Skilled Nursing - Repost from 11/3/2021

It’s been a year. And the help from the posters here has been immeasurable. I want to keep my original posting of the events of that time available - mainly for selfish, personal reasons. But also to tell my story. So I’m going to repost a few threads from the old boards.

This is partly a memorial and partly a tribute to those who helped me though probably the hardest couple of weeks of my life. So pretty please treat it as such. I don’t need further condolences - the time for that has passed. But I also don’t want to forget these events. Hence, the reposting to hopefully keep these writings for posterity.

There is no reason to respond, although further responses are welcome. My only request is that you read through all of these reposts before responding to any of them. Lots of questions were answered, some in the thread and some in later threads. I’m not sure how many there will be, but there will be several.

There are also several side issues brought up. I’m leaving those in place as originally posted. If you want to discuss one of those side issues, I’d ask that you please start a new thread.

Author: ptheland

Subject: Skilled Nursing

Date: 11/3/2021 12:25 PM

No. of Recommendations: 4

1pg nailed it. Just got a call that the Dr is ready to boot DW from the hospital to a skilled nursing facility. And they want to do that today. Great.

I’m supposed to pick a facility. With no warning about what was happening. Lovely.

At least they suggested two facilities that are near by and that probably accept our insurance. Probably. Oh - and that might have space available. Or not.

In the mean time, I’ve got to get to my own pre-op check up and do a bit of rescheduling for the in home help for DS, as he’s in school again today.

This is going to be a fun day. [Where’s the sarcasm emoji?]



Author: sheila727

Date: 11/3/2021 12:35 PM

No. of Recommendations: 0

I’m supposed to pick a facility. With no warning about what was happening. Lovely.

Thoughtless, heartless…and then some!

I don’t know where you live and what kind of hospital DW has been in, but in my experience (NYC), hospitals have social workers on staff to help family and patient in transition situations, when some kind of special care is needed—not simply returning home to life as usual. I’d find out if the hospital has a social worker and if so, how quickly you can discuss the situation and get advice about a facility.

Is DS hopefully feeling good about being back in school? And does that reduce the stress and strain for you?



Author: Borgney

Date: 11/3/2021 12:40 PM

No. of Recommendations: 1

This is the most frustrating thing I dealt with for both Mom and Dad. The assumption you will drop everything and figure out what the next step is. They do this all day every day, you don’t, but it’s just assumed you will figure it out.

After Mom’s stroke and rehab, they said “Here you go, take her home. Home therapy will call sometime in the next week to schedule PT/OT.”

Uh, she can’t find her a$$ with both hands. What am I supposed to do with her?

Dad fractured his hip. They discharged him without inpatient PT, leaving me to figure out, again, what am I supposed to do with him? And the shot he needs daily? My husband dressed my Dad.

My husband is Norwegian, and he is appalled at our system.



Author: 1poorguy

Date: 11/3/2021 3:21 PM

No. of Recommendations: 1

My husband is Norwegian, and he is appalled at our system.

Our system is great if you’re healthy (and/or rich). Once you have issues, you realize its shortcomings. In Norway (and most other 1st world nations) they have a good system no matter who you are.

The hospital gave me notice, and a list of potential candidates for 1poormom. The big problem was finding space when she was going to be discharged. They tend to be pretty full-up all the time.

When I was released from the hospital following back surgery, they could only find ONE place that could take me. Apparently they handled it for us (I was sorta out of it). 1poorlady left that place in tears, and checked me out the following morning.** I didn’t want her to take the burden, but she was not going to be swayed. As it turns out, I was mostly OK. Used a walker for safety, she showered me (making sure the water didn’t linger on the sutures), and got in-home PT.

**1poormom’s place was a lot better. She hated the in-room AC because it was loud, but she had a room to herself, and the staff were really nice. I was sharing a room with a guy who couldn’t toilet himself, and screamed in his sleep.


Author: YewGuise

Date: 11/3/2021 3:32 PM

No. of Recommendations: 2

I’m supposed to pick a facility…
At least they suggested two facilities that are near by and that probably accept our insurance. Probably. Oh - and that might have space available. Or not.

Yeah, it’s a mess. The hospital’s social worker should find a place with an opening, as well as manage the transfer of records.

Note: if you can’t physically be there to move your DW, then the hospital can arrange medical transport. Given your full schedule today, that might help, and you could then visit your DW later, at the facility, to see what the next steps are.
Sneak preview: at the hospital, patients wear hospital gowns. At the nursing home (/rehab), you’ll have to supply PJ’s and 2 or more changes of day clothes, labeled (use a marker) with the resident’s name. If they offer a laundry service, opt in.

It’ll be a ridiculously busy day, however you cut it. Good luck.

also has stories


Author: YewGuise

Date: 11/3/2021 3:38 PM

No. of Recommendations: 1

…I’m supposed to pick a facility. With no warning…

Wherever she lands today doesn’t have to be long-term. You can use the next week or two, as you recover from your surgery, to research other options, and move her later if appropriate. Rather a nuisance, but you can only do so much in one day. And today’s more than half over already.


Author: ptheland

Date: 11/3/2021 4:30 PM

No. of Recommendations: 4

Our system is great if you’re healthy (and/or rich). Once you have issues, you realize its shortcomings.

Sounds like a good jumping off point for my further experience today.

