Posts filed under ‘Doctor/Physician’

Medical Care- A Consumer’s perspective- Brookdale Pt 2

Part Onehttps://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 Fourhttps://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 Sixhttps://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)

https://www.nhqualitycampaign.org/…/Drugs_that_may_cause_psychiatric_symptoms…visual hallucinations, fear, paranoia, agitation, anxiety. Sudden … Hallucinations, paranoia, delusions, confusion, mania, anxiety … Digoxin (Lanoxin*).
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!!!!!!!
https://www.ibisworld.com/industry-trends/market-research-reports/healthcare-social-assistance/nursing-residential-care-facilities/nursing-care-facilities.html

 

July 11, 2019 at 1:20 pm Leave a comment

Medical Care – a consumer’s perspective-Brookdale ( Skilled Nursing)

Part Onehttps://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 Fourhttps://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/

This time when we were told we would have to  make plans for my  husband to  leave the Cleveland Clinic Rehabilitation Hospital ( after 19 days) were were given a list with  54 skilled nursing facilities but more time in which to  make a decision.

The case worker at Cleveland Clinic Rehab Hosp. printed out a list of 54  facilities within a 25 mile radius, with  ratings from Medicare .gov Nursing Home Compare .

As you  can see page one  with  the closest to  home ( as I  already  had checked them out) were crossed off.  “One” of  the complaints I  have of Medicare in their ratings , in our situation, was we needed  physical therapy  and rehabilitation and although  “staffing” was rated, Health  inspections and Quality   were rated  there was not a rating for the “caliber” of rehab and therapists.

 

I would like to  point out that at Brookdale  aka  WESTLAKE VILLAGE CARE CENTER 28540, village Drive Westlake Ohio 44145 , the rehab therapy  and therapists were excellent. I  wish  I could say  the same for  90  percent of their aides.

20 of the 54 facilities were listed in their staffing  by Medicare as “much  below or below average”, even when their overall rating was above average or much  above average – very  confusing .

The star system given my  Medicare was also  misleading ( Brookdale) – Westlake Village was given a 5  out of 5  star , comforting to  me when we chose this facility  and also  the staffing as “above average” – I don’t know who at Medicare rates these facilities but this was not in any  way  a 5 star facility unless the bar is set  very  low!!!!

Take a look at the first page ( first photo) of the report of the 5 facilities  4 received 4 out of 5 stars but each  of them has a rating of below average for staffing.  and one Lake Pointe Health  Care a 1.

NOTE: you  really  have to  do  your homework and that is hard when you  are having to  choose a facility  for a loved one during a traumatic time. I thought I  had done my  homework with  this facility. Since my  husband was in the University  Hospital system, as were all his doctors, I  checked and  Brookdale  had access to  either the Cleveland Clinic System and for us a doctor with  University  Hospitals.  It had taken me weeks of being “out of our system to  get him back into  UH.

I was happy  in our choice having done as much  research  as I  could , ratings , recommendations etc.  looking on line . https://www.brookdale.com/en/communities/brookdale-westlake-village.html?cid=yext

The trip from the Cleveland Clinic Rehabilitation Hospital via “transport” was again a fiasco  of waiting  and  miscommunication as to  what sort of transport was needed.

Although  I had had problems at the Cleveland Clinic they  had been addressed  for the most part quickly  and efficiently , however we left on a sour note and with  “personal belongings in a large bag”.

Due to  the tension dealing with  Doc Martens  transport I didn’t realize that along with  my  husband carried by  one of the administrative staff to  the ambulance was  the lift pads and sling pad  from both  his bed and  wheelchairs  and various items .

 

The  lift pads/sling pads ( plastic)  we discovered later ,when I  looked into  the closet at Brookdale where the bag had been placed as personal effects   had fecal matter attached, bad enough  but considering this was also  contaminated with  C’diff  most worrying and dangerous in my  laypersons opinion.

Here we were bringing into  another facility  contaminated matter!!! This practice of transporting these items  should not occur , after all you  don’t know where they  have been.

This was not a good start to  our stay  and within 4 days I  was ready  to  pull my  husband out of this 5 star establishment ……. TO  BE CONTINUED…..

