2 state nursing homes land on U.S. watch list

[Jen]

We toured each facility before my mother was admitted. Either myself or another family member was there EVERYDAY. I does NO good if the staff and physicians don't listen to the person who know the patient the best, the family.

[SANDRA MYERS]

MY MOTHER IS IN GENESIS AT THE WALDORF CENTER.THEY CONSISTENTLY GIVE POOR CARE. ,THEY HAVE INJURED MY MOTHER SO MANY TIMES,i WILL CONTINUE TO REPORT THEM BECAUSE THEY STILL CONTINUE TO DO WHAT THEY WANT.MY MOTHER CANNOT TALK OR REACH FOR ANYTHING SO SHE NEVER GETS ANY WATER OTHER THEN WHEN I GO UP THERE AND THATS EVERY DAY 3 TIMES A DAY,IF NOT MORE.

[diane]

my dad passed away at manor care,rossville in 2002. i hated that place for the care he received,the staff. he was just going there for a short time after surgery.he never made it back home. i truely believe that place made him worse,and did not care for him at all.the care he received was a reason for his death,even his doctor's were conviniced of that. he was not changed on a regular basis,feed properly,fell out of bed,due to the bed rail's were not in place. there is no care going on in that place.... it is to late for me,can't something be done for someone else's dad.

[Kassie]

You named Manor Care for Rossville, why didn't you name Genesis for Waldorf? Waldorf is owned by Genesis, which has a lot of nursing homes in the Maryland area.
What about the pharmacy involved, NeighborCare/Omnicare?
You could wrote a book about their legal problems.

[bethbaker]

As a long-time journalist who covers aging issues, I can tell you that nursing homes do not have to be this way. I had the privilege, while writing my book Old Age in a New Age (Vanderbilt University Press 2007), to spend time at wonderful places across the country who embraced a new transformational way of providing services and a high quality of life to people in nursing homes. They set the bar high, creating a sense of home, rather than hospital. They restore dignity and meaning -- even fun -- to people's lives and reward staff with respect and decision-making for a job well done. It can work -- believe me. I've seen it.

[Clare from Voices]

When people ask me to recommend a nursing home, I refuse. Situations can change rapidly.
I have watched good nursing homes go downhill rapidly because of a change in staff or ownership.
And I have seen some that had awful surveys then have a good one.
If people need to have a family member in a nursing home, they should be prepared to visit often, sometimes at odd hours (10:00 PM for example. They should be trying to find out what sort of care their family member should be receiving, and advocating for that care. They should join a family council, or form one if there isn't one available at their facility.
Finally, anyone interested in long term care should write to Senator Barbara Mikulski, who serves on the Committee on Retirement Security and Aging, and ask her to co-sponsor S. 2641, the Nursing Home Transparency and Improvement Act. This is the first change in nursing home law in nearly 20 years. A similar letter to Ben Cardin would also help.

[a concerned individual]

From experience, I know that alot of the problems that exist in nursing homes have a great deal to do with staffing issues. I don't believe that employees don't want to treat people like they want to be treated I believe it's due to their inability to do so as a direct result of understaffing. I place the blame on those who generate the pt per staff ratios as they need to be increased. For all of you out their who have loved ones in a nursing home please try to remember that their is still good left in this world. You may find it in the smallest of places but it is there. Don't give up and pray to God everyday that the situation improves

[former staff at manorcare]

the place needs to be gutted out and rebuilt from the foundation up.there's a lot of dedicated employees there who really care and are good at their jobs. you can only do so much when you're understaffed and overwhelmed. i beleive when people come in for the tour they're misinformed and not painted a realisitc picture. lets face it it's not a high-end nursing facility.the administration is not culturally diverse and do not relate to the people who are actually giving the care the staff many are new to the profession need and require more training many are new just out of school the pay could be higher families are abusive to staff when they need to vent to physicians and administrators many of the administration personnel just walk around and point a finger how can you blame the little workers if you don't give them the tools you have family members who stay all night at the bedside when there's three patients to a room what about privacy laws you have consultants making a lot of money mocking at the facilities management but laughing all the way to the bank

[DCA]

This link should work
http://www.cms.hhs.gov/certificationandcompli...

[gdpawel]

Congress is turning up the heat on nursing homes, or so it seems. The House Energy and Commerce subcommittee on oversight and investigations held a hearing that focused on problems with regulation and full disclosure of ownership.

Surprisingly, this subcommittee had not held an oversight hearing about nursing home care since 1977. This indicates a rather lackadaisical attitude on the part of Congress in regards to our senior population. The last significant change in nursing home regulations was the Nursing Home Reform Act of 1987.

Now it seems Congress maybe serious enough in examining whether standards continue to provide an appropriate level of care and protection for residents of nursing homes.

The subcommittee released a report commissioned by the Centers for Medicare and Medicaid (CMS) that suggested that the regulatory enforcement system for nursing homes has a lot of problems.

All 46 Manor Care nursing homes in Pennsylvania staff below a standard recommended in a Centers for Medicare and Medicaid Services (CMS) study as putting residents at risk.

