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Just happened to my family member -- while at the hospital, the NH is now refusing to readmit! They shipped my family member off to the hospital and now we are scrambling to try and find a new NH in the midst of this pandemic. Their initial notification was a phone call -- then followed by an involuntary discharge notice. Even though there is an appeal process it will take too long to go through the process. After speaking with the local ombudsman, I am learning this happens frequently. What a nightmare, and how devastating to my family member who did nothing wrong. They are required to give 30 days notice and are refusing -- would rather take a fine. How can this be legal?

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vashti14 I hope you would not even want your family to go back to that facility. What they done to your loved one was heartless. I see a person I wouldn't want caring for my loved one.

You don't have to be stressed trying to find a facility for your mom, that is the responsibility of the hospital social worker. Then again, on the other hand, I am not sure how the social worker is a that hospital. If it is a caring compassionate SW, fantastic, if not, they will try to send your family member to the first nursing facility that will accept them. Sorry, for what you and loved one are going through. I know first hand because I am going through the exact same thing.
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I looked at Vashti's profile. She has only posted 2x once in 2013 and now. I think you may be confusing her with a post from Haily/Sunshine.
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Hi Everyone,
Thank you for your kindness and for taking the time to reply. And most of all, thank you for representing what it means to be caring, compassionate human beings. I rushed to sign up to the Forum and didn't thoroughly read through the profile questions. I have updated my profile. I've tried to respond to most of the replies. This has been an excruciatingly painful experience for me as the daughter who loves her mother dearly, and would not have intentionally done anything to cause her the discomfort she is in now and the horrible nightmare we are going through because of out of protective concern about her care, I became known as a "hell raiser". I am in prayer mode now, hoping and praying that the next facility is not another nightmare.
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BarbBrooklyn Jul 7, 2020
Vashti, there is a time and place to be a hell raiser; there is also the right way to do it. Not knowing how you went about it, this is what I learned:

1. Know who controls what. It took me a LONG time to find out that the aides were supervised, NOT by the nurses but by the Unit Manager, while the Nurses were supervised by the DON. The social worker was supervised by the Director of the Facility. So if something was awry, I needed to figure out what supervisory line to go up.

2. Bring treats. Each week when I visisted, I would bring a tray of donuts, cookies or a cake. I found out one of mom's nurses had celiac disease, so I brought gluten free treats also. I left these at the nursing station with a big note that said "thank you from Mrs. A in room 102".

3. Care meetings are where you get most of your answers. Make sure that they are scheduling them as often as they are required in your state. Go with a list. Ask what their plan to cure the deficiency is. Tell them what YOUR priorities are.

4. Observe your parent. Is your mother happy and content? My mother was not a complainer, but she was able to say (even with aphasia) what displeased her. She wanted to get up late and stay up late. The NH was able to accommodate that. There was stuff that would have driven ME batty, but that wasn't in my wheelhouse. Getting mom what SHE wanted was.

5. I had a couple of serious issues with the NH at the very beginning of mom's stay there regarding her medical care. I asked for a care meeting to straighten it out and asked, very quietly why I shouldn't be considering thinking about reporting the issue to the ombudsman and the Joint Commission. I would never report without telling them that I going to, because you have to a. make them realize that you know how to do this and b. give them a chance to correct the issue.

In our case, they corrected the issue and we moved on.

It sounds as though this is place that sees poor care and fine their way of doing business. Not all places are like this, although I'm sure it varies widely from state to state, depending upon how regulated the homes are. And yes, this place took Medicaid.

If you are in a state where homes are laxly regulated, the solution is a political one and you need to make your voice heard not only by the regulators but by the folks who write the regs and set the fines, i.e., your state's representatives. They ALL have staff that deal with elder affairs and that's someplace you need to make your voice heard.
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VAshti, this is in the SW's hands.

Good for you for reporting them. If you dont file an appeal, isn't that like you were admitting that they were right?

All of the issues that you mentioned regarding your mom SHOULD have been reported to the Ombudsman and the Joint Commission. Sometimes we get posters here who are upset about the shade of lipstick their mom was wearing.

My mom was in an imperfect NH for over 4 years. I never smelled ANYTHING. It's completely unacceptable. I hope you've explained this to the SW.

And DO NOT accept discharge to your home.
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vashti14 Jul 7, 2020
Thank you... sending you a virtual big hug.. and a zillion thanks for the advice about not accepting discharge to my home. I've been feeling desperate because she has been in the hospital for over 2 weeks waiting for the SW to find a new NH, but I will continue to wait and not offer my home as an option.
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VAshton I don't think an elder law attorney is the best attorney for this situation.

I would contact the BAR association and law schools to find out what type of lawyer would handle this situation. Medical malpractice or what?
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vashti14 Jul 7, 2020
Okay, GREAT advice. I will redirect my search for help with the BAR associations. Thank you , thank you.
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Vashti, just to cheer you up...

