Part One– https://thatwoman.wordpress.com/2019/03/22/the-ratings-of-medical-facilities-series-it-begins/
Part Two- https://thatwoman.wordpress.com/2019/04/09/medical-care-from-a-consumers-perspective-ohio/
Part Three- https://thatwoman.wordpress.com/2019/04/22/medical-care-a-consumers-prospective-mercy-health-lorain/
Part Four – https://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/
Part Five – https://thatwoman.wordpress.com/2019/05/27/medical-care-a-consumers-perspective-cleveland-clinic-rehab-hospital/
Part Six – https://thatwoman.wordpress.com/2019/06/15/medical-care-a-consumers-perspective-brookdale-skilled-nursing/
This will, hopefully, be the last in the series of medical care received in various medical facilities , three different types of medical care, and three different providers. Ideally this post should be in two parts but I want to leave Brookdale behind so it will be lengthy.
The common denominator was the insurance coverage Medicare and Medical Mutual. Although I am fighting one bill ( will be explored in this post) and the Medicare evaluation of Brookdale as mentioned in Part SIX is an issue for us, on the whole Medicare and Medical Mutual – so far – has been less than the nightmare I thought it would be.

I believed we were spoiled by the nursing staff/ aides and housekeeping staff at Mercy Health Lorain, upon reflection they set the bar very high– a few of their physicians I found decidedly lacking ( see Part One).
Also , the Cleveland Clinic Rehabilitation was beautifully clean and the food was very good , rehab staff were excellent, you knew what time therapy was every day and who what and where so families could adjust schedules to participate with the patient. You knew who the nurses were that day and your aides. Unfortunately, it was down to a small percentage of aides that spoiled the experience and also caused a health issue ( in my opinion) by spreading C’Diff from one room to another and then sending contaminated material with the patient to another facility. Brookdale
Ah! Brookdale, Westlake Ohio…..the 5 star Skilled nursing and rehabilitation facility which is in the middle of a very large Assisted Living and Senior Living
Brookdale Senior Living owns and operates over 1,000 senior living communities and retirement communities in the United States. Brookdale was established in 1978 and is based out of Brentwood, Tennessee. https://en.wikipedia.org/wiki/Brookdale_Senior_Living
The typical Brookdale Senior Living CNA salary is $12. CNA salaries at Brookdale Senior Living can range from $10 – $15. This estimate is based upon 66 Brookdale Senior Living CNA salary report(s) provided by employees or estimated based upon statistical methodshttps://www.glassdoor.com/Hourly-Pay/Brookdale-Senior-Living-CNA-Hourly-Pay-E6433_D_KO24,27.htm
Independent living prices average $2,900 monthly. The majority of locations will cost between $2,300 and $3,500. Skilled nursing communities are available as a Basic Monthly Service Rate of between $6,000 and $8,500.
I have not received the cost of our one month stay at Brookdale Westlake “skilled nursing and rehab ” in Westlake as of today’s date but I do know one charge was $400 per day.
After the poor experience of “transfer” from Cleveland Clinic Rehab Hosp. Avon (which was paid for by self -pay) I wasn’t in the best of moods . I understood from literature that I had read this was a “newer facilty”. I understood it to be around 10 years old. In my opinion it was becoming a little “shabby” without the chic.
I should point out this is a very large complex and the “skilled nursing” ( bit of an oxymoron in my opinion) section had quite a large turnover of people coming in and out of rehab. However, my first impression after leaving the gleaming white , bright Cleveland Clinic Rehabilitation Hospital(CCRH) was one of “OH!” and not in a pleasant way. The parking for the visitors for the skilled nursing/ rehab section was awful, you had to hope the parking gods were on your side as you drove round and round hoping for someone to leave.
Please note this a critique of the Skilled Nursing and Rehabilitation Section of the complex, I have no thoughts or opinions as to the rest of their complex and assisted living sections.
The facility allows pet visits to the patients rooms, all well and good but unlike The CCRH where there was a designated area tile floor) for those pet visits, animals in all shapes and sizes routinely walked the “carpeted corridors” , one little fella dragged his bottom along the carpet which made me go eeeewwwwwww. Had they been bathed, de-fleaed , some looked as if they weren’t exactly a pampered pet? I did take my dog to see her master at the CCRH after going through the paperwork and a shampoo. I did not bring her to Brookdale!

The room was supposed to be “homey” and an effort was made in the design and décor. However too many bumps and bruises on the paintwork, furniture left an impression of needing a redecorating. The “homey” bedspread with its little bag of goodies, had decidedly seen better days , faded (hopefully) through a lot of washing? Again, being spoiled by the open airiness of the CCRH with large windows this was a bit of a disappointment , his room was dark and yes in my opinion a bit dingy. The photo from their website is really not a great representation as to the “light” in the room we had. After the pristine cleanliness of CCRH it was a bit of a disappointment Oh well thought I different facility not a hospital .