 

 

June 15, 2019 at 9:10 pm Leave a comment

Medical Care – a consumer’s perspective-Cleveland Clinic Rehab Hospital

Part Onehttps://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 Fourhttps://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/

 

Cleveland Clinic Rehabilitation Hospital Avon Ohio, was NOT on the list of 34 facilities given to  us by  Mercy Health social workers – Lorain Ohio.  I  did some research  on my  own, went to  the internet and to  my  facebook page and asked local friends if they  had had good or even poor experiences with  facilities in the area. Cleveland Clinic Rehabilitation Hospital came up as being a good facility.  https://my.clevelandclinic.org/locations/rehabilitation-hospital/specialties

My  daughter and I  spent a Thursday  morning touring the facility. It has all the benefits of a hospital doctors  , rehabilitation therapists,  nurses,  aides and the focus is of course on rehabilitation. The facility  is only  a few years old and shiny  , white and extremely  clean. The rooms were large , bright and airy. We were most impressed with  the rehabilitation area and the state of the art equipment .

However, my  husband ( due to  Medicare Insurance  rules) apparently  could only stay  for 19  days.  It is my  belief  he probably  should have been released to  that facility  further along in his recovery. He was paralyzed down one side  and was on a plethora of medications. One which  was given to  him at Mercy  by the “ghost dr.” which  causes confusion etc. Again not being a physician and not knowing at the time he was even on this medication I was also  unaware  that in order to  combat the confusion ( also  he was on pain killers) he was being given another drug for Alzheimers.

I must interject here as to  hospital to  hospital transportation, I  wish  I  had something good to  say , you  really  are at the transporters “mercy”. The time arranged   leaving Mercy to  the Clinic was supposed to  be 11 a.m However, although  I  was supposed to  follow him to  the new facility  I  couldn’t by  6 in the evening after waiting hours and hours I went home and told them to  call me when he was being transported . You  see I  had to  sign the admittance papers and permission to  treat. At 9:00 p.m. I  called the Clinic who  told me that it was so  late he would probably  now be transported the following morning . I went to  bed only  to  be called at 11:15 by  the Cleveland Clinic Nurse that he had been sent to  them a few minutes prior  and could I  give the permissions verbally. ( This was not the only hiccup with transport).

I was, on the whole, extremely  pleased with  this facility  but it was not all good news. Once again the rehab staff were wonderful, and it was so  organized, you  knew exactly what he would be doing and when, I  was very  impressed with  the rehab staff, also  the cleaning staff once again were in the rooms every  day  and sometimes more than once. The nurses were for the most part very  professional and helpful as were 80 percent of the aides.

My  husband needed help  initially from two  and on some occasions three individuals to  see to  his needs. The confusion caused by  the drugs  did not help, that and the weakness and immobility of his left side. He had to  learn to  use his vocal cords  again ( which were stretched due to  the intubation) . It was a few days before I  realized he was still taking the medication for gout  which  should have been stopped at Mercy.  The medication Colchicine, can  and does cause diarrhea  and stomach  upset. The gout symptoms had abated and he really  should not have been still on this drug , especially  since it does also react with  Digoxin  but of course I  was unaware he was on this drug as well.

I  did insist since the diarrhea was an issue  they  stop the Colchicine. I also , once I  found out he was on Digoxin  ( Lanoxin),  they  stop or change that medication    BUT and here is the issue  it seems that doctors at this facility  and other facilities in the chain are loathe to  change another “specialists” diagnosis and treatment.  This was a huge problem  for us. One because we were out of our network and OUR team of physicians and specialists who  knew his history  and his courses of treatment we had to  rely  on basically  strangers to  his situation.

Therefore I  started asking for a daily  list of all his medications

Once he was off the Colchicine he stomach  upset went away. BUT not for long  a woman in the next room came down with  C’diff https://www.cdc.gov/cdiff/what-is.html . Now it was put to  us that my  husband came down with  this due to  the huge amount of antibiotics he was taking and had taken. BUT that is not the whole story:

IF the lady  in the next room and not had the infection first I would not have done more research thinking  it was because of the antibiotics . Although  the staff were for the most part adhering to   handwashing etc protocol not all of them did . Infact  I  would say  20  percent of the aides were lax in that area. I  actually  had to  throw away  his cellphone as it somehow became covered in fecal matter ( C’diff contamination) and was put on the bedside table. My  husband was incapable of having reached the table.  I  will say  that for the most part the aides and nurses did respond to  his call light in a timely  manner.

