Nursing Home Inspections and Nursing Home Violations

The government has been advertising the Medicare.gov website to let seniors know the nursing home inspection reports are available online (they also allow other websites to download this information and Caregiverlist also provides it).  I have been hearing the ads on NPR and elsewhere.

The nursing home inspection reports are a nice starting point  for seniors and their family members when evaluating a nursing facility for a short or long-term nursing stay.  But it is important to realize that these nursing home inspections are only performed once every 15 months.  Ask any Certified Nursing Aide who has worked at a nursing home (working at a hospital or nursing home is required as part of their certification training) and they will tell you that most nursing homes have an alert "code" that goes out when the nursing home inspectors walk in the door - - - it could be just announcing on the P.A. that "Minerva is on line 1".  This means everyone is on their best behavior.  It reminds me of elementary school when parents sat in on the classroom - even the bullies were nice to everyone on those days, including the teacher.

In addition to the inspections only being made every 15 months,  the nursing home violations are not included in the inspection report, and, actually, this is the information you really need to know when evaluating a nursing facility. 

If you really want to make sure you are going to be moving a senior into a quality nursing home, the best way to find out the quality of the care is to find out the number of nursing aides on staff per number of beds and to talk to the staff.  In addition, find out the monthly nursing home violation report in your state.  As you'll see from the June, 2008, violations in Illinois, many of the violations most likely happen because there just aren't enough caregivers to manage problem residents and to assist with bed sore management.

This is why more seniors are opting for care in the home by a one-on-one caregiver.  Senior Home Care Agencies provide in-home care for a cost of between $16 - $28 per hour, depending on what part of the country you live in, and this fee provides for all the payroll taxes, insurance protection and active management of the caregiver.

Nursing Home Violations For The Month Of June 2008

SPRINGFIELD, Ill – The Illinois Department of Public Health today announced the following type “A” violations of the Nursing Home Care Act were cited during the month of June. An “A” violation, which is the most serious licensure violation imposed by the state, pertains to a condition in which there is a substantial probability that death or serious mental or physical harm will result.

The statement of violation for each facility can be obtained by clicking on the facility's name.

Alden Alma Nelson Manor, a 268-bed skilled facility located at 550 S. Mulford Avenue, Rockford, has been fined $32,500 and notified of license revocation for failure to prevent and protect residents from abuse. Three residents were physically attacked by another resident. The facility has requested a hearing on the Department’s action. A status was held February 26 and settlement negotiations are underway.

All American Nursing Home, a 144-bed skilled and intermediate care facility located at 5448 N. Broadway Street, Chicago, has been fined for failure to maintain a sanitary kitchen and ensure proper food handling to prevent hazardous food borne illnesses. Kitchen staff was observed preparing food without washing hands or using gloves. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $1,200.

Allen Court, a 16-bed intermediate care facility for the developmentally disabled located 1650 E. Main Street, Clinton, has been fined $20,000 for failure to implement its own policies to prevent neglect of a resident. Staff failed to provide a thorough assessment of the resident’s symptoms and did not provide immediate medical attention after a fall. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Belhaven Nursing & Rehab Center, a 221-bed skilled care facility located at 11401 S. Oakley Avenue, Chicago, has been fined $30,000 for failure to provide necessary care and services to residents to prevent pressure sores and treat new sores. The facility has requested a hearing on the Department’s action. A status in the case is April 16.

Blue Island Nursing Home, a 30-bed intermediate care facilities located at 2427 West 127th Street, Blue Island, has been fined $15,000 for failure to adequately supervise residents and monitor a resident’s consumption of alcohol and prevent the resident from physically abusing two other residents and a staff member. The facility requested a hearing on the Department’s action. A status in the case was held February 26 and settlement negotiations are underway.

Brother James Court, a 99-bed intermediate care facility for the developmentally disabled located at 52508 St. James Road, Springfield, has been fined $10,000 for failure to implement facility policy and procedure on Abuse and Neglect. The facility also failed to recognize the need for additional supervision of a resident after a sexual incident between two residents. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

Cardinal Hill Healthcare, 90-bed skilled care facility located at 400 E. Hillview Avenue, Greenville, has been fined $55,000 for failure to provide adequate supervision to prevent a resident from choking which resulted in death. A resident took another resident’s sandwich without staff knowledge; was later found without vital signs and pronounced dead. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

East Peoria Gardens Healthcare Center, a 103-bed skilled and intermediate care facility located at 1920 Springfield Road, East Peoria, has been fined for failure to provide necessary care and services to maintain health. In the case of 4 residents, the facility did not (1) perform cardio pulmonary resuscitation (CPR), (2) provide adequate supervision, and (3) monitor worsening medical condition. As a result, 3 residents died and a fourth suffered gangrene to a toe. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $32,500.

