December 2, 2009
Lakeview Nursing and Rehabilitation Centre, Inc.
Mr. Ted O’Brien, Administrator
735 West Diversey Parkway
Chicago, Illinois 60614
Re: Resident Eddie Nance
Mr. O’Brien:
On November 25, 2009 I attended my uncle’s care plan meeting. In attendance was the patient Eddie Nance, his brother, Otha Nance, Jordan Hall, David and I. There was no an activity, dietary, rehab personnel, or speech therapist present. The staff present at this meeting could only assume what the other departments are doing or not doing. My family is seeking comprehensive information at any care plan meeting. Bits and parts will not do.
The issues for redress are: staff attendance for care plan, the time frame allotted for the care plan process, my uncle’s placement in a room where there are 4 people, his speech therapy, and staff responsiveness to family request for information.
I have requested this in the past, but here we go again. When a care plan is suggested for Eddie Nance, I would appreciate your nursing home having all responsible parties for my uncle’s care present at the table, such as social services, nursing, speech, dietary, rehab, etc. I have continuously requested all staff involved in the care of my uncle should be present to provide the necessary, first hand, information needed to the family; and if they cannot be present to provide “written” documentation that can be read and understood by the family members, and your staff on their nursing home experience and progress.
At the meeting on November 25, 2009 social services and nursing were present. Social services had to inform my family on the progress of these other departments. This is inappropriate, to say the least.
Mr. Jordan Hall informed my family that the care plan process for my uncle was allotted 15 minutes. 15 minutes will not address the issues of my uncle, and the redress of my family regarding his treatment. I am not familiar with your staffing or daily program requirements, but it seems that if my uncle has a quarterly care plan scheduled there should be more time allotted for redress of medical and physical care. Even though we went well into a 45-minute discussion and conversation about my uncle’s care, it was appropriate for the issues raised. Most of the time went to Mr. Hall’s elaborate and detailed account of Medicaid/Medicare payments for the speech therapy we request; and the inappropriate conversation from Mr. Hall on Medicaid/Medicare fraud and an audit of your facility. The speech therapist should have been in attendance.
When my uncle first entered your facility in May of 2008, he was a resident on the 1st floor. Due to his unfamiliarity with his “new” living arrangements, your environment, and your lack of security on the front door of your facility, he attempted to or left the facility. Subsequently, your nursing home put him on the 3rd floor, in a locked environment, in a 2-man room. This was more than a year ago.
Since this event and the progress my uncle has made with assimilation to your facility and the program, my family requested your facility move my uncle to a non- or less restrictive environment, such as to a floor where he has more movement and access to daily walks outside, and possibly progressive rehabilitation toward self-sufficiency. Instead, your facility put him in a 4-man room, on this locked environment. I discovered this move on November 25, 2009, after his care plan meeting. I left a message at the front desk for your social service Director Jordan Hall and your Director of Nursing Barbara Erlenbush to call me to discuss this dilemma. I explained to your front desk clerk the nature of the call; she took notes, and informed me she would leave a message for them to call me after they finished their care plan process with another family. I did not receive a call from either of them as of the writing of this letter. I think a week is sufficient time for someone to call.
During the care plan meeting, my family discussed the speech therapy process and progress of my uncle. Mr. Jordan Hall explained the Medicaid/Medicare payment process as it applies to speech therapy payment. Mr. Hall talked about how he did not want to create a scenario where my uncle’s treatment raised “red” flags suggesting the possibility of “fraud” to Medicare where it may give rise to an audit of your facility’s patient records regarding Medicare payments, and the like. Families of patients in your facility are not concerned with whether your facility will have an audit or not!!! If the care of a patient is determined on whether your facility will incur an audit, then there is something seriously wrong with the “human and physical” services your facility renders. The statement made by Mr. Jordan Hall regarding an audit because of concerned care for a patient was absurd and an outrageous.
Therefore, my family request (1) appropriate staff attendance and participation for the care plan process of my uncle as it applies to “his” situation; this is not a “cookie” cutter situation where you can put all your patients in a box, (2) the time frame allotted for the care plan process should extend or be scheduled according to the needs of the extended family; In my 15 years of social service practice along with a Ph.D. in Human Services, I would suggest there is generally not a lot of family participation in a care plan process. Therefore, since it is well established that my uncle’s family cares about his recovery process, there should be time allotted to discuss the details of his care in your facility; (3) my uncle should be placed on a floor where his movement is not as restricted as being on a “locked” floor so his “restorative” process is not impeded or limited from recovery. This placement should also refrain from being in a 4-man room. My uncle should be placed in another 2- or 1-man room on a less restrictive floor.
As it has been stated during care plan meetings for over a year, my uncle is in compliance with your rules and regulations. If you have security issues or concerns at the front door of your facility, I would suggest you take care of it instead of taking it out on your patients and their families; (4) I requested a 2nd opinion at this care plan meeting regarding my uncle’s assessment for continued speech therapy toward full or partial recovery of his speech, not his “swallowing” as has been the only focus of your “team” of professionals. At this care plan meeting Mr. Hall was in defense of the speech therapist in your facility, and their assessment of my uncle’s recovery process and the deterioration based on research from the field of speech therapy.
This is illogical and ridiculous. Research results can be manipulated and the outcome can be skewed. My family wants a 2nd opinion. This 2nd opinion should come from the Jesse Brown VA hospital where my uncle has been a “medical and physical” patient for years; and (5) my family would appreciate a response from staff when we request it. I have continuously informed your staff that my uncle will not be pushed under the rug or fall off the table as it relates to some of the “common” practices of bad human/social services and patient care. Families want a response, when they demonstrate concern for their family members in the care of nursing home facilities. We all have heard the stories regarding malicious and retaliatory care toward patients in nursing home facilities. Please respond appropriately with answers to my dilemma.
Respectfully submitted,
Fred Nance Jr., Ph.D.
Human Services/Social Policy Analysis
cc:
http://clickforjusticeandequality.blogspot.com/
Mr. Ted O’Brien, Administrator (fax copy sent; hard copy in the U.S. Mail)
