Stop Sign Abused

The federal government has started using a red stop sign on the national nursing home website, if inspectors cite abuse.  The stop sign might mean a health care community has a problem, or it might mean you should stop even reading the national nursing home website. 

Recently, a top flight community had an incident.  A nursing assistant was accused of being rough transferring a resident from one chair to another.  Even though there was a difference of opinion about whether it was rough or that the resident was struggling, making the transfer difficult, out of an abundance of caution the nursing assistant was terminated.  The community immediately reported the incident to the appropriate government agency.  The agency responded that they were not going to investigate further.  

Six months later during an inspection, the inspectors reviewed the incident and fined the community approximately $100,000 for abuse.  Their rationale was that they have a zero tolerance for abuse, so any abuse must be penalized.  Lutheran Services Carolinas and every other health care organization had a zero tolerance for abuse before the government did. The person was immediately terminated and reported.  Events will happen, but how health care providers address an event is the test.  What more can an honest provider do?  The broken federal system is running good communities and good people away; do we want to leave our elders in the hands of who’s left?

Nursing Home Clarification

WCNC published a story about seven Charlotte area nursing homes on 2-11-20. Unwittingly, WCNC shared just part of the story.

The federal government system for inspecting and reporting on nursing homes is flawed,inaccurate, and antequated. The government recently added a stop sign to its system, which purports to warn people about nursing homes where abuse occurs. And the government definition and guidance on abuse is byzantine.

While the nursing homes noted may have had problems, they could also be among the best. If a rogue employee neglected or verbally abused a resident and the nursing home immediately fired the employee, the nursing home would still be cited for the abuse, and would have received a "red stop light." In all fairness, it is possible that a nursing home did not take appropriate action and should be punished.

There is no substitute for being actively involved in your community nursing home. If your friends are there, if you visit there regularly, you'll know where you and your family will want to go if and when the need arises. And the need will arise. Go visit your local nursing home this week!

One cannot reduce a person to a sheet of paper, and one cannot reduce a nursing home, a health care community, to a piece of paper. The old saying is "seeing is believing," not "reading is believing." Please don't believe everything you read.

Orpha Shuford. Well done, good and faithful servant.

We lost Orpha Shuford this week. Mrs. Shuford worked at Trinity Village, the Lutheran Home in Hickory, NC, for most of her 50-year nursing career. Mrs. Shuford was a saint! Wife of a Lutheran minister, Mrs. Shuford's ministry was seniors. She ministered to the people who called Trinity Village home. She was professional, quiet, kind, and always at work! Mrs. Shuford died with week at the age of 96, living where she served so diligently, at Trinity Village. Well done, good and faithful servant.

Nursing Home Over-Regulation and Solution

Complaining is a job, problem solving is a vocation. I have always appreciated people who don’t just complain, but come with a plan to fix the problem. That gets harder the bigger the issue, the less control we have. Our current politics and societal changes come to mind.

Recently, I found myself once again railing at the overwhelming issues health care professionals face due in large part to over-regulation. Our national nursing home regulatory process costs millions and doesn’t work. We are regulating nursing homes as we have since the 1970s and just continue to pile on more regulations and more penalties and more paper, but we are not getting the return in quality and cost efficiency our parents, our nation’s senior’s, deserve.

I’d like to offer a solution, not just a complaint. In this age of technology, our federal government is spending millions of dollars a year to drive 4-5 or more inspectors to every nursing home in the United States for 3-5 days every year, or more often. Think of the salaries, the mileage, the hotels and meals. Then add the administrative costs, the teams that inspect the inspectors, and the people who go out and inspect when a complaint is lodged. The government is spending millions of all of our tax dollars, health care professionals aren’t providing care because they are responding to inspectors, and quality is not much affected.

This failed system is not the inspectors’ fault. By and large I have found inspectors to be dedicated public servants, they are just working in a broken system.

There’s a better, simpler, cheaper way than the current broken system. Nursing homes can be monitored through technology, inspections of high performing nursing homes could be curtailed so more time could be spent with true under-performers who need it, all nursing homes can be routinely monitored through current technology, the complaint process could be improved, inspectors can become collaborative consultants, not just inspectors. Quality could go up, and cost go down. How many times do taxpayers get an opportunity like that? Instead, our country continues to live by the quote from Albert Einstein, “The definition of insanity is doing the same thing over and over and expecting different results.”