Mosaic Living Center, a 150-bed long term care facility for residents under the age of 22 located at 7464 N. Sheridan Road., Chicago, has been fined $10,000 failure to provide nursing care in accordance with a residents needs. Due to the facility’s failure to properly monitor a resident with a history of removing a feeding tube, the resident lost almost 30 pounds. The facility has requested a hearing on the Department’s action. A status conference was held February 8 and settlement negotiations are underway.

Moweaqua Nursing & Retirement Center, a 70-bed skilled care facility located at Maple and Macon Streets, Moweaqua, has been fined $50,000 for failure to supervise a resident at high risk for falls. The facility did not assess nor make changes to the plan of care for the resident, after repeated falls. As a result, the resident fell and died after suffering facial fractures and head injuries. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Parents and Friends of the Specialized Living Center, a 100-bed intermediate care facility for the developmentally disabled located at 1450 Caseyville Avenue, Swansea, has been fined $20,000 for failure to implement a diet order for a resident at risk for choking. The facility did not monitor the resident who had received the wrong texture and consistency of food. The resident was hospitalized after choking. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Regal Health & Rehab Center, a 143-bed skilled and intermediate care facility located at 9525 S. Mayfield, Oak Lawn, has been fined $25,000 for failure to adequately supervise four residents identified as unsafe smokers. Three of the four residents require continuous oxygen therapy. The lack of supervision resulted in one resident suffering burns to his face. The facility has requested a hearing on the Department’s action. A status in the case is March 5.

St. Anthony’s Nursing & Rehab Center, a 120-bed skilled and intermediate care facility located at 767 30th Street, Rock Island, has been fined for failure to develop and implement a plan to address a resident’s sexual behavior toward other residents. The facility also failed to implement effective interventions to monitor the resident responsible for sexually abusing two other residents. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $12,000.

Timbercreek Rehab & Health Care Center, a 202-bed skilled care facility located at 2220 State Street, Pekin, has been fined $20,000 for allowing two Certified Nursing Assistants with findings of abuse on the Health Care Worker Registry to work at the facility. The facility also failed to protect residents from abuse by one of the CNAs, who was later found to have broken the wrist of a resident. Both were terminated. The facility has requested a hearing on the Department’s action. A status in the case is March 3.

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Memory Exercises for Seniors and Caregivers

Just as exercising your body improves your muscles, exercising your brain also improves your memory capabilities, leading research shows.

A senior's 60-year-old brain will take in information two to three times slower than a 20-year old brain.  However, senior minds can learn new tricks as even older brains can grow new and stronger connections (this is why seniors who suffer strokes can effectively rehabilitate and regain their physical and mental capabilities again by retraining the brain through therapy exercises - but if they don't do the exercises, then they don't regain the movement, which why having a proactive and encouraging Caregiver is essential).

You can build your mental savings account while you are younger by continuing to involve yourself in activities which require thinking - play monopoly and scrabble, do crossword puzzles, join committees and boards which require active thinking and planning, develop new hobbies such as golf or playing a musical instrument.  And, even more important, don't stop becoming active when you retire from your day job.

Research shows you must exercise your mind regularly and be consistent (it really is the same as with physical exercise - you can't just show up and run the marathon without properly training for months).

Caregivers can bring along the crossword puzzle from the daily newspaper to do with their senior client or find a trivia book or a magazine article to discuss.  Anything that makes the mind think will work.

 

How Alzheimer's Disease Changes Behavior

Everyone forgets something now and then.  How many of us have left the house to go someplace and then remember we forgot to bring something along or wondered if we unplugged the iron or what time a meeting we scheduled weeks ago is suppose to start?  Sometimes we simply have too much information going in and out of our head to properly process it or we don't take the time to really listen and file it away while multi-tasking - regardless of whether we are a senior or not which is why we all have the so called "senior moment".

I am often asked how memory loss for those with Alzheimer's Disease is different than other types of memory loss.  One of the most common answers to this is that Alzheimer's Disease impacts a senior's decision-making ability ongoing and includes confusion of "person, place or thing".  Instead of just forgetting what time a meeting is scheduled for, they might also forget where the meeting is to be held and who is attending or they might confuse their sister for their mother.  Confusion comes into the picture along with the memory loss.

PBS has provided informative programming on Alzheimer's Disease and their website provides a chart showing what part of the brain impacts the various behaviors experienced by those with Alzheimer's disease and makes it a little easier to understand how this disease differs from other types of memory loss.  

