Investigating Care Facilities

[Rana Goodman]

I am currently working on an investigative series regarding health facility issues, including assisted living, acute care, nursing homes and such. While I am putting this together, the following links were provided to me by the Dept. of Health & Human services. I am posting them in the event that you might have wondered where you can find information, file complaints or just ask questions, 

The Department of Health and Human Services’ Bureau of Health Care Quality and Compliance (HCQC) licenses more than 30 types of health facilities, including skilled nursing facilities. Links to Nevada laws and regulations, including licensing information, regarding skilled nursing facilities can be found online at https://dpbh.nv.gov/skillednursing/.

HCQC receives complaints against health facilities and appreciates the public being another set of “eyes and ears” to possible violations of state law and regulations. Complaints against health facilities can be filed online at myhealthfacilitycomplaints.nv.gov. Each complaint is assessed and prioritized based on a situation. HCQC will assess and investigate complaints to ensure the safety of patients and the public.

The Bureau’s public search at findahealthfacility.nv.gov enables anyone to look up actively licensed health facilities and find results from inspections (either routine inspections or inspections related to complaints) of those facilities.

Additionally, the Long-Term Care Ombudsman Program with the Aging and Disability Services Division (ADSD) receives complaints on behalf of residents in long term care facilities in Nevada. The Ombudsmen work with residents to address their concerns. Any resident living in a long-term care facility is eligible and the services are confidential.

All residents of long-term care facilities, friends and relatives, health care professionals and long-term care facility staff can make a report to the Ombudsman program.  The Long Term Care Ombudsman Program helpline is 888-282-1155 or they can complete and submit the form online at https://adsd.nv.gov/Programs/Seniors/LTCOmbudsman/Inquiry/Complaint_Form/

[Rana Goodman]

Sent via email by a resident who prefers her name not be used:

We have recently been dealing with our own horrific experience with the Horizon Ridge Skilled Nursing and Rehab Center (HR Rehab) and weren’t sure who we should complain to about the place.  I can assure you, there is nothing “skilled” about the nursing at HR Rehab, nor is there anything remotely close to being rehabilitative about this place.  It does look nice from the outside and the lobby furniture is attractive.  That’s about ALL that can be said that is positive about the place.

Unfortunately, it seems that the health insurance companies have never taken the time to find out what the overall conditions are at any of the places that appear on their “preferred provider” lists.  Perhaps if they had someone on their staff whose job was only to read the reviews posted by their customers, caregivers and bereaved family members, the companies would learn many of the facilities that they pay the big bucks to are filthy, germ-ridden hell holes.

In our case, my 90-year-old, sight and memory-impaired, mother had replacement knee surgery done by Dr. Tait at St. Rose Hospital on September 12th. Pre-surgery, the doctor had ordered two specialty items for her to be used post-op for at least 30 days—Rechargeable compression cuffs to prevent blood clots, and a wearable ice pack for the knee.

Three hours after her surgery, we noticed that her knee was being iced with something other than what the doctor had ordered and what we had been told to bring to the hospital when she was admitted.

After we complained, a nurse reluctantly put the doctor provided ice pack on without the outer cover, once the pack had melted, we never saw it again.  We didn’t know it was missing until after we unpacked her stuff at the HR Rehab facility.  I spoke to floor nurses on various shifts, but no one knew where the pack could be, despite our suggestions that they look in the freezers in OTHER rooms!!  No one offered to order a replacement or reimburse us.  Remember, Nevada gave licenses these people that take care of us…

Wednesday afternoon mom was settled into the re-hab facility, where she was to receive daily therapy, regular icing of her knee and the wireless compression cuffs put on each night while she slept.

When we went to see her the next day, she said the bathroom didn’t have any towels and she had to wash the night before using the paper towels in the wall holder!  I went to the nurse’s station to ask for some cloth towels and could barely get any of the staff to look up.  Finally, an aide walked over to a rolling cart marked “Linens” and when she opened it, it was totally empty!  She said she would have to go onto another floor to see if they had any and later came back with only two washcloths.

Not even 24 hours in the place and I was already having some grave reservations.  But this was one of the places that her insurance covered.  There were a few others on the insurance list, including Canyon Vista Post-Acute, which she had been at a few years ago, and a place that I wouldn’t even bring a dead animal to.  But EVERY one of them on her list of providers had really poor write-ups, primarily complaining about the short-staffing and limited therapy, and the HR Rehab seemed to be the lesser of the evils.

Four days into her stay, mom said her foot was very cold.  I pulled back the cover and nearly fell over at how bad her leg looked and how swollen her foot and toes were. (see six days photo). I was scared that she was developing a blood clot and went to the nursing desk. No one at the main desk seemed the least bit concerned, nor did they even get off their chairs to take a look, saying they would let the floor nurse know when she was done making her rounds.

We then learned the staff had not been putting on the compression cuffs since her admission,  the cuffs finally got put on, however mom was seated in a manually-operated recliner so she could watch television the leg rest was up. But the lever was so difficult to operate, that even I couldn’t use it to lower the leg rest.   she couldn’t get out of the chair.  Well, you can guess what happened next.

One of the nurses said my mom didn’t want to wear the cuffs to bed, and if a patient refuses something, they can’t force them to comply.  I told the nurse that mom was cognitively unable to make her own decisions and we, with Power of attorney in hand, wanted the cuffs used nightly as the doctor had instructed.  My husband started making random visits to see what types of treatments she was getting and found the cuffs weren’t being recharged after being taken off in the mornings.

It became clear to us that this place really didn’t have any good plans in place for my mom.

managers” and all the staff “meetings” supposedly being held to discuss her needs.  My mom was allowed to sleep in as late as she wanted (“because she’s old” the nurse told me)

Her therapy consisted mainly of rotating her ankles while seated and not what the doctor had ordered she do!

We thought her confusion was seeing the wires on the cuffs while they were recharging.  We again demonstrated and explained that the cuffs were wireless and that she should just get out of bed as usual, get her walker and head into the bathroom.  And if she felt unsteady, she should use the pull cord to ask for assistance. By the end of that week, we knew exactly what she had been talking about.   Apparently, the night shift never bothered to read the instructions for proper use of the compression cuffs. (Or for the lone ice pack that was used only one time and then put into the closet instead of the freezer).

Now mom is back home at the assisted living facility we had moved her in to this past July.  She’s getting around on the new knee quite well, and amazingly, never asked for any pain medication since the surgery.  Her in-home therapy continues three times a week and is much better than what little she got at HR Rehab.

After this is the Elder Services Ombudsman the best place to complain about doctors, referrals, and insurance companies, should I just complain to all those you posted on your blog?

 

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