Refugee Defined

Language matters. As we discuss refugee and immigration issues with people on both ends of the political spectrum, it is clear that language divides. We have not done a good enough job educating people on the simple definitions of a refugee, immigrant, and asylees.

A refugee is a person who has had to flee her/his country of origin out of fear of persecution or death. I have started to use the term legal refugee. Legal refugees are people who have been extreme-vetted, generally wait years in a refugee camp in a third country, and then are invited by the United States government to come live in the United States. Non-legal refugees could slip into the US, but that doesn’t happen often as it’s too difficult to get to the United States. A good example of non-legal refugees would be the boat-loads of Syrian refugees making their way uninvited across the Mediterranean Sea into Europe. I would still categorize non-legal refugees as illegal immigrants.

An immigrant is someone who has chosen to leave her/his country of origin for economic and other reasons. Legal immigrants are those who have applied to the United States and been granted permission to enter the country. An illegal immigrant is someone who has entered the U.S. without that permission, or who overstayed their time if here on a time-limited status. A 2017 study estimates that 42% of the illegal immigrants, 4.5 million people, are here because they have overstayed their expired visa!

Asylees are people who have entered the U.S. or arrived at a port of entry and requested asylum to escape persecution or death in their country of origin. Chinese people account for the most asylees in the U.S., followed by El Salvador, Guatemala, and Honduras, Mexico, India, Nepal….

When Lutheran Services Carolinas talks about serving legal refugees, and advocating for legal immigrants to fill jobs when there are no Americans to fill them, I have heard no opposition save the most extreme. Language matters.

Seeing Jesus

Dear Friends,

I had the opportunity to visit a border state on June 11, 2019 with a group of health and human services leaders. It's easy to fall into the political debates; it's hard to ignore suffering people.

A bus took us to a very nice neighborhood where a number of the homes have been built by Habitat. In a row of six Habitat houses, three are owned by legal refugees who escaped war and death for a new life in America. The home owners were from Afghanistan and the Congo. They are succeeding! They are working homeowners who keep a spotlessly clean home. All three proudly opened thier homes for us to tour and talk about thier journey. The extreme political rhetoric on both sides doesn't match reality.

Our next stop was an aging auto repair shop where we met the proprietor and another entrepreneur, Iraq and Cuban refugees respectively. Both escaped to come pursue the American dream. The car repairman now employs eight people and has a successful business. The other has started a commercial cleaning service that is growing rapidly. He's keeping his day job till he's got enough business and help to transition to full time. Both took out and quickly repaid a micro loan from a sister Lutheran organization to our Lutheran Services Carolinas. The extreme political rhetoric on both sides doesn't match reality.

Our last stop was to a church where every Monday one or two ICE buses pull up and dump approximately 100 asylum seekers. The Lutheran organization arranges housing, communications, clothing, etc. for these people who are on their way to sponsoring family members across the country. We had the privilege of plating and serving lunch and visiting with 47 of these asylum seekers. They had been in the United States for less than 24 hours. Thanks to the Lutherans, they had had a good night's sleep, a shower, etc. after a horrible ordeal. The extreme political rhetoric on both sides doesn't match reality.

The Bible tells us that when we clothed and fed those in need, we have done the same to Jesus. Wow, I saw Jesus this week.

Criminal

Criminal podcast 114 was interesting, then went sideways into infuriatingly one-sided. They started bashing nursing homes, ignorant that many organizations have transformed into skilled living communities.

The speakers stated that the big problem with taking care of someone’s body is forgetting about their mind, and giving agency and dignity to people. “No one listens to you when you’re in a nursing home. No one listens to you when you’re over 65.” Then they discussed the rate of suicide, and nursing homes try to make residents easy to manage, just getting their bodies thru the day. Fake news!

Since one person is a thief, do we extrapolate that all people are thieves?

The speakers obviously have not heard of person-centered care, or life in a Lutheran Services Carolinas community: chaplains, activities from singalongs to games to beach trips, one on one visits with bedbound people, snow sledding, painting classes for people with memory issues, drum circles, political discussions,.... People can sleep late, stay up till all hours, it’s their call, not ours.

Go see for yourself! And go visit to make life better for a person living in any assisted or skilled living community!