Same here Russ. A decade ago the majority of the nursing homes were deplorable at best. Two things changed this dramatically--unannounced state inspections and competition.

I have a nephew who is part of the state inspection team, and so is his ex wife. They carefully inspect about three facilities a week, and no inspection is announced. They'll show up after dinner, before breakfast, times when no one is expecting them, and in some instances they've shut down sections of a facility until the problem is solved. That can be real expensive to the owners.

Also during the past decade, huge, new facilities have opened everywhere you look. Each is competing for the almighty dollar, and the competition is keen. I personally know people that have been in some of the NHs and rehab centers near where I live and they all raved about the care they received and how quickly they were being rehabilitated.

I don't know about Kentucky, but things have really taken a turn for the better in Maryland's extended care facilities.

Gary

Don and Gary...I'm so glad that facilities in your areas are adequate. That's extremely rare. I'm talking about the national situation as a whole, which is deplorable. I thought that the upscale places in Kentucky were OK, too. The first one that Doc and his wife were in was beautiful...$7500.00 a month. Even had a guy in a tux playing a grand piano for every lunch and dinner...great looking food...great servers...friendly AD's. It didn't take long to see that all was not what it appeared to be. Diet restrictions not adheared to. Diabetics eating desserts off of other residents' plates. Rampant dehydration issues. Med errors. Untrained staff, inadequate staffing issues at night, blatant neglect and much more. As Doc's condition worsened, the places he was shuffled off to got successively worse. Once a resident does not meet minimum requirements...the ability to transport himself to the dining area, for instance...he/they are "out of there". That's when I got into a pretty in-depth study of the national situation, including a review of all state standards and records from across the country. I teach research statistics and methods. I used these skills to analyse performance in all 50 states. None come close to meeting the standards set for them by their own regulatory/administrative agencies.

Believe me, I quit a 30 year corporate job with a Fortune 500 company in 1995 to be a primary caregiver, and have devoted my life to fighting for accountability and adequate care, and it just "ain't happening". I have been to Washington to testify at hearings...correspond with lawmakers weekly concerning minimum care standards and visit nursing homes once a week as far away as Michigan and Georgia. Universally, what I find is a national embarrasment. The field is so lucrative that more facilities are being built, but most of the fees go to enriching the stockholders/owners, not to improving the level of care.

Sorry that I got on my soapbox, but this has been the defining issue/cause in my life for the last 14 years. Everything else...my company, music, instruments, all the other "toys"...everything else but my family is secondary.

Doc is a nationally recognized psychiatrist...former state commissioner of mental health, retired state mental hospital administrator, retired VA physician who ran a major Alzheimer's/dementia ward, and no amount of money can buy adequate late stage Alzheimer's care. I've explored ALL the options. Luckily, we secured a place for him at a VA as a "private-full-pay" resident (contrary to some beliefs, VA patients who did not suffer major injuries in a war pay fees based on income and financial need). Care was the best we could find, but sadly, recent State budget cuts have resulted in a degeneration of care which is bordering on being unacceptable. I check on him every day, and it's rare that I don't see "glitches" that make me mad as HELL! Here is a person of considerable wealth. Think of what's happening with very needy people relying on Medicaid for their care.

It is a national trajedy, and it just makes me SICK!


Russ