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Thursday, September 27, 2007

New York Times Series - Nursing Homes: More Profit, Less Nursing

I just read an article in The New York Times dated Sept.23, 2007 titled "At Many Homes, Less Nursing, More Profit" that describes what happened when a group of investment firms purchased about 48 nursing homes. This article happens to appear during the same week when a front page article in my local paper, the San Luis Obispo Tribune asked "Is the Quality of Elder Care in Jeopardy".

The San Luis Obispo Tribune also had articles on "Finding Quality in Long Term Care" and another titled "County's Worst Residential Homes Are Cited After Repeat Violations."

The New York Times article describes the steps the investors took at one of the homes purchased to reduce costs The residents at the Habana Health Center, in Tampa, Florida saw changes that meant they were "worse off" according to the article.

The article says the number of registered nurses was cut by one-half and budgets for supplies, resident activities and services fell. A series of incidents showed that the residents were suffering, according to the regulators.

The New York Times says the investors did well financially but the situation for the residents went downhill. Regulators "repeatedly warned that staff levels were below mandatory minimums."

The article describes the situation when nursing homes are purchased by investors, costs are reduced, profits go up, and the homes are sold for a profit.

People who are thinking of moving to a nursing home, or of moving a relative to one, need to find out what the options will be if they are not satisfied with the quality of the care. If the home is purchased by investors who reduce spending on staff, supplies and services, will the residents be able to move to another home?

An important question to answer is always "How many aides are on duty for each resident? Not just how many aides are on the schedule. After employees have called in with excuses to be absent, which happens especially often on weekends, how many aides are physically present for each resident?"

Other important questions include the following.

What does the local long term care ombudsman have to say about complaints and violations at the facility? Does the ombudsman, who investigates complaints and resolves them, recommend this nursing home?

Can the staff communicate well enough to read, understand, and follow directions for care and to write notes to keep track of changes?

Can the staff communicate well enough to provide quality companionship and interaction? Is the atmosphere conducive to good emotional health for your loved one, and do you feel comfortable when you visit there?

If a number of staff members cancel, as may happen on a weekend, is there a supply of trained replacement staff available at short notice or does the reduced staff just take on more residents per person?

If you visit the facility, especially on a weekend night, does the staff appear short handed and to be rushing from resident to resident?

If your loved one needs assistance, how long is the waiting time? How much time does the staff have to assist your loved one? Is the assistance accomplished in a hurry?

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