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My mom has been in a skilled nursing home for 8 years. For the first few years things were great. Then there was a huge change in personnel. Many left. Things changed and not for the good. I developed a rare spinal condition that impairs my mobility. I couldn't visit as often. I have managed weekly visits. Mom had two injuries to each hand within a week. The last gash required steri-strips but because it wasn't reported mom received no wound care. The nurse was notified by the CNA who did nothing!! No documentation or incident report, no wound treatment. It was like it never happened. Sounds like someone doesn't want anybody to know anything. Now I am worried all the time. I am all my mom has near by. I am a mandated reporter. I believe in it. My siblings, who are across the country, don't want me to report due to reprisal, like discharge. Would you report to your state authorities?

Your siblings are being ridiculous. Investigating and reporting injuries sustained by your mother are not grounds to discharge her. The idea is plain silly.

You arrive for your weekly visit and find that there are four cuts on your mother's hands. Two cuts per hand. One of them looks nasty but has not been treated. There is nothing on her file about anything relevant.

The idea, here, is primarily to ensure that she does not sustain further injuries. That is what matters.

1. Get the nasty cut treated.
2. Find out what happened. If you get nothing from the staff except dumb insolence or helpless panic, you will have to figure it out yourself. What is she scraping or hitting or knocking her hands against? What is causing these injuries?
3. Put right whatever the cause of the cuts is. If you really can't find it (there's a limit to what could be doing it - fingernails, bolts on wheelchairs or commodes, bed frames, door frames, the underside of dining tables - look closely at what she comes into contact with) then consider options such as cotton gloves.
4. Require an explanation from the SNF of how this came about, why it was not documented and managed as it ought to have been, and how this situation will be prevented in future.

If I found that I was prevented from following these steps, or if God forbid I returned the following week and found more injuries, THEN I would get external authorities involved, certainly.

Meanwhile I'd probably think it a good idea to start researching alternative nursing homes anyway. You never know when you might need one, after all.

Your siblings are across the country and you are already doing all you can. Are there any local friends or neighbours you might recruit as extra visitors, just temporarily?
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Reply to Countrymouse
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rovana Jan 12, 2020
This sounds like a practical workable way to proceed and prevent further injuries.
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Like yesterday.
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Reply to Isthisrealyreal
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Start researching and try to find other facilities, then interview them, with a checklist of questions.

I'd find another safe place for Mom before calling in the authorities though, as there might be retaliation.   But once Mom is safe somewhere else, definitely involve them.  You might also report to Medicare as well; I don't know the frequencies of their reviews, but perhaps a special review might be in order for a noncomforming facility.
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Reply to GardenArtist
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You must report this to the relevant state and county agencies, all of them. They are not allowed to retaliate in any way, including evicting your mom. (In fact your mom may get better care when they see you will report any poor care that amounts to abuse.) Good luck.
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Reply to thepianist
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Be known at the place. Be CLEAR at the place. Be heard at that place. Be loud enough to let everyone know this is NOT ok... WHAT HAPPENED TO MOM?

WHY WAS I NOT CALLED WHEN THIS HAPPENED? WHY ARE YOU ALLOWING MY MOTHER TO BE HURT AND THERE IS NO FOLLOWUP NO PHONE CALL TO ME?

Ask her doctor that you want a her to be evaluated for Palliative care and/or Hospice care. Perhaps that is what the Skilled Nursing Home is supposed to do.

when my mother was in the hospital, for what, I don't recall, too many times, I went to visit her in the morning before going to work. I found her naked leaning over her bed and asleep... And she was near the nursing station. I yelled and I was very mad, what the Hell,,, Never have I seen anything like that before. They were quick to fix that, how long was she there like that? No idea. The guy I was screaming at, quickly admitted that he just clocked in, he just got there. Really? that's an excuse?
Did you ask why there were injuries? And demand an explanation. Is mom totally disabled? Perhaps they got someone working who doesn't know how to maneuver or handle people correctly....
My hsopice nurse says she can personally by herself handle a 275 pound man without creating brusies or marks.
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Reply to MAYDAY
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Vikistvin65 Jan 10, 2020
Your sound like me. I am no means "quiet."
I post notes, document, yell if I have to. I do try to be nice but nobody hears nice, lawsuit and report seems to get their attention. But still won't meet my demands- like a 1-2 day suspension of the nurses that I reported the injuries to and still did nothing. Not even wound care or incident report.
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Sorry, I forgot to read ur profile. Call the Ombudsmen and ask for an investigation. As a Nurse, they know what ur talking about. Love it when my daughter shows up in her scrubs. No more trying to intimidate me. I have someone who knows how it works. Maybe the State dept that oversees them.
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Reply to JoAnn29
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Call the Ombudsman in your area thru the Department of Aging. Their role is to protect resident rights and they are often able to keep tge facility on their ties. They will get an explanation from the facility and they know when something should be reported.
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Reply to Jennifercrane
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Cetude, I'm sorry to learn that your experiences were so negative, but I've seen just the opposite in a variety of facilities.  Certainly there were some that were better than others, but I've never seen anyone pull a PEG tube out, and based on how a doctor handled removal when it was no longer needed, I think it would take a lot of painful tugging for a non medical staff to get a PEG tube out.

As to staffing, there are state mandated standards.   I don't recall if it was something like a 1:11 ratio or more or less, but that was a question I learned to ask before placement (after a bad experience at one hospital related rehab facility).

I'm sorry to learn that you've experienced poor and frustrating care, but there are some very good facilities available.   After several rehabs, I found a top notch religious affiliated place for my father.
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Reply to GardenArtist
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cetude Jan 16, 2020
These numbers reflect these two ratios: 
Resident: nurse ratio 
Resident: CNA ratio*
The numbers were insane:
32:1 nurse and 16:1 CNA- Ohio
44:1 nurse and 44:2 CNA- Tennessee
50:2 nurse and 15:3 CNA- New York
66:2 nurse and 66:4 CNA- Illinois
50:1 nurse and 30:1 CNA- Georgia
60:1 nurse and 60:3-4 CNA- Nebraska

https://nurse.org/articles/nurse-staffing-unsafe-long-care-facilities/
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Yes, I would. And if possible have a friend stop in to see her if you can't. Stay on top of this if you can. Why would your siblings think of reprisal or discharge when your mother was hurt and it wan't her fault. The facility needs to be held accountable.
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Reply to Rbuser1
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I was thinking about your problem. I am 85 and hubby is 88. Our skin tears just looking at it. Especially where the sun hit it all of our lives, like hands and arms. As you know, if she is on Blood thinners that will make it look really bruised and bad too. That said, what other posters said about looking in to it is a great thing. You never know.
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Reply to MaryKathleen
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MAYDAY Jan 13, 2020
Hospice reminded me when my aunt tore open her arm.. Started itchiing, and scratching, and tore the skin wide open... Hospice to me everything your just said about skin, and blood thinners do not help....

My friend told me about Arnicare.. Cream and pill form...supposed help heal the bruising.
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