Are all skilled nursing facilites for rehab the same?

Standards can look the same on the official sites, but it's the staff that matters most.

Sadly, where we live matters, as well. In my community, most of the facilities are very good. I agree that most non-profit facilities tend to hire better and simply are more likely to be run with residents in mind. Faith based homes are often some of the best and your loved one needn't be of the faith that supports the home.

We have one local nursing home that was owned by a Lutheran based company, then a secular non-profit and then a Catholic foundation. It remained excellent the whole time, though the Catholic sisters that bought it seemed to do the best. Part of that may be that there is more general knowledge about good nursing home culture now, but part of it is their mission.

Over the 15 years that I was directly involved, I found the home excellent. Not perfect. Mistakes were made. Not every aide was an angel. However, in general, the staff was remarkable and in some cases they fall into my "prayers for life" category. I'll never forget them.

I feel terrible for the people who have little choice but to place their loved one in a poor facility. Caregivers must pressure members of congress and others for better senior care and that means better nursing homes for all.

My main point is that we can't paint them all with the same brush. Also - the age of the furniture matters far less than the caring of the staff. Ideally, a nice facility with good rooms and a wonderful staff - well, that's nearly perfect. However, I'll go for great staff first every time.

Take care,
Carol

Hmmm, I can relate on both ends. Having parents go to rehab nursing facilities and working in one now.
When my mom was alive, she was in and out quite a bit. I helped with caring for her, my Dad kept her at home with our help until she passed away.
After she passed away, I felt lost. I felt like my purpose for existing was gone. After counseling, I decided to become a CNA (Certified Nursing Assistant) then also got my TMA (Trained Medication Aide). I love working in a Skilled Nursing Facility and Rehab. I love my residents. They are like my family also.
That being said, most facilities as I have learned are understaffed, not because they want to be but because there is a shortage of CNA's. I would do just about anything for my residents within reason. However, I am human. While I do my best, there are times I can't keep up with all the lights. I have done my best to take time with each resident when I am with them. I don't want them to feel rushed or that I don't care because I do. I answer the call lights as quickly as I can with that in mind. I answer them as I see them come on.
The problem being, each resident thinks they should be first, even if their light wasn't on first. I am only one person. I am not lazy and I do care. While they don't see this, I don't take breaks that I should even though they are taken out of my checks, because I put my residents needs before my wants. That is however, how burn out happens. I just feel that my residents are important. I love them. I know there are some who may not care and are only there for the paycheck. They give the rest of us a bad name. I am not one of those. I don't like being grouped in that. I can only do what I can do.
Just keep in mind, there is those of us that can't help being understaffed but love the people they care for.
No, we don't want to make your family permanent residents as much as it may seem that way. I have residents that have gotten better and went into a assisted living facility. I am happy for them, but make no mistake I do miss them. They become like family. That being said, I have seen some that left and shouldn't have because they weren't ready. My mom being one of those who signed herself out because she "thought" she was ready and wasn't, then ended up having to find another facility because they have waiting lists and filled her place when she checked herself out.
The point is, we don't want our beds to be full for the purpose of just being full. We are happy for residents that get to leave when they are ready. Sometimes people think they should be able to be on their own when truthfully, they just can't.
Important things to check on when looking into facilities is:
-Are they a "for profit" or "non-profit" facility?
-Are they a Christian facility? May not seem important, but trust me it is, Christian facilities are supported better and tend to hire as such).
-What is their Aide to resident quota?

Something else to think about is most full time aides are working 12 hour shifts, and with few breaks. Please give them the benefit of the doubt if you aren't sure.
Just my 2 cents. Sorry for rambling.

While I appreciate LauraO's comments, I am grateful and hopeful that there are persons with her dedication and compassion being employed in rehab/nursing homes. However, from the last 2 weeks of my experience with the "5-star" rehab/nursing home my mother is in, I am discouraged, disgusted and fearful for my mother's general well being.

I have done my due diligence in researching nursing home/rehab places and I am convinced from talking to my husband's numerous colleagues/contacts in the health care/long term care field that you will get adequate or subpar care from these type of facilities. It just is what it is. For people who have commented that their loved one is in a wonderful nursing home with excellent care, I applaud them for find such a facility.

