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My 94 year old mother has been in assisted living for 2 years. She is legally blind (she has about 5% vision) and very frail. She gets around using her walker. She is on Medicaid. About 6-7 weeks ago she started having a rash that itched. The hospice people gave her an anti-itch cream that didn't seem to help. So, we took her to the doctor and they prescribed prednisone for the inflammation. This didn't seem to help, so they repeated it again and it still didn't help. A little over a week ago we were notified by the AL facility that mom's room had bedbugs. They told us that they had seen "something" like bedbugs a couple weeks earlier but "weren't sure". They didn't mention it to us when they had this suspicion and we, as well as the rest of the family continued to visit her regularly. Fortunately, no one in the family has had any bedbugs from the visits but we are diligent in inspecting for them now. The only time in the past couple months she left the facility was for doctor appointments or our house for dinner.


The AL will be treating her room soon and they have told us that any follow-up treatments may have to be paid by the family. Mom is on Medicaid and none of the family has the funds to pay for this. Since no one in the family has bedbugs, we suspect that someone in the ALF brought them into her room.
Can they require that the family pay for treatment when none of us brought them in? Could she be evicted for this? Should Medicaid be contacted?

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I would contact the health department, I bet that someone that is affiliated with the facility brought them in. I would also let others know, ie any visitors you come across, so everyone can take precautions to stop the spread.

I would send a certified letter to the administrator and copy the Health department that the family will not be able to cover any of the costs to eradicate the bedbug problem in their facility. I would address the fact that no one that visits mom has any issues in their homes or places of work and that leads to the belief that the facility had someone in, vendor, employee or ??? that introduced the bugs.

This gets it on record that you are denying responsibility for the existence of and the eradication of these horrible creatures.

Be sure and keep a copy and document every conversation. Facilities are great at placing blame and responsibility on others. Don't accept it and fight it if needed. They are being paid to provide a safe, clean environment for vulnerable people. They have failed to do so. They will try to pass the buck.

Let us know how goes it and be mindful of what you store to protect from treatment. These little creatures hide in, on and around everything. Maybe remove and treat photos and anything else that can not be replaced by yourself, but do treat everything.

I agree with Bella, people that have never experienced an infestation don't really understand how traumatic it is. It is not something to be calm about, it needs to be treated with a vengeance. Maybe that would stop the spread.
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TaylorUK Aug 2019
Absolutely - this is their problem. If they have them in one room unlikely to be the only one. Wonder if there was any change / addition of bedding or soft furnishing at time problem started.
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It should be the ALF's responsibility. Check her contract about pest management. You may need to contact the licensing agent for the ALF or Better Business Bureau for assistance as well.
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Thank you for your helpful comments. The ALF just provided a temporary unit for her to move into. We made certain that everything that went into the new unit was cleaned (washed and high dryer heat). We also purchased new clothing, shoes, bedding, etc. Her other unit is supposed to be treated next week. Hopefully all goes well with the treatment.
We will follow your advice and protect the photos and other personal items so that they are not damaged.
I appreciate all the advice and don't consider any comments here to be a rant at all. Until someone (elderly parent, family member, visiting friend) actually goes through this and experiences the frustration and anxiety involved they shouldn't make disparaging remarks. Treatment is very expensive...thousands of dollars....and something as simple as a short visit to a resident can create serious financial issues for the unsuspecting visitor. Especially if they have no idea of the infestation.
We found out yesterday that the ALF actually knew of this more than 6 weeks earlier, not "a couple weeks" as they initially said. That makes it even more frustrating.
With regards to moving, there are very few local options available for medicaid residents. We have looked into these with no luck but will continue to do so.
Last night was her first night in a bug-free room and hopefully her last. Thank you again for all the suggestions.
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jacobsonbob Aug 2019
We hope ALL her future nights are spent in a bug-free room!
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Contact the State and complain about her living conditioned and also start looking for another, cleaner, more caring place!!! Dr J Grenan
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GraceNBCC Sep 2019
Reports to State and Elder Abuse Agencies will get their attention and get it on the record. Corporations hate this but Must be held accountable!
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Tell them they own the facility and are obligated to manage pest control. Can't see how she brought in any bedbugs when she hasn't left and no one in family has had problems. More than likely a new patient (or staff member) has brought them from home.

