Mom's NH plans to stop using bed pads. I am livid! Any advice?

As a nurse myself in long term care for many many years, this is what I would do.
Write a letter to to administration and the owners telling them how this new policy effects your mother.
Contact the state and inquire as to the law that says this is double briefing. It is not in my state. Double briefing is using two briefs. Not a pad and a brief.
Start shopping around for another nursing home! If this issue impacts your loved one this much you may have no other choice.
Mask if you can have it care planned that your loved one is to have the pad in addition to the brief. Especially once you learn that this is not double briefing in your state either.
They obviously haven’t invested in cloth bed protectors. If they had this would not be a cost issue. If they are under Medicare or Medicaid payers they cannot charge you for her items necessary for their care. AND they must provide everything necessary for their care too.
Regarding the pressure ulcers they are liable for there development and any worsening of them. This is indicative of inadequate care unless they are extremely malnourished or at the end of life which doesn’t sound like it’s the case.
Report them to state for this also.
Honestly, it sounds like they are not running a good home at all.
The fact that families are upset regarding this decision and they have had no response to this for you, is highly indicative of this.
Nursing homes are often census dependent on whether or not they are actually making money. What is the census vs capacity? That should tell a lot. They are often not the huge money makers that the owners estimated them to be. But that never means they can cut on care or care items!
You are in charge of the care they receive never let them tell you differently. If their interpretation of the double briefing regulations is false, which I believe it is, they need to be educated and remedy this immediately. The state can be called to rectify the misinformation. I hope this helps! Best of wishes.

I commented on this earlier but I fell I must update a little.

DW is back in the hospital and they have discontinued using briefs. Claiming a reduction in infections.Well last night Dw needed to answer the cal to nature. Being a former CNA slipping the big fall prevention belt was easy. so was figuring out which side of the bed to use. Three of the rails were up, the fourth, her exit route was easily the choice.
But, she has a fear of walking and falling so when I noticed what was going on I tried , in vain, to get her to the bathroom. But the bladder was having now of thi
and emptied right there onto the floor. I called for assistance. the RN responded quickly and proceeded to wipe the floor with towels, no custodial care at night, and sanitizing wipes. then checked the bed and proceeded to clean DW. Requiring more than normal wiping because she had stood in the urine.
Was anything saved by not using briefs.
Then this afternoon came the double whammy. bowel and bladder discharges. I again called for assistance. Two people to strip and change the bed and clean DW.
Almost sounds like labor is cheaper than briefs. Leave it to the bean counter to screw up a good thing. Their hands don't get soiled in the discharged product.
Meanwhile another patient is going without scheduled care. And a big sack of laundry.

I commented on this earlier but I fell I must update a little.

DW is back in the hospital and they have discontinued using briefs. Claiming a reduction in infections.Well last night Dw needed to answer the cal to nature. Being a former CNA slipping the big fall prevention belt was easy. so was figuring out which side of the bed to use. Three of the rails were up, the fourth, her exit route was easily the choice.
But, she has a fear of walking and falling so when I noticed what was going on I tried , in vain, to get her to the bathroom. But the bladder was having now of thi
and emptied right there onto the floor. I called for assistance. the RN responded quickly and proceeded to wipe the floor with towels, no custodial care at night, and sanitizing wipes. then checked the bed and proceeded to clean DW. Requiring more than normal wiping because she had stood in the urine.
Was anything saved by not using briefs.
Then this afternoon came the double whammy. bowel and bladder discharges. I again called for assistance. Two people to strip and change the bed and clean DW.
Almost sounds like labor is cheaper than briefs. Leave it to the bean counter to screw up a good thing. Their hands don't get soiled in the discharged product.
Meanwhile another patient is going without scheduled care.

Update on my previous comment.
Went into the tv room tonite to check on DW since she was not in the bed.
OMG! found a kitchen chair spotted in large dark brown spots. She was on the love seat wrapped in her huggie. Checked her. Huggie stained as well. Furiously headed to bedroom. Found two over sized things looking like hershey's kisses on the carpet, bed sheet stained also.
Rushed her into bathroom to clean and headoff any infections. She has pressure wounds on her bottom.
Returned to kitchen to clean and disinfect chair. Removed huggie to treat stain. Discovered easy chair with Bed pad had stains on it. Thankfully I keep pads on it.
Chest at foot of the bed has a pad on it, stained also.
Removed stained bed sheet and treated stains. Cleaned carpet with shampoo and vacuumed.
Last but not least, Treated MY SHIRT she was wearing in place of gown for stains.
Sheet, huggie, and shirt to the laundry for wash and dry.(note: it is a king sized bed.
I get to make the bed for the second time this week. Making a king sized bed is no easy task for a 70+ year old, old man ain't easy. It is not consided to be exercise by the FEDs either.
And these resident facilities want to discontinue using pads? It is evident to me they have very little experience cleaning up a person and room for this type of incident. Their plan will cause other patients to go without routine service and care. Not to mention this will lead to our family members exposed to fecal waste and infection.
I agree that this is all just a scheme to increase charges and wonder what may be next on their list.

