My mom has been physically injured twice within a week. I have used all options. Do I report to state authorities? Many other issues.

Like yesterday.

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.

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.

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.

Call the Area Agency on Aging. Talk to the ombudsman to request a check on that facility.

Absolutely report it. So sorry this is happening.

Before I reported to anyone (though yes I probably would, depending) I would want to know how these injuries were happening. How are they happening?

Sounds to me like something has changed in her surroundings or in her control of her limbs so that your mother is repeatedly knocking or scraping her hand(s) against some object that should not be there. What might it be?

Yes - make the report and there should be an ombudsman program for the facilities you can report to. It's anonymous. It's the responsibility of the people to whom you report to get to the bottom of how the injuries occurred. It would be difficult - I would think - for you to trust that you are getting the full story about that. It's likely not much will come of it - but at least the facility will be on notice that there are folks paying attention. Also, if your Mom is eligible for hospice, that is more eyes that will be laid upon her from their nurses, CNAs, social workers, chaplains, etc. just to help monitor the situation.

Is it a gash or a skin tear. Not much you can do for tears. Steri- strips are usually used because the skin is so thin stitches can't be done. Is Mom in a wheelchair where she scoots around. My Mom kept hitting against tables. It is so easy for the elderly to get bruised up, get gashes and skin tears. My DDs patient hit my DDs glasses and the patient got a skin tear. Her sister had a fit but it wasn't my DDs fault.

I am a RN. I know how fragile the elderly's skin can be. This required steri-strips because the gash was so wide, her hand so bruised, red and very sore to the touch. The second one in a week. There was no way to understand what, how or why because there wasn't one word of documentation-_- not even an incident report, which should have been done as soon as the nurse was notified. As I said in the details no documentation of her injuries, no treatment plan. Absolutely NONE.

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.

The sooner you report the injuries, lack of wound care, AND the lack of support documentation in her file the better. Also inform them that you were hesitant to report these issues for fear of retaliation against your mom or discharge from facility. Does mom know how it happened? Does she seem scared or apprehensive around any specific people who care for her? Our elders are afraid to speak up at times. Would mom be eligible for hospice or palliative care? The more eyes the better.

Two thoughts/questions- have you gone up the chain of command? NOT that you should have to be concerned about that specifically, but it would be a sign that you WANT her to be able to stay in place while the PROCESS is followed.

Second, and much more difficult, is it possible for you to maintain an objective non defensive stance in your communications? There was one major instance in my mother’s residence over 5 years that caused me to snarl a bit, but because I had been objective, specific, and reasonable during other less important gripes, my SNARL was heard and addressed.

The reporting system for my mother in her setting was VERY EFFECTIVE, and the reporting system for my current loved one is also EXCELLENT, even with a confusing and annoying situation with two non-communicating POAs.

I'm SO EARNESTLY IN YOUR CORNER on this issue. My present LO is a fairly severe fall risk, and she has received exemplary attention for various incidents, and I have the enormous good fortune to be able to get to her residence or the local receiving hospital when something happens.

Hoping you can resolve this issue to your mother and you own comfort levels. Please let us know how things proceed.

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?

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.

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.

I think you have to assess based on what you feel about the facility overall. Are there other nursing homes in the area that you could move her to? What is your mother telling you -- verbally/nonverbally?

My mother has been in two nursing homes in the last 16 months. She's been in a very good place now for 8 months, despite the fact that she's fallen out bed twice and has been dropped by two different CNAs twice while assisting with the bathroom. They call me right away and let me know. I have no idea if this means they report it or not. Actually they call about most things. Because my mother continues to tell me "how nice they are" -- she never said it about the last nursing home (that had a 5-Star Medicare rating, but couldn't hire a cook on the weekends, or manage to answer the front desk phone at all!) -- I feel that I have to go by my overall experience and my dialog with my mother.

