Hospice under fire.

In the early days of the Medicare hospice benefit, which was designed for those with less than six months to live, nearly all patients were cancer victims, who tended to die relatively quickly and predictably once curative efforts were abandoned.

But in the last five years, hospice use has skyrocketed among patients with less predictable trajectories, like those with Alzheimer’s disease and dementia. Those patients now form a majority of hospice consumers, and their average stays are far longer — 86 days for Alzheimer’s patients, for instance, compared with 44 for those with lung cancer, according to the Medicare Payment Advisory Commission.

When I worked at a faciity for people with dementia, they always called in the Hospice people when we didn’t think there was any hope…and you know what? The residents almost always got better; they didn’t die. I don’t know if its the medications that are used under Hospice management, but I saw many, many residents actually get better with alertness, eating, ADL’s, behavior. Of course many other residents used Hospice services for it’s intended purpose- to make the experience of death as dignified as humanly possible.

Interesting article about how it’s all changed from what it started out as.

Looking at last months archives of Nursing Homes Magazine, I found this article:

Striving to be employers of choice

Quality resident care that enriches quality of life and independence is the primary service of senior living communities. What most senior living employers have known for years is that the employees are crucial to this mission. Our employers believe that the best way to help employees care for their residents is to care for the employees. To accomplish this, senior living providers believe in maintaining and enhancing positive, direct, and meaningful relationships with employees.

Hmm.

So what do they list up?

We will adhere to the highest ethical standards in all aspects of our operations, including our relationships with employees.

We will comply with the letter and spirit of all federal, state, and local laws.

We will maintain and enhance excellence in resident care and services.

We will maintain a positive, direct, and meaningful relationship with employees by providing rewarding and meaningful work, individual recognition, career development, fair wages, employer-sponsored health insurance and other fringe benefits, open communication, effective problem-solving, and an environment fostering mutual respect and dignity.

We recognize the right of employees to engage in union and other protected concerted activity, to make an educated and informed choice about representation, and to express that choice through the time-honored process of National Labor Relations Board–supervised and valid secret ballot elections.

Okkkay…that last part mystifies me. WHY would any organization come out and proclaim to be employee friendly YET speak of unions? If a company strives to be the best employer yet panders this union talk, then we know the company isn’t all serious about being the best.

Nursing Homes/Long Term Care Management has a new look and it’s much easier to find articles and content. I also think the URL is different as well. Check your bookmarks to make sure.

The CMS has listed the nations worst nursing homes. Background HERE.

Here’s the list:

Alabama:

— Eastview Health Care Center, in Birmingham.

— Woodley Manor Health & Rehabilitation, in Montgomery.

Arkansas:

— Benson’s Nursing Home Inc., in Nashville.

California:

— Yuba City Care Center, in Yuba City.

Colorado:

— Eagle Ridge at Grand Valley, in Grand Junction.

— Kindred Healthcare & Rehab Center of Northglenn, in Northglenn.

Connecticut:

— Wethersfield Health Care Center, in Wethersfield.

Florida:

— Apollo Health & Rehab Center, in St. Petersburg.

— Key West Convalescent Center, in Key West.

— Palms Rehabilitation and Nursing Center, in Lauderdale Lakes.

Georgia:

— Laurel Baye Healthcare of Lake Lanier, in Buford.

— The Place at Augusta, in Augusta.

— Shoreham at Marietta, in Marietta.

Hawaii:

— Leahi Hospital, in Honolulu.

Iowa:

— Blair House, in Burlington.

Idaho:

— Gooding Rehab & Living Center, in Gooding.

Illinois:

— Berkshire Nursing & Rehab Center, in Forest Park.

Indiana:

— Hillcrest Centre for Health and Rehabilitation, in Jeffersonville.

— Valparaiso Care and Rehabilitation Center, in Valparaiso.

Kansas:

— Atchison Senior Village, in Atchison.

— Ottawa Retirement Village, in Ottawa.

Louisiana:

— Lake Providence Subacute Rehab, in Lake Providence.

— Plaquemine Caring LLC, in Plaquemine.

Massachusetts:

— Cedar Hill Health Care Center, in Randolph.

— Milton Health Care, in Milton.

Minnesota:

— Golden Valley Rehabilitation and Care Center, in Golden Valley.

— Mcintosh Manor, in Mcintosh.

Missouri:

— Senior Estates, in Kansas City.

