viernes, 17 de julio de 2015

Five-Star Nursing Homes

In 2011, Ken Chandler brought his elderly mother to a nursing home that had Medicare’s seal of approval, a five-star rating. After a series of troubling events there, Mr. Chandler now feels misled.

Self-study activity:
Watch this New York Times video and say whether the statements below are true or false.

1 Ken Chandler feels his mother was being neglected in the nursing home.
2 Essie May Chandler never lived with Ken Chandler and his family.
3 Ken Chandler’s mom had an accident at the age of 90.
4 The Chandlers were unaware of the complaints filed against Rosewood Nursing Home.
5 The problem with the rating of nursing homes is that the homes rate themselves on three factors: health, staff and quality.
6 Essie May Chandler had a fall while eating in her bedroom.
7 Essie May Chandler used to have a shower three or four times per week.
8 Essie May Chandler died in the nursing home after her fall.

I had visited her the day before, she seemed fine. I went back in the next day, she was completely bruised to her chest, the back of her arms, her back. Nobody was watching my mom, nobody was really tending to her. They were just pushing her in a hallway or leaving her in her room to eat alone.
The government’s website shows this is the best of the best facilities, and so does the facilities website shows it’s the best of the best facilities, and they are proudly displaying their five-star rating. It’s the industry that is being protected, not the patient who is in there.
My mother’s name was Essie May Chandler. She lived with me and my wife and her family for six years. She enjoyed kids, she loved her grandkids. It was like five in the morning, my wife heard a thump, and we went in there and she’d fallen to the floor.
Ken Chandler’s 90-year-old mother had broken her femur. After a successful surgery, the family had one day to find a rehab facility for her recovery, close to their Sacramento home. They chose Rosewood.
When you walk in, there’s a big billboard and it has orange stars on it, and it’s um listing why it was five stars.
On Medicare’s nursing home compare website, Rosewood received five stars, the highest rating awarded. The Chandlers had no idea that despite Rosewood’s top ratings, it was the subject of one hundred complaints filed to the state of California since 2009. Advocacy groups say the number’s closer to 160, double the state average.
They’re not putting state violations on the federal websites, so it really doesn’t give an accurate picture because they don’t have all the data.
Carole Herman has been an advocate for the elderly for over thirty years.
I went in and here’s Rosewood Post Accute. So the overall rating is a five star. The health inspections was average.
Of the three factors that determine an overall rating, only the health inspections are conducted independently. The other statistics, staffing and quality measures, are self-reported by the nursing home. This self-reported statistics can boost a three-star rating into a five-star rating overall.
The federal agency that runs Medicare came up with this five-star rating system as a consumer tool, as a great idea.
Lesley Clement is representing the Chandlers in a lawsuit against Rosewood and its operating company, North America Health Care.
The problem is, you know, it’s garbage in, garbage out, so whatever they’re telling the feds, the feds are not… Federal government isn’t going in and double-checking that their numbers are accurate.
Dr Patrick Conway, who helps to oversee the nursing home compare website, says the star rating has successfully motivated facilities to improve their care.
What kind of reassurance can you give to families that they can be comfortable with the accuracy of these ratings?
Yes, I think for a family selecting a nursing home for their loved one, I’d say a few things. I think, one, I think the five-star rating is a starting point, but then I would highly encourage the family or caregiver to visit the home, to visit it multiple times, to really get a sense of the home and its culture.
You don’t have a lot of time to go out and check these facilities, how are you supposed to know. If you get any notice, maybe it’s a day.
I think the government website as it’s currently operated it’s very dangerous because people rely upon it, and right now there are people looking at the website and making a choice.
These are the Rosewood Post-Acute complaints in this file…
Carole Herman’s advocacy group has helped families help complaints about Rosewood to the state.
Elder abuse, insufficient staffing, falls with injury, broken hip, bed alarm is not working, failure to treat, failure to chart, again insufficient staffing, delay in sending the patient to an acute hospital, insufficient hydration which can cause death and I believe in this case the woman died.
It happened on the 14th of February and the nurse practitioner called us and told us everything was fine. She had a fall and I said, out of bed, and she said, no, she was eating dinner in her room and the nurse came back in the room and found her lying on the floor. I go, why is she in her room eating alone again. And she, she couldn’t explain why, I don’t know. Me and Lesley looked to the records and she actually started on levaquin the night she fell. When they left her in her room by herself eating, what were you thinking?
This is the hallway where Essie resided. This is the nurse’s station, that’s the med cart. So in addition to this pattern of falls, they weren’t toileting her and they weren’t bathing her. When you look at the records, she goes ten days or more without a shower, she has repeated urinary tract infections, plus she’s given all this psychotropic drugs on top of it. Every case comes down to under-staffing. Nobody is looking at her as a human being and what her needs are.
North American Health Care, which operates Rosewood and thirty-four additional facilities, disputes the claims in the Chandlers’ lawsuit and denies any false reporting of staffing levels. The company’s CEO declined to appear on camera but in a statement defended the company’s dedication to quality care.
It’s not a natural way to die, so they, they…
They just didn’t do their job, and I’m sorry, I mean, I’m not trying to blame it on the staff but I do think whoever owns these places is their responsibility to make sure there’s enough staff to take care of these elderly people.
Dr Conway hopes to improve Medicare’s oversight of staffing levels.
We are working on a system right now to actually bring in payroll data reliably across 15,000+ nursing homes. We are also making sure we do not have people that are, for example, over-reporting or self-reporting in a way that is inaccurate.
During her six months at Rosewood, Essie Chandler suffered eleven falls, the final fall resulted in two broken legs. She returned home 40 pounds lighter with her legs bound in braces. She died six months later at home with her family.
People always have guilt after care-giving and you always think you could have done more but it’s, it’s torture, Sid will never forgive yourself.

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