Fighting back:

OAKLAND, Calif., Sept. 26 /PRNewswire/ — SEIU United Healthcare Workers-West and SEIU Local 121RN have filed for injunctive relief seeking to stop Tenet Healthcare Corp. from cutting health benefits for nearly 7,000 California hospital employees, including registered nurses, pharmacists, licensed vocational nurses, respiratory care practitioners, radiology technicians, surgical technicians, and certified nursing assistants.

Workers represented by the two unions have been in negotiations with Tenet Healthcare for nearly a year. In June, Tenet and the workers reached an agreement on maintaining all health benefits and costs. Last week, however, Tenet changed their position and announced that they plan to cut benefits beginning in November, during the open enrollment period with PacifiCare, which administers the corporation’s health plan.

Once an agreement has been made it needs to be honored. Tenet is well known for pulling stunts like this. Again, these for profit centers are not worth the jobs they offer. Sooner or later, employees are screwed over.

Proposal For The Nursing Shortage:

(CBS) CHICAGO An Illinois senator introduced some new legislation this week. The plan is to improve the current nursing shortage by providing better career incentives, as CBS 2’s Suzanne Le Mignot reports.

Norene Brown says she’s worked as a certified nursing assistant for 11 years. Brown says she’s always wanted to be a registered nurse and Senator Dick Durbin’s new legislation, can make her dream a reality.

“What it would do is enable me to advance myself into the next level of nursing, without having to worry about how I’m going to pay for it,” Brown said.

Brown says using the Nurse Training and Retention Act of 2007, would provide her with scholarship money to become a nurse and after 10 years, any loans she took out, would disappear. She says this would be life changing for her.

“With this $8.50 that I’m earning, it’s disrespectful – it really is,” Brown said. “Because I shouldn’t have to worry about how I’m going to pay my bills; I shouldn’t be living from paycheck to paycheck.”

Sen. Durbin says the legislation he introduced earlier this week is aimed at easing the nation’s nursing shortage.

“In just six or seven years, we’re going to be one million nurses short of what America needs – one million nurses,” he said.

Durbin says through the legislation, grants are given to organizations who work with their employees to improve their skills to become nurses. Durbin added, hospitals will be charged $1,500 for each nurse they bring in from overseas.

“We need their help,” Durbin said. “We obviously have this nursing shortage, but we’re going to have a fee attached to bringing these nurses in to provide scholarship funds for home grown American nurses.”

Durbin also says qualified nursing school applicants are being turned away because there are not enough faculty to teach them. A program allowing retired military nurses to pursue graduate degrees to become nursing faculty just won state approval. The senator says the program will help ease the shortage of nursing teachers at universities.

I only wish we had more details. Overall this sounds good but many questions remain unanswered. It’s a great policy directive, but we need the nuts and bolts as well.

For all the talk about how much better health care is in Great Britain, when I read articles like this I cannot agree with the pundits. Great Britain is far behind the US when it comes to health care, especially with it’s older citizens. The US is decades ahead on all matters related to nutritional health of our nursing home residents.

Hospitals and care homes are to face a major inquiry into the way frail elderly people are allowed to go hungry.

It follows research backed by charity studies that more than half of all older patients are at risk of malnutrition.

Ministers have agreed to support the investigation into which patients arrive on wards or in homes suffering from malnutrition and how their treatment is handled.

The inquiry comes in the wake of reports which say malnutrition among the elderly is widespread and that nurses and staff regularly neglect to ensure that vulnerable people are helped to eat meals.

Meals are left out of the reach of patients or residents, critics of hospital and care home standards have alleged.

They say that staff frequently fail to help patients eat, or remove meals before they have had a chance to eat them.

Of course the problems are the same: Not enough staff to assist with meals…but what about the standards? And why is this ONLY beginning to get attention in GB? We’ve known about nutritional problems in elderly who reside in nursing homes, here in the US for YEARS. so much that it is regulated by our government.

The Daily Mail has highlighted neglect of older people in its Dignity for the Elderly campaign.

Last year the Government launched its own ‘Dignity in Care’ campaign aimed at ending, among other abuses and instances of neglect, malnutrition of older people because care staff are too busy or otherwise pre-occupied to help them eat.

The new survey will involve medical and support workers in hospitals and staff in care homes who will answer detailed questions about their screening of newly-admitted patients and residents over three days later this month.

Professor Marinos Elia of BAPEN said: “Malnutrition is preventable and if treated early can improve outcomes for patients and residents.

“In the long run, treatment saves the NHS and social care system money as the cost of treatment is small compared with the potential benefits to be gained.”