— St Elizabeth Healthcare and Rehabilitation Center, in Florissant.

— West Village Manor, in Columbia.

Mississippi:

— Hinds County Nursing & Rehabilitation Center LLC, in Jackson.

Montana:

— Evergreen Missoula Health & Rehab, in Missoula.

North Carolina:

— Sunbridge Care & Rehab/Triad, in High Point.

New Jersey:

— Victoria Health Care Center, in Matawan.

New Mexico:

— Fort Bayard Medical Center, in Fort Bayard.

Nevada:

— Evergreen Mountainview Health, in Carson City.

New York:

— Vivian Teal Howard Rhcf, in Syracuse.

Oklahoma:

— Northwest Nursing Center, in Oklahoma City.

— Pawhuska Nursing Home, LLC, in Pawhuska.

Pennsylvania:

— Ashton Hall Nursing and Rehab, in Philadelphia.

— Brighten at Broomall, in Broomall.

South Carolina:

— Magnolia Manor — Moncks Corner, in Moncks Corner.

— Ridgeview Manor Nursing Facility, in Hopkins.

South Dakota:

— Aberdeen Healthcare Center, in Aberdeen.

— Bennett County Hospital and Nursing Home, in Martin.

Tennessee:

— Overton Park Health Care Center, in Memphis.

Texas:

— Taylor Care Center, in Taylor.

Virginia:

— Ruxton Health of Woodbridge, in Woodbridge.

Washington:

— Evergreen Centralia Health & R, in Centralia.

— Franklin Hills Health & Rehab, in Spokane.

— Frontier Rehab & Extended Care, in Longview.

Wisconsin:

— Luther Home, in Marinette.

— Willows Nursing and Rehabilitation, in Sun Prairie.

Washington, D.C.:

— Carolyn Boone Lewis Health Care Center

How sad…and we can be sure a lawsuit will happen.

ESCONDIDO – A 94-year-old woman who wandered away from a nursing home early Thanksgiving morning and was then struck and killed by a car was wearing an alarm bracelet designed to alert staff if she left the building.

I often hear from CNA’s and others who work in Long Term Care…I get emails and phone calls and letters from folks all over the world. One of the most common issues I hear about is how management ignores the hard workers, or groups them in with those who don’t put forth as much effort. It’s really a demotivating thing when this happens. I came across this blog for Leaders, and how timely this is. This post stood out among the many, and it’s aimed square at the leadership team-and I want it known for this site, this should be targeted towards the Administrators and DONs:

Difference Makers
He suggests that we make a conscious effort to look for and collect the stories of those people that go above and beyond and know when to break the rules in order to make a difference. Then retell them over and over to make them a part of the organization’s culture. The stories should have a behavior-oriented point and help people to connect their situation to that of the heroes in the story. “Finding your heroes and recognizing their behavior is key because recognized and rewarded behavior is repeated.” Here are several ways he suggests we go about finding heroes in our organizations:

* Harvest examples of extraordinary employee behavior, making sure to get the complete story and all the facts.
* Look at customer feedback
* Ask your customers about the level of service they receive at your organization
* Develop a consistent program for recognizing your organization’s heroes and their stories. Make sure no one gets overlooked!

In our work it shouldn’t be too hard to find those who go above and beyond; those who work extra shifts without any notice, who sign up for endless overtime at the expense of family time, those who accept the harsh assignments day in and day out without complaint….the examples could fill a book. And it’s not just about nursing staff- this lesson could be applied for ANYONE who has a career in a nursing home.

Administrators and DON’s: Look for your difference makers and cast the light upon them. While you’re at the Leader Blog please scan this article too. It’s shouting out at YOU.

A Mom and her daughter have something in common: They live in the same nursing home.

WORCESTER _ It’s not unusual for a mother and daughter to spend time together, especially around the holidays.

It is unusual when they share a nursing home.

And it’s practically unheard of when mom has passed the century mark.

Dorothy Simonson, 105, and her daughter, Gloria, 80, enjoyed a full Thanksgiving dinner at the Schohanna Adult Rest Home on Thursday, their fourth together at the assisted-living facility on Main Street.

Both women have a “healthy appetite,” according to daughter Gloria, and they praised the cooking of home owner and resident caregiver Jestina McLean. It was a traditional meal with turkey, dressing, potatoes and all the trimmings.