We can all see this new policy is going to be a train wreck. But I think I can see where this train is actually headed! Moneyville, next stop! They'll not allow the pads for those already wearing briefs. Once this ill-advised strategy fails their next course of action will be to reinstate the pads - for a fee! Or charge an extra daily fee for residents whose beds need to be changed more often now. They may have found a way to get Medicare/Medicaid to cover these 'extras' in other areas, so they're trying it with these 'services' too. These idea of charging extra for every little thing is common in my area, and depending on your financial situation/insurance some have been stuck paying these fees out of pocket. The owners and operators of these nursing homes are despicable - it's ALL about the money.

Advise them that this is unacceptable as it's unsanitary among other things.

Tell the Nursing Supervisor you will not accept that decision & want clean chucks & bed sheets every night for your lo or you will take her to a different NH. You can also talk w ombudsmen too....or health Dept

Next time you visit your mother, go in armed with your camera from the moment you enter her room, through checking the condition of her and her bed or chair, and documenting the condition of her clothes, skin, sheets, mattress, wheelchair, etc. Bring a newspaper with you and begin the photos or video showing the newspaper for proof of date of visit.

Moving an old person who cannot assist in repositioning himself or herself without a draw sheet or Chux causes shearing forces on the skin. Examine your mother's skin - bony prominences, buttocks - for pressure ulcers. Learn about pressure ulcers and how they are staged. Check out the National Pressure Ulcer Advisory Panel.

Typical administrative decision where the “powers that be” quite literally - don’t have to get their hands dirty.

If in fact, “They” were ever having to do any of the actual work - this moronic policy would have never come to be.

Guaranteed they’ll be plenty of folks - especially the poor souls who have no one from the outside world seeing to their care - stewing in bedding that is repeatedly soiled, left to dry and soiled again.

Its heartbreakingly tragic.

p.s. If your or your husband know and are on friendly terms with any of the other residents - particularly those who are on their own - it would be nice if you could discreetly check on them - and the condition of their bedding. Cause you know that it is the neglected residents who will suffer the most with this further neglect. While it isn’t a pleasant task it would certainly be appreciated by the resident AND it may bolster your position towards reversing this inhuman policy.

p.p.s. - This place is gonna start smelling like a urinal in a freeway rest-stop men’s bathroom.

My guess is that this is a little bald headed statistician sitting in a windowless office on the 11th floor who has been told by the Doard of directors to reduce expenses by 20% so there is enough money in the kitty to afford the year end bonuses for the executives plus the the new minimum wage increases.
This won't be the only area he cuts, expect your chicken pot pie to contain lots of gravy and carrots but only one sliver of chicken.
Likewise toilet paper will be put in those dispensers which only allow you to tear off two sheets.
The days of blanket warmers will also be gone and cold drinks will be at room temperature.
Now I have seen really stupid waste. A CNA lined a commode bucket with four disposable chucks - not to the seat, the interior of the town. What was the purpose of that you may ask. (I should say see my answer next week for the reply!!!!!!!!!!)
Well it was to save having to empty and clean the commode. She had first put in a large garbage bag then the chucks. When the patient had finished she was able to just gather up the entire thing and dump it in the "infected" trash container. Took me a while to get my eyes back in my head on that one.

My advice to the original poster is keep after it. No patient should ever be left in soiled underwear or bedding. you can call your State health board if things don't get settled.

Update: thanks everyone so much for your comments. DH just got off the phone with the Ombusdman (who was pretty quiet on the subject at the Family Council meeting). She completely agreed with us that it’s poorly thought out, calling a bed pad double briefing is totally BS, and just a cost cutting issue that’s going to backfire. Today she is facilitating the Residents Council meeting and some residents are going to complain. One of these residents ran into the issue yesterday where she had wet through her brief during the night, no bed pad, her bed was wet and she insisted the entire bed be stripped and mattress sprayed. The ombudsman is going to tell the residents and staff that this is exactly what needs to happen each time. Since my DH or I am there every day, she requested that we document for a week the condition of Moms bed (smell or wet), the response we get if it’s an issue, and call her back. And she told him we can complain to the Department of Health if this turns into the fiasco we all foresee.

DH will be there today and he’s on the warpath anyway since I told him she was soaked through to her wheelchair yesterday when I got there. Not really a bedpad issue, but another symptom of a poor toileting process. Grr.

This is insane! I also would love to have a conversation with the person that made this "rule" Actually no conversation just have them work the floor and change a few briefs as well as bedding for a day or two.
I had a fairly large pad for my Husband and I think if I had not had it the sheets would have been changes several times a day. I also used the pad as a "draw sheet" to help position him up or down or side to side in the bed.
Is it possible to change the term of the particular piece of fabric from a bed pad to a draw sheet?
If they still insist on removing and doing away with pads I would...
Make more frequent visits and check the bedding carefully and if it is in the least soiled complain until it is changed.
If this happens more than once file a complaint with the State Health Department.
Post a "review" on Yelp
File a complaint with the BBB
Any other way that you can bring attention to this do it.

