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The staff at my brother's 24-hour care nursing home where he's been for six months seem to view me as a nuisance. I visit regularly, and I'm Healthcare POA, so I stay on top of what's going on with my brother. I recently got into a shouting match with the nursing home doctor over how I handle information from doctor's visits and tests. The hospital posts test results and visit notes on a MyChart website. I print off information from the website and deliver it to whatever nurse is on duty at the time. What happens to the information after that, I don't know. It appears it's not getting passed on to the doctor, and he's blaming me for it. He says I should arrange to have the hospital and medical center doctors contact him directly to discuss visit and rest results. They don't do that for anyone. All medical information is posted on the website. When I explained that to the nursing home doctor, he told me it was "unacceptable."



Yes, I'm venting here, but with all I do for my brother and all I've sacrificed personally (relocated from another state), it angers me that the care facility staff don't cooperate. I seldom see any other family members when I visit. Perhaps the staff isn't accustomed to having family keeping such a close eye on patients. I have talked to the social worker about this problem, and I told her I would be glad to give her the login information to the medical website so she can handle the transfer of information and get me out of the middle of the mess. The social worker said she has to see how the staff want to handle it. I just don't need this extra aggravation.

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IMO: Everyone with a loved one in a nursing home should get familiar with the Federal statutes regarding nursing homes. They are extensive - though, unfortunately, not enforced. Most staff have no clue, because management and owners don't want them to know. :-|

To me - this statute goes to the heart of the matter and summarizes what is required.

42 CFR § 483.24 Quality of life.
Quality of life is a fundamental principle that applies to all care and services provided to facility residents. Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident's comprehensive assessment and plan of care.
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You are experiencing what I experienced for over 5 years of caring for my mom daily. Nursing homes (almost all of them) do not want any "oversight." I consider them "warehouses for the elderly." Let me tell you what I went through at the self-proclaimed "high end" (Hyatt) nursing home where my mother resided (as a Life Care resident of a continuing care retirement community (CCRC) - meaning she had, unfortunately, what was effectively a long-term-care insurance policy for her life, but limited to their facility): The illegally banned me when I filed a complaint with the Florida Agency for Health Care Administration after a demented man kept attempting to enter my severely limited mother's room (something I had reported to the facility multiple times). It took 2 months to get before a judge who ordered "immediate access." They attempted to discharge my mother without any legal basis. I requested a hearing. They lost. They attempted again to discharge my mother without any legal basis. They lost. (During that hearing, I discovered that their attorney was married to the Chief of Field Operations for the Florida Agency for Health Care Administration - the agency tasked with enforcing the nursing home laws!) The facility then fabricated that I committed battery on one of their staff. (I was not convicted.) My mother died in June.

Any other resident's child who was there regularly (at least multiple times a week) and advocated for their parent, was similarly treated with disdain. I consider the owners and the management of the community and its "care" facility truly evil. They are tasked with care, but implement, knowingly and willfully, neglect.

I am making it my life's work to alert as many people as I can avoid "Life Care" CCRC policies, and nursing homes in general. While there are extensive laws governing nursing homes, our governments have failed abysmally to enforce them, and in my experience, the system of enforcement is clearly corrupt.

BTW: Lower level employees, hospice staff, and others commended me on the care and advocacy I provided my mother. I didn't want to be in a battle, but the facility's uninvolved owners (essentially private equity) and management didn't display any concern for residents, particularly those who were as limited as my mom (blind, immobile, and unable to ask for anything - though she could hear and understand).
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I wouldn't even try to guess who is "right" in what has become a "right-fight". When things descend to this level there is usually nothing but warring and retaliation, and that leaves the senior you love and are trying to protect in some level of danger, because while you are shouting at the doctor, the information that needs to be relayed isn't being relayed.
If you think that overall this is not the facility for your brother, you should seek out others. But do know that an adversarial relationship often works against the person you are trying to protect. There may be problems with the next facility as well if things cannot be peacefully resolved.
Where there is a will there is a way. It seems to me in this, the only example you gave us (there may be many more) the easy way is to ask the doctor where you can send the information so he gets it. The nurse (trust me, I was one) has no power in any situation, and if the doctor doesn't listen to you, a client, he isn't likely to listen to her.
I sure wish you the best. But I do know that when the shouting starts the solutions move to the background. You are a loving Sister; I know--I was one. I know the terror struck to your heart when you are the advocate for one you love who is helpless to advocate for himself. I truly wish you the very very best of luck.
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The facility I Mom was in has 3 doctors you could chose from. One was Moms PCP backup when he was on vacation, so I picked him. All 3 doctors had practices outside the facility. The facility was just like doing rounds at a hospital. See if this facility offers a choice.
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You are correct. I see no problem in printing off the info and asking that the doctor gets it. Where it goes from there is not ur problem. Does he have an office at the facility? Maybe place the info on his desk or email it to him. Actually, the info should be going in brothers file so the doctor sees it. Did this doctor take the place of brother's prior PCP? Or does brother still see his PCP prior to entering the facility. If so, maybe the facility doctor does not like that. As long as the facility does not have a rule you need to use their doctor, you can use whomever u want.

This doctor is in LaLa land. When my Mom was in a hospital never did any of the doctors consult with Moms doctors. When I suggested to one doctor to call Moms I was told while Mom was in the hospital she was that Doctors patient and she would handle Mom her way. When I have gone to other Drs they usually do write a report and send it to my PCP. Where I live we have hospital groups. Any doctor you see within that group can log on to the shared system and see ur results. Maybe he can request access to the Hospitals system and Medical Centers. HE can also call these doctors and request written reports sent to him. All u as POA need to do is sign a HIPPA form giving permission to have this info released to the doctor. Maybe thats the problem, no HIPPA forms have been signed allowing the other doctors to release info.

Maybe call the Hospital and Medical Center and ask how things are handled from their end. At some point a HIPPA form had to have been signed. See if this Doctor is on the forms. Email this info to the Facility Doctor. That would include the HIPPA form you signed allowing him access to brothers records. You can also fill out a HIPPA form from his end allowing him access to brothers records. Most of these facility doctors have outside practices so they have their own receptionists who can call the Hospital and Medical Center and request the info.

Usually when I go to another doctor or facility, I am asked who I want the results sent to other than the doctor referring me. The doctor referring always gets the reports. If you want another doctor to receive them too, you can request it.
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Im sure the nurses and doctors have access to medical records. They probably feel you're stepping on their toes. Just my opinion
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JoAnn29 Jan 2023
This Dr is a jerk. He has a God complex.
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