Trends in Long-Term Care - U.S. Senate Special Committee on Aging

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Now, this is another th<strong>in</strong>g, we found nurs<strong>in</strong>g personnel listed on the
nurs<strong>in</strong>g home schedule as be<strong>in</strong>g on duty, and also found them <strong>in</strong> other
facilities that had been on duty at the same hour, the same tour, which
would mean that one or the other job was suffer<strong>in</strong>g, and if they were
work<strong>in</strong>g <strong>in</strong> the hospital and the nurs<strong>in</strong>g home, most likely it was the
nurs<strong>in</strong>g home that was suffer<strong>in</strong>g, because the hospital would not tolerate
this.
Then the adm<strong>in</strong>istrative personnel-<strong>in</strong> most of the homes there are
no adm<strong>in</strong>istrative personnel from 4 p.m., on Friday, until 9 or 10 p.m.,
on Sunday.
Most of them refuse to hire a Saturday adm<strong>in</strong>istrator-a qualified
Saturday adm<strong>in</strong>istrator. They will br<strong>in</strong>g <strong>in</strong> anybody just to sit there
and say I am an adm<strong>in</strong>istrator, but not qualified by the regulations set
up by the New York State Department of Education.
Now, this is an actual letter that I myself and another <strong>in</strong>spector
wrote to a nurs<strong>in</strong>g home about a Saturday morn<strong>in</strong>g visit, and it was
an unannounced visit.
It was dur<strong>in</strong>g this same outbreak of shigella that I spoke of when I
first started talk<strong>in</strong>g.
I would like to read just a few of the actual violations that we found,
and it is just a few, because this is a report that goes back to the adm<strong>in</strong>istrator
that I just spoke to you about.
Although the home has an adm<strong>in</strong>istrator and five assistant adm<strong>in</strong>istrators,
none were on duty on the day of this survey. A check of the
sign-<strong>in</strong> book revealed that on Saturdays the assistant director of nurses
acts as adm<strong>in</strong>istrator. He does not have the background for this position
nor does he meet code requirements.
Because of the many problems <strong>in</strong> this home and, presently, because
of the positive cases of shigella <strong>in</strong> this home, there should be a capable
adm<strong>in</strong>istrator supervis<strong>in</strong>g this home every day.
We went to the kitchen, exam<strong>in</strong>ed the meals be<strong>in</strong>g used.
The meals be<strong>in</strong>g used on the day of the survey, March 7, 1971, was
dated February 27, 1971.
Now, patients' closets were taken over by employees for their own
use, and their own personal lockers. Locks had been put on the
patients' closets, so that the few meager belong<strong>in</strong>gs the patient has,
he has no place to keep them.
Now, this is about a patient's clothes. Many patients would not
wear any undergarments. They would wear the p'ants or shirt over the
bare sk<strong>in</strong>.
Patients were dressed <strong>in</strong> soiled and unironed cloth<strong>in</strong>g, <strong>in</strong> many cases
cloth<strong>in</strong>g with p<strong>in</strong>s on the clothes.
Some patients wore mismatched stock<strong>in</strong>gs and/or were without
socks or shoes.
Many patients wore ur<strong>in</strong>e-soaked or ur<strong>in</strong>e-sta<strong>in</strong>ed garments.
Male patients were <strong>in</strong> need of shaves.
Several patients occupied beds which were labeled with other
patients' names.
Can you imag<strong>in</strong>e what happens when the medication nurse came
around?
The medication closet was unlocked and unattended, the key to this
closet and the key to the sedative box were <strong>in</strong> a desk drawer. Anybody
could come <strong>in</strong>, and they had access to this medication.