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KathyB1125 Asked October 2016

What are the laws regarding nursing aid in an assisted living facility?

I helped my sister move into a very nice assisted living facility one month ago. She is very happy there, and, everyone seems very helpful. Yesterday, I took her to her podiatrist, who noticed a small break in the skin under her second toe. The doctor wrote an order for an application of Betadine to the break, to be covered with a band aid. I purchased the betadine and band aids, and, brought them to the nurses' office. I was told that they are not allowed to do this. They contacted the skilled nurses to come to the facility, they said it is not a skilled nursing treatment. It is evidently up to the family to perform this. I live 20+ miles away, and cannot go there twice a day to put a band aid on her toe! How is it that the nurses can check her blood levels, give her an insulin shot, put a band aid on her finger, but not her toe? She is obese, has arthritis in her back, and knees; has had her second hip replacement in March, and cannot reach her feet! Has anyone run into a similar situation? It seems ridiculous.

BarbBrooklyn Nov 2016
Great news! Thanks for letting us know!

KathyB1125 Nov 2016
The Director explained that the nurses employed by the AL are not allowed to change any sort of dressing due to insurance restrictions. They did call my sister's podiatrist , she rewrote the order. Now, a visiting nurse will come to the AL 3x a week to apply the betadine and change the band aid.

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BarbBrooklyn Oct 2016
I'm curious what answer you get Kathy. It would seem with a doctor's written order, and with nurses on site, this would be doable. Please let us know.

zythrr Oct 2016
Maybe they have their own podiatrist who comes in to do this, and of course bills it to Medicare. The nurses, probably don't want to deny the podiatrist, a way to make a living.

KathyB1125 Oct 2016
Thanks for the link. I did call the Director of Resident Care, and, am currently waiting for a return call.

geewiz Oct 2016
Here are the RI laws for Assisted living facilities
http://sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/7999.pdf
But from what I see on this site, there seems to be some places that provide assistance but are more like board and care places. You might need to address this with the Executive Director. Sometimes the nursing staff gets bit away from what the purpose of the facility actually is!

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