My 86-year old frail, hard of hearing (2 hearing aids), incontinent mother fell and broke her leg in her home the day after Christmas. She had to have emergency surgery on Sunday (Dec 27) to put a plate and screws in her femur. On the next Saturday (Jan 2) -- 6 days after surgery and on a holiday weekend which is a nightmare of understaffing in nursing/rehab homes -- she was transferred at 6 PM to the rehab/nursing home. I was appalled that they could release a frail old lady so quickly after surgery but the surgeon and attending physician at the hospital deemed her "ready for discharge".

Before being discharged, nursing home/rehab centers make you fill out their application/questionnaire relative to the patient's finances and what type of assets they have, because that's what determines if they want to accept you and how soon they will have to rely on Medicaid to support her. My mother has a small pension annuity from my deceased Dad, owns a small tri-level home, and very limited assets. The rehab place we chose did not want to accept her until my husband contacted the CEO/owner of the place and basically begged him to take her.

She has now been there 2 weeks in this "5 star" facility (according to Medicare.gov) and she's already developed a nasty bedsore. I agree wholeheartedly with Careisgiving's comments above. While I have found a "few" aides that give a damn, the majority seem uncaring and just going through the motions. My Mom is completely vulnerable -- she has a brace on her broken leg for support and due to her confusion and mild cognitive degeneration, she cannot use the call button to call for assistance. She is totally incontinent. She's unable to "know" when she's soiled herself. Her care plan states she must be changed and repositioned EVERY 2 hours but that is not happening. I've brought this to the attention of the Unit Nurse Supervisor and the Director of Nursing of the whole facility but nothing changes. I feel I have to be at the facility10 hours a day to make sure someone is responding to her needs.

She is a 2-person assist patient -- meaning they need a hoyer lift to lift her out of bed or a wheelchair to put her into bed, roll her over, change her diaper, then lift her back to the wheelchair. However, many times after they change her, they just leave her in bed laying on the same bedsore that she's developed because they don't put supports (they use pillows and not foam wedges) under her.

To take her home is not an option as she requires skilled nursing care 24/7. She (and we) have no money for private duty nurses/aides. To change facilities is also not realistic, as again, I have checked out all of them and they are either the same (short staffed with underpaid, undereducated aides) or worse. I had to complain vigorously to the Director of Nursing because while I was there, an aloof CNA (aide) was making my mother scream in pain just changing her diaper. The aide says to me, "Well it's gonna hurt" when she pulls the diaper out from underneath my Mom. Are you kidding me???? WTF???? Needless to say, this aide was written up and no longer assigned to my mother. However, I won't know if she ever gets reassigned to her because I can't be there 24/7 and the aides are "floaters" who go from facility to facility in this nursing home chain.

The care for the frail, vulnerable elderly in this country is atrocious. Careisgiving is correct: "some don't care and are lazy but are too stupid to want to better their skillset to get a higher paying job, so they're content with the low pay grade because unless they commit negligence they're guaranteed a job." I've heard horror stories from friends and family with loved ones in our local nursing homes from lack of responsiveness, bedsores, laying in urine/feces, being dropped in the shower room, lack of attention, etc. My observations from just a short 2 weeks is that RN's occupy the nurse's station to "supervise" the LPNs who are at the med cart in the hallway basically taking vitals and passing out pills. The bulk of the patient "care" is performed by the aides, many of which "call off" because they want a day off or miss the bus to the facility or whatever excuse, so whatever aides are left are frustrated and resentful that they now have double the patients to take care of. The turnover in aides is tremendous. My mother is reliant on them to change her soiled diaper every 2 hours but because she is so needy (needing 2 aides and a hoyer lift), she is the last one to be checked on. The aides to patient ratio is probably 1 aide for every 10-15 patients, so when my mother needs 2 aides, yikes! And again, she can't even push the call button to ask for help. I am beside myself. I don't think my Mom has any realistic chance for any meaningful "recovery" so her days will end here suffering at the hands of non-responsive staff. However, PT and OT will continue to do "rehab" per the surgeon's orders.

Again, Careisgiving is correct: "it's just that they want all beds filled - all the time - for business - so if there's an opportunity to keep a patient there due to development of another health condition or the patient's health condition declines, they'll keep running up the insurance." My mother is non-weight bearing on her leg for 3 months, THEN she's supposed to have more "rehab" to try to get her on her feet. This will put her into the Medicaid "status" at that point (when Medicare and her private insurance no longer will pay) and I'm sure they will determine at that point that no more rehab will help her and they will want to move her to the back of the nursing home for long term care. She's 86, frail, declined cognitively, has severe osteoporosis, osteoarthritis is both knees (bone on bone).

