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My 91 year old father has terminal cancer and was under hospice care at my sister's home. Just before Christmas, he was transported to hospital because of violent behavior and admitted. He was treated for a urinary tract infection and when ready for release my sister wanted him to go to a nursing home because they felt that they could no longer care for him at home (caregiver burnout after 6 months). He got put into the only facility that had an opening that weekend, a very poorly rated skilled nursing facility. He fell 3 times in the first week there and he is not getting the level of care he was getting when he was at home, although he is still under the same hospice care organization as when he was at home. We want him to move to the hospice nursing facility but there are no openings. He is miserable and misses my mother. How can we get him transferred to a better quality nursing facility where he can be safe and cared for during his remaining time? (He will qualify under medicaid since my parents do not have any assets and their income is not high). My sister is the sibling who has medical power of attorney etc. since she lives in the same city as my parents. I am out of state but would like to try to find him a better place quickly.

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Thank you everyone for your responses. We are working with our case worker from the hospice organization to get him placed elsewhere. She is reaching out to a few facilities that may have openings. I would love to get him into a facility where my mother is in adult daycare(dementia) so they could more easily see each other. I called and talked to their admissions director but once she learned my father was Medicaid funded she was not that encouraging. How much money would we need to get him in the door? My father is doing very well but is already living beyond time oncologist had estimated so I would like his final days to be as pleasant as possible. My parents have been married 65 years and now he sees mom once or twice a week. My heart is breaking that he might end his final days where he is, without my mom. so I guess I will send in the application and write a letter and find out who is in charge of the admissions for the skilled nursing home.
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CGL, I'm so sorry for your father's situation, and for the stress that you and your sister must be going through. It's especially difficult for you having to do what you can from a distance; but then it's also very difficult for her because she must be feeling shell-shocked and helpless; and meanwhile your very elderly father has terminal cancer. What terrible times you're all going through.

As regards getting clear information on dealing with the system local to your parents, what about calling the hospice organisation's local director and asking for advice - having a "what would you do in our situation?" type of conversation. A senior manager in that company should have a good deal of useful knowledge and contacts to pass on, I'd have thought.

There are two goals you can usefully aim at.

1. - your personal priority, naturally - is to get your father moved to a better SNF; and I agree that this does need to be expedited because your father may become too frail to be safely moved. If that hasn't already become the case, indeed.

I don't know that this is true, n.b., but based on my general understanding of the ombudsman's role I wouldn't have thought that placement as such came under it; though again you may get useful tips about how to get things moving. Call and ask, how can it hurt?

2. addressing the poor standards in the current SNF. Even if the processes are often too slow for this to be likely to help your father now, yes, you should put a formal complaint in writing. Complaint, by the way, doesn't mean whine or vent in this context: make it a factual description of the incidents that have taken place, state what professional standards you believe the facility failed to meet, state what the consequences to your father were, and copy it to the SNF director and to whichever regulatory body is responsible for enforcing care standards in that state/district/area. That may not be the Ombudsman, because usually an ombudsman resolves disputes between parties remaining once the standard complaints processes have already been exhausted - you'll need to dig around and find out who is responsible for what. The point of this exercise is a) to get everything on record; b) the possibility that it may improve your father's care, as long as what you say is objective, constructive and fair; and c) that you will be playing a good citizen's part, which may not be of much practical help but is some consolation at least.

And meanwhile - in your free time??? - be persistent. The squeaky wheel gets the grease. And yes do put him on as many waiting lists as you like, only make absolutely sure that any facilities you get him down for are in fact going to be better than the current one. Don't forget there are drawbacks to shunting him around, too, so for him to derive any benefit from a move they really have to be significantly better.

Please go easy on yourself as far as you can. Of course you want to move heaven and earth for him, but don't demand the impossible of yourself and don't despair if you can't come up with a solution. You can only do your best. Best of luck, please let us know how you're getting on.
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I wish I knew more, but I have never had that kind of situation. I know it must be very stressful.
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Perhaps I am not being clear. I am working with my sister by asking questions and trying to get advice. The nursing facility reported the falls to my sister and they were documented by the facility. I am just trying to understand how long we would have to wait to find him a bed in another facility and if there is a way to expedite the process since we are concerned about the level of care he is getting. I am seeing his situation in person as I stay one week every month to work and help out and will return there again in another couple of weeks. So can my sister (who is the MPOA) and I approach the PA ombudsman to request assistance in placing him in a better facility? Or do we just need to get him on waiting lists for a number of facilities and hope for the best? I am looking for guidance from people on this site who know more about how the system works than I do.
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If you are out of state, you have not actually seen him fall. As an Ombudsman, I really have to have first hand witnesses and I have to work with the MPOA. I certainly understand your distress, but I suggest you go see him and his situation in person and work with the MPOA.
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We have him on the waiting list for the hospice facility. However, there are limited beds so I want to get him on more than one waiting list to improve his odds of getting into a better nursing facility. My sister and her husband are so burned out they do not want to do anything more to help my father. I just talked to a facility we like and know is good so I could start the paperwork process to help out. But my question really is, is there a way to try to expedite the process to get him out of there faster? Should i report the fall issues to the state ombudsman to get help him getting him a bed faster?
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Will your sister work on this? Can she check out other places? Are you in agreement on this?
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