I have worked in many facilities and they all seem to be the same there is staff that is great with the residence and really care. Yet there is a lot of staff that are only there for the paycheck. I would report your concerns to the state but know that the state calls ahead of time when they do an inspection so documentation can always be fixed before they come. It is very hard to find a good care facility when you go to look for a facility ask for their state book this will show everything that they have been written up for it is supposed to be a record for the past 5 years. If there is any way that I can help or you have more questions please let me know. I know it is hard when you want the best for your parents or a loved one but you feel like you're in a hard position!

When you see her with injuries, take pictures. Hope you have a cell phone with camera on your visit.

Institutionalized care is horrible--that's why lawyers say to visit often as in daily and inspect the skin. I do not care what anybody says or how they look--they are awful and pest holes of germs and parasites. If there is a scabies or C. diff diarrhea outbreak..you can bet it is in a nursing home.

That's why I took care of my mom at home until she died, and she lived a very peaceful life surrounded with love but I also sacrificed my life for her. I did everything I could for her including a feeding tube but it provided her all her needs, I did a bowel and cleaning schedule, changed her about 5 times a day (at least) and her skin was in perfect condition and not once did I ever have give her a single narcotic or psychotropic. Irony Alzheimer's disease did not kill her--God took her life with liver tumors and liver liver failure. But I made certain only God would take her life. So I cannot reproach myself or feel any guilt because I really did above and beyond to keep her safe, healthy and comfortable.Her care was based on a very strict routine -- her mind was confused enough but a routine kept her feeling secure, and only the last three months of her life she was bed ridden. But her mind also totally gone and could no longer respond to the environment; it was like taking care of Terri Sheivo her Alzheimer's was truly most advanced stages. Still I put her in the living room daily and kept up a routine, then back to bad after about 6 hours. I still have that Hoyer lift to remind me what I been through every single day.

That was my mom and I would never dump her in some filthy nursing home. She was the only thing in this life that mattered to me. She was my life, heart and soul..and I lost her forever..but I did all I could for her in life. When I lost mom it feels like nothing in this world could possibly hurt me any worse than losing her. That is how much I love mom.

Since you stuck you mother in a nursing home my advice is to VISIT DAILY and inspect her skin. Do not miss a single day. The burden is still on you and your family to make sure she is getting quality care. But like I said I would rather cut my own arm off before sticking my mom in one of those pest holes.

YES!!
Go online and report elder abuse.

Is this NY? The health system needs lot of changes, and the culture in NYC.not sure about other states.Even if you report an incident,nothing happens in NYC,only money matters ! no good health system.The doctors are negligent too.If you report an incident or illness, at least the doctor should stand up for the residents right... none here. worse than 3 rd world... no CCTV cameras either... no evidence for anything... plenty of frauds.

Vikistvin65 You are a State Registered Nurse therefore You know exactly what to do in Your Mom's case. I would advise that You assemble the entire Family together as You all visit Your Mother in the Nursing Home and decide as a Family what action is necessary to take to protect Your Mother. Do not make the decision on Your own, and be prepared to go the full hog here and have Your Mother placed in a safer and more secure Nursing Home Facility.
Good Luck.

Eight years is a long time to be in a nursing home. If your mom is approaching end of life, and you don't want to move her, perhaps it's time for an outside hospice service to supplement your mom's care. With an outside service also witnessing and reporting changes in your mom's condition, the facility may do a better job. Hospice will be your eyes and ears when you can't be there. There are issues of coordination when hospice is provided in a nursing home setting, for example getting the hospice doctor and facility doctor on the same page, but you are a nurse and that gives you more insight. If all else, you can at least discuss the possibility and nuts and bolts of hospice with one or two hospice organizations to see if this idea would improve your mom's day-to-day experience. My mom received hospice services from an outside organization in a nursing home setting. The one-on-one care that she received from her hospice CNA (one hour a day-5 days a week) was far superior than the attention mom was receiving from the nursing home. She was also seen by a hospice nurse twice a week, as well as an occasional visit by the hospice volunteer assigned to her and other auxilliary people. It certainly took the pressure off of me as I had been the only one to assist both mom and dad in their last years (2011 to 2018) and I was getting pretty burnt out by the various crises large and small that occur in this difficult time of life. Hospice is a big decision and frankly, there is no perfect care, but it might be the best solution for your mom and you.

