My husband is here currently for the rehab/transition part of the facility. His case is complex and though we had been downgraded to Skilled Nursing, we ended up here for LTAC level care. Note: We arrived here when it was Kindred and it is currently under new management as Grapevine Medical Lodge. I am hoping this transition will cause improvement.
I can say right off the top that we would not still be here if it were not for the rehab staff. They have been awesome through this and have caused marked improvement in my very broken husband. And the new owners have already improved the equipment in the rehab room and have shown a willingness to improve further. Hoorah for the staff and their dedication to the patients and for their taking the time to create a list of items that can benefit the patients. That being said we have not been impressed with the rest of the facility from day one.
Our arrival was in late afternoon/early evening. Even with a portion of the day to prepare, I can assure you they were not prepared. With broken pelvis and skin grafts, we coordinated ahead (or thought we did) for an upgraded mattress. It was not there when we arrived. The transport vehicle cannot wait around for the facility to catch up, so our only choice was to transfer him to the regular mattress. When the air mattress did finally arrive, it was not what the social worker at the hospital had described to us, but at least the pressure would be off his damaged parts. I won't even bother describing the fiasco involved in transferring from the stretcher to the bed, and then the poor mattress to the air mattress. In summary, I can say they are not used to seeing someone with his level of injuries in spite of classifying as an LTAC facility,
After settling in a little, I realized their cleaning staff has different standards than a hospital, even though they are supposed to be able to handle people with infections. Our room had clearly not been sanitized for a new patient. I understand it can be a little difficult to clean around patients, but this was an empty room. I can only call it a high level cleaning at best and I don't believe the restroom was addressed at all. The toilet and shower had CLEARLY NOT been cleaned. I addressed it with the staff first thing the next morning. The toilet was at least addressed. I bagged up the shorts that were left in the shower and added them to the trash. The shower and its previous tenant toe prints in the soap scum were addressed later when rehab elevated him to shower ready, saw the shower and addressed it with the cleaning manager. Even then, his mom re-cleaned it to feel it was acceptable for someone with an infection risk. My recommendation is that the Manager of the cleaning staff should inspect and sign off on each room/area made ready for a new tenant, at minimum.
Another issue experienced early on stemmed from rough treatment early on. While not elderly, my husband was in a lot of pain from the broken pelvis and other injuries. When he needed to use the "bed pan" rolling was very painful. In spite of my assistance in supporting his leg during the roll, the staff was very rough in handling and cleaning. I can't imagine the ordeal that it is for older patients with more fragile skin and joints. I can totally understand why the patients might avoid bathing and other cleaning if the same heavy hands are in charge.
Related to that are the quality of the standard mattresses. As I stay at the facility almost as much as my husband, I have experienced the standard mattresses first hand. At just over 40, I think I still bounce back pretty well, but my shoulders, back, and hips are still achy and sore when I get up (we don’t have a fancy mattress at home) and I don’t sleep through the night because of the discomfort. Buying a mattress topper only helped slightly. I don’t know if that is a facility issue or an industry issue, but for the sake of our elderly, a better mattress should be found/made to fit these tiny beds. If you HAVE to send a family member here and they do not merit an air mattress, I fully recommend investing in decent quality mattress toppers. (May need more than one eventually for mishaps.)
The food is pretty bland and unappetizing as far as my husband is concerned. We do, however, understand that the normal clientele of a facility like this might prefer bland. Our biggest problem coming in was that in spite of filling out the meal cards, it seemed that the kitchen staff wasn’t paying that much attention to them anyway. It’s gotten better, but still can be problematic. Sometimes it’s simple things, like asking for Raisin Bran and getting oatmeal. Sometimes it could cause health issues. In our case, Vitamin K rich foods are off limits because of the blood thinner. So giving cabbage (or something like that) instead of whatever was asked for could cause a negative reaction with his meds. Not too much of an issue because we are coherent enough to make the decision to not eat the food that is bad for him (and/or go buy something at a local restaurant if needed.) It does make me wonder if the same things are happening to the elderly patients who might not be mentally aware of such issues and are just made to eat what is in front of them. We were only briefly spoken with regarding dietary concerns, and that was one week after our arrival. It seems like a discussion should be had regarding those needs should be had the day of arrival, allergens and interactions noted on the dietary card, and the card adhered to except where a client picks something that would be bad for them. (Sorry Mrs. Jones, you can’t have the sugar cookie with your diabetes. Sorry Mr. Smith, you can’t have Coleslaw because it will cause issues with your medications, remember?)
Regarding the nursing staff, they are usually nice and try to be helpful, but are sparse and occasionally hard to locate. Should your nurse be on cafeteria duty, you can basically expect to get attention to what ever need you have in 60 or so minutes, because they don’t overlap care in the wings. This seems a bit questionable, as many of the patients (as I walk by the rooms on this wing) are eating in their room. What if someone happens to choke or get sick or have a reaction to a food interaction? If they can get to their call button in time and from where they are positioned, it may be some time before someone checks on them. I’ve seen call lights on over rooms for extended periods of time. And had patients call out to me from their room asking if I could get their nurse. Because of that, I feel my husband is lucky that I’m here to hunt down staff as needed. They are, however, very reactive if you decide to go out for air in the wee hours. We aren’t trying to escape the facility, just the smell.
On the smell, please address the ventilation. Clearly there is no negative pressure on the restroom exhaust system or at least not enough. That combined with the carpeted hallways and the scent of feces that seems to have imbedded itself in much of the furniture (including the questionable mattresses) makes the air quality oppressive and often repulsive. If there was some draw pulling the funky air out and the fresh air in, the quality of living would be much improved. It can take hours for the smell to clear out from a single movement. (I sprayed aerosol at the vent. It fell down. It should have been drawn up a little at least.) 80 plus medicated and fibered people defecating throughout the day cause a continuous supply of smell. Surely a quality exhaust system would help.
One last thing, would it be too much to hand out an Orientation Guide when checking in? There is A LOT of information coming at you at once when dealing with this type of move. Having something to refer back to would be a great help when the dust has settled and your loved one is (relatively) comfortable. Here are some suggestions to include
• These are the items that should be in your room upon arrival, if not please ask.
• This is how the schedule works (i.e. someone will be bursting into your room between 5 and 6 am asking if you want a changing)
• This is how Nursing/Medication works
• This is how assisted bathing/restroom time works
• This is how Dining works
• This is how Housekeeping works
• This is the entertainment available continuously
• This is how scheduled events and entertainment work
• This is how visitation works, after hours visitation works
• This is how having pet visits works and requirements
• This is how rehab and other therapy works
• This is how transportation to offsite appointments works
• This is how x-rays and other odd necessities work
• These are the staff types and what they are responsible for
• A map to help you locate dining, rehab, entertainment, etc.
• Calendar of events
Every time we pass the “Zero deficiencies” Banner on our way to rehab, we shake our head and wonder if there is a really low bar to pass or if who is friends with someone. We absolutely would have been gone the first week if it had not been for the rehab staff. I can only hope that the new management raises the bar and makes this the kind of place you would want your loved ones to be in, not settle for because they are the only nearby facility that managed to pass as an LTAC.