CMS contracts out the oversight of each nursing home to each state's health department. Not only is the each state's health department the problem, CMS may be part of the problem too!

CMS uses stealth moves like putting out the word that surveyors shouldn't cite anything they don't absolutely have to, cutting or under-funding oversight budgets, and looking at self-reported and unaudited data (data reported by the facilities themselves and no oversight agency verifies audits to ensure that it is even true).

Nursing home inspections depend on the paperwork to verify the residents are getting good care. Manor Care pays nurses to make sure the paperwork is perfect, thereby ensuring a good inspection.

In the past few years, a wave of new owners and investors has begun purchasing nursing home chains. These private-equity firms are unregulated and new to the nursing home market.

Many worry that the top priority for these new owners will be profits, rather than providing the staffing and resources necessary to ensure top quality care for our loved ones.

Frequently, they use complex corporate structures, separating the nursing home real estate from the operating companies and putting multiple layers of limited liability partnerships between themselves and the day-to-day operations of the nursing home.

The Carlyle Group already planned to restructure its take-over of Manor Care, which will comprise about 300 corporate entities that could obscure ownership and make it more difficult to regulate care. It split the company's real estate holdings from the rest of the business so the properties could be used as collateral to raise funds in credit markets.

Ownership structures with multiple stakeholders have been used by other private-equity firms to minimize liabilities and shield them from regulator inquiries like when cutting staff is made to improve profit margins. They use these kinds of structures to avoid taking responsibility when taking control of nursing homes.

Private equity is buying up this industry and then hiding the assets, and when residents are dying from lack of proper care, there is little the courts or regulators can do, while they skim off the profits to line the pockets of investors or plow the money into separate ventures that have nothing to do with nursing home care.

CMS and the states lack the tools to keep up with the rapid changes in the industry, to know who actually owns the country's nursing homes and who should be held accountable for the residents in their care. There is a crisis in our nation's nursing homes. The residents their need help!

[gdpawel]

How Much Do We Spend on Nursing Homes?

The nursing home sector accounts for roughly 6 percent, or $124.9 billion of the more than $2 trillion that we invest annually in healthcare. As always, the question is “Are we getting good value for our money?”

Given how vulnerable nursing home patients are, questions about quality deserve special attention. Maggie Mahar does the basics, how much do we spend on nursing homes?

http://www.healthbeatblog.org/2008/06/health-...

[PGCSmitty]

My great grandmother was raped and left for dead there.

[jody]

How can you hold m/c legally accountable ? My Mom was severly overdosed with morphine at w/c in 2004 & I got there in time to call 911 & get her to e.r. It was all well documented but I did not follow through because I was afraid of repurcussions from other nursing homes if she had to go somewhere else later on...for her sake I kept silent...Now that they have been exposed I would like to add my story to whoever does the watch list, since I have proof from e.r. records etc... in hopes it will help close the facility down. For that matter, why are emergency rooms not required to alert authorities when they obviously see and have to treat these cases???? If it were a child being so abused, authorities would be notified and action taken right away...Where are the laws for our elderly, who by the time they reach nursing homes are often as not...as helpless as children??? They raised our generation and now our generation should be giving them the care & respect they so deserve...In other societies the elderly are revered and cared for...WHY CAN"T WE GIVE THEM HUMANE JUSTICE AND PUT THESE ABUSERS OUT OF BUISNESS...SURELY IF THE TAX PAYERS REFUSED TO PAY FOR INHUMANE TREATMENT OF HUMAN BEINGS WHO ARE HELPLESS...IT WOULD STOP !

[employee]

I am an employee at Stella Maris (not for much longer) and I have to agree. We are left without enough help so often that those of us that want to give the best care we can, cant. Today we were so short that I had to take care of 12 people. They dont care if we can do it or not, they just tell you what you want to hear to get all your money and you are stuck. Im seeing it everyday and it is killing me. Then the hiring you mentioned. They have classes there and hold the students to 1 year employment at $9.00 an hour. We all have to work every holiday if they tell us to and if there is 2 feet of snow, we will get written up if we call out.They do not take care of the employees at all and that is why so many of them are soooo lazy. It is wrong. I do the very best I can with what I have to work with and I know that it is not enough. It feels like Im one of very few in a crowd that cares and sometimes all I can do is say a prayer as I leave each room. Ive only been there 4months but am leaving to work as a private duty GNA so that I can give the absolute best care that I can. My heart goes out to those of you that do not have a choice but to place a loved one in a nursing home. I hope that I never have to make a decision like that. But if I can make a suggestion to anyone that has a loved one there. They sell small cameras that are small and can be hidden very easily. You can record or set it up that you can watch from your computer. They are not very expensive and ebay has great deals. That way you know what is going on and you have proof if you need it. YOU HAVE A RIGHT TO KNOW!!! Outraged, Im soooo sorry that you and your mom suffered that kind of neglect!