One aide,  in particular, left a lot to  be desired, from his treatment of my  husband  and his response times were not great, his laxness in this area and lack  of hand washing protocol  was a great concern.

 

Please understand a patient is in pain  and although  they  had been told of the back injury   it took at least a week for them to  address the situation ( it hadn’t been addressed at Mercy so  not on his record) , which  meant sitting in one position or laying ( when you  are partially  paralyzed) can be unbearable and since you  can’t move  the aides had to  do  it for him. This did cause “some ” of the aides  frustration and it showed.

Chris Ritchey Face book icon

 

There was  another aide  who also  needed to  be retrained or let go  in my  opinion.  I came into  find my  husband half in  and half out of the bed, the top  sheet wrapped around him and soaked with  water. Actually  I  had just walked into  the room with  one of the hospital administrators, so  she did witness the situation. She immediately  went to  work taking care of my husbands comfort. The aide , when she was called , said he spilled water on himself… remembering the jug was on a table  out of his reach and he was not able to  move his left arm at all, that scenario was very  unlikely. I looked at this aide and said:

“so  he spills a jug of water all over his bedding and you  leave him laying in it?”  

The aid turned to  me and said:

“SORREEEEEEE”( in a very  sarcastic tone)

I then turned to  the administrator ( names available) and said

“she is done I  don’t want her anywhere near my  husband

The administrators at the Cleveland Clinic Rehabilitation hospital did address my  concerns but as I  told them what stopped them from getting  great review  on the place as a whole in my  opinion  was 20 percent of their “aides”  and it was those 20  percent that  caused situations that should not have happened, but it is those situations you  remember .

HEALTHCARE IS A HUGE BUSINESS AND EVEN THOUGH  WE THE CONSUMERS ARE PRETTY  MUCH  AT THEIR MERCY (NO  PUN INTENDED) WE ARE STILL CONSUMERS PAYING FOR A SERVICE.

We were assigned one doctor for my  husband and he called in others as needed  such  as another cardiologist, ultra sound  etc.  The doctor was quite nice, spoke very  softly but with  a heavy  accent so  I  was once again forever asking him to  repeat what he was saying and every time he was in the room he was costing ( according to  the bills I  received) 350 to  500 dollars for up to  35 minutes. I should go  through  the dates to  see how many  times a day  but considering I received 74 pages of bills each  page having at least 5 charges on them I am honestly  too tired to  do  the homework.

The discharge date  ( the 19 days being almost up) I was given another list of this time 54 “skilled nursing facilities ” for the next part of the journey  and this time I  did have time to do  some homework……….. To  Be continued

 

Cleveland Clinic Rehabilitation Hospital gets a B plus…. it was an A minus  But then that C’diff situation  was made worse…… more on that as we continue….

 

 

 

May 27, 2019 at 10:02 pm 1 comment

Medical Care, a consumer’s perspective- Mercy Health – Lorain ( 2)

Part Onehttps://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/

Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain

After hours of torment and worry , my  husband was in ICU- Mercy  Health , Lorain. The brain surgery  went well, now a matter of time.  I  have been in ICU’s more times than I  care to  remember , each  hospital a little different.

I have to  state here and now the  ICU nurses and team at Mercy were wonderful to  us. I cannot say  enough  about them , they  were so  caring and compassionate. The housekeeping staff who  cleaned  and cleaned would see me sitting in the small waiting room whilst tests and all things happening to  make my  husband comfortable were happening. I would see a hand reach  out and put down a cup  of coffee or fruit drink and a smile.

Yes, they  made things so  much  easier.

I really  had to  force myself to  think and stay  upright and ask questions of the myriad of people who would come in an out including physicians, physicians assistants, residents.

 

Indeed  on a few occasions I had no  clue as to  who  they  were , some not all introduced  themselves, very  businesslike  and with  a clipped manner  when answering my  questions or observations. In the end, I  learned to   ask  those questions of the nurses and they  would check  for me. When  dealing with  “one or two  of the physicians”  the answers were ensconced in medical terms  and a couple of times I  had to  have them repeat their answers  due to  heavily accented language I  found difficult to  grasp. That was something I also  had to  deal with  later on as well.