Some (well, a good many) years ago, my sister in law was a young intern working in a major teaching hospital, doing the dogsbody rounds on a medical ward. She ran into trouble with a very, very elderly, very frail patient whose daughter was... how can I put it. A bit trigger-happy when it came to dealing with inexperienced overworked young doctors who were doing their best. Things got sticky, and my poor SIL is not the world's most resilient or sanguine person, and she was beginning to dread going to work; but going over the admission notes once again in a desperate search for ideas that would make this sweet old lady "take up her bed and walk" SIL noticed that the lady patient had been born in (then) Calcutta.

"Oh really?" said SIL "my sister in law's granny was born in Calcutta too."

Long story short: it didn't take long for them to find out that the trigger-happy daughter was my mother's schoolfriend; SIL was able to reunite her and my mother (who stayed in touch for the next nearly thirty years), and the daughter's opinion of SIL's medical expertise also miraculously improved!

Now then. If you haven't been happy, the NH ought to have been taking care to find out why and put things right even if it isn't something with a direct bearing on your mother's care; but if they won't do that, maybe you can. So that's why I ask again - what happened? Because if there is any way of not moving your mother from an environment where she is settled and happy, we need to find it.
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vashti14 Jul 7, 2020
It is that they are retailiating against me for constantly reporting them. They obviously cannot say that on paper, . No health event triggered this "emergency eviction". Honestly, I believe that they were tired of dealing with me and are willing to accept fines. It was a nasty surprise. The NH Administrator, stated I was a "difficult family member" and overly involved" with her care, The box they checked was "unable to meet the resident's needs". They did not go into detail. I've since learned that I can request the details about why they feel they are now not able to meet her needs, and will request them when I appeal, but that will take time.

She does require a high level of care, but nothing has changed about her medical condition in the last 4 years that would warrant an involuntary discharge in the midst of a pandemic because they are unable to meet her needs". Her behavior hasn't changed, her care needs haven' changed.

I do have a pretty forceful personality. and definitely arguments occurred when staff ignored call lights, refused to change my mother, and when I found her unbathed and smelling like urine and feces. Some of their staff is pretty revengeful. When I would report them, they would ignore my mother's care (not change her, not feed her, not bathe her). I contacted the facility's leadership team and the state agencies overseeing recently for the umpteenth time after several members of the CNA staff shared with me that my mother was being neglected. Supposely the NH was investigating but I believe now that they were developing a plan to involuntarily discharge her. Sending her to the hospital was a convenient exit strategy. I did offer to change out the POA responsibilites to another family member, allow myself to be "banned from the facility" so that she would not be discharged in the midst of this pandemic and moved to another faclity where the risk of Covid infection is high. They refused to consider it as an option. So she is suffering the consequences of having her life disrupted.
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Vashti, I think that you are in a good position if the SW is doing all the leg work and the hospital is not releasing her.

Use this as a learning opportunity for future placement. If it were my mom, I would be calling non-profit religious based facilities.

I had a hard time dealing with the idiots that were supposed to be caregivers for my dad and I had to back off and only worry about the law of the situation. I called every governing body and the facility was eventually shut down for violations. I knew then that I was a problem because I saw what they didn't want anyone to see and I spoke up, because I ignorantly believed that they just didn't know and they would correct the situation once they knew. Nope, they knew and it was intentional negligence, so me advocating for my dad was a problem.

Follow your heart and hopefully you will make a difference for someone else. I did and it felt good to know that they would never be able to injure another family like they did mine. One person can make a difference.
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vashti14 Jul 7, 2020
Thank you! Definitely using it as a learning opportunity. I am exhuasted I must say mentally, physically and emotionally. This has been an unbelievable ordeal.
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Vashti, I can understand that if the conflict is between you and the NH, that would make it difficult to negotiate with the NH. But is it really not possible for anyone to speak to them? Whatever happened?
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Vashti, file the appeal.

It may be that the need that your behavior is difficult has gotten around the community. NH directors share information, I imagine.

Might we ask what caused this?
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vashti14 Jul 7, 2020
Definitely fling the appeal .. for what happened see my reply back to Countrymouse.
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Vashti, I think there is a problem about understanding the problem! Is the family member who was a nursing home resident and was kicked out the same family member who was kicked out? Or was it another family member, NOT the resident, whose actions resulted in the fmily member's being kicked out? Both are possible. Also, in your profile you indicate you are caring for your mother at home, but the problem involves someone who has been living in a nursing home. Different people who have replied about the problem have made differing assumptions about whose behaior resulted in the resident's being kicked out of the NH. Please clarify. Thank you!
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vashti14 Jul 7, 2020
Hi Caroli - my mother lives in a nursing home (not at home) where she has been for 4 years and sadly it was my behavior (not hers) that resulted in her being kicked out of the nursing home. The NH sent her to a local area hospital for acute care and after being admitted, the NH called to say they were refusing readmission. She was due to be discharged a week ago, but cannot leave until a safe discharge is in place. (Hospital SW is having a difficult time placing her in this CV-19 environment.)
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It happens all the time. This is what it looks like if you actually expect your loved one to get the care promised and paid for.