[gdpawel]

Nursing Home Transparency and Improvement Act of 2008

Summary of Major Provisions of the Act

Improve transparency and accountability in the ownership and operations of nursing homes

Corporations would be required to disclose their owners, operators, financers, and other related parties. Facilities that were part of chains would be required to submit annual audits. Purchasers would have to demonstrate that they were financially able to run facilities.

Require disclosure of how Medicare and Medicaid funds are spent

Providers would have to report wage and benefit expenditures for nursing staff on cost reports. Cost reports would be revised to categorize spending for direct care, such as nursing and therapies; indirect care, such as housekeeping and dietary services; capital costs, including buildings and land; and administrative costs, which often include the company’s profits.

Establish independent monitoring of chains

The federal government would develop a protocol for an independent monitor of chains to analyze their financial performance, management, expenditures, and nurse staffing levels. It would provide for corrective action and collection of civil monetary penalties.

Collect accurate information about nurse staffing

The government would collect data electronically from nursing homes on the number of RNs, LPNs, and nursing assistants, using payroll records and contracts with temporary agencies as the source. Data would include turnover and retention rates and hours of care per resident provided by each category of worker.

Provide better public information about nursing homes

Nursing Home Compare would be updated with more timely reporting of surveys; ownership information; accurate nurse staffing data, including turnover and retention rates; links to survey reports (Form 2567) when states put them online; enforcement actions; and all Special Focus Facilities identified for three years. The government would undertake a study on how to improve the website to make it more useful and understandable.

Implement new consumer complaint processes

The government would develop a standardized form consumers could use in filing complaints with the state regulatory agency or ombudsman. States would be required to establish a complaint resolution process for residents’ representatives who were retaliated against, including denied access to residents, if they complained about quality of care or other issues.

Provide for higher civil monetary penalties and other CMP reforms

Federal civil monetary penalties would be increased for the first time since the 1987 Nursing Home Reform Act – up to $100,000 in the case of a resident’s death. Fines would be held in escrow during appeals of deficiencies, no longer delayed until appeals were resolved. Federal CMP funds, which are now returned to the U.S. Treasury, are encouraged to be used for the benefit of residents.

Provide for reporting of closures and continuation of federal payments

Nursing homes would be required to give 60 days notice of closure, including a relocation plan and assurances that residents would be transferred to the most appropriate facility or other setting. No new residents could be admitted after the notice was given, and the federal government could continue Medicare and Medicaid funding for residents until relocation was completed.

Authorize studies of temporary management; special focus facilities; culture change; and nurse aide training

The bill provides for studies of temporary management; the characteristics of Special Focus Facilities, including ownership; best practices in culture change; and training of nurse aides and supervisors. Dementia management would be added to the initial 75-hour nurse aide.

[Knights Of Columbus]

Let me sound off on this before you narrow the circle! Even though that I am a grandparent, I have been checking on my mother and father that are in their mid 90's and fortunately, they are in good shape. The reason is because they keep nice and active, that is good. Personally, when their time is up for conventional living, I want them to go to the Sunrise Assisted Living Community home. That is a nice place and they will get great care. After working for the government for more than 34 years, they accumulated enough wealth in their 401K to afford a nice place like Sunrise Assisted Living. They told me recently that they are doing well at the moment but will keep that in mind for the future.

[Ben]

I can't comment on either of these facilities as I've never been in either of them, but I DO have experience with a ManorCare nursing home here in WI. This nursing home corporation as a whole is HORRIBLE! When our Grandma was admitted to a ManorCare facility the care was so horrible she almost died as a result. She was never repositioned, was given the wrong medications, received no assistance with feeding/drinking, NOTHING. The call button was always out of her reach. The nursing staff was lazy, incompetent, and uncaring. If our family hadn't been around to push those lazy employees to do their job, she would have died. I HATE MANORCARE. My sincere sympathies to everyone else posting on here who has had similar problems.

[employee]

Does anyone know where an employee can go to report a facility neglecting a resident? I actually went to the bathroom to cry today. Im trying sooo hard to avoid a terrible accident. Ive reported it to 5 different nurses within the last week. Nobody will do anything! God I wish someone would care for these people! We have so many lives in our hands yet are soo heartless! Its like they get so used to seeing people dying that they stop making effort to avoid unnessiary incidents. THEY DO NOT CARE!!! GOD PLEASE HELP THESE PEOPLE!!!

[Ben]

You need to contact your state government immediately. You can remain fully annonymous, and even if you choose to give your name, the state will NOT "rat you out." Please do something. You can find phone numbers on the internet of how to contact the appropriate officials.

employee wrote:

Does anyone know where an employee can go to report a facility neglecting a resident? I actually went to the bathroom to cry today. Im trying sooo hard to avoid a terrible accident. Ive reported it to 5 different nurses within the last week. Nobody will do anything! God I wish someone would care for these people! We have so many lives in our hands yet are soo heartless! Its like they get so used to seeing people dying that they stop making effort to avoid unnessiary incidents. THEY DO NOT CARE!!! GOD PLEASE HELP THESE PEOPLE!!!