I wrote to  the CEO of Mercy ( Edwin Oley) after we transferred to  the Cleveland Clinic Rehab Hospital . I have copied parts of the letter and my concerns . I  have left out the physicians names  for this blog but they  were named in my  letter. Needless to  say  I  have not received any  response from Mercy  Health  Lorain ( not that I  expected  any    but “received and filed ” might have been polite at least :

Excerpts and notes  from the letter- February  12th 2019

For the attention of Edwin Oley, Mark Rau and Cheryl Rieves

Dear Mr. Oley,

I am writing today not only to thank the nursing staff for their excellent care, and also “housekeeping ladies” in the ICU who were so kind and helpful during our time of crisis and all but one of the physicians.

January 18th my husband had a fall – although his Doctors are at St. John’s West Shore we were taken to your ER. I have no complaints with the treatment there . He was admitted with a small brain bleed , which they felt would be absorbed and that is what looked like was happening. He was in ICU for a couple of days , then in general population and then sent to your REHAB unit. Again, I find no fault with the care, the nursing and rehab staff or physicians .

January 24th my husband suffered another major brain bleed in your Rehab unit ( on the right side of his brain) It was totally due to your response team , staff and Dr. XXXXX that my husband didn’t die, he literally was minutes away from that happening .

We were so grateful this happened IN the hospital had he been elsewhere he would have died. After major surgery he was sent back to CC11 in ICU – he was intubated and the care was wonderful . It was there I encountered Dr. PXXXX who did not impress me, I didn’t even know who he was and he certainly did not interact with me at all.

 

Wednesday January 30th my husband was finally able to come off the “tube” I must state here , my daughter and I had been putting in 15 hours shifts, trading off so one of us would be there , a terrible and emotionally draining time .

 

Six days after the surgery and two hours off the breathing apparatus I went home for a rest . I was woken by a Social Worker phoning me to explain “I would have to make a decision as to my plans for my husband “ I told her I have no plans he hasn’t even woken up – any plan I would have would be to get him sitting in a chair. She stated I would have to let them know and would leave a list of facilities in his room . which she did!

NOTE THIS IS THE LIST OF FACILITIES GIVEN TO  US BY  MERCY HEALTH  SOCIAL WORKERS!

 

 I want you  to  put yourself in our position, we had had a terribly  traumatic time very  little sleep for days  and we were given a list of 34 places  one of which   my  husband needed to  be transferred to  in coming days. We didn’t know “what his prognosis would be, if he had major brain damage and here is the list  “check them out…….( this certainly  was not helpful)

Saturday February 2nd My husband was moved to Tower two North– Once again hours after being in the new room I was sent another Social Worker – I had to make plans – he was still out of it and on a feeding tube and unable to swallow on his own . I reiterated I had no plans I couldn’t make an educated decision until I talked to my medical professionals who knew his history and were not in your network. I asked if this is rehab why couldn’t he stay at Mercy in the Rehab unit where he was initially – I was told flat out he would no longer meet the criteria of 3 hours daily . Dr. AXXXXXXXXXXX of Rehab would not accept him. I said well I am not making a decision until I know more.

Every day I was prompted by   staff as to my decision.

Tuesday February 5th – during rounds – Dr. PXXXX and a host of people came into the room . I had only had cursory glances with this Doctor – I didn’t even know why he was there, every other physician explained who they were and what their specialty was , including therapy professionals. The communication in that area was excellent.

 

During this particular round Dr. PXXXX informed me they would have to put a feeding tube in his stomach, and I would have to make plans as to where I was sending him. The Social Worker also reiterated when I asked:

 Why can’t he stay at Mercy Rehab after all I felt comfortable and they saved his life.

ONCE again I was told Dr. AXXXXXXXXXX wouldn’t accept him .

 

Dr. PXXXX said:

you have to decide and he needed “skilled nursing”

I said

No I need to talk to his Drs.- PXXXX informed me “transfer him to St. Johns , I said the insurance wouldn’t cover that as it would be a lateral move, I would  check out some of the facilities on this list and since I had been in the hospital for days on end I hadn’t had time . He informed me that once the feeding tube was in he would be ready to leave.

I suggested, it seemed to me they were doing that to   get rid of him.