The bed was actually quite small, and no sides. Apparently “nursing homes” cannot restrict the occupants ( such as the side up in a hospital) neither can they belt you in a wheel chair. This was all well and good but for a patient that has very little trunk strength and one who was a fall risk this was not ideal. I was told we could request the sides if we went through the paperwork and the Dr. must write out a prescription to have the sides installed. I said this is what I wanted done. That was the last I heard, and actually he fell out of the bed twice, a chair once and the wheelchair once. Not so good when it comes to the fact he had just had major brain surgery after a fall.

After 4 days of being a resident the bathroom became the holding room for dirty sheets, linens, towels used diapers and pads ( remember that C’Diff) I was ready to remove the patient from the 5 star facility and interaction with some very off putting aides . I called the head nurse and one of the administrators , after my daughter was given the pads etc to clean up the leaking Foley bag. Since she was gowned and wiping down the room with cleaning cloths due to the C’diff maybe they did think she was a staff member, as we were told. Obviously no-one else up to that point – knowing there was an issue with C’diff wore those items. ( Benefit of the doubt)

Some aides did make a half hearted effort to “gown up” after the complaint, however, latex gloves routinely ended up being taken off and thrown into the “general purpose waste basket”, well those that made it in as they were thrown – I was forever picking these up and emptying the room trash!
As for “housekeeping” I can’t remember that happening to any degree maybe weekly and only once was there what I call a thorough cleaning ( the Sunday after I complained ) whereas in the previous two facility it was daily and sometimes twice a day.
The ‘weekend administrator” did get the bags of laundry and garbage out of the bathroom , did send in a cleaner and apologized. The “head” nurse did get the Foley bag removed, changed the mattress to an air mattress, as he was starting to get a bed sore due to being stationary and unable to move on his own ( eg. roll over) and was also very uncomfortable due to a pre-existing back condition. And so it began…………
The rehab staff were very good, he could not have intensive rehab at this facility , again only so often due to Medicare restrictions. But on the whole we were pleased. My goal was to have him ambulatory , able to get into a bed at home and to be able to get to the bathroom. This was going to mean on a walker at least because this “Old House” was not wheelchair friendly.

Since there was definitely an issue with 85% of the aides ( remember the staff that was above average according to the Medicare evaluation ) my daughter would spend every morning going with him to rehab, not the organized times etc of the CCRH we were expecting, she would stay until after lunch and I would come later in the afternoon through the evening. Night times were very bad for him, but he was on digoxin and although he had adverse reactions to this drug we could not get Doctors to take him off of it ( prescribed by the ghost cardiologist from Mercy)
Note: the moment he was home and our cardiologist saw him digoxin was “nixed” and so were many of the other medications.
I am sure the administrative staff as well as a number of the aides were not at all happy with my advocacy for my husband. A “difficult patient” due to medications, pain and confusion and a difficult wife 😉 . I would ask you to remember this man went to bed at Mercy woke up eight days later after being intubated and having respiratory arrest unable to move , unable to speak ( due to his vocal chords being stretched, ) not knowing where he was and what happened and having an 8 inch slice taken out of his scalp. He remembers nothing at all from Mercy , very little from CCRH and too much from Brookdale, Westlake.
Patients were told they could eat in the dining room and for the most part the food was fine, the aides in the dining area were very helpful and the view of the duck pond a nice outlook. Mealtimes became a highlight to one trapped in a wheelchair.
The call light response times were awful, in our case, of course being a “demanding patient” who wanted to use the bathroom or get out of the bed and wheelchair due to his discomfort didn’t help. The notice on the board in his room “call don’t fall” didn’t count for much.
The Administrator did print out a record of the response times to the call light. Amazingly they had response times of 30 seconds up to 5 minutes.
What they hadn’t realized with the amount of time my daughter and I were putting in and the fact that as a blogger and ex- columnist I have this penchant for documentation we also kept a record of those call times and for the “most” part they didn’t concur with the print out. With that printed out response time for his room number I received a bill for another patient, which I duly returned, that had had that room previously.
March 17th he fell again , this is an excerpt to Medicare appeals as they denied the cost of the emergency room Dr. after I insisted Brookdale transport him to St. John’s after yet another fall.
“On March 17th I received a call from the night nursing staff at Brookdale that my husband had fallen trying to get out of his chair. The nurse informed me he had bruising to his abdomen and an abrasion to his left leg.They could not tell me if he had hit his head. Considering they stated he had only fallen 10 minutes previously to calling me I was concerned they could not tell me whether he had hit his head and that bruising to the abdomen was already in place. I deemed it important considering the history of previous weeks of major brain bleed and surgery he should be checked out by someone other than an LPN. Hence the trip to St. John’s Westshore Emergency Dept. He was monitored in the ER and after a few hours sent back to Brookdale .
It is my contention that due to the recent history of falling and two brain bleeds the ER was the appropriate facility at 1 a.m in the morning. Brookdale, in my opinion did not have a qualified individual on duty or equipment to ascertain a diagnosis. The ER was the best place”