I feel so guilty that I can't do anything to make my mother's last days on this earth pleasant. I dread the thought of my Mom (or any elder person) having to die like this. I almost pray to God that she will die. I feel like a horrible daughter.

im with freq .
the staff may be smarter than they look . my aunt was often left un alarmed in her bed or chair because unofficially the rehab team wanted her to use her muscles as much as possible even tho she was a fall risk . they werent far away and were listening intently . i cant say enough good about them .

My mom is in a NH going on three years now. She was at death's door when she arrived and is now stable and content. Mom rings when she needs to go to the bathroom and staff is responsive. Her roomate rings for everything and is not ignored, but they don't come running.

My name is Don M. I havd been a Nursing Rehab Resident for 4 past years due to a Surgical Medical Accident which left me paralyzed. Before that in my career I rose thru the ranks as a highly skilled medical RT of a Trauma 1 Hospital. During my 4 years before escaping Nursing Rehab industry I was in 5 different Nursing Facilities from the Low End accept anyone facilities to Top End, private insurance type skilled care. So I had to enter this discussion to help out. Nursing Homes hire CNA's and LVN Nurses from the same Regional Area Labor pool of whoever or Whatever Staff is available for Hire. There is a Shortage of Nursing and not many want to be a CNA who does the most. Now that presents Another Problem,,, Keeping Staff to Show Up is the Trade-Off to Quality Care.., ANY BODY is better than NoBody.., So the business of NH Care will trade-off the Quality until they can find someone better and the Residents suffer during this time with a SLACKER.., or someone who is non-caring.., I Have Seen it ALL.., The BEST WAY to address this is to write REVIEWS to "Warn Smart Internet Families" about Poor Quality Care Issues because Often NH Management will Cover-Up woeful behaviors.., YOU can also go to the Dept of Disability (DADS) inspection review Website to get an idea.., of what is not being done properly. BUT LASTLY.., Visit Loved Ones many times in every week.., The More STAFF knows you will visit the better care is given,, at least until you leave.., FINAL ADVICE,, "KEEP MOMMA OR DAD AT HOME" and hire Nursing Homecare Service. Seriously..., DON

While I wholeheartedly agree with both Careisgiving and Help2day, I am now terrified if anything should ever happen to my FIL, that he needs Skilled Nursing Home Care! I as yet, have never needed to actually look into such care for him, and he has lived with us in our home for the past 12 years, he is 86, and the potential for such in the future is almost undeniable. I have been investigating all day on the internet, for a way to get some respite care time off, but after reading the last few posts, I may well forget the whole darn thing! It Sucks to be Us!

Penny wise, pound foolish comes to mind.

I think 12 hour shifts are in humane.

The aides at my Dad's brief stay at a rehab facility were kind (from what I could see) but over-whelmed, particularly after meals when everyone had to 'Go' at the same time.

I know things are overwhelming for caregivers, but please, try to get politically active. Goose your politicians, join big groups. If you can't do it now, when your journey is over don't forget what you've been through. As if you ever could forget, right?

Brief Rant ahead. Jude, I don't think it's hidden at all. "The State" has no intention of making care homes "more attractive" or paying any extra for care (I'm in America in what is called a conservative red state i.e. Republican). Our governor declined Medicaid expansion and fights almost any expansion of social services. We have a fund to entice businesses to come to Texas and offset corporate expenses in the millions of dollars. Education and affordable child care is chronically underfunded. We are building new toll roads, but the public aka "free" highways infrastructure is crumbling. Too many requests for too little money. And it will only get worse. In America, going on Medicaid is NEVER going to be as pleasant as being at home. Government is always going to push for family to take care of caregiving (I have a son with autism - talk to me about lack of respite sometime!). The best hope we have is to take care of health as much as we can and figure that we will only have care we can personally pay for or talk family into. Institutional care for profit substandard since The State doesn't want to pay ANY EXTRA, especially in the upcoming worldwide recession. Look at year-end sales reports from stores - we are NOT buying in America (and much of America is consumer based). China is slowing down. The flood of political and economic refugees is not slowing and people are clamoring for funding for refugee care. Just time to hunker down.