating the fire at the Anderson Guest House as a crime but hadn’t ruled out the possibility of an accident.

“We’re not saying it is definitely a crime scene, but we are treating it as if it is and trying to determine if the fire was set by somebody who had a nefarious motive,” Gov. Matt Blunt said.

Ohio: A nursing home has lost it’s funding and may be closed down.

One of Iowa’s largest nursing homes could soon be forced to close its doors due to allegations that residents have been repeatedly subjected to neglect and physical abuse.

Administrators at USA Healthcare of Urbandale, which is home to 111 seniors, were notified Monday that state officials intend to revoke the facility’s nursing home license at the end of December. At the same time, federal officials notified the home’s administrators that they intend to shut off Medicare and Medicaid funding for the home effective Friday.

The home can appeal both of those actions, but an appeal would not delay the federal government’s decision to pull government funding from the home this week. Because 97 of the home’s 111 residents depend on that funding to pay for their care, the federal action alone could force the home to close its doors.

Bad time of year for this action.

This facility has a long history of problems though:

The home has been cited for dozens of deficiencies in the past year. It currently owes $46,350 in federal fines, and there are at least $10,400 in state fines outstanding.

Monday’s action is tied to a series of state inspections that began in May. After each inspection, state officials revisited the home. In each instance, the inspectors uncovered more problems, some involving serious injury to residents.

In August, for example, the home was fined $400 for allegedly failing to protect residents from physical and sexual abuse at the hands of other residents. One male resident diagnosed with psychosis had slapped, punched, kicked, choked and threatened to kill residents and workers on at least 18 occasions. The man, described by inspectors as “very strong,” broke the clavicle of a fellow resident by tipping over a wheelchair.

The most recent state inspection was two weeks ago, when the home was clearly in danger of losing its license. Inspectors discovered that one resident had recently suffered second- or third-degree burns on her leg after cocoa was spilled in her lap. They allege that workers were aware of the burn but didn’t provide immediate first aid, then didn’t provide any treatment for two days.

The burns were serious enough that one nurse allegedly described them to inspectors as “deep and ugly,” adding that they “made me ill.”

Inspectors asked one aide why she didn’t tell her colleagues of the injury. She allegedly replied, “I absolutely should have reported it. I don’t know why I didn’t tell.”

During the inspection, state officials also noticed that a resident with a history of violence was being watched by workers from the home’s business office, despite their lack of training for such work. Three aides and one nurse in the home’s Alzheimer’s wing allegedly said they hadn’t completed their required training.

Inspectors also observed that one resident who relied on the staff to be toileted was left in bed for three days, at times lying in urine-soaked bedding. Two workers allegedly admitted that they had falsely indicated in the home’s written records that they had helped the resident out of bed on several occasions.

For years, USA Healthcare of Urbandale has had problems meeting the federal government’s minimum standards for resident health and safety.

In 2003, the home was initially fined more than $100,000 for allegedly taking two residents off their oxygen ventilators without a physician’s order. One of the two later died. The home’s respiratory therapist allegedly told state inspectors, “Residents should not be doomed to be on a vent the rest of their lives.”

In 2004, the home was fined $350 for alleged neglect that resulted in a resident’s thumb being amputated. The facility’s medical director allegedly told inspectors the home had “dropped the ball” by routinely neglecting to provide the resident with appropriate treatment. Later that same year, the home was placed on a state list of 18 “chronically poor-performing homes.”

In 2005, an employee of the home was charged with wanton neglect after being accused of physically abusing a 94-year-old female resident. The worker pleaded guilty to a charge of simple assault and was fined $50.

The Nursing Home Administrator found an article about aides and a nursing home medical director being ARRESTED in NY state….

New York State Attorney General Elliot Spitzer announced this week the arrest of nine nursing home employees, including six CNAs and the facility Medical Director. A hidden camera was placed in the room of a resident for a five week period, where it observed:

-Resident did not receive restorative therapy twice per day as ordered
-Resident was not turned every two hours as ordered
-Resident was not toileted every two hours as ordered
-Resident was not assisted with feeding at every meal as ordered
-Resident did not receive medications consistently as ordered
-Resident was not visited by the physician as documented

AS ORDERED.