I would try to get the situation on hold, because evictions like this make it harder to find a facility that is willing to take your loved one.
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vashti14 Jul 7, 2020
Hi.. it's too late to place the situation on hold. The NH involuntarily discharged her while in the hospital. The only remedy is to file an appeal which will take 30-90 days. I am working on that now, mostly to stop them from doing this again to other vulnerable at risk adults who could get evicted in the midst of this pandemic.
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vashi14 Am I missing something here? Some that have responded to your post have mentioned "your BIL". I don't see anywhere in your post where you referred to your family member as your "BIL."

Yet, some are so fast to respond.
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lealonnie1 Jul 6, 2020
If it walks like a duck and quacks like a duck........it might just BE a duck! :)
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I haven't, but it may be similar to renting an apartment, etc. Managers decide a resident is too much trouble. It's especially true when housing is in short supply. Managers figure they can fill the rental quickly, and willing to take a loss. They often do that by not renewing the lease, but it's not unheard of to be given notice to leave before then. It's despicable they did it like that to your family member, especially with the virus.

I pray you find a nice home quickly.
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vashti14 Jul 7, 2020
Thank you.. it is despicable, especially in the midst of the worse crisis for our country and how it is impacting nursing homes. The NH is retaliating against me for filing multiple complaints with the agency who oversees NHs in our state, that resulted in fines and citations for such issues as pressure ulcers caused by not changing her, poor hygiene (not bathing her for long periods of time, unreported falls, mysterious bruises, ignoring her call light for hours, not feeding her, severe staffing shortages (I often helped out other residents), CNA staff (those who cared) reported other issues of neglect, etc.), I also included concerns and observations about neglect with other residents who did not have family members to speak for them, watching them being pulled up to the dining table, not being fed, and then pushed back to their rooms, walking past them smelling like urine and feces. I was there every day and yes, I should have moved her a long time ago but wanted to fight the "lion" I knew then be introduced to a new set of problems. I've learned that all NHs have problems, some more severe than others. Yes I was a pain in their side.
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Unfortunately, "legal," only becomes important when standing in front of a judge. In the realm of nursing homes, it's all about money, nursing homes are in business to collect money, providing good care is secondary.

If its a Medicaid approved facility all residents and patients within that facility are entitled to federal protections, in theory.

Realistically, if a nursing facility doesn't want a particular resident, or if a higher paying cash candidate requests admission, the nursing home will "backdoor evict," lower paying or difficult residents/patients.
Nursing homes will create documentation to support an eviction, by labeling that person as a danger to others, or no longer needing that level of care. It's incredibly easy, and a lucrative way to dump high maintenance or lower paying individuals.

Depending upon your location; contact the State and feds to file a formal complaint, and hire an elder law attorney

ALWAYS APPEAL, file that appeal while you're locating a new nursing home.
File an appeal to maybe discourage the nursing home from doing onto others what the facility has done onto you.

Caveat Emptor -If you fight for your family member to stay,and win, the family member will be subjected to ongoing eviction attempts.

Nursing home employees will lie cheat and psychologically intimidate, to get rid of your family member.
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vashti14 Jul 7, 2020
Thank you! Excellent advice. I have started writing up an appeal and for the caveat emptor. I have not been able to locate an elder law attorney -- getting a lot of "no's". I don't think it is lucrative business for them to handle this type of case, and most specialize in other areas. I've tried "googling" elder law attorneys, called local bar associations, nothing yet. I hadn't thought about the type of treatment that could occur to my family member if granted re-entry in the facility. I've been beating myself up with guilt about the situation I have placed her in, her lost relationships (staff and residents loved her), how sad she is now, and the difficult transition it will be to move to a new facility in the midst of Covid-19. I won't be able to visit the facillty (NHs are still in lockdown in my state). Her mental illness diagnosis limits the number of facilities available.
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Let me guess........your brother in law is the 'difficult' family member who's not REALLY difficult and NEVER does anything 'wrong', just keeps getting kicked out of all the Memory Care homes he's been in. Over and over again, and always unfairly. Right?

Have you ever contacted an Elder Care attorney with this situation you keep finding yourself in?
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worriedinCali Jul 6, 2020
And why isn’t the guardian the one scrambling? BIL has a guardian. The family has no authority to get him placed anywhere ;)
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What state and NH is this? Call? You're fortunate they did.

