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A year has come and gone since my 95-yr old mom went into NH care following hip surgery. At first, Family Care meetings were scheduled every two months or so but petered out as the year progressed (and, coincidently, when Medicaid kicked in). The last one was four months ago.


After I recently reported an incident that suggested potential mistreatment of my mother by an aide, I was assured by the social worker that it would be internally investigated "immediately" and that I would be kept fully informed. I was not. (The SW never got back to me.) I had to hunt down the nursing director who then provided information on the appropriate steps taken, policies followed, and further actions. I was then satisfied that the matter was properly addressed but very disappointed that I was not kept "in the loop."


So now I'm wondering why four months have passed since the last FCMeeting -especially since this recent incident might have prompted one to ease our family's concerns and demonstrate due diligence.


Are Family Care Meetings only provided "as needed?" Is it up to the family to schedule them?

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I imagine that the frequency of mandated meetings varies depending on where you live. It's only natural that there are more meetings while the facility and family get to know each other and work through what needs to be included in the care plan, beyond that period I think we had a scheduled meeting every 6 months? These are meant to discuss major changes and/or problems and as progress reports, they are not to "keep in the loop" of daily/weekly routines.

Just looking at it logistically these meetings (and the prep work) take up a considerable chunk of the day for all the senior staff, there are many residents in each facility and holding one CC per day could only cover 30 residents per month.
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We had a few issues in the NH that my mom did rehab. They were very responsive to the incidents. I was satisfied. I had no problem speaking with the social worker or the head nurse.

How did you inform them of issues?
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I’ve dealt with an assited living, memory care unit, 2 rehab facilities and now a nursing home. Overall the care my parents received has been pretty good but issues do arise.

Dont be shy about looking up the director of nursing or whom ever when you’re on site. If they are busy set up a meeting ASAP. You don’t have to wait for some scheduled meeting a month from Sunday.

Be firm with these folks but not abrasive and combative. These jobs are not easy. It’s better to have a working relationship with staff and admin if possible.

I had some adjustment issues when my dad moved to his new place about four months ago. Bathing, meds, laundry , dentures not getting cleaned etc. I wasn’t a jerk about it but I was very firm and let them know that I was watching things closely. Dads doing well now, I talk to the staff regularly and we respect one another.

And I’ll be dropping off some valentine candy and thank you cards at all the nurses stations next week.
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anonymous1013622 Feb 2020
Windyridge, thank you! Your advice is helpful.
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Where my step-father is, it is like a little town, everyone knows everything about what is going on, including the director. There are no formal meeting set up on a schedule, if we have issues we set one up.
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My mom's nursing home did the meetings about every four months. The staff scheduled them. But we also had opportunity between to bring up anything of concern. In four years we had one aide my mother didn’t like, she couldn’t communicate well enough for us to know specifically why, but she made it clear she didn’t like the person. We requested the aide not work with mom again and the request was honored. The aide actually didn’t last much longer. Never hesitate to bring up a concern. And taking cookies or doughnuts to the staff is always a good idea
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I'm going to state that communication at my dad's NH/LTC is extremely spotty. Their policy is for an annual care conference however, family has the option to schedule one at any time. And my sister and I have no problem with calling for one when we feel it's needed. They have to abide by the request. We even specify who we want in attendance.
It is sad to say that I have to constantly send more than one email to get follow up to a question. We have told them that they need to reply within 24 hours and they promise to but don't. By "them", I referring to the DON, the nurse coordinator, and or the administrator. My dad is at a continuing care community and is private pay at over $10,000 a month. My running joke is that to get that good level of care he would be at the $15,000 level. ha!!
You can certainly contact your ombudsman in your state and make a formal complaint if it's something that is not being addressed.
But, ask the DON or administrator what the policy is on care conferences. At least annual should be the minimum.
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Stressed808 Feb 2020
If the emails go unreturned at the nursing home, then contact the owner of the facility. They need to know if those in charge are doing their jobs. If you still get no answer, then report to the ombudsman.
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Look at the policies of your mom's facility. Then, talk to the administration about instituting regular meetings for your sake of mind. If it was my parent or LO, I would like to know about their diet, hygiene, participation in social activities, weight, and doctor's notes from the most recent visit.

I have a question. If your mom went in for hip surgery, why is she still in rehab/residential facility? Does she have osteoporosis? Is she not getting daily rehab to help build up muscles? It seems that the plan would be to help her get strong enough to go home.
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You can demand a meeting anytime. It's important to keep abreast of your loved ones concerns and issues while living in a Facility.
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Care Plan Meetings are a Federal Requirement for skilled nursing homes who accept Medicare/Medicaid residents. Care plans are to be done on admission and they are then required every three months. The initial care plan is to be scheduled within 21 days of admission, the home has 14 days to do the assessment and then must schedule the care plan within 7 days.

Care Plans are not optional in skilled homes that takes Medicare/Medicaid, they are to be done every three months. Care Plans are also required any time there is a "significant change" in a resident's condition.

Families are to be invited to the Care Plan Meeting, if you have not been invited I would call the Care Plan Coordinator (called the MDS Coordinator) and asked if there has been a Care Plan. Many times homes have them without the family knowing. Families should be invited, it is our right unless your loved one has told the home that they do not want you to be invited.

Note: Assisted Living Communities and Skilled Nursing Homes that do not accept Medicare / Medicaid are not required to do the Care Plans because the Federal Regulations do not apply to them, they only are regulated by State Regulations. That being said most communities do have the a "care plan" typed meeting.

Families in any long-term care community can request a "family meeting" at any time to discuss concerns.

If a family wants an advocate to attend a Care Plan Meeting with them, contact your local Long Term Care Ombudsman Program. Ombudsman are the Federally mandated advocates for residents in long-term care facilities. They are experts in the laws and there is no charge for their services.

There are changes happening right now with how payment is going to be made to homes. The Federal Laws have just been updated, these changes have been implemented over the last three years with phase three going into effect in November 2019.

Some of the final rulings for different regulations are still being worked out.
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This same issue happened to me where I made a complaint of mistreatment and I was not kept in the loop as I was told. Had to keep asking the nursing director what the status was and received no answer. I think they did something once that they mentioned in the meeting I had, I forget what that issue was called, but that was the end of that. I would think the meetings should still continue because it tells you the status of the patient.
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Nursing Home care meetings can be turned around on the patient and their family in a complete 180°. Case in point - my late mother was in a Nursing Home, which is where we expected her to stay as she lived alone many states away from her 2 adult children. I actually had to move from Maryland to Massachusetts. So she was in the rehab unit and we expected her to transition to the long term care unit. Care meeting is 7 days into her stay. They say to her "Ma'am, you're too well to stay here." WRONG ANSWER. DEAD WRONG as less than 48 hours later, she suffered a stroke there and passed away from it.
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NeedHelpWithMom Feb 2020
So sad, Llama. Stories like this educate others.
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Just wondering if you were able to get a meeting scheduled?
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My MIL is on Medicaid in LTC. Me and hubby still working full time and help caring for our 9-yr old grandson. The facility doesn't schedule the meetings on weekends or after hours, and always in the middle of the day. Our office is 20+ miles away from the facility. So, we just do call-in conferences.
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