Dorothy, born Sept. 10, 1902, at her grandmother’s house in Weymouth, Mass., is well-known in the Worcester community. She taught grade school and high school there since 1932, retiring in the early 1960s.

Although frail, the two women are in “excellent health,” according to McLean. While Gloria does most of the talking for the pair, her mother easily recalls dates and events, such as her first teaching job in Hancock in Delaware County.

Neither woman has a particular secret to longevity. “You jut have to keep going and going,” said Gloria, born Sept. 2, 1927.

The sale of Manor Care to Carlyle may be in jeopardy, in Ohio at least.

THREE WEEKS after the sale of Toledo’s Manor Care Inc. was to have closed, the deal has been stalled by state regulators nationwide, and Wall Street is getting jittery.

In a sign that investors are worried that the $6.3 billion deal might not be completed, shares of the nation’s largest nursing home operator were trading last week nearly 9 percent below the $67 price at which they will be redeemed if the sale goes through.

“It’s worrisome,” said one analyst who spoke on the condition of anonymity. “The longer this thing takes to close, the more bad news may pop up.”

Good. The more time, the more truthful information can be brought to light.

Things might get a bit whacky here over the next few days, up to a couple weeks. We’re upgrading our version of WordPress- the blogging platform used for this site. Also a brand new design is in the works which will enhance everyone’s visits and locating content will be much easier!

Stay tuned!

About that nursing home where maggots were found in a man’s eye:

DELAND — Before a World War II veteran came to the hospital with reports of maggots in his eye, the nursing home where he lived was ordered to correct a long list of problems that included serving residents spoiled milk and moldy bread.

“The milk was curdled and had a pungent odor,” an official from the state Agency for Health Administration wrote in a March 20 report of an inspection at the University Center West at 545 W. Euclid Ave

The inspector who discovered the open carton of milk with a straw in it alerted a staff member, who then discovered three more outdated cartons of spoiled milk in the center’s kitchen and two in the dining room. On the same day, officials found a loaf of wheat bread with a “green fuzzy substance” and “flying gnats” on a shelf near a bed, the report states.

On Nov. 7, Anthony Digiannurio, 82, a Purple Heart recipient, was taken to Florida Hospital DeLand at 3 a.m. from University Center West with respiratory problems. The hospital staff discovered the elderly man had maggots in one of his eyes, an infected breathing tube, a partly inserted catheter and bed sores on his left elbow, according to a DeLand police report.

This week, Sandi Copes, spokeswoman for the Florida Attorney General’s Office, confirmed her office is conducting a criminal investigation into the man’s care.

Uugh! So the reports were not sensational as some suggested. It makes me ill to know such places exist.

The facility has been under scrutiny for the past two years for a host of problems, according to a 77-page report by the Agency for Health Care Administration obtained by The Daytona Beach News-Journal in response to a public records request. The nursing home is owned by the nonprofit Hearthstone Senior Communities Inc., also known as AGE Institute of Florida Inc., based in St. Petersburg.

Inspectors found many certified nursing assistants had no training to deal with Alzheimer’s disease patients, and poor hygiene when treating patients with staph infections.

In February, an inspector reported the facility failed to investigate or report seven abuse and neglect allegations, including one by a resident who said staff members saw the resident vomit but did not clean off the resident on July 20, 2006.

“I slept in throw-up all night,” the resident told the inspector.

All the deficiencies noted in the report had been corrected as of April 2007, agency spokesman Fernando Senra said. Reached by telephone Wednesday, Jo-Ann Grasso, University Center West administrator, refused to comment or remain on the phone long enough to learn the subject of this story. Previously, she said the facility was cooperating with authorities and conducting its own investigation into the Digiannurio case.

The inspection report described residents unable to receive help when they couldn’t feed themselves. On Feb. 7, an inspector watched a resident in a wheelchair with stiff fingers who could not use utensils eventually stick the stiff fingers in the food and “suck (the) fingers for nutrition,” the inspector wrote. Unable to hold the glass of milk, the person had nothing to drink, the report said.

For two years this place was red flagged…and yet it’s still open, free to neglect residents. I think our inspection system works just fine; I think the fine system stinks and this bulloney about “working with the facility” to make improvements is just that: Bulloney. Close these places down for good. Send the management team to jail for a couple years too- and perhaps some of the nursing staff as well. There are never good excuses for MAGGOTS being in the eye of a resident. God only knows where else they’re living!