Dr. PXXXX left the room whilst my daughter was asking a question re the stomach tube….. only to return and said AXXXXXX  MXXXXX ( name of local facility) !!!! I understand he some interest in that facility.

Actually the next morning ,my husband who finally woke up to some degree, pulled out the feeding tube from his nose, they couldn’t put in the stomach tube due to food in the esophagus and it was delayed until Wednesday at which stage he had been now moved to Cardiology .

He has AFIB and because they couldn’t feed him his heart medication in liquid form they moved him so they could give it in his IV. Whilst in Cardiology they once again tested his swallowing capabilities and he passed- no stomach feeding tube)

 

Again another Social Worker came in what were my plans ????I spent the next hours researching and pop in visiting these facilities –

I was told Mercy Allen had no beds available and I couldn’t give them a date anyway .

 

At this point in the epistle I would like to add that my husband has for the past 16 years has NOT been able to take Statin Drugs of any kind. In fact in ER we specifically stated and it was put on his wrist ALLERGY STATINS  HOWEVER, some Physician , whom I never heard of or spoke to PRESCRIBED LIPITOR- A STATIN which actually started to cause my husband issues.

My daughter stopped the nurse from giving the 2nd dose. After checking I found written in the note “QUESTIONABLE ALLERGY”) NOT ONCE DID ANYONE ( INCLUDING THE PHYSICAN ) ‘QUESTION THE FAMILY AS TO WHY THIS DRUG WAS NOT ALLOWED!

 Cardiology sent my husband back to 2 north

( NOTE: it was only  later at the Cleveland Clinic  I  found out my  husband had been prescribed  Lanoxin by  the same “unknown physician”. Had I  known  I  would have mentioned that  it was found in a previous “heart issue” Lanoxin did cause serious side effects with  him.. such  as paranoia , confusion ( remember that  for chapters two  and three of the journey. Again this is partly  due to  my  not remembering all the drugs he has had issues with  and the fact they  did not have access to  his full medical history

As I researched, Wednesday and talked to many people I decided on the Cleveland Clinic Rehabilitation Hospital – Avon. Their representative came an evaluated my husband late Wednesday evening . My daughter and I toured the facility on Thursday morning the 7th . We were very pleased with what we found . THIS FACILITY WAS NOT ON THE LIST GIVEN TO ME!  ( Note you  can see I  penciled it in on the list from Mercy  Health)

 

THEN IT STARTED – For days and days I was told Mercy would not accept him back into their rehab unit WHERE we had asked to go time and time again. BUT LO AND BEHOLD HAVING BEEN TOLD FOR OVER A WEEK NO!!!!! ALL OF A SUDDEN – OH WE WANT HIM HERE- HE CAN STAY PLEASE ! I had all sorts of staff and Directors etc – stating he COULD GO BACK to Rehab. I spoke to Rehab representatives who had found out that morning he wasn’t coming back –

Dr. PXXXX actually told the staff  I was sending my husband to a skilled nursing facility – which was NOT TRUTHFUL I hadn’t made up my mind at that point and was waiting to hear back from the Clinic. HE HAD NO BUSINESS SPEAKING FOR ME!!!! AND Dr. AXXXXXXXXX had not made any such determination as to my husband’s status as I was told by Rehab. Staff on Thursday morning .

 

The decision to leave was very hard we had received excellent care but what with the No Room at the Inn fiasco  and the pushing to leave and make other plans during a time of great distress for me and my family and the “statin” situation we have moved my husband. He is very weak but starting to respond.

 

My feeling is your facility fell down in not communicating to the family properly – social workers should give “all pertinent information”- in laypersons language and a full explanation as to why ( days of paper work etc) to families who are under stress as it is.

 

At least two of your physicians caused more harm, emotionally to the family and in one case could have caused other issues. Due to the protein treatments given in ER , to combat the Xarelto I informed them that within days he would get a major gout flare up ( Gout initially   due to statins after his open heart surgery in 2002. Which is WHY NO Statins) . He did get a Gout attack on the Wednesday Jan 23rd in Rehab, they drained the knee and gave him a cortisone shot but the damage was done.