Call your Ombudsman's office and ask them if this charge to a patient is a legal charge. They will get to the bottom of it fairly quick. The medicaid offices and facilities who get calls from them want problems fixed fast with accurate responses.
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Oh my goodness my mom went through the exact same thing with bites on her arms for three months!! Numerous itching creams, assisted-living nurses, three doctors, the Admimistrator all said no it’s not bites ! I suspected bedbugs, wanted to take precaution but the administrator shot me down and said “absolutely not there were not bedbugs in our building!!” Looking back I should have went in her room myself and pulled her bed apart, flipped it upside down to check for bugs because no one in the building would do that, they kept telling me , “our exterminator is spraying and they give us the all clear.” I’m itching as I speak. I’ve posted here before about bedbugs and some people told me to quit overreacting, to calm down and let’s see what we can do about the problem. The problem is, no one takes bedbugs serious and that’s why there’s such a “problem” with them everywhere, these facilities want to keep it quiet because they will lose business. Let me tell you it’s all about proper protocol and residents and family members do have the right to know that there are bedbugs in the building. My dad , when he was still at home, had bedbugs and we got them from him, and we ended up getting them in my house from my mom several weeks ago because I had her with me going to doctors appointments etc going back-and-forth. I had to have two vehicles sprayed down, couldn’t drive them for a week, had my granddaughter’s car seat sprayed down, which I found out later I had to get rid of because it wouldn’t pass inspection because of the spray! When the bugs in moms room was finally discovered (and that was when she caught one and put it in a baggie when I was talking to her on the phone and telling her how to do it) they left her in that same room with her resting her head on her kitchen table. Her bed and recliner were flipped upside down. I threw a fit and demanded that they put her in a clean room. The housekeeper told my mother that she would have to find a place to stay like a hotel...Grrr!
Finally administrator agreed to put her up in their show room but they really didn’t like it because she would be on furniture that they are leasing and was afraid of bedbugs getting on it etc etc...
Yes it has been a nightmare, and it didn’t have to be!!!! Catching a bed bug problem is crucial, and can be taken care of with a lot of diligence and hard work but it is doable!!!!! I am not a freak out type of person, but this subject I feel very strongly about. I’m trying to bring awareness everywhere I go because if people would pay more attention to this problem there wouldn’t be such a breakout of these bugs everywhere!
I could tell you so many stories about this it’s crazy, I’m sure I’ll be raked over the coals hear about my rant.
I can’t see how they will make you responsible for the spraying, hopefully others here will guide you on that. I do know bedbugs can be brought in from anyone so they can’t completely blame your mom... more than likely someone else there at the facility has them to.
All of my moms personal belongings got sprayed down with insecticide, totally saturated pictures in their frames, it seeped underneath onto the pictures, the toaster inside and out etc. etc. etc. The room did get heat treated and then sprayed again. I cannot believe the condition of her room when I finally was able to get back in there!! It looked like a tornado hit and then an earthquake. My husband and I demanded that someone from corporate come for a sit down meeting and inspection of her room. They suggested that I should’ve got mom renters insurance to cover the damages because they will not clean up the mess in her room. I’ve reported them all to our Ombudsman, local health depart. and the state nh health Dept and made numerous complaints there, they are still investigating.
We have since moved mom into a new AL, had to buy her all new clothes, shoes, everything since it’s still bagged up.

any questions, just ask...good luck!
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inkandpaper Aug 2019
We just spent quite a bit of time treating bed bugs in my MIL's home. It was an unbelievable labor intensive process. And it is very expensive. It has been very, very stressful. We also got mattress protectors- if they somehow or another reemerge, they won't get into the mattress again. Even those are expensive if you get good ones. (Also if there are any in the mattress,they can't get out. In a couple of weeks, we might check inside the protectors. We are not up to it right now. The store she bought the mattress from denies that the mattress came with the bugs, but they showed up within a week of her getting that mattress. I really feel for you. Your situation sounds even more stressful.
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Immediately contact Medicaid, the Office on Aging in your county, the state ombudsman and all the officials involved in caring for these people. You should NOT have to pay. This is serious and I truly believe something will happen to force the home to take care of and pay for the situation. Stand strong and start checking on this now.
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Bed bugs can live in crevices of furniture for up to about a year....but your mom has been there for two years so it is highly unlikely that she is responsible for the problem. Bed bugs, however, can be picked up by people travelling on vacation or they can hitchhike on/in someone's backpack or other purse or bag or another resident or their visitor brought them to common areas of the building where they have set up shop, like a couch or wingback chair. The assisted living facility should pay for the entire facility to be inspected top to bottom and treated where necessary. It is the only way to stop the bedbugs from becoming a chronic problem. Your mom will need assistance from you in properly bagging belongings etc., but she should not be charged.
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I skimmed through most of the answers but wanted to just quickly share one observation:

I think that, unless the admission documents specify otherwise, the facility would have to have some proof that the problem originated in your mother's room, or was specifically lined to her presence.   Otherwise, it seems to me more like an attempt to intimidate and create an unfounded accusation.

Have the admins stated why they think she should have to pay for future treatments?   I'm assuming then that they wouldn't be treating any other rooms?
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I agree with GA - this lady has been living in the facility for two years. How likely is it that this very recent infestation originated with her room? - unless somebody brought in second-hand, unlaundered soft furnishings: bedlinen, pillows, mattress topper, eiderdown, rugs or anything like that, which in itself seems pretty improbable.

The facility must deal with the infestation, it must ensure that all rooms are free of infestation; and their giving you notice that follow-ups would be the liability of the residents and their families sounds to me like a bit of a Hail Mary effort to spread the cost burden.

Have other families been told the same thing, do you know? I should ask around, it might be revealing.
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GraceNBCC Sep 2019
I agree Country Mouse...giving "advance notice" does not free the facility of their legal obligation to provide a safe and sanitary living environment.
They are trying to scare families into paying a cost they are not responsible for. What they can and perhaps should do is require all family & visitors bringing in 'soft goods' to bring them to the office to be checked and labeled...a sound practice. Fine those who violate That Rule.
Staff can ask to check visitors wearing clothing where bedbugs can catch a ride, especially if they have visited a room that has been infested before. All visitor need to be warned about any possible infestation.
Hiding it for 6 weeks is a Health Code Violation. If the family had carried BB home after visiting their LO, they could file a civil lawsuit since the facility failed to inform them. That will give the NH a wake up call!
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