It is possible that the short sighted view is doing away with bed pads will cut cost for the laundry. I bet they will find just the opposite will happen.

I really don't understand that notion.

If a person is lying in bed and has a bowel movement, where do you think the faeces will go? The idea that they will politely skirt the genitals, even if they didn't also bedaub the rest of the unfortunate person from waist to knee, is... bonkers.

If a person is bed bound, I could never understand the reasoning behind use of diapers. Draw sheets alone not only are easier to remove and clean but stool will not go into their privates and cause a urinary tract infection.

This is a common practice in many LTC facilities. They will use a folded sheet under the person as a "draw" sheet to aid in turning and repositioning the patient. It is definitely an effort to save money as incontinence pads cost around $25.00 to $30.00 dollars each and don't last long with the amount of washing they get. The LTC will say that if the patient is changed every two hours as regulations say, there is no need for a pad under them. The truth is that many people are "heavy wetters" and will urinate through the brief in less than two hours. However, in my state, the use of pads has been cut drastically for the last several years.

I see no reason not to use the pad for positioning the patient. I'm looking at a book titled "Fundamental Nursing Procedures" by Rita Tobler RN, MSN. On page 49 it talks about positioning " when moving a client a nurse can use a draw sheet also called a pull sheet or turning sheet... ". A draw sheet is a regular sheet turned to run across the bed. I'm not a nurse,but I have taken care of people confined to bed. That sheet is very useful. I've used the pad for the same positioning purpose. They don't want to use the pad for financial reasons. Management people are not aware of the actual work being done. The will save laundry with the pad but get alot more laundry and staff time with all the bed changes. So stupid. I know you are upset, but maybe wait to see how this plays out. They may change their minds when the numbers on their spread sheet look worse. You could certainly talk to the omsbudsman privately. They may be quiet at the meeting because they know how this will play out in the end. If the beds are wet, the home is in violation. The policy itself is not a violation. The omsbudsman is picking her battles maybe? This situation is a lot like an airline. If the airline could take out the seats and pack us in standing like on subway at rush hour they would do it. Good luck. Thank you for advocating for your mom and her fellow residents.

They always use these pads to turn my mom on her side when changing her. Did they say why this is a "no-no"? (Maybe an accident?) I'm glad your DH asked for something in writing and would be interested to hear what comes from that. In my mind, management at NHs need to do a much better job of training and supervising their staff. Maybe call and talk to the Ombudsman directly and ask why this new practice is considered ok? I think I was told during a care meeting that these pads were used to help prevent bed sores (pressure ulcers is the term they used). My mom can't hold weight on her legs, so they'd have to hoyer her out of bed to change the sheet, and that would definitely not be good.

There is no well-intended policy adjustment that cannot be turned into a complete pig's breakfast when certain types of management get hold of it.

Double briefing bad. Increases length of time between changes = higher risk of skin breakdown. Agreed? Sure! Of course, we're all agreed on that.

Ergo anything that lengthens time between changes is bad. Ummm...

Ergo, anything that *could* be used to enable longer intervals between changes is bad. Even if that's not what you're actually using them for, nor what they are actually designed for. What?! NO!!!

Cotton bed pads aren't great as slide sheets because you get too much friction if there's a shearing risk.

I'm fascinated to hear how much extra time they're scheduling in for all the bedding changes. And extra time for having to move bed occupants while they do that - or are they going to change the bed with the occupant in situ, and have they thought through the additional health and safety factors with that..?

Or, they could threaten any CNA found misusing the pads with keel-hauling. Can't see anything wrong with that option...

So what if the staff are using them to help reposition, from personal experience I can tell you that they are really helpful for that! I wonder how long this new policy can last and whose brilliant idea it is - the amount of laundry will simply be switched from bed pads to sheets, and the incidence of pressure sores will increase if staff have more difficulty repositioning and therefor do it less often. Be vigilant and keep detailed records of any negative effects you see.

They are discontinuing the use and I am looking into using them. Not only on the bed but the floor around the bed. And we have the big mattress protector in place. Still it is a big pain stripping the bed at four in the morning and doing the laundry as well as washing her or having the bladder go into the empty mode, all over the place. And this is at home no less.
I would want to know just how the NH is going to provide the additional protection to prevent the various diseases and infections this may cause.
The slow response of the hospital to soiled protective underwear was bad enough.

These are washable ones. Maybe its becoming costly to launder.At Moms facility bedding were done offsight. Maybe they will use Chuxs in place.
If a person soils bedding, I doubt if its left on the bed and if so I would think its against some State regulation.

I have never heard of this practice! My husband and mother ALWAYS had a Chux pad undernesth them. With understaffing in facilities, a resident isn’t changed immediately and the pad helps draw wetness away from their skin. Lying in urine or feces causes skin to break down and also causes infections. I was taught it was ok to use an undersheet to help turn my husband.

Wow. I’d be calling administrators of the facility and if you are told the same thing, I’d find your local agency who overseas facilities and give them a call.