Like the US, GB will face many obstacles when they try to “fix” this problem; and the NHS certainly won’t pay more for any fixes that are recommended. Nations all over the world are discovering the bad results of long term care facilities- and a few are looking at alternatives instead of short term fixes.

More about nursing homes/assisted living facilities hiring and then firing or HIDING staff who have criminal backgrounds.

NEW PORT RICHEY - A man applied for a job at a home for the elderly. He had pleaded no contest to a violent felony; he was hired nonetheless. One morning last week, police say, he lunged at an 78-year-old Alzheimer’s patient and punched him in the face.

The man went to jail, but he was not the only person with a criminal record on the New Port Inn’s payroll. At least two other caregivers also had records. And before state investigators arrived Tuesday to survey the facility, those caregivers were swept out of view.

Not good. I suspect we will be reading more about this in the coming weeks. (I hope so anyway).

The tales found in the Texas Department of Aging and Disability Service’s disciplinary files can be savage, sad and stomach-turning. But they are intended to serve an essential purpose: protecting Texas grandparents, disabled children and the terminally ill from abusive or dishonest nurse aides and other caregivers.

But dangerous blind spots plague the system that oversees them, a Star-Telegram examination has found. Across the state, caregivers facing discipline for sexual misconduct, theft, abuse — and a fatal case of neglect — were all able to find and hold new jobs.

Consider this: The department has banned about 680 people — for life — from working at any of the facilities it regulates. Yet every two years, the department renews the certifications of some of those same workers as nurse aides. One San Antonio aide, blacklisted for stealing an elderly man’s identity in 2005, has a new certification good through 2009. A Lubbock aide banned for swindling an elderly woman out of more than $100,000 works for a healthcare staffing company and insists she’s not caring for patients — “We do billing,” she said. Another, banned for neglect, was fired from a Plano nursing home only after the Star-Telegram questioned her status in August.

Just how do those workers keep getting recertified? All the state requires for renewal is evidence that an aide is still working.

So if a blacklisted aide continues to hold a job and sends that evidence to the state, no one checks to see whether they should be working before issuing the renewal.

Some have read the article at the NYT about nursing home investors buying up homes, cutting back services to the point of near neglect, and selling the properties for a huge profit. This is an awful horrible thing to read about, but it’s been happening a lot longer than some think. Those of us who have worked for chain owned facilities KNOW of the cutbacks and supply shortages, and many of us learn to work around it. When we do that, we enable this scheme to continue. When we make excuses for these places, when we claim it’s “not that bad”- we are allowing some terrible wrongs to happen. We’re fooling ourselves just a little; but in fact we are fooling the public a lot. One thing about this: We may not even be aware we are employed by one of these nursing homes believe it or not. IF you were hired by an outside group, and IF the facility places limits upon basic supplies AND there are a very few RN’s in house, you probably work at an facility that is being managed under this profit driven scheme.

Nonetheless, the details of the article are ethically wrong and we would all do the entire industry a favor by refusing to work at facilities owned by these groups; families and doctors would be wise NOT to allow an admission and investors would be shocked to know they are party to such neglect- investors are often people like you and me- who buy some stock hoping to make a little profit. Being assured by the holding company of good care and all, and having little real knowledge of the industry, investors continue to buy.

This should also serve as another reason we need to work towards getting people out of nursing homes. The desire to earn a few million bucks on the lives of our most treasured and vulnerable people is inexcusable. But money talks- our elderly often won’t.

We would be very interested in hearing from more aides who believe they are currently or have, in the past, worked for a home managed like this.

How decisions are made to cut staff:

DANVILLE – Vermilion Manor Nursing Home lost almost a million dollars last year, but a financial consultant thinks the county-owned facility can be profitable not only this year but also for at least the next four.

Mike Harmon of Harmon and Associates in Danville told county board members Tuesday night that the key to making the 233-bed nursing home profitable would be reducing the largest expense – personnel costs – which constituted about 88 percent of the nursing home’s expenses last year.

For several years, the county has subsidized the nursing home with additional taxpayer dollars.

Taxpayers already support the nursing home with an annual property tax levy that generated about $650,000 for the facility last year.

Earlier this year, the county set up a payment plan by which the nursing home is paying back to the county the extra money it was given last year to cover its budget deficit.

It has already made seven monthly payments of about $24,000 toward the $880,000 debt.

The county hired Harmon at a cost of $4,000 to analyze the nursing home’s finances and determine how the facility could operate profitably in the future, continue to pay its debt to the county and not require additional funds from taxpayers.

Harmon compared Vermilion Manor’s nurse staffing hours per day to state and national averages.

Vermilion Manor’s were higher in every category, and Harmon said reducing that expense is key to making the facility profitable.

