GAO Faults State Nursing Home Inspections

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I completely agree, nursing homes are not truly homes for those who live there, yes we aim more towards residents right thatn int he past. However, the ultimate goal is to hire lots of office staff anf quality assurance personel to make sure that all the paperwork is done perfectly to meet the needs of the over-regulating government. The thing they forgot to over-regulate and really need to is the number of CNAs to residents in LTC facilities. I know you cannot just have a magic, there needs to be a formula derived base don teh level of care needed by the residents who live there.
I currently work in a 47 bed LTC facility, and 97% of those people are very low-functioning and require total care. As a CNA, we literally run for 8 hours to try to meet patients needs, and we just can't. The administration and the governmetn are not aware of this because they spend their time in a padded desk chair with a lovely window view. Residents get inadequate care and have to wait a long time to get care because there are not enough CNAs. We here things like, 'compared to similar facilities of this size we have the appropriate number of aids.' News flash - no two facilities will ever be the same. Something needs to be done to open everyon's eyes and move from paperwork & profit-centric to resident-centric care.

Michelle Kerschner of IA 9:41PM July 05, 2009

Maryville Daily Times
1/7/2009
Dear Editor;
I agree with Bernie Bowman’s, letter to the editor on December 31, 2008 (former CEO, Asbury, Inc.) assessment that simple answers are often wrong. Answers should be examined and carefully scrutinized. Data for my arguments are from CMS (Centers for Medicare and Medicaid Services) and NCCNHR (National Citizens' Coalition for Nursing Home Reform).
I agree that staffing should NOT be given so much weight in the rating system. As long as nursing homes meet the Federal and State staffing standards, why should they be penalized? After all, abundant staffing does not necessarily translate into better patient care. For example, one of the facilities within a fifty mile radius and with above average marks on both staffing and quality measure ratings also has the unique distinction of having 20% their residents’ with pressure sores and 22% with severe pain of those measured, NCCNHR had a similar argument. In the above case percentages are above the averages of all those nursing facilities in Tennessee and United States. Pressure ulcers should carry more weight in the rating system. Quality measures that NCCNHR believes are valid and strongly indicative of quality of care are: High-risk pressure ulcers, long-term catheters, restraints, UTIs and weight loss”. NCCNHR also issued a caution about using only one source as the sole source for determining the best nursing home for you. Some nursing home data available from CMS is flawed and should be corrected and new quality measure elements applied:
1. Not all nursing home ratings are based on all quality measures. One rating was based on less than 30% quality measures. CMS justified this as not enough residents are available to make this determination. But, in some cases they reported qualities measures 1% or less in nursing homes with 100 residents or less which calculates to be at least one resident. This lack of quality measures flaws the rating results and is unfair to nursing homes that are rated on all quality measures.
2. Trying to decipher the annual survey report on the CMS web site is like trying to judge the contents of a book by its title. A consumer should visit the nursing home and read the unedited report.
3. One of the most important quality measure, CMS could provide; is trends, that is, devise a method that would show a trend over time for all quality measures. This would alert the consumer to continuing and deteriorating nursing homes performance or the opposite.
What can I do as a consumer? One great source for consumer information is on the web, at NCCNHR, just Google this acronym in the search block.
Final analysis: Some nursing homes with low ratings are good nursing homes, while some of those nursing homes highly rated are not so good. As a matter of record and as a volunteer conservator, I have had several clients in one of Mr. Bowman’s facilities; each of them received excellent care.
Some of my experiences come from my service as Volunteer Ombudsman in several nursing homes in Blount County, thirteen years, a member and Chairman for Blount County Council on aging, and a member and Vice-Chairman for East Tennessee Council on Aging and disability.

Jerry Rowe of TN 10:14AM January 23, 2009

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please of AL 9:53PM November 01, 2008

Abuse exists. Having spent 3-4 hours daily for 10 years with my 80-year old sister, pralyzed from the neck down, and finding her with broken upper-arm bones (two breaks within 6 months and all three within one year)--in a Washington, Ill., nursing home that has many lwsuits pending and should be shut down, and another, supposedly the best in the west, equally as negligent.

B. M. Solomon of AZ 2:30PM August 03, 2008

I've worked in the field for almost 25 years, it doesn't need to be this way, I see CNA's working very hard and doing the right things. The regulations are massive and if you truly wanted all the regulations complied with you would need 1 staff person for every 5 residents which the government nor anyone else seems to want to pay for. What we need is a working collobarative with the government and health care to make the changes necessary to give every elder the quality of care and life they deserve. We need to spend less time on paper compliance and more time with the resident.
The other big problem probably one of the main reasons we have these problems, you can't make healthcare a for-profit business, owners want the return, the return should go back into the nursing home to make improvements, but the for profit world wants a bigger bottom line.
The less for profits in this industry the better the care will ultimately be!!!

George of NJ 9:11AM May 19, 2008

So, What else is new? The GAO is part of the bureaucracy which feeds at the public trough. I suspect that most of them are pushing paper too.
It is no different in any so-called Civil Service Organization. I have worked in several of them most of my adult life. All seem to have bloated budgets and are loaded with drones who just go through the motions.
How long have we had Nursing Homes?
How long have we had the GAO inspecting them?.
Does anyone expect that anything is going to change? I sure don't

Frank of CA 9:02PM May 17, 2008

Having worked in nursing homes, I can only agree to the deplorable care of the patients. Myself, I would rather die than be sent to a nursing hole. Yes, I do mean hole. Once I saw two nursing assistants drop a woman of about 70 into her bed from a distance of about three feet above the bed. I had to quit this type of work because of the abuses, and, more importantly, the blind eyes in Administration.

Deborah Davis of KY 9:21AM May 17, 2008

I've worked in nursing homes for the past 14yrs, and the patient to direct care giver ratio or just unrealistic. There are more people pushing paper work then care givers. There are certain people that think the ratio is adequate , they should have to work a day in the care givers shoes, and see if they can perform the duties expected.

Pamela Burns of MI 9:23AM May 16, 2008