Recap of the morning. Get son off to school. Eat breakfast, read some news. End of relaxation. Get call from hospital case manager that the Dr want to discharge DW today. Have just enough time to read her message with SNF suggestions before taking a shower and getting off to my own pre-op appointment. I think that’s where I left things.

So while at my pre-op tests, my cell phone rings, which I dutifully ignore until the appointment is done. It was the case manager, wanting to know my decision. As if I’ve had enough time to make a decision. I call her back and put her off a bit longer. Not more than two minutes later, I get a call from one of the facilities, wanting to tell me all about their wonderful place which will take great care of my loved one. [Sarcasm font needed] She offers me a quick tour, which I take her up on. I head straight over there from my appointment.

The front door is plastered with probably 10 different notices related to Covid protocols for both staff and visitors. The gist of this is that staff gets screened outside the door when arriving for their shift, while visitors are to go in for their screening. Gotta have your vaccine card or a negative test. (I can do both!!!)

So head in, and am greeted by their receptionist. Introduce myself, ask for the person I’m meeting. Receptionist hands me what turns out to be a marketing survey. No temp check. No examination of vaccine card. Sales person — oops, that’s patient care coordinator — comes out, greets me, takes marketing survey, and we head in for the quick tour. We have a vaccine booster clinic today, that’s available for both staff and residents. Elevator up to the 3rd floor, then she realizes I’m not wearing the required face shield in addition to my mask. So back down to get that, assured that it is cleaned and sanitized between uses.

Back up to the floor for the tour. Facility is OK. A bit messy with various bits of equipment all over the place, but such can be the nature of places that do rehab. Carpets a bit worn. But it’s clean and doesn’t smell bad (says the guy with a permanent sinus condition, a high tolerance for smells, and a face mask properly covering my mouth and nose). Back to the lobby.

Sales person — darn, did it again — patient care coordinator finishes up sales pitch and asks if I have any questions. I do. “Are you as lax about all your protocols as you were with my screening when I entered the building?” I made sure to speak up so the receptionist could hear the question. Bumbling and stumbling and excuse making and apologies ensue.

For the record, I’ll also point out that there was a vendor who had entered the building as the tour guide was finishing her pitch, and I noticed that he was properly screened and signed in. So my experience may have been nothing more than an error. But I was not encouraged by the receptionist’s making of excuses rather than accepting responsibility for a mistake.

I then talked to the other recommended facility. Again, an obvious sales pitch. What are your visiting hours? 9 to 4. Which have to be done by appointment. And will be done outdoors. No visitors inside the facility. Is your staff vaccinated? I’m not sure. I think most are. So I can’t see the inside of your facility? I’m sorry, that’s not allowed with our current covid protocols. Then I get a presumptive close: I can call the hospital and let them know your wife will be coming here. I hate presumptive closes. I hate them with the white hot flames of a thousand burning suns. And I hate not being able to see the inside of their facility even more. So the first place is my choice.

With that out of the way, on to the ranting about the state of medical care in the US.

My experience is limited. So take it as an anecdote and not data. I knew our system was messed up, but I had no idea how messed up it was.

The hospital has been great. While I’m not intimately familiar with this hospital, it is one that I’ve been in a few times as it is associated with the PCP we’ve had for 20+ years. So we’ve been there for various tests and such. Seems to be well run, always clean and inviting, with nice grounds. Their procedures 18 months into this pandemic are thought out and organized. There’s an outdoor corridor blocked off to public access so that staff can easily get between buildings without having to constantly screen at each door. Into the lobby through one set of doors, with crowd control rope to get you to the screening and security station. Exit is through the adjacent doors. Masks are required of everyone indoors. All visitors have a temperature screening, have to sign in, and have to present ID and their vaccine card or a recent negative covid test. Visiting hours are typical for a hospital (8 to 8). They are limiting visitors to one per patient at a time, with exceptions allowed for the gravely ill and for both parents of children. (And a catch all exception they can point to if it’s ever needed.) I’ll also point out the hospital is a non-profit. One of the few left out there.

The SNFs? They’re garbage. Shoddy screening. Messy. Multiple notices posted haphazardly, seeming to address problems that have arisen rather than being developed as part of a well-thought plan. Silly rules. Masks AND face shields? No visitors indoors? Ridiculous visitation policies and hours. And no one is really sure of the costs. Can’t even say if they’re contracted with our insurance plan.

I’ve had compassion for those going through the medical industry to get care for their loved ones. But there is nothing like experiencing it for yourself to really understand how screwed up our system is.

–Peter <== sitting around a hospital without much to do but ramble on about medical care for a bit.


Author: sheila727

Date: 11/3/2021 5:07 PM

No. of Recommendations: 0

Wow. What a saga already—and you’ve only just begun!

Have they said how long she’ll be in the SNF? When my husband was transferred to an inpatient rehab facility after 18 inpatient days at Sloan Kettering, following his leg salvage surgery, the social worker helping me make arrangements had told me that it would normally be for 10 days. I raised my eyebrows, given my husband’s condition. And she said that they were going to ask for 2 weeks. Which they did. And was approved.



Author: tconi

Date: 11/7/2021 7:58 PM

No. of Recommendations: 0

Masks AND face shields?

for the number of people that wear masks incorrectly, i do not entirely disagree with this.

peace & covering nose and mouth

Such a powerful revisiting!!! Feels like you are starting to come up for air.