Picking a nursing home

Wether for yourself or someone else choosing a nursing home is one of the toughest things a person does. Sometimes you get it right and sometimes not. It is easiest to do it right the first time. It is no big secret that one of more beloved career turns has been inspecting nursing homes. It is probably the most rewarding job I have ever had in terms of actually doing something worth while. So I have a few insights on choosing a nursing home.
Naturally the best thing to do is return home. If family or friends cannot help out with care issues home health may be available for a short period or employ outside help. I recommend investigating long term care insurance, trust set up for care issues, and being knowledgeable about alternatives before the time comes. Money issues will arise when it comes to Medicaid so plan ahead as they sometimes "look back " up to 6 years.
Nursing homes can have dual purpose with dual payor source. Medicare pays for 6 weeks nursing home care following 3 nights stay in hospital for what ever reason. Usually this is because the patient needs therapy in order to go back home. The other more typical is long term care for some one who cannot return home and care for themselves.
So the first thing is to do research on the homes and find which homes your doctor goes to, if any. You will also need to find out if they take Medicare, Medicaid and or Medicaid pending. Some facilities will not take Medicaid pending because there is no guarantee Medicaid will be approved leaving them stuck with a bill in the thousands.
Ask friends and family what they have heard about a building and the staff. Talk to your neighbors and listen to what they say about a facility.
Make an unplanned visit. Best if you go to see a friend or someone who is actually a patient there but if that doesn't happen pop in. More than likely they will ask you to make an appointment with a social worker or customer service representative, if they do this you might wonder what they are hiding.
While are waiting for your tour to start find the survey book. Any time the state comes and inspects the facility they write a report called 2567. These are the deficiencies found during the states visit.
The first column has the F tag it will appear as F 222 or F 323 followed by SS=A or SS=F. The F tag is the rule that the government has deemed necessary for all nursing homes to comply with you can find those online just search for appendix P and PP. The SS is scope and severity or how many people can or are affected by poor practice.The following is a copy of the grid.

Tags with SS of A, B, C are usually minor, D, E, are more serious  higher than F you might want to start asking a lot of questions. If they have G to I consider going someplace else and J, K, L you need to leave and go someplace else. The yellow plots on the grid are tags in care areas. Care areas are the greatest concern. This means that the care staff are providing is substandard and possible harmful.
The first part of each tag will tell you what the requirement is. These range from providing private place to make phone calls to administering medications correctly. I consider "paper tags" those dealing with Frequency of assessments and doing care plans as drivel. Actual care tags are what you need to look at.
Go during a meal, lunch and supper are best. Go to the dining room and see what is happening. You need to see what the food looks like and smells like. Are the residents eating it or pushing the food away. Ask someone how the food is. Are office staff passing trays? Is the food left on trays or placed on the table like at home. Dining should be as home like as possible. Are staff offering alternatives? Is the food hot, cold food cold? Watch to see if staff are handling residents food with their hands. Are residents being fed? If so is the person doing the feeding sitting or standing over them, or feeding more than one person. Stop and think about how you would want to be fed and what you want to eat.
Will visit this more in Part 2. I do answer questions if there are any.

more ruminations

I try to be green. Spunky recycles all the newspapers Spunky even adds a little ammonia to the mix. (spunky is my elderly, overweight, deaf dog) I have all CFL bulbs in the house. It helps that they are less expensive to run. I plan all my outings so that I use the least amount of gas possible. I plan shopping trips and errand runs so that they are done in one trip. I have discovered Organic milk. Normal milk has hormones in it and it makes me have hot flashes.
Why do people stand right in front on the elevator door blocking your exit from the thing. Do they not know the sooner you can exit the sooner they can get on. Nearly had some goomba knock me down the other day trying to get on the elevator. For added measure I ran over toes with the suitcase I was dragging behind me.
If you sit around and talk bad about other people then you will talk bad about everybody and anybody.
If you don't feel good tell me once, but don't go on and on about all your illness and parts that hurt. I give empathy once but not a dozen times. Go to the doc and get yourself fixed.
Back to being green. We have a rash of dead birds here due to West Nile virus. I will spray and spray and spray because I can get it too and because the dead birds in the yard are a pain in the but, besides the dog keeps trying to eat them.
When you get to be my age if they shave off your pubic hair for surgery it doesn't grow back. Then you look like some dilapidated hooker.
Met a woman who has had more plastic surgery than I could count. She is older than I am. Her silicon fun bags would drive me crazy as she said she sleeps in a bra because she doesn't want them hanging to her knees. Her face has been stretched and it looks pretty good however they didn't do her neck or the skin on the cleavage. It is all old and gnarly. Kind of defeats the purpose.
I have great hairs. Others complain theirs is falling out, too thin, wrong texture, on and on. The only problem with my hairs is it is very grey as I have never colored it. A little "Sun IN" back in the day  but no awful chemicals.
Watched "the Girl With the Dragon Tattoo" yesterday, awesome movie.
Your screaming idiot children who throw balls over my fence will no longer have a ball.
Doing all this is very cathartic. Have a nice day.

Back to the unemployment office

Well it is over. I am torn because I really needed the job but the the people were awful. They are the reason why nursing home surveyors have a bad name. To rant and rave and carry on in such a place is awful.
So when he told me today that West Virginia was not going to use contract surveyors it was a relief. It was also a lie. He had already told us they got a contract for the work but he refused to share the details in a group.
I will enjoy being home again with my precious deaf dog and sleep in the comfort of my own bed.
Bedsides it will give me more opportunity to write here.

