Nursing Homes

One out of every three Baby Boomers will at some point need a nursing home. Not necessarily for permanent living. Many will go for rehab after heart surgery or an orthopedic repair, never thinking the stay could turn deadly.

Robert Pineda, a New Mexico accountant, had surgery on his injured knee, then went to a rehab near the hospital. Inadequate care led to a bedsore, which became infected, requiring several surgeries, landing him on dialysis and a ventilator. He was taken off life support one week before his 69th birthday.

Here in New York, Lana Chmielewski said her mother spent “11 days of hell” at James Square Health and Rehabilitation Centre in Syracuse. She developed bedsores and an infection, forcing her back to the hospital, where she died four days later.

You can blame the indifference of hospital administrators and government officials for the frequency of these tragedies. When hospital patients are told they need to go to rehab, instead of straight home, the hospital hands them a list of facilities.

Beware. Some facilities have five-star ratings from Medicare, but others have only one or two stars, meaning substandard care. Hospital staff don’t tell you that.

Laura Rees took her 88-year-old mother to a facility on the top of the list, clueless that it had only one star. Three weeks later, according to the California judge who ruled in the case, Laura’s mother was left to “drown in what appeared to be her own excrement.”

What can families do? Complaining to the facility usually elicits “We’re short-staffed.” That’s what Lee Ann Johnson was told when she came to James Square each morning, always finding her husband drenched in urine.

Conditions were so bad, the state attorney general raided James Square in June. But enforcement actions are rare. New York has 600 nursing homes, and 40 percent of them provide substandard care, according to Medicare.

The worst facilities appear on Medicare’s Special Focus probationary list. Currently there are 82 listed, including three in New York, one in New Jersey and one in Greenwich, Conn., with the misleading name RegalCare. Even that list isn’t foolproof: James Square wasn’t on it, despite the horrors uncovered there.

New York state keeps a publicly available tally of complaints filed against private nursing homes. It’s worth checking. Still, facilities with numerous complaints stay open, filling beds with unsuspecting patients.

For guidelines to selecting a safe post-acute-care facility please consult RID’s informative brochure, 10 Steps You Can Take to Reduce the Risk of Infection in a Nursing Home