Do doctors and nurses understand the orders they write are at times just not possible to carry out??

This is just SICK.

Three former care workers at a Sterling Heights nursing home admit posing for photographs with a corpse but are fighting a criminal charge of mistreatment in what could be a precedent-setting case.

Ericka Nichole Jackson, Tahirah Hasseena Shakur and Keisa E. Cooper, all of Detroit, were fired as nurses’ aides at Cherrywood Nursing and Living Center on 15 Mile Road and charged with patient abuse under the Public Health Code for the Oct. 13, 2004, incident. The nursing home was issued a citation by the state Department of Community Health for violating the resident’s right to dignity under the Public Health Code.

The defendants, according to an assistant state attorney general, were “playing with” the body shortly after a woman had died. Jackson, 25, patted the deceased woman’s hands, said, “Wake up,” and held up the deceased woman’s arms, according to state officials. Cooper, 30, allegedly bent the woman’s legs before she and Jackson posed with the body while Shakur, 33, took a photograph with a cell phone camera. The women laughed about it afterward, according to officials.

The defense attorneys Monday filed a motion Macomb County Circuit Court to appeal a late 2005 ruling by Judge Kimberley Wiegand of 41A District Court in Sterling Heights to uphold the misdemeanor charge.

The attorney general’s office claims mistreatment of a patient, but defense attorney Derek Wilczynski argues in a legal brief that the woman was not a patient because she had died and thus could not be mistreated.

No. In our training we are taught to treat a deceased body with the utmost care and respect. The fact that is a dead body doesn’t mean anyone can do these things. The aides should be prosecuted to the fullest extent of the law. And I’m taking a risk here by mentioning this: The names of the aides, 2 of them anyway, indicate A LOT to me. Call me racist, call me intolerant.
But I have seen disrespect towards living people in the hands of “diverse” aides, and it’s not remotely funny.

This is nice.

It can be hard looking at an empty chair when the family gathers around the table for Thanksgiving dinner, knowing that the person who belongs in the chair is unable to attend because their health requires they reside in a nursing home facility.

That is why the Stoddard County Ambulance District is once again providing their Home for the Holidays program, transporting elderly patients that are unable to travel except by ambulance to their family’s home to celebrate the season.

“This is the 21st year that we have performed this service,” said Stoddard County Ambulance District Manager Dave Cooper. “I first heard about this program when I attended a management conference 21 years ago.

“They were discussing ways that the ambulance districts could become more involved with the community and this one struck my fancy.”

The program will take place Thursday, Nov. 23. During that time, patients will be transported from the nursing home facility where they reside to a residency anywhere in the county. The visits are allowed to be as long as the patient and nursing home facility directors deem appropriate, anywhere from a few hours to even an overnight stay.

“The holiday season is a time that families should be together, and we understand that due to physical limitations this can be impossible for some,” said Cooper. “It’s our gift to the community, and we enjoy providing this service.”

Massachusetts is one of the latest states to test new programs that aim to keep elderly and disabled at home vs. admitting them to a nursing home.

Since her elderly mother broke her hip and began using a wheelchair 10 years ago, Elizabeth Connolly has provided 24-hour care.

Bathing, cleaning, and cooking for her mother, who’s now 100 years old, was a financial hardship, as her four children approached college age. But when doctors encouraged Connolly, now 59, to check her mother into a nursing home, Connolly refused.

“We’re not going to let her die in a hospital,” the Stoneham woman recalled telling them.

A new program enacted by the state Executive Office of Elder Affairs and the Office of Medicaid is aimed at easing the financial burden on families like Connolly’s, by paying them about $18,000 a year to care for an elderly or adult disabled family member at home. The Connolly family is one of several dozen to benefit from a pilot program that will be instituted statewide on Dec. 1.

The Enhanced Adult Family Care Program addresses a growing shortage of paid professional caregivers, and the wishes of many elderly people to spend their last days at home.

“It just takes the pressure off,” said Al Norman , executive director of Mass Home Care, an association of nonprofit providers. “You don’t have to find new caregivers, you don’t have to find new housing — you’re maximizing existing resources to keep people out of foster care homes.”