One star is too much. The "care" at the Carlyle is scary. My "resident" was at the Carlyle to recover from surgery to close a pressure sore (she has paraplegia), and for physical therapy to get her back to being able to transfer to and from her wheelchair after a LONG episode (6 months) of being in two hospitals, one LTAC, and two SNF's (the second of which was the Carlyle), being treated for the pressure sore and the resulting infection, etc.
Fortunately she, unlike many other residents, was able to speak up for herself about the smaller irritations of this place--like seldom getting a chance to order her meals for the next day and then, IF she got a meal (sometimes she didn't) seldom getting what she ordered. It was really odd for me to have to bring a grilled cheese sandwich to someone staying in such a luxurious LOOKING place. BTW, the food was not great--except for the deserts which, unfortunately she didn't want (but which they insisted on bringing).
However, there were some things that she couldn't address, at least in time to make a difference: like the abysmal hand hygiene practices. I know I am hyper-sensitive to this since I work at one of the hospitals she was in and am aware of how much we focus on hand hygiene as the number one way to reduce or prevent hospital-acquired infections. At the Carlyle I NEVER observed staff using hand gel before or after leaving a patient's room. Of course it would have been difficult for them--there was, in this expensively decorated facility, only ONE hand gel dispenser on a hallway with 10 beds on it! Two weeks after she arrived at the Carlyle, she was diagnosed with a MRSA urinary tract infection, which spread to her surgical site. She was negative for MRSA at both of the hospitals and the LTAC she was in, including the hospital from which she transferred to the Carlyle. She knows when and how she was given this infection as she observed the poor technique used when her catheter was first replaced at the Carlyle.
It's a wonder that she didn't get an infection at her PIC line port too--she had to tell the person who was trying to change the dressing that she had it on 180 degrees out of its correct orientation.
When she first arrived at the Carlyle, she needed to be on a Clinitron bed, which they did provide (SNF's rent things like this when they need them). When the time came for her to switch to a different kind of low-air-loss bed, they changed the bed out, but ignored her when she told them that the new bed was too hard and was obviously mis-adjusted. Finally, after a week and a half on this malfunctioning bed, she began to develop skin breakdown (including on the flap that had been formed to close her pressure sore). Her surgeon (a real gem) was called and said he would come see her the next morning (on a Saturday....on his own time). Mysteriously, that night, the bed began to function correctly. The surgeon gave orders to begin turning her regularly, etc. but the wait for the healing of this NEW skin breakdown set her back two or three weeks in her physical therapy, as some of the things they were doing (like sitting on the edge of the bed) had to be curtailed.
BTW, the PT and OT personnel were great. A few of the nurses (all LVNs) were good too, Unfortunately the staff turnover seems to be pretty high, and one or two of her favorites weren't there very long.
One night, another resident (apparently suffering from dementia) burst into her room in the middle of the night from the courtyard in the center of the building. Fortunately, a staff person was close on the heels of the intruder, and bundled that poor person out of the room.
Oddly, no one from the Carlyle apologized for this event or came to see if she was okay (she was, in fact, scared to death). Later, when a care conference was finally granted, the administrative person seemed to begrudge the time being spent listening to this mere resident's complaints about the care, the food, etc. and seemed mystified by the idea that an apology was owed for the middle-of-the-night trauma. Oh, and speaking of conferences, all the nursing homes are supposed to have resident councils with regular meetings. We didn't see any indication of there being a resident council or any meetings of such a group over a two-month stay.
This place seems to be leaderless. No one seems to be running things administratively and there was no evidence of organized nursing protocols and practices. The marketing person (an RN) who recruited for this place said there was a policy of rounding on every patient once every hour. Sure enough, there was a clipboard on the inside of the door to the room. However, the staff either ignored it or went through at the end of a shift and signed off for each hour. NO ONE ever rounded on her. They came when called (eventually) and when it was time for meds. After a few weeks, the clipboard disappeared.
Don't be fooled by the ratings on the Medicare or DADS websites. These places shine their shoes before the announced inspections. The ratings are meaningless. Medicare and other third-party payers REALLY needs to start reimbursing SNF's the way Medicare reimburses hospitals: based on patient satisfaction—although that might lead to a shortage of SNF beds, since for-profit businesses like the one that owns the Carlyle would probably have to fold.
When she left (last week of 6/14), the place was nearly empty, and the staff had been cut back to the barest of bare bones. A friend who works for a hospice that used to contract with the Carlyle said they have had revolving door administrators since they opened. That hospice terminated their contract with the Carlyle. I don't see how the place can stay open. As much as the word is out about their scary “care,” my guess is that they will have to change hands and change names in order to have a chance of surviving.