re: JBE, the COVID After Action Report (AAR) and the case against Nursing Homes...

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The fact is La. rules force granny and grandpa into nursing home when thousands could be better served at home and for millions less.

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What rules are these? I seriously don't know. I DO work in a nursing home in south Louisiana as a consultant that is required by the state (dietitian) -- the state requires an RD in the building ONLY 8 hours a month. The company I work for tells me to "get my work done" and has never ever argued when I went over my "contracted hours" which is 24 in writing. It's often that I got way over and not an eye is batted.

Here's what I can say about our home: It's an older home -- it's clean, it's updated, it doesn't smell. We have people who come short term for rehab to the skilled unit (23 beds) and we have long term residents.

I've been there for 12 years. In that time period, there have been 3 administrators before the current one, 2 DONs and 2 ADONs. Our staff is mainly LPNs as in any nursing home but we have 5 RNs in the building daily as well as on the weekends. Our wound care nurse is an RD that is certified in wound care.

~~I see little to no facility acquired wounds (they are often admitted with them OR return from the hospital with them despite them going to the hospital with none).

~~We have some CNAs come in on their day off OFTEN at meal times to feed the people that otherwise won't eat when they're not there (fortunately most do ok with eating)

~~We have residents who CHOSE to be there -- one was being taken care of by her dtr adn then her OTHER dtr got cancer so the daughter was taking care of two people. The resident told her daughter that she wanted to go to the nursing home to relieve the burden == the daughter was in tears upon admission. Resident is thriving and doing fine.

~We have MANY that have zero family or it's a cousin/niece/along those lines who tend to them but "tending" to them is basically being available to report when something happens to the resident. Some are more involved than others but some not so much.

~~We have SOME who the family dumps there and allows their family member to linger when they should be on Hospice because "I hate him but I need his check". Yep, you read that right.

~~Our showers days are MWF or TThSat and it depends on which side of the hall that you're on. If you're too sick to go to the shower/bath, you get a bed bath -- if you refuse, well that's your right but as some point they do get talked into it.

~~Just to point out (not that I recall seeing it here but still) this is their HOME and they have rights. I cannot go into his/her room and take chips,candy, soda out if they're on a diabetic diet -- I have to discuss it and document it But to removed it from his/her room would be a violation and I could be reported. Just one example.

~~Do we have unhappy families? From time to time, yes -- grievances are written, meetings are held and I'm not privy to the outcomes but I can tell you we don't lose many residents to home across town. We do lose residents to other homes in other cities/states when it's better for their families to have them closer.

I could go on but I'll stop. In my role, I go in, I do my job, I visit extra with the residents, I get paid. I'm NOT privy to much of what you guys have mentioned re: payments, etc and I don't know much about the legislation. I'm just happy to be able to do my job and provide some smiles/interaction to the residents while doing it.

I am sure that there are more points that I could make but I can't remember all of the posts. I do know that the company that owns the homes does NOT own the therapy company, the xray service, the lab services, Hospice or Home Health. Lab/xray services are provided by a local hospital and the Hospice/HH is up to the choice of the resident/family and way more than one option is given.

I'm truly sorry that those who've had poor experiences with a nursing home have had to experience that. Would I put my mother/father where I work? Yes, I would -- I would also make it my business to check on them at different times of day and I would call at the first concern that I had (as I've encouraged someone in this post to do during these covid times). Would I RATHER my parent at home with me when the time comes? Sure BUT they have both said to PLEASE not do that and to make sure that they're in a good, safe place and to visit and tend to them. What WILL I do?? Time will tell.

I’m not condemning all nursing homes. They are vital and it’s good that La. and the Feds support nursing homes so they can provide thr care that Granny and Grandpa deserve.

I just believe that there should be quality options to nursing homes and if granny and grandpa find one that best suits their needs then the state should support that alternative just as they support nursing homes.

Other states provide more of that support than La. does. It seems to be working well for them, the elderly and everyone concerned,

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Other states provide more of that support than La. does. It seems to be working well for them, the elderly and everyone concerned,

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Is the funding less for nursing homes and more to the waiver servies etc? I know that our social services talk about and apply for those for many of our resident who may be able to even think about going home (the comatose, tube feeder isn't likely going home) but I'm not 100% sure about this.

I can also add I think that we have 3 private pay residents -- I was talking with the business office manager as I was curious if any of ours had LTC insurance and was told that we have 3 private pay.

I posted a link to an Advocate article above. They ran a series of articles outlining how our system works compared to most of the states.
We spend more, but they get better results. I suggest you read the three Advocate articles if you are that interested. They are eye opening.
And thus isn’t an anti JBE rant, Jindal with along with nursing home interests too.

Problem is there are too many residents that have significant chronic physical issues and not enough cna’s and therapists

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~We have MANY that have zero family or it's a cousin/niece/along those lines who tend to them but "tending" to them is basically being available to report when something happens to the resident. Some are more involved than others but some not so much.

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This is a sad situation. My Dad had to go into a nursing home last June. He has been living with me and had been driving until january 2019. But his was slowly going down hill and probably shouldn't have been driving up until the point he was. He started falling and I tried my best for it not to get to that point. But he dr. called me and basically said you cannot do it by yourself anymore. He needs 24 hour care. By the time I was able to get him in a facility he was in pretty bad shape physically and mentally. He couldn't walk on his own or get out of bed without help before he left home. He was sleeping 20 hours a day and his mind was a mess. This continued when he entered the facility. He was in a wheel chair and he was imagining things and his fluid was fluctuating like crazy. Went in the hospital 3 times in the first 2 months he was in there and it was really a struggle. But by about September he was improving a lot. Since about late October he able to walk around his room on his own and uses a walker when going around the home. Only time he uses his wheel chair is on shower day and he only uses it then because it is easier for him to sit in to get dressed. He is really doing really good. I would really would love to be able to bring him home but I know that the reason he is doing so well is because he has a regular routine and has care 24/7. The home he is in has its problems but it is far better than others I have heard about. Until all of this started I would visit him a couple of times on the weekend and several times during the week and I would bring him snacks and do his laundry. What is bad my brother doesn't call him or go visit at all. I see other ppl in there that never get visited. I want to take my brother and beat him with a rusty tow chain but the law tends to frown on shite like that.

It’s incredibly lazy to say that the problem lies at the feet of nursing home staff and administrators.

The issues are deep though from the moratorium on Certificates of Need for new beds not allowing for free market competition to the LDH and CMS attempting to regulate quality into nursing homes which never works.

There is also a significant portion of residents in facilities that are not appropriate for a geriatric environment. Mental health patients that have nowhere else to go and end up there.

Nursing home industry needs reform bad but it needs to start with the millions being pumped in the political system by nursing home operators. Not the CNA wiping up shite for 10.00.

Nice start on your list, but it runs deeper into the legislature than that.

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Some people willingly live in a nursing home and are very happy.


I disagree

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It's alright to disagree but I am stating a fact