Quote from: TDoS on Mar 10, 2024, 07:44 AM

Quote from: RE on Mar 09, 2024, 01:06 PMAdd to that the exorbitant cost of my substandard care now of about 200K/yr, which is pocket change by comparison.
RE

Having noticed the environment which can be seen in your videos, it looks fairly advanced compared to the environment my mother as one example has available. Of course, she suffers from dementia and doesn't know what a computer is nowadays. You look like you've got equipment and some basic mobility and undoubtly a bed and food. Is the food bad? Or are there other particulars of the substandard care?

Oh, compared to the typical assisted living home, this place is a palace. It's the next step up the ladder, referred  to as a Skilled Nursing Facility, or "SNIF", pronunced "sniff".  It's the level below a full hospital ward, where you get sent as rapidly as possible from acute care (an operation, usually 3 days) for recovery, where you can remain for up to 100 days with Medicare picking up 100% or the care.  After that, if you aren't able to return home to independent living, you get sent to an assisted living home, unless you can  qualify for Long Term Care, which requires a certain level of disability that Medicare has some formula for determining. This is reevaluated annually.  So far, I have met this requirement, so I have been here about 1.4 years now.  I will never go back to an assisted care home, which are nightmares.  I am capable of independent living despite my disabilities, as long as I get a reasonable amount of time from a home health care aide known as a PCA (Personal Care Assistant).  That was how I was living before I got sent here, the result of my PCAs not showing up or quitting without notice and being left alone for days.  I became ill, lost 1/3rd of my body weight, became too weak to make my transfers between chairs to the toilet, and developed another case of cellulitis, the infection that  took my right leg.  If I do not meet the requirements for LTC next time my case is reviewed, I will only go to independent living again, and for that they have to find me an apartment before I will sign my discharge papers.  They can't throw you out on the street if you refuse to sign, although they do make your life miserable.

Unlike assisted living, a SNIF has a 17:1 ratio of Nurses during the day, and 34:1 at night.  The main staff are CNAs (Certified Nursing Assistant, which takes a slightly longer training course and an exam to pass than PCAs, who get about a week of on the job training.  These workers are slightly more professional and dedicated than PCAs, who are these days either old folks not yet old enough to collect social security, moms of school age kids who want to make some cash while the kids are in school, or HS students who do it as an after school job.  They are all highly unreliable, and the old folks are often not in much better shape than you are.

However, being better than absolutely awful doesn't mean you are good.  The CNAs are often recent immigrants with poor english, most can't spell even if they speak english and were born here, so if you ask one to help transcribing a grievance you dictate, you have to spell everything for them.  There usually is a staff member or 3 out sick, and they are short staffed.  Many patients require a lot of maintenance (not me) and wait times can be quite long if you are on the toilet waiting for help in wiping your ass.  I have waited 30 min and more in the past, now if somebody doesn't show up in 10 minutes I just pull up my Depends and let it do the wiping, and catch one of them later in the day to help me change to a clean pair.

The staff doctor now is an agency, the 3rd different one since I got here.  There is supposed to be 1 MD, and 1 NP or PA on staff for all 100 patients, they do almost nothing and I hardly ever see one.  We haven't had an NP or PA working here since my first 3 months or so.  Both the doctors and the nurses who take these jobs are the lowest of the low in the professions.  Lowest paid, recent immigrants, retired nurses sometimes as in need of help as the patients.  They don't understand basic computer skill for keeping records on dispensing meds, which is their main job.  My meds have been screwed up and not reordered before running out on average of every other month.  If you are a person with intense chronic pain, and you have to wait 2 days for your pain meds to be shipped up from  the lower 48, you can become more than a little irritable.

Unlike Assisted living, they have a real kitchen staff (mostly Philipino who don't speak english), but they still use the lowest quality meat and veggies available for the recipes which are sent up from corporate headquarters.  It is better though than the dog food scooped out from cans and heated on the stove from Assisted Living.

I have had to file 2 grievances in the last week due to a dementia patient invading my room because the CNA supposed to keep tabs on him was incompetent at her job, which in this case simply is to keep said patient from entering any room but his own from the common area.  He can get very agitated and aggressive, and poses a danger to me and to himself.  If he gets in here, he can damage or steal my personal property, and I can't sleep because of the constant threat.  If I have to stop him from getting in here myself, the only means I have is by trying to push him out wth my electric wheelchair, and if I do that one of us is sure to get hurt, and I'll make sure it is him not me.  My chair is heavy with a steel chassis and powerful motors.  He is old, frail and unstable.  He'll lose badly in this collision.

This palatial living costs the taxpayer $200K/yr.  To me, that seems an awfully high price for what we are getting.  Maybe I expect too much,like to feel safe, eat quality food and get help from a competent staff.  Maybe I expect too much?  What do you think?

RE