When my mom went to LTACH, the NH quietly discharged her, even coming to her LTACH room to make sure there would be no issues with the state,

There was no call about discharge or even reason for discharge.

As long as it is by the book to appease the state, then they can legally do this.
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vashti14 Jul 7, 2020
Thank you. Unfortunately I have learned through the Ombudsman that NHs can and will ignore the regulations which state a 30 day notice must be given. The fines and penalties are minimal so they accept the fine. I hear it is happening across the country, which is why I asked in this forum whether any have experienced this. I am now hearing stories. It is a national tragedy against a defenseless vulnerable population.
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Do you actually WANT universal income and universal health care, Barb? Do you know what that means? Who would work?
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MargaretMcKen Jul 6, 2020
I think the 'universal' is another way of saying 'in your dreams'. There are some dreamers, but they never make it as politicians.
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I think that family members forget that having an elder in a NH, as opposed to at home is like the difference between having a child in public school and being homeschooled.

In both cases, at home, you have an audience of one and you can endlessly tailor the environment to suit the person who is being taught/cared for.

In a group environment, you get the benefit of professional services, many eyes on the situation, supervision and socialization.

No, your student or parent does always get their favorite desert or matching lipstick. But you do get to go out and make a living and insure your own future.

Until we have universal income and universal health care and we can all stay home and do what we wish with our time, we need to understand that the care in a NH is not going to be exactly what it is at home.
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Arwen31 Jul 6, 2020
Well you made a great point, something that I had never thought of.
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Just curious how "difficult" was the family member. Not the resident.

We've all done it. Tried to micromanage when a LO is in a NH. Can't be done. Shift changes, weekend changes and personalities. Work schedules, it will never be the way you want it to be. There was a poster who thought the aide should make sure his wife had her favorite jewelry on. Not the aides responsibility. Your lucky the residents clothes match. I am lucky to have a daughter who is an RN and worked in rehab/NHs for 20 yrs. I would ask her what to complain about.
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AlvaDeer Jul 6, 2020
Great reply, JoAnn
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What is the relationship between the family member who did nothing wrong (by which I trust you mean the family member who was the actual NH resident) and the family member who appears to have set the cat among the pigeons?

If it is possible to sit firmly on the cat-setter and bind him/her over to keep the peace in future, perhaps it might be possible to negotiate directly with the NH. Of course if the difficult one is the resident's primary caregiver or representative or POA and does not agree that he or she is the problem, this would be tricky, though.

Gosh I'd love to know what happened. For the NH to say they won't have this resident back no matter what it costs them, it must have been pretty spectacular.
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Butterfly72 Jul 6, 2020
I am currently in a very similiar situation. My mom is om a Personal Care Facility. My brother who visits once in a blue moon is demanding of the staff and constantly going to sue them for abuse, both physical and mental. Tells them that they never call hi,when in fact they have given up trying to call him as he will not respond. During the virus he demanded to be allowed to visit. Now that he allowed to visit he does not visit or even phone mom. Her 100th Birthday was 2 days ago and he never phoned or sent a card or visited. Security is now on the watch for him, if he comes near mom he will be charged. The things that he has said and done to staff in 3 different facilities are absolutely horrible. As the only other family member I am totally ashamed of his actions. We had to get a Public Trustee involved due to his behaviour towards mom. He has stolen from her and neglected her in the past. I can see why a person would be asked to leave a facility, in this case because of the actions of a family member.
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Yes. This is a business. They are not required by law to provide services when patient or family cause disruption. If you had a business, would you? They just did what we ourselves are often forced to do--they did the ER DUMP.
I think that YOU are not the one left now holding the bag so to speak. It is the hospital social workers who will have to find placement. You can help, be open to visiting, but if you were unhappy with the first place, subsequent placement, places who accept patients now in covid times, is going to be even more difficult.
I think that there is a lesson in this. We all know the problems of nursing facilities; I am not her to deny them; they are many and awful. But this is where it often all ends, and the elders are dependent on the care in these facilities. It is now a case of more bees got with honey, I am afraid. An adversarial relationship will get you nowhere fast, and the repercussions will come down on your elder. So sorry for all you are going through. Put this in the hands of the social workers. You honestly have little choice.
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shad250 Jul 6, 2020
Lol

Hospital SW compile a list of NH, you pick 3, SW call, see if accepted. if not repeat process until find one that does, even if low rated.
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I think you may need to dig deeper into why the NH refuses to take your family member back. It is a difficult time right now, and simply saying 'you're out' MUST be backed with actual issues.

I don't know the rules about this. Probably varies from state to state.

If the NH would rather take a fine than re-admit for 30 days--there must be some reason.

You have a right to know what happened, if for no other reason than to be able to advocate for your LO.
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shad250 Jul 6, 2020
I believe rules are different state to state.
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