Bad Nursing Home List a Good Thing: Let’s Get This Fixed

  • My mind is spinning. While I'm taking a break from reading a riveting book on how we can improve our nursing homes and other options for our elders, and how this is being done in many pockets of our country, (the book is "Old Age in a New Age," by Beth Baker, and I will review it in a post on this site, at a later date) I open my e-mail and am presented, by Medicare and Medicaid Services, with a published list of the 54 poorest performing nursing homes in America.


    I read the New York Times article titled "Government Outs Some Nursing Homes." I view the list. I try to be open minded. A valid point in the article, made by Brain Teed, who heads a facility on the list, is that there are regional differences in standards, so a facility that is considered poor in one state could be okay in another. I know this to be true, because I receive e-mails that shock me, from people who live in parts of the country far from me.

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    But why is this the case? Why isn't there a standard that all nursing homes must meet, or suffer consequences? Why aren't states mandated to have higher standards, so people, particularly people who are long-distance caregivers, have a better idea of where these homes stand? I am fuming over the whole sordid deal.


    I'm used to some pretty good facilities. That doesn't mean perfect, but I see efforts toward the resident centered ideas Beth Baker writes about, happening all over my area.


    I write regularly about empowering all staff members, especially the Certified Nursing Assistants - the hands on caregivers - so that they are heard and respected. This is part of resident centered care. After all, they are the people who know the residents best. I see these things being put into place, locally. I see Medicaid residents treated in the same manner as private pay. I see some pretty decent things going on and improvements coming in by the truckload.


    Then, I open an e-mail from California. A woman is worried about her mother having to go to the "county home." County home? Didn't they go out during the 30s and 40s? What the heck? I open another, this one from Alabama. Same thing. My blood pressure is rising. This just shouldn't be happening.


    I hear from a friend who has a father with Alzheimer's and the father is in a local nursing home. He thinks the father is over-medicated. This is here. This is my town. This is not good. My friend is moving his father to another facility. I'm left wondering if this is a black mark against this facility or if this is an over-reaction or misunderstanding on my friend's part. Whatever the reason, I applaud him for being watchful and concerned. We all need to be. I will be listening more closely for other remarks about this home.


    With a list like the one published by Medicare and Medicaid Services to wake us up, even those of us who live in an area that has high standards are reminded to sharpen our eyes and our ears. We need to be more vigilant and more demanding of our political leaders.


    Our elders deserve the best care available. Unfortunately, not all of our elders who need care will be in  nursing homes with resident centered approaches (even though that was supposed to happen long ago). But no elder should have to live his or her last days in one of these sub-standard homes on the list.


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    A home that lands on this list, whether it's in a state that has high standards or low, needs to get fixed. It needs close scrutiny. We caregivers and professionals need to nag our local, state and national leaders, mercilessly, to get laws in place that make sure there are no substandard homes operating anywhere.


    We caregivers and professionals need to push hard to see that there isn't a huge discrepancy between what is considered good enough in one state, but substandard in another. Kudos to CMS for "outing" these substandard homes. This problem needs to be fixed sooner rather than later. Our elders don't have time to waste.


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Published On: November 30, 2007