As time wore on and actually his discharge times got put back , I realized that, in our case , although the rehab therapy was very good, it wasn’t enough. He was spending too much time “waiting” and sitting in a wheelchair for the two to three hours of rehab and at least two days a week where there was no rehab at all. ( Again due to Medicare restrictions). So as his Dr. concurred and my husband was unhappy at the facility and was at least able to use the walker (with help) and we felt we could manage his care we discharged him from Brookdale Westlake on March 29th.
I am pleased to say that in April he went into out patient physical therapy at NeuroSpine Care, Sheffield Village, three times a week. He has progressed amazingly well and they have him transitioning to a cane , able to stand and do the things that make life normal.
http://www.neurospinecare.com/
I do not agree with Medicare ratings that this is a 5 star facility, but then again I do not know how low they set the bar!
The best I can give this facility in rating , remembering it was supposed to be, according to Medicare, a 5 star facility is a C minus. Although there were highlights such as the rehab staff, the “aides” were another let down and remember these are the individual that are dealing with your loved one. ( I would say my general impression was that the aides were dealing with quite a few patients each shift and if their stated wages were anything to go by they need a raise in order the attract better qualified individuals !
Remember this is a FOR PROFIT facility and you are the consumer not a charity case and Medicare and yourself will be paying for the “business”
of care and rehabilitation!!!!!!!
July 11, 2019 at 1:20 pm
I have written about you every month on the 3rd of the month as my memorial to you – your life and your art work. A few months ago I wrote these lines in the post https://thatwoman.wordpress.com/2019/04/03/april-3rd-forgotten-chris-ritchey/
““They say you die three times – once when your body fails you – again when you are buried ( funeral) and again when you are forgotten”.
Death of the body and death of memory. When you are buried and that headstone in place is a remembrance of sorts but there’s the rub how long will that headstone last?
Most of us believe that record of our being in the places designed for such – as cemeteries and crematoriums will last forever, not so especially with the way things happen with cemeteries in recent years. This Blog https://lisanneharris.com/2013/05/12/sadly-utterly-abandoned-churches-cemeteries/ Ms. Harris has a plethora of photos from around the world of these sad places. The forlorn graves sinking into oblivion once held the tears and heartbreak of mourners who grieved over their loved ones. Even in this old neighborhood the citizens of Lorain in the past plowed under and buried the little Charleston Village Cemetery
https://thatwoman.wordpress.com/tag/pioneer-cemetery-lorain/

I read once , here you can’t reclaim or take out graves until 100 years after the last burial. But that is another law that is circumvented. I know it happened to your Great Grandmother and Great Grandfather and Great- Great Grandmother, the site was moved (although other family members wouldn’t have it) but I remember visiting those graves in a totally different area of the cemetery and one was missing altogether.
You are not dead because our love of you is alive and you are in our thoughts and dreams daily.
Your Nana was not afraid to die, she was actually welcoming her demise -99 years is longer than most get on this earth.
She had out- lived her brothers , sisters, friends of her youth. She was ready but as she sipped her tea one day near the ending she look at me over the rim of the cup and said
“you won’t forget me will you, Nikki and the children will remember they had their Nana”.
There is no headstone in a “family plot” because that is not what she wanted. Her ashes will hopefully one day make it back to “her England” , time and life permitting.

Today, I received a notification from the Crematorium in England
St Marylebone Crematorium – Memorials
about your Grandfather. What a mess that was when he passed , he had gone off with someone else – had a new family – although he clung still to his old one. Due to the fact he never remarried, I was still his next of kin, the arrangements were left to me although his “woman” did orchestrate some aspects.
Then a few years on, since Nana and I were home, we went to the crematorium and I asked the office where my fathers ashes were interred. Imagine my guilt when I found out no-one had ever claimed them! I had thought his fancy bit would have, she obviously was done with him after he died. I was told his ashes were scattered in a part of the crematorium I was shown the spot where his ashes had been scattered and was told
“I could have a “tablet” positioned on the walls surrounding the Willow Garden, and are ideal for those who wish to mark the position of a loved one whose ashes have been scattered below.”
It was decided, only Nana would have nothing to do with it , didn’t want her name mentioned and went and sat in the rose garden. This is truly a beautiful place. I realized, although his work of a cross ( commissioned by the Governor of Gibraltar) hopefully still adorns the altar in the Naval Chapel there ,

there was not a permanent dedication ( well as permanent as can be in this life) but one day even that small reminder will be taken from the wall

Anyway I purchased a “tablet: and every 10 years I receive an invoice to renew the dedication, a few hundred pounds. No-one goes to the crematorium anymore to pay their respects, I am not sure anyone other than I ever did but I paid this invoice today because his name is there , the fact he lived and died on those dates is still there and he is not forgotten and he did live and he loved me and I , him

My Dad and I happier times
Oh his great grandson has the look of him but only I and a photograph of old realize that :


And that is why I write about you month after month for as long as I can so you know you aren’t forgotten and that you lived…….. and are still loved with every breath in my body………..

Breath of Life – Celtic Knot – Chris Ritchey
July 3, 2019 at 11:25 am
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