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long term care - not really this side, but didn't want to chance it
Posted by: Fritz
Date: August 05, 2022 10:06AM
The state of the residential long-term care industry

the last graph is most amazing to me.

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Re: long term care - not really this side, but didn't want to chance it
Posted by: cbelt3
Date: August 05, 2022 10:15AM
MRs. cbelt3's experience in the industry tells me this study is well done.

Assisted Living and Nursing homes are insanely profitable. Workers are underpaid, corners are cut with care. And let's not forget to mention... COVID emptied out a number of long term care facilities... residents died in job lots. Now residents DID get immunized as quickly as possible. Staff ? A majority refused vaccination (WHY ???)

Mrs. cbelt3 fought for her residents and worked tirelessly to improve their quality of care. If her health had not forced her to retire, she would still be working in that industry. She loved the work, loved the residents. Hated the mismanagement and corner cutting and worked hard to train new workers to be empathetic and caring.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: Filliam H. Muffman
Date: August 05, 2022 10:22AM
Which graph, Figure T?

I have commented previously that end-of-life-care institutions are typically treated as profit centers by owners. They ration employees and their pay to keep $$$ rolling in.

"Janitor and cook keep shuttered assisted living home residents alive"
'If We Left, They Wouldn't Have Nobody'
https: //www.npr.org/2014/11/21/365433685/if-we-left-they-wouldnt-have-nobody

It's not just the US. Canada has similar problems. Japan is struggling to find immigrants to fill elder care positions.



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Re: long term care - not really this side, but didn't want to chance it
Posted by: kj
Date: August 05, 2022 11:57AM
I worked for a non-profit nursing home for 14yrs. I could go on and on. It's always been a mess, as far as I know. The home I worked for did not make very much money. We sent 12% of our money to the mothership, which is really good if you are in the know.
It's ridiculously complicated at this point, but a biggie is that it should not be done for-profit, period. Care is too costly. All available money has to go to care. Also, gov't intervention has not been particularly effective. Layers and layers of rules have resulted in more and more money spent on less care. Many, many highly paid people who don't actually contribute to direct care.
We always had horrible staff issues. The most notable was that when mandatory back-ground checks happened, we lost most of our staff. Think about that...this was in about the year 2000.
The fact is, women, minorities and especially immigrants seem to have better ethics, which means they do what's needed out of the goodness of their heart when not treated well or paid well.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: hal
Date: August 05, 2022 12:56PM
I moved my mom from a large corporate operation to a tiny one in July 2020.

Whatta fricken nightmare! But SO grateful that we did it - it was my sister's idea - I was against it, but yielded to her expertise as a social worker.

The big operation worked quite well during the non-pandemic times. There was a big dining hall where most of the socialization took place. There were platoons of workers.

But the times I was in there in July 2020 (which we all thought was nearing the end of the worst of the pandemic) was a nightmare. The elevator lobby had turned into a food distribution station. A dozen of workers were trying to figure out which styrofoam box of food went to which room.

All of those poor old ladies (80% women) were locked into their rooms for weeks at a time. The woman that used to run the place with an iron fist looked haggarded. It really looked like the whole thing was going to implode in another week or two of this. And 'this' went on for months. I haven't been back since. I hope they are all ok.

And all of those employment stats matched up with what I saw there.

The new place is tiny - just a dozen residents spread over two large converted houses.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: kj
Date: August 05, 2022 01:02PM
That's good you guys are involved. Involved family is probably the single best predictor of good care. Probably shouldn't be that way, but it is.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: Fritz
Date: August 05, 2022 02:23PM
shortly after our dad passed, our mum (barely) bought herself into a new (at the time, 20 years ago) life care at 81 ish. It was corporate administered and connected to a local worship and 2nd rate hospital down the street from a world class Uni hospital.

all was well until she ended up in asstd living around 92.
then reality set in.

it wasn't as bad as some I've read about, probably because we live in a moneyed area. Most of her co-owners had serious $$$. She did not.
The fed them like they were going to slaughter.

When full scale nursing became necessary, the fiscal person tried to get me to sign over this that the other, medicare, medicaid, etc. Cause mum was out of "reverse mortgage" $.
But there were too many shiny BMWs, Mercs, etc in the exec parking lot for my taste. And too many weathered clunkers in the worker lots. I saw way too many EoBs that looked padded to me.

I fault no one for making a living. But there's making a living and there's kushnering a living.

"The facility is supporting her now." uh huh. That's the contract both the facility and mum signed. Oh well.

Judging from conversations I had with nurses and head nurses. The $ was bs. Especially considering I'm a high school drop out and they definitely were not. I believe the "aids" made minimum.

Nursing was 95% white. Aids were 95% black, Latino and English as a 2nd language.

Bless the lot of them. With 400 residents, it is a near thankless job.
Mum was mellower than mellow until she was restricted by nursing behind doors so that the rest of the population wouldn't have to look down that tunnel.

The week before her 97th, mum asked how old she was. Mum made her way out the day after 97. It was hard, but welcome. Probably for mum .... especially.

She lived thru 45 but didn't have to face covid45.

"hope I die before I get old."



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Edited 1 time(s). Last edit at 08/05/2022 02:24PM by Fritz.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: Bill in NC
Date: August 06, 2022 10:02AM
Quote
hal
I moved my mom from a large corporate operation to a tiny one in July 2020.

Whatta fricken nightmare! But SO grateful that we did it - it was my sister's idea - I was against it, but yielded to her expertise as a social worker.

The big operation worked quite well during the non-pandemic times. There was a big dining hall where most of the socialization took place. There were platoons of workers.

But the times I was in there in July 2020 (which we all thought was nearing the end of the worst of the pandemic) was a nightmare. The elevator lobby had turned into a food distribution station. A dozen of workers were trying to figure out which styrofoam box of food went to which room.

All of those poor old ladies (80% women) were locked into their rooms for weeks at a time. The woman that used to run the place with an iron fist looked haggarded. It really looked like the whole thing was going to implode in another week or two of this. And 'this' went on for months. I haven't been back since. I hope they are all ok.

And all of those employment stats matched up with what I saw there.

The new place is tiny - just a dozen residents spread over two large converted houses.

Had to do much the same with my mom.

Back when she was sick every resident statewide had to be evaluated to justify placement.

If you needed more than minimal assistance you had to go to a SNF...couldn't stay in an ALF.

Once mom was bedridden due to the progress of her dementia I moved her to a converted private home out-of-state with fewer than a dozen residents & a much better staff-resident ratio.
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Re: long term care - not really this side, but didn't want to chance it
Posted by: kj
Date: August 06, 2022 02:32PM
Assisted living was all about creating opportunities for money-making, and not at all for good care. All the assisted living facilities here were opened by real estate people. They had no idea. They seemed to pioneer the idea of promoting people to manager with no pay increase, and making them fill in shifts when people called in, etc. And regulations were nearly non-existent. One assisted living in town had a 50:1 resident to staff ratio. Our nursing home was 13:1. And they lied on evals to take residents who needed more care than they could provide. Also refused medicaid and would only take private pay. Nothing but a money move. I left the industry in 2008 though, so I'm sure it's changed a lot, but probably not better.
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