Many times a senior may not have their memory loss properly diagnosed.  Because there are a few drugs which can slow the progression of memory loss and services available to help both a senior and their family members with the emotional aspect of dealing with memory loss, definitely make sure you visit a geriatric doctor who can provide a proper diagnosis.  Caregivers can provide better care if they are informed on the type of memory loss the senior has been diagnosed with as there are many tools available for exercising the mind and slowing the progression of memory loss.  It has also been shown that meditation - simply emptying the mind - can be very beneficial for those with memory loss, as well as relaxing.

 

 

 

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Caregiving: Very Fulfilling Work

Unemployment rates have continued to increase in the last few months, with California reporting a 9.3 percent unemployment rate in December, 2008. January numbers for unemployment are also expected to be at high levels throughout the country.

For those looking for employment, the good news is that there are still plenty of jobs available for senior caregivers.  Senior Home Care Agencies hire both Companion Caregivers and Certified Nursing Aides or Certified Home Health Aides (the Home Health Aide designation and certification is available in some states but still does not exist everywhere).

The job description for a senior caregiver usually includes assisting with personal care, meal preparation, light housekeeping, laundry, medication reminders, exercises, companionship and running errands or escorting to doctor's appointments.  For those seniors who are receiving hospice care or who are recoving from a stroke or hip replacement, more hands-on personal care may be required, including transfers from bed to wheelchair to toilet and assistance with bathing and eating.  Some seniors require mostly companion care because of memory loss.

Caregivers are usually assigned to individual senior clients, maintaining a regular schedule.  But as hospital stays have become shorter and more seniors prefer to stay in their own home with one-on-one care, Senior Home Care Agencies are constantly hiring Caregivers. Some senior care requirements will require no professional experience, other than a caring personality and other care assignments will require at least one year of experience.  In addition, background checks, reference checks and training must be completed before beginning a care assignment.

Caregiverlist provides information about senior caregiving jobs, including pay, benefits, training, interview tips and job descriptions - - just click on CAREGIVING JOBS in our top Nav Bar to learn more.

And, if you or someone you know is job hunting, submit an application on Caregiverlist to be connected with hiring senior care companies in your area for current and upcoming openings.

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Saving for Senior Care

With all the craziness in the financial markets of late, everyone is concerned about their savings - especially seniors who are living on a fixed income and who are perhaps watching their savings fall along with the market.

Here is the good news and bad news about senior care.  If you have "some money" you are going to need to foot the bill for any caregiving services.  But if you have no money, the government will take care of you for as long as needed, only this care will need to be in a nursing home.  But you will be fed and cared for as long as required.

Each state implements their own Medicaid program - Medicaid is the insurance program for very low income seniors.  Usually the state asset level for Medicaid qualification is around $2,000.00 in assets.  Caregiverlist provides details on each state's Medicaid program, complete with contact information, within our "by state" senior services section:

Find your state on Caregiverlist and learn about the Medicaid qualifications along with other senior services, including the senior driving laws, background checks and Senior Helpline.

 

 

The Aging of Benjamin Button

The Oscar nominations for this year are out and the movie "The Curious Case of Benjamin Button" has socred nominations in several categories, including best picture.

The movie, adapted from the 1920's story by F. Scott Fitzgerald, follows a man who is born in his 80's and ages backwards.  By turning the wisdom of aging around, the movie offers much food for thought for those of us of all ages, including seniors.

Anyone who is a caregiver will definitely appreciate this story, and appreciate the acting (and of course, Brad Pitt is still easy on the eyes).  Check it out.

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An Historic Inaugural - Especially for Our Seniors

Our first African-American president will take the oath of office tomorrow in front of an audience that will include many seniors who can remember segragation and their grandparent's stories about slavery.

One of my dearest friends is African American and another is Chinese American and I cannot even imagine not having the opportunity to interact with other cultures or being segragated from someone of another race.  But today is also Martin Luther King day to remind us that it has taken much work to create opportunities for those from all backgrounds in this country.

It is also a reminder to us of the different viewpoints a senior may have because of the era that they lived in.  One of the biggest challenges for senior caregivers is to try to connect with the senior in a way that understands the senior's viewpoints and needs.  Sometimes it is very difficult for a younger caregiver to understand that a senior is not comfortable with their style of dress or jewelry or language - but when we take the time to think that we all go with what we know based on our environment and then think about the environment someone was in 50 years ago, we can better understand where they are coming from.  And then we can try to connect to them with sensitivity towards their thinking.