Photo  source : https://www.researchgate.net/figure/Healthcare-professional-views-of-hospital-to-home-care-transitions_fig1_230565561

Why the 2nd massive brain bleed the next morning – well we aren’t sure, but REHAB staff saved his life and the fact he isn’t there today at your facility is entirely at the hands of administrative decisions poor communication between social workers and overriding a medical allergy without discussing why it was necessary with the family. Questions feel free to contact me……

I  don’t think  I  need to  go  into  further detail this letter pretty  much  said it all. And the cost so  far  for Mercy Health  –  is approximately  $70,000.00 and climbing .

 

Next Up  Cleveland Clinic Rehabilitation Hospital

 

 

April 29, 2019 at 9:59 pm 9 comments

Medical Care -a consumers prospective-Mercy Health Lorain

 

Part Onehttps://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/

Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain

Our particular health  care journey started with  a fall January  18th/19th 2019 and a call to  911  and a rescue squad. Since the patient, my  husband, had fallen and was unconscious for a few minutes it was decided to  take him the the emergency  room. In this case  although  our physicians and hospital of choice is St. John’s Westshore, the drivers  would only  take him to  the nearest ER.

29000 Center Ridge Road
Westlake, OH 44145
https://www.uhhospitals.org/locations/uh-st-john-medical-center
 The rescue squad insisted he be taken to  Mercy Health Lorain.
https://www.cincinnati.com/story/news/2018/02/22/mercy-health-merge-bon-secours-health-system/362456002/

In July 2016 – another fall had required a trip  to  the Mercy  Health Lorain ER. I was not impressed at all with  that particular visit, the ER at that time left a lot to  be desired, imho  and after three hours of not seeing anyone higher that a Nurse Practitioner  I  insisted my  husband be transferred to  St. John’s West Shore.

The diagnosis was very  serious  Rhabdomyolysis 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365849/.

Many  days were spent in the hospital recovering from this health  issue and all the problems it entailed.

Needless to  say  a trip  to  the Mercy  Health ER in Lorain was not something I  relished, but I  knew I  could insist on him being transferred if worse came to  worse.  I  have to  say  I  was pleasantly  surprised in the difference from 2016.  We were seen quickly  by  a team of nurses and a physician ( not one lone nurse practitioner) and when the diagnosis of a small brain bleed an intracranial bleed   was determined.

A brain hemorrhage refers to bleeding in the brain. This medical condition is also known as a brain bleed or an intracranial hemorrhage.

I was relieved to  have a  Neurosurgeon who  was already  in the ER  come in an explain the situation. The fall had caused this small brain bleed but it was exasperated by  the fact that since 2016 my  husband was on the blood thinner  Xarelto

https://www.mayoclinic.org/drugs-supplements/rivaroxaban-oral-route/side-effects/drg-20075013

The ER “team” had to  use other meds in order to  lessen  and counteract the effects of the Xarelto. I had to  sign papers to  that effect. As I signed the required documents I read of the “proteins” that would be used.  This brought up  another problem … because all my  husband records were with  St. John’s and his UH physicians  the records at Mercy  were very  sketchy  and out of date.  Proteins being pumped in to  my  husband will cause ( within 4 days) an attack of gout.  Of course his doctors at UH  were aware of that  but I had to  inform the ER physician of this, I  think  he thought I  was  not at all to  be taken seriously  and the almost “pat on the head – there/ there” look crossed his face. Gout indeed?????

So  there you  are in the ER at 1 in the morning trying to  rack  your brain , as you  are worried and anxious as to  what this particular “team needed to  know” allergies, past medical history , medications he was on, when he last took anything, insurances  because Mercy  did not have access to  his patient information – they  are under a different system.

 

I  am sure they  thought I  was over stating the problems, gout and bad reactions to  statins, so  NO  STATINS- remember that because it does come back  to  haunt, both  the gout and the Statins.

This is something in my  opinion that needs to  be addressed. We  as a family  decided to  have him admitted to  Mercy  for observation, the bleed location was not operable and they  hoped it would be absorbed. The decision to  stay was based on two  reasons:

1. The Neurosurgeon  I  immediately  liked and felt comfortable with  and 2. that particular weekend there was a major  winter storm hitting the area and roads were closing.

Hindsight has confirmed that our decision to  stay  was indeed the right one.

A hell of a storm broke that morning and roads were closed. I  could not get out of my house for two  days. My  daughter and husband with  their large vehicle did manage.  Cat scans were done and all was progressing nicely . However, 4 1/2 days after he was admitted the “proteins” did do  their damndest   and a major gout attack  took place, blood pressure and pain were an issue. A doctor was called in to  give  a shot and to  drain the knee on that Wednesday  evening.

