Know what aging parents face


Imagine your aging mother had to go to the hospital and is now discharged from the hospital. The Discharge Coordinator tells you that your elderly relative needs to go to rehab and go to a facility to get him, because the hospital won’t provide him now. She needs physiotherapy and occupational therapy, you are told. The person in charge of the discharge does not make any recommendations as to where your elderly relative should go, but they give you a list of facilities and ask you to decide within two days which one you want.

You don’t know how to choose a place. The Discharge Coordinator used the word “rehabilitation” to describe the type of place, but did not use the words “nursing home”. A rehabilitation center IS a retirement home. The very thought of this scares a lot of people, and for good reason.

The nursing home industry emerged after Medicare and Medicaid came into effect in the mid-1960s, and exploitation soon followed. About 82% of nursing home funding comes from Medicare (federal program) and Medicaid (combination of federal, state, and county funding). In other words, we, the taxpayers, pay for most of the care in these homes. From my own days as a young nursing student working in a nursing home to earn some money, I have noticed an alarming trend. Homeowners seemed to make money from the steady influx of tax dollars while residents of these homes deprived themselves of the basics they needed. One summer when I worked full time in such a house, we didn’t have enough sheets to keep the beds clean. I quickly found a way to grab extra sheets from the laundry cart and stash them in a patient’s closet, so they would be available to change his bed after the inevitable accidents he had every day. . Otherwise, no clean sheets! It was horrible. That was just a small example of what was wrong there.

A recent article reposted by Long Term Care Community Coalition revealed shocking facts from a lawsuit filed in New York by nursing home owners. The previous governor had signed into law a law requiring nursing home owners to spend 70% of the revenue earned from their ownership of the homes on direct patient-related expenses. More than half was to go to direct resident care: the salaries of nurses, orderlies and nutritionists, for example. But the application of this law has been suspended with various explanations.

A new $10 billion plan introduced by New York Governor Hochul calls for $4 billion to be spent to subsidize the salaries of healthcare workers. And as with the previous “Safe Staffing Act” which was suspended, the profits owners would be allowed to reap would be limited. The government would claw back profits above a certain limit. Retirement home industry tycoons, for-profit titans, have filed a lawsuit in Federal Court, claiming that this cap on their profits would be unconstitutional, a grab on “private property”, despite the fact that the property is in fact mainly provided by taxpayers. When they laid out their profit margins in their lawsuit, the results were staggering. .

This profit faces extreme staff shortages, resulting in neglect by residents and an assertion by industry owners that they are barely breaking even. According to their own claims in the case, they are doing much better than breaking even.

What this can mean for you, the consumer

If your elderly parent or other loved one needs to go to a nursing home or rehabilitation center at any time, know how to make an informed decision about where you allow them to go. This means you need to do your research. Medicare has created a five-star rating system to Compare nursing homes. The idea was good, except that the majority of the data for this assessment comes from the nursing home itself. The home inspections that are supposed to take place are not happening as planned. I wouldn’t rely on that alone, because it’s suspect simply because it’s based on self-declaration of conditions like staffing. This can be handled after the fact, once the assessment is done. It’s better than no system, so just use it as a guide.

What families should do

Here are some steps you can take, once you have a list of prospects to place your loved one.

  1. Search each of the places listed and see how they are ranked. A “five star” may or may not be good. A “one star” is sure to be awful.
  2. If possible, visit the proposed facility, unannounced. If you see elders lined up along the walls in wheelchairs, doing nothing, sleeping, that’s a bad sign. The same goes for the lack of staff with them.
  3. If you can’t go on your own, you can find a care manager or placement specialist to give you some insight into the reputation of the facility. Maybe for a fee, one of them could go visit and see what it looks like, reporting back to you.
  4. Make sure a bed is available when you need it for your loved one. With the pandemic, more and more people are in hospitals and nursing homes recovering from Covid. You cannot get your first choice.
  5. Closely supervise anyone in a nursing home. If you’re far away and can’t visit, call at least every day and ask the charge nurse or person caring for your loved one for updates and progress reports. Ask if your aging parent is actually following the doctor’s prescribed drug rehab. Due to staffing shortages, they may not be getting the prescribed care and you need to push for this, stand up for your aging relative and hold the home accountable for providing care.

The essential

Nursing homes and “rehab facilities” can be pretty dangerous places. Understaffing is widespread and very problematic. Large, for-profit nursing home chains are among the worst at creating safety risks for your loved ones. If you have a choice, look for a smaller nonprofit, some of which are run by faith-based organizations. It’s not a guarantee, but it’s less risky than a huge for-profit corporation with hundreds homes focused on our tax dollars. complex needs. Non-profit status is not a guarantee of quality. Sometimes this only means higher profits, as owners are relieved of the tax burden they would otherwise have to pay. Above all, pay attention daily to what is going on with your aging relative in any nursing. Don’t rely on the house to provide what it is supposed to provide. Some do, but many don’t. It is up to the family and caregivers to protect aging parents and other family members during the rehabilitation process.

A checklist with explanations to help you avoid mistakes in choosing a nursing home is available in my eBook, Ten Tips for Checking out a Nursing Home.


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