One of the greatest assets President-elect Barack Obama brings to the White House, according to those who know him well, is his ability to listen and connect with people from all walks of life and from all viewpoints.  This is definitely a skill we all need when dealing with someone much older or much younger than we are - I am sure in addition to his many other skills, President-elect Obama would also be a stellar caregiver!

 

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Living to Age 100 Becoming Common

One of Caregiverlist's employees will be taking time off next week to visit her 100-year-old Grandmother who will soon turn 101.  Reaching age 100 doesn't receive as much attention as it did when my great-grandmothers turned that age.  Instead, reaching age 105 or 110 grabs the limelight now because more and more seniors are living to be 100.

According to the U.S. Census Bureau, the population age 65 and older is projected to double between 2000 and 2050.  We have modern medicine to help us age a little better and with advances in nutrition and an easier lifestyle, Americans can expect to live way past retirement age.

This means seniors who retire in their 60's need to plan for their next 40 years - life is far from over at retirement.

The news media has picked up on a story about a Chinese senior this week.  The Chinese woman, at age 107, decided that she is interested in getting married because she does not want to be a burden on her relatives now that she can no longer do everything for herself.  She apparently did do all her own laundry and household tasks until recently.........although perhaps a husband is not the answer for help with those things?  I don't know, maybe it works differently in China.  In a country where arranged marriages are a common practice it is very impressive she has waited this long.  I wish her luck! , ,

Senior Volunteering

President-elect Barack Obama said Wednesday that he wants his inauguration to be about more than him; it should be about getting all Americans involved in community service.

Obama and Vice President-elect Joe Biden and their families plan to participate in service projects in the Washington area Jan. 19th and are encouraging every American to roll up their sleeves and become involved in their communities to renew the promise of America.

If you are a senior, this is a reminder to get involved in your community, especially if you are retired and now have the time to volunteer.  And if you are a Caregiver, this is an opportunity to take the skills you have learned to other seniors.  Seniors are usually the most grateful group to volunteer for as many of them may have experienced the loss of family and friends and are open to making new friends and welcoming volunteers.

From meal programs to senior services, you can find out about senior volunteer programs through your local Area Agency on Aging and you can find this information in Caregiverlist's "By State" listings.

And, if you are thinking about becoming a professional caregiver but do not have paid experience, look into volunteering with a local hospice which will usually provide you with training and assign you to one-on-one care with a senior.  This is great caregiving experience that will assist you in finding a caregiving job.

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Dr. Sanjay Gupta: New Surgeon General?

Apparently Dr. Sanjay Gupta, of CNN fame, has accepted the job of Surgeon General.  And now the news media is talking about how appropriate this choice may be.

He is a medical doctor.  And he clearly knows what the issues are since he is on the front lines with daily news deadlines which also means he can communicate and hustle......probably all qualities that will serve him well as Surgeon General.  I think it is quite fine that the choice is not a government official.  It is kind of refreshing, actually.  Especially when you consider government officials came up with a "donut hole" for medication coverage for seniors.  That program would never had sold in the private sector. 

CNN's Dr. Gupta is known for promoting a healthy lifestyle through diet and exercise for longterm health.

The grim reality is that many seniors do suffer mobility, breathing and heart problems because of years of unhealthy living.  Improper diet, smoking and lack of exercise have contributed to a decline in their health.  Advances in medicine have enabled them to stay alive with medications, oxygen and medical equipment, but this is at an added cost to Medicare and to taxpayers.  And it means family and professional Caregivers, at an additional cost, are needed to help them get through each day.  Certainly many seniors could not have prevented their medical issues.  But many other seniors perhaps could have limited their medical issues with a change in lifestyle (and this applies to all of us, at all ages, right?).

As a side note, there has also been new mentions of a "nanny issue" (a nanny was hired but payroll taxes were sort of not paid, which is an issue if you were the employer of the nanny who did not pay the taxes and may be taking an appointed government job) for one of Obama's nominees......another reason to realize the value of using a Senior Home Care Agency for senior care services - professional management will insure that taxes are taken care of as part of the payroll benefits, along with substantial insurance protections such as Worker's Compensation Insurance and Professional Liability Insurance......those who think they are saving some pennies by skirting taxes with a hire-direct caregiver should think at least twice before they go this route.  An uninsured Caregiver can sue their employer (the senior) for many things and no protections are in place.....and the IRS can hold the senior responsible if the Caregiver does not pay their payroll taxes (and if you are going to be appointed to a government job, senior caregivers are in the same boat as nannies when it comes to paying taxes).

 

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