Lynina2 is new to me and I think her answer below is spot on. Do try to remember that with this aging, this lack of mobility, this general weakening ever single system is affected, and the skin is one system most profoundly affected. At 77 my own skin is so much more fragile now, and 85 my brother's is 10 times as bad, and my dad died at 95 with skin that you could virtually peel off his arm causing bleeding and huge purple spots with almost no pressure whatsoever. You have seen changes in personnel that is something that is almost societal at this point in my mind. The phone company, the bank, the counter at Macy's, who is getting the help and care they got a decade or two ago? They are paying less and less in wages so that people are having to have all members of the family work, often in two jobs. I know of a case where there are THREE jobs. To make the household independent. Like you, and as a nurse, I believe in being a mandated reporter. But I also believe in being certain we are getting it as right as we are able. I would report these incidents. If you do not see some improvement, or if you do not like the responses, then I think it is important you call in an ombudsman who (TRUST ME) they do not like to see coming. Even when they are in the RIGHT. There are often such tight rules and regulations and licensure that there are few other than large corporations who will even risk doing this work of caring for our elders anymore.
I would ask you when you see things to consider what you see overall at the place, what you hear when you visit. Would ask you to consider your much loved elder and what might happen at this point around your own house.
As to steri strips, on aging skin they can cause more surface tearing and are inappropriate for surface cuts, they work only for deep gashes. A wrap is more appropriate and without oily salves even THOSE cause more trouble.
You will have to decide what you see and what you must do. Just trying to give you the other side or be the devil's advocate so you will consider it all and wishing you good luck.

Oy. I am guessing by you being a mandated reporter, you are in a profession that requires it. While I understand your siblings concerns, I am more concerned about further harm to your mother regardless of your reporting or not, and what might happen or is already happening to others...you don't say how these injuries supposedly happened, or if mom is reliable/able to tell you. I would report it; I'm not sure who I would call first: the police in the location the facility is located, if only to file a report (I'm not sure if you think there is enough proof that it was outright abuse?), an elder law attorney, or the long term care ombudsman, in addition to the state. The LTC ombudsman may know the process and have contact information and might be a good starting spot. Hopefully your actions will spare others.

Have a meeting with the facility to find out what was documented about the injuries and have them show you the documentation in her records. If they cannot produce something, ask why it is not there. It might be time to contact licensing agency for your area or the Ombudsman's office.
If you are mandated, then you follow the law of your profession and rules. None of us can change those requirements or give advice on do you follow the rules or not. If you wait until something worse happens (that they don't report) it will come back for you to explain - why have ALL of the injuries not been reported until after the serious injury.
For your siblings in regard to your professional mandate - would they rather to ensure she gets to stay in the very place that may eventually seriously injure mom in order to avoid a problem now? That would be like leaving their kid in day care when they see bruises, but don't want to exert the effort to find a safer place for the kid. Would they do that? If yes, you would be mandated to report their kid in danger as well.

If there is a problem, start at the bottom and work your way up the chain of authority.

1 - Talk to the nurse. Realize that the nurse is responsible for the care the CNAs perform. Let him/her know that you are also lodging a complaint with their supervisors.

2 - Lodge complaint - be specific - with the facility. Give them a reasonable time to address your issues. You should see improvement within the week. If no improvement within 3 weeks...

3 - Lodge complaint with the state. If I was going to lodge a complaint with the state, I would also have another placement for my LO available.

You are in a tough position. You should report these incidents for your mother's safety, but you don't want the facility to retaliate by further neglecting your mother's care in response to your complaint. It sounds like the facility is cutting corners in patient care and is covering up incidents. It might be wise to move to a different facility, but I bet that is hard to do, esp after 8 years in one place!

Look for another facility. Things have changed where she is... you are not going to make a dent other than raise their defensive modality, but otherwise, expect more of the same. Ok to make a change for the sake of Mom and your peace of mind. Two injuries in one week is too many, the facility has lost its credibility regardless of diplomatic communications. You owe them no explanation, just take action, to the best of your limitations & restrictions. Much Love and Light 2 U and Mom.