How do we manage these nursing home problems?

1 answer | Last updated: Oct 11, 2016
A fellow caregiver asked...

Can a nursing home send a resident outside a facility (to a local hospital - 5 minutes away) and require that a family member attend with the resident?

Can a nursing home require a caregiver/responsible party (as signed in the original agreement) to sign a discharge from Medicare if the resident is still receiving skilled nursing care (sterile dressing) for a pressure wound acquired after entrance to the nursing home from a hospital stay of one month prior to entering the nursing home?

How long should a resident have to wait to be transferred to a toilet or bed when it is evident that there is inadequate staffing? Who do you contact to make this better for all residents who are in the same situation?

Expert Answers

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

Wow - it sounds as though you have had a difficult experience with a loved one who lives in a nursing home. While Medicare is a federal program and the benefits are the same from sate to state, each facility operates differently. Much of the actual care received by residents depends on the individuals on the staff at the facility and its management.

Of course, if there is a medical need, you want the facility to send your loved one to a hospital. I am not aware of any regulation that allows the facility to require that a family member ride in the ambulance. It is likely that the resident may want someone familiar to ride along. In general I recommend that nursing home residents be sent to the hospital only in the most extreme emergency, because the experience can be so traumatic for them.

I cannot find the question in your second paragraph. Again, I don't think there is a regulation that allows a facility to require a signature from the responsible party. Usually the facility wants Medicare to continue as long as possible because they make money on it.

How long should a resident wait to have a call light answered?? Not long! Maybe 5-10 minutes, best case. However, remember that most facilities are understaffed. That means longer waiting times.

Your best course of action is to contact the Ombudsman program in your state. This is a federally mandated program that is an interface between the facility and its residents and families. The Administration on Aging (AoA) has a good explanation of the program at On the site there is a link to the contact information for the program in all states. Call and identify yourself as the relative of a resident in a facility and request an investigation.