 

Early  Thursday  morning I received a call from the nurse at Mercy …

 

“my  family  had to  get to  the hospital right away – there had been a complication- my  husband had collapsed with  a massive brain bleed- we needed to  get there quickly”

By  the time we arrived at Mercy Health he was already  intubated and prepped for major brain surgery. He had had a massive subdural hematoma:

 

“People with a bleeding disorder and people who take blood thinners are more likely to develop a subdural hematoma. A relatively minor head injury can cause subdural hematoma in people with a bleeding tendency.”

  https://www.webmd.com/brain/subdural-hematoma-symptoms-causes-treatments#1

As luck  would have it the Neurosurgeon  that had inspired confidence in that ER was ready  to  operate . My  husband was rushed into  the operating room , we were told to call relatives etc. I  have to  say  the “rapid response team” of nurses and professionals were wonderful , they  did along with my  favorite neurosurgeon ( by  now)  saved his life that morning . 

Hours in the waiting room, moved to  ICU and prognosis iffy– the next 72 hours  would tell the tale …..

To be continued …………….

 

 

April 22, 2019 at 11:26 pm 3 comments

Medical Care – From a Consumer’s Perspective- Ohio

 

Photo Source :  https://revenuesandprofits.com/top-20-u-s-healthcare-companies-by-2016-revenues/

 

Part Onehttps://thatwoman.wordpress.com/2019/03/22/the-ratings-of-medical-facilities-series-it-begins/

 

The amount of money  spent “annually” in the United States on health  care  is, according to  Forbes Magazine

Americans spent $3.5 trillion on healthcare in 2017, adding up to 17.9% of GDP, nearly the same as 2016’s 18% share. Healthcare spending grew by 3.9%, the slowest it’s grown since 2013 and slower than the previous year’s 4.8%.

The main reason overall healthcare spending grew more slowly was because of less growth in the amount of healthcare services people used and in the use of fancier services like MRI instead of CT scans. This is one category called “use and intensity” and is what’s left over after the report authors at the Centers for Medicare and Medicaid Services subtract out spending growth that is attributable to U.S. population demographic changes and healthcare prices going up.

https://www.forbes.com/sites/elliekincaid/2018/12/06/the-amount-americans-spend-on-healthcare-is-still-growing-but-more-and-more-slowly/#66d12d242eea

And you  can find a good article on the breakdown of those costs in this article by  the Washington Post https://www.washingtonpost.com/news/wonk/wp/2016/12/27/the-u-s-spends-more-on-health-care-than-any-other-country-heres-what-were-buying/?noredirect=on&utm_term=.d76a430d79f9

White Coat of Death by Chris Ritchey

My  point is: This healthcare industry  is a HUGE , unwieldy , money  devouring creature ,  as we spend  to  stay  alive, enjoy a “healthy ” life for longer .   Americans are paying through  the nose.  The healthcare “industry” from doctors offices, clinics, drugstore/ drugs, emergency  rooms, ambulance services  hospitals , nursing homes – they  truly  do have a lucrative business https://www.payingforseniorcare.com/longtermcare/statistics.html

Percentage of all federal domestic spending that goes to the elderly: 46%. Average annual health care costs for older Americans who earn more than $30,000 a year: $11,000 … Average cost to stay in a US nursing home for one year: $76,680.
and yet  the hourly  wage for a nursing home assistant according to
https://www.indeed.com/cmp/Nursing-Home-Rehabilitation-Facility/salaries
Average Nursing Home / Rehabilitation Facility hourly pay ranges from approximately $11.46 per hour for Dietary Aide to $19.00 per hour for Admissions Coordinator
Photo Source https://smithandjones.com/resources/blog/rise-of-the-healthcare-consumer
“The consumer movement is partly an age-related phenomenon. Each generation of patients has unique emotional triggers and motivations for how they choose care providers. Seniors (age 70+) still follow their doctors’ recommendations, but Baby Boomers (age 45-65) treat healthcare decisions more like consumers: they research their options, challenge assumptions and rely on conversations to make their choices. Young adults (age 20-45) are more inclined to shop around and show preference for healthcare brands; while they won’t admit it, they’re heavily influenced by great advertising, social networks and word of mouth recommendations.”
All the cost involved in healthcare  comes from “we the people”  in the form of paying for insurances, through  various programs, government, private and out of  our pockets – we pay  one way  or another . Therefore, it seems to  me the healthcare industry  needs to “listen to  their consumers”. That is probably  wishful thinking  because  we the consumers are a “renewable source” so not really  important in the business plans of CEOs or CFOs.
One woman and her blog is not going to  change a damned thing ( and they  know it) , but at least the information will be out there and some of the situations that needn’t have happened on my  family’s latest “health  journey” could be addressed, by  Medicare , the hospitals and skilled nursing facilities  we have dealt with  in the past  three months – after all someone’s life , happiness and health  were at stake  and we are paying for it- big time .
I will document the good the bad and the downright ugly from my  perspective as a CONSUMER, NOT a MEDICAL PROFESSIONAL……….
To  be continued……..