We have consultants coming into nursing homes and recommending nursing positions be cut, in order to cut a profit.

When this happens, we cannot call these places nursing homes- because the nursing isn’t happening as it should.

The dangers of assisted living facilities and small residential group homes:

Before going to sleep on Aug. 31, 2006, a 72-year-old woman living at Oceanside Home Care in Los Osos was fed some macaroni salad and corn bread.

The next morning staff at the six-bed residential care home found her lying unconscious on the bedroom floor. Paramedics took her to the hospital after diagnosing a diabetic coma—her second in three weeks.

The woman, whose identify was not released by state investigators, never regained consciousness and died in the hospital seven days later.

Her death prompted an investigation by state officials, who found Oceanside had “insufficient and unqualified” staff who failed to monitor the woman’s diabetes. The woman’s memory was impaired, and staff did not follow her prescribed diet, record her glucose levels and track her insulin injections, inspectors found.

Assisted living facilities and group homes do not have to utilize nurses; or CNA’s. Anyone can work at these places, as an aide. Anyone can be “trained” to check glucose levels and pass meds. Often we see illegal immigrants working for these places out in CA and the other western states. Another problem with assisted living- it’s not regulated. At all. Anything goes…and we’ve seen countless examples of this here in horror stories like the one above.

For families looking for info about assisted living facilities, that info is often hard to find. Key questions to ask would include how many nurses and CNA’s (make sure at least some of the aides are certified) work each shift; how often are residents checked on through the night; who is responsible for passing medications AND very importantly, are the residents themselves responsible for this? Inquire about staff education about meals, snacks and diabetes and other nutritional issues if it’s pertinent to your loved one.

Good news:

Despite the graying of the nation, the percentage of elderly living in nursing homes has declined, according to Census data released today. The downturn reflects the improved health of seniors and more choices of care for the elderly.

About 7.4% of Americans aged 75 and older lived in nursing homes in 2006, compared with 8.1% in 2000 and 10.2% in 1990.
[...]
The nursing home numbers do not include assisted-living facilities. “There’s no federal definition of assisted living and that’s a void in the data,” Bolda says. “Fortunately, communities are taking responsibility for addressing the needs of older adults rather than waiting for federal policy solutions.”

Let’s hope the numbers continue to go down…and that includes assisted living. Community housing is not home- no matter how pretty it looks. Bring the money to the families, who can take of their elderly loved ones at home. The best solution and also the least costly.

A new book written by a woman who worked as an aide. Celia Berdes, of The Direct Care Clearinghouse writes an excellent review, which I am quoting some portions from here- as readers hopefully know, the red text is a link to the DCCH site:

Dancing with Rose: Finding Life in the Land of Alzheimer’s (York: Viking, 2007), a new book by Lauren Kessler, is the best book yet written on the lives of old people in residential care and the people who care for them. It is not the first book about working as a nurse’s aide: Sallie Tisdale’s 1987 classic, Harvest Moon: Portrait of a Nursing Home, was based on the author’s work as an aide, and more recently, Thomas Edward Gass’ Nobody’s Home: Candid Reflections of a Nursing Home Aide (2004) gave a highly personalized and excessively candid report. Dancing with Rose, by contrast, balances the personal with the public, and Kessler tells her story with such skill and sensitivity that the reader will find it hard to put the book down.

More:

The leading players are nurse’s aides, and Kessler does an excellent job of capturing them and their work experiences. She tells how some seem to have an aptitude for caring, often relying on their experiences of mothering or other kinds of nurturing. She pinpoints the role of attitude, how for some each new task is taken up with a sense of mission, while for others it is just another chore. She describes the special skills that they use in giving Alzheimer’s care, how they must intuit needs that cannot be expressed and witness residents’ decline without looking away. She describes in fine detail the effect of doing everything–cleaning, feeding, laundry, toileting–for more than ten residents per shift. Without flinching, she describes the challenges of low-wage work, the incessant search for a little step up, the hanging-by-a-thread arrangements for childcare and transportation that enable women to do this sort of work. And she describes what it means for workers to care for residents who always, ultimately, die.

Dancing with Rose leads us to this inescapable conclusion: that caring aptitudes and attitudes of skilled direct care workers are the most important components of high quality care. In a call for systemic reform, Kessler asks us to think about our own aging: ”If I do need help when I get older, if it becomes impossible for me to live independently, how do I want to live? Do I want to be cared for by an overworked, underpaid woman with so many chores to accomplish on her shift that she can barely spare a minute to talk to me?

To read the entire review go here- the Direct Care Clearinghouse.

Sounds like an excellent read, and it’s pretty inexpensive too!