This job

The job that I currently have is ending next week. I really like doing this job the only problem are the dragons I work with. Why do I say dragons because they breath fire. A couple of weeks ago we split up the teams that week 2 of the worst were in a different facility. It was a pleasant week, our work was done and there was no drama. This week back to pure hell. I even had the queen dragon dragging me around by the nose. When she wanted to dictate that everybody go back to the place of work really late and then really early I put my foot down and did not do it.
These dragon wanted to catch the nursing home locking someone out of the building and to catch them using less people than stated to transfer someone out of bed. Well they found nothing. What they succeeded in doing was making themselves really tired and making the whole team look like dragons.
I would like to continue to have this job but the dragons need to have their fire removed.

Injustice

My new job is keeping me way to busy. I really do not like it. I like the job it is just that the people I work with are self serving bitches.
We are supposed to be providing a service that ensures the residents in nursing homes are safe and cared for. I find it improbable that someone who can make derogatory statements about the residents of the town, the home itself , and the workers are able to make an objective opinion about what they are seeing. To make snide remarks of someone's parentage, relationship status, or economic status are uncalled for. I do not want to be near you because how do I know you are not saying the same crap about me.
So we are working in West Virginia and they have this law or statute that allows a doctor to sign a paper that makes anyone they want to loose all their rights. This paper states that the person "lacks capacity" thereby giving decision making authority to someone else. I cannot imagine being unable to decide what medications I wan to take, where I want to go, if I even want to not be tied to a chair because I might fall down.
Other states do not do this. In order to do something even similar would be to have a court appointed guardian. That is only going to happen if you are so out of touch with reality or comatose. Time for WV to get with the times and get rid of that piece of paper and the stigma it places on people. This is a good reason to not live in WV.

Cupcakes with

I have a sweet tooth that hurts all the time. In order to get it to stop I bake things. I also bake things when I get really bored. I usually do things by scratch but they have come out with a mix that makes cupcakes with filling in the middle.

Follow the directions on the box. Mix up the batter and place at least a heaping tablespoon in the bottom of each paper cup. Next comes the creme filling. Drop a tsp into each cupcake. Try not to let it touch the paper. Use a toothpick to adjust it to the middle. If it bakes touching the paper when you take the paper off the filling will stick to it.

Top each one with more batter making it as even as possible.
When done allow to cool completely. The package warns that the filling can be hot and burn your mouth.

So these particular ones are yellow cake with white filling and I thought I would try a new icing product with it. This product allows you to mix up your own flavor of icing. So I choose caramel as something different. I usually make caramel buttercreme by scratch to top a great chocolate cake. So as you can see from below the cupcake wound up with most of the filling towards the bottom. It is a trick to get it centered. Not real crazy about the fake carmel flavored icing either. It did however take care of the tooth.

Things that come to mind.

Requirements to work for the TSA. Any one would think they would be dumb, stupid, irritating and general asshole. Well this is true however, clever is another one. What other job in the world can you only have a GED or HS diploma, get a government job with retirement, insurance, and other benefits. They get paid $22 and hour for standing around and intimidating others.
I once was at the airport and messed up one of those full body scans by moving. I said just run the scan again. The powers that be claimed they could not as it was not their policy. Wake up idiots, you make the dam policy, change it. Anyone who frisks old ladies, young children, and cancer patients with colostomies needs to find another place in the world. TSA has become the terrorist.

I shop at Kroger. Have for years. My local store has decided to reorganize and redecorate the store. I cannot find a dang thing. Food stuff on the same isle with cleaning fluid. Make sure you read things well. I will go someplace else till you are done. Who knows I might like them better.

Airlines. Here is an idea. If they have a seat in the window board them first, then the middle seats and the aisle seats. Make first class board last because they hold up the line. Stop charging for luggage and make EVERYBODY check bags. All that scrambling around to stuff your bag in a hole it doesn't fit is irritating and slows us all down. Saw a lady the other day who couldn't figure out where to put her bag, and I suspect really couldn't lift it, just left it in the aisle. This same woman spent 20 minutes trying to figure out how to lie down using 2 seats.

If you get on a plane wearing a costume that denotes a particular religion that the rest of the world suspects, speak in loud foreign languages, or have screaming kids you will be looked at and might even get unwanted comments. You did it to yourself get over it.

New kind of frosting that you add flavor packets to. Nice idea to make it your own but even better is if you place the display at eye level so we can see the packets without reaching way up and messing up the whole display.

Presidential election. I am still making up my mind. If I go with Obama it will be 4 more years of nothing new.(only because the house and senate won't work with him) or 4 years of new shit no one wants from the man who looks like a used car salesman. Can I move to England or France for 4 years?

In West Virginia there is a political race going on where Ed Boober is running for some office. Sorry all I could see was the Boober part. Seriously consider a name change like my friend Bertha Butts is now Bitsy Butts. What were you thinking?

Do not put me in a nursing home. They are warehouses for the undead. They exist only to line their pockets with government cash not to take care of you. If they cared about you then why does the government have to keep going in year after year and inspecting them. If they cared they would do it right the first time and every time.

If for some reason I should ever get killed in a wreck that was brought about because the Houston police were chasing some idiot who didn't want to stop for a traffic ticket, then please sue the city for billions of dollars. They place us all in jeopardy with these pursuits and they need to stop.

My dog is deaf. It will be a different challenge to communicate now.