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My mother made the heart wrenching but necessary decision to put my dad who has Alzheimer's into a nursing home 7 months ago. We worked with a geriatric caregiver to find an NH. The NH that she recommended and that we ended up putting him in seemed clean and pleasant and on our initial visits before placing him there, the staff seemed nice and knowledgeable Unfortunately the place has turned out to be awful. The CNAs are routinely verbally abusive to patients (I’ve heard them say “Sit down and SHUT UP!” and “What did I just tell you??” Is there a more demeaning question a person could ask an Alzheimer’s patient?). My dad walked unassisted into the NH on his first day and has not taken a single step since. When we ask about this they say it’s the progression of the disease. When he moved in there he could use the bathroom on his own most of the time but he’s been in Depends since then. My mother, who is there with him for 3-4 hours every day, routinely has to ask staff to change his Depends. Often he’s soaked to the bone, including his pants and his wheelchair. He’s had a chronic UTI since he got there. And finally, they’ve lost five pairs of pants and at least eight shirts, despite the fact that my mother opted to take his laundry home every day rather than have the facility wash it. They’ve called her at home on at least a half dozen occasions to tell her to come there ASAP with more clean clothes because otherwise he will not be able to get out of bed that day. Period. My mother and I have had three meetings with the NH administrators to a bring these problems to their attention. Things get better for a few days then return to “normal.” My question is, do these problems rise to a level that warrants filing a formal complaint with the state about the facility? I’ve talked to the state’s ombudsman who oversees this facility and he doesn’t seem to have the authority to do anything.

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Ask to see the report of the last state inspection. There may even be more problems than you see. Move dad ASAP.
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P.S. But don't file any complaints until you get your father safely away from there. And it wouldn't hurt to document everything you see until he is residing elsewhere. If they get even nastier, you can drop the bombshell that you've been documenting their behavior and mistreatment. But don't use it as a threat unless you're forced to.
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Agree that it's time to very quickly find another place. The treatment you describe is well beyond anything acceptable, regardless of whether the patient is a Medicare or Medicaid patient.

The facility gets paid; dollars, checks and/or electronic checks all translate to $$$$. There's no justification for distinguishing between a Medicaid and Medicare patient, but I have the feeling there's more going on at this place than just discrimination based on the paying source.

Given that you've observed improper behavior with other patients, I think it's the nursing home administration that's the problem, not the paying source.
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Things go missing in care centers, especially when there are dementia patients who don't always remember property ownership rules.

Persons with dementia do get worse. This includes things like mobility and incontinence.

What really grabs my attention, though, is the way the CNAs speak to patients. OMG. Get Dad out of there! That is totally and completely unacceptable. And it is no harder to treat Medicaid patients humanely than to treat self-paying customers that way.

My mother (on Medicaid and now hospice) is in a nursing home. She has dementia. She has some behaviors that could be very irritating. I have NEVER heard any staff member address any patient in the manner you report. The building is old. It hasn't been recently updated. It is clean but somewhat shabby. But the care, and especially the staff attitudes is excellent. These are kinds of things that are hard to judge when you are looking for a place.

Start looking again for suitable care centers. See how many dementia patients they have and whether they staff has had training in dealing with them. But really, telling ANY patient to SHUT UP is mind-blowing. I am not sure if these things rise to the level to be reportable to the state. But, after I moved my parent, I would write a letter detailing your concerns.
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Personally, I would look for another NH...there are good ones out there. My thoughts are that you can file a complaint (but still move your dad), but the time involved in making positive changes is too lengthy to want to suffer it out when dealing with a parent who is in their care. Hugs to you and good luck.
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