April 9, 2019 at 12:52 pm 5 comments

The Ratings of Medical facilities Series- IT BEGINS

These past weeks have been very  tough both  emotionally  and physically on this family. I  have not written anything for those weeks  except of course for the 3rd of the month  remembrances of my  son, Chris.

Hopefully  as we come to  the end of  “hospitalization” and I  am still in a state of hope that will end soon and we can move on to  healing at home and with  “out-patient therapy”.

Honestly   every  single day  since January  19th has been taken up  with  the health  issue , there has been no  room in my  life for  all things “Lorain”, blight, history , drug dealers  and housing courts and “less than ” judges  , slum lords,  or any  of the other 60 categories covered over the years on this blog.

I am lucky  if I  can get home , get something to  eat and fall into  bed. I  am too tired to  research  and weigh  in  on , Lorain City  school fiasco   https://www.forbes.com/sites/petergreene/2019/02/27/lorain-ohio-and-the-failure-of-school-takeover-policy/#47fa8004faa6     as I  have done in previous years , saving historical sites, attend any  of the meetings. I  was lucky  I  had a break  to  do  the tax papers for Charleston Village Society  Inc. – the “site” on 2nd and Oberlin has not  had my  attention at all, thanks has to  go  to  the volunteers and City  of Lorain Utilities for stepping in. I  haven’t even written our annual report for the website  but I  will.

the site today

I will focus on the three healthcare facilities we have personally  been involved with  since January  18th 2019

Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain

3700 Kolbe Rd.
Lorain, Ohio 44053
Photo  Mercy  Health  website
 then the transfer  to  the Cleveland Clinic Rehab Hospital – Avon
for 19 days 2nd week in February  2019
33355 Health  Campus Blvd- Avon Ohio 44011
Photo – Cleveland Clinic Website https://my.clevelandclinic.org/locations/directions/415-cleveland-clinic-rehabilitation-hospital-avon
and currently since February  27th –
  Brookdale- Westlake Village Skilled Nursing /Rehab
28450 Westlake Village Dr. Westlake Oh 44145
https://www.brookdale.com/en/communities/brookdale-westlake-village/skilled-nursing.html
Photo Brookdale Website
I would remind readers of this blog  , as always :
these are my  personal opinions based upon my  personal experiences with  documentation and records where applicable”.
I will of course be sending the links to  these posts as they  happen to  the  administrative officers of all the facilities involved with  their chance for rebuttal or explanations and for their information.

Chris Ritchey Face book icon

The great , the not so  great experiences and the “need to  address issues” will be explored.  I am in no  way  shape or form  touting myself as a medical professional or even any  great knowledge of the medical field. However, I  have been involved , as readers are aware in many  issues on this site for the past 11 years including  “health  care issues galore in the past 10  years”   and I do  due diligence.
This is no different  except of course the toll it has taken personally.  I  have documented as we have traversed the “health  care system” made the notes  and tried to  be as unbiased  as much  as possible…… it will be noted when  my  frustration becomes personal 😉 .  The series will explore the treatment, the health  insurances, the family  responsibility  and after care.
And so  it will begin………………

March 22, 2019 at 1:31 pm 5 comments

Older Posts


Categories

Archives

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 214 other followers

September 2019
M T W T F S S
« Aug    
 1
2345678
9101112131415
16171819202122
23242526272829
30