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my father was placed 3 months ago in a NH (doing well on admission, no bed sores, good appetite, 90 y/o with parkinsons) which doesn't take insurance, very expensive private pay which you would think you'd get better care but definitely not the case, he was recently hospitalized twice for pneumonia and dehydration, while in hospital he never came out of the bed so discharged each time weaker than before, we also now have a one to one aide with him (private pay as well) for most of the day to help with eating/drinking, just had an emergency meeting with the director of nursing to make some changes to diet, etc.....but I don't trust they are doing the right thing, went in without bed sores and hospitalized with infected bed sores, now he seems to be quickly deteriorating, one sibling wants to take him out and make a complaint against the place, some siblings don't want him to make another move, any suggestions?

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I'm not sure what you mean when you say they don't take insurance. That would be a huge red flag for me. It may mean "private rest home, subject to little or no regulation".

I can only relate my experience. My mom doesn't have Parkinson s, but is post stroke, post broken hip repair. She came to her current nh setting as a rehab patient after hip repair. They got her walking again with a walker. She's been hospitalized three times since her admission in September 2013, two pneumonias, one pleural effusion. Each time, she has returned to nh as a REHAB patient, covered by Medicare. They get get her as mobile as possible. She's had one bedsore, which was tended assiduously by their wound care doctor who rounds once a week. She also sees a geriatric psychiatrist who monitors her emotional and mental state. The APRN is there everyday who reports to the Geriatrics doctor who oversees mom's care.

This is not a perfect place by any stretch. It's a facility built in the mid 50 and it's a bit run down. Bit it's clean and cheerful.

Is your father eligible for Hospice care? Was he eligible for rehab at his last hospital discharge? I think I'd be asking a lot of questions at this point, and maybe looking at other facilities. What made you choose this one in the first place?
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thanks, I meant to say that they do take his Medicare and a monthly amount from his social security check, and there was also a one time fee upon admission (over $100,000)

yes, eligible for hospice but if on hospice, he won't receive any of the pt he is receiving, out of all the places in the area, this is supposed to be the better one....
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Just to make sure I'm understanding correctly, this facility charged over $100,000 as an admission fee? Not $1,000 or $10,000? For $100K I would expect much more than he's getting.

I would list all the concerns you have, his pre-admission status as well as developments that have occurred at the facility, and the actions (or inactions) taken to address them.

Then make sure that the administration/management sets time aside to sit down once again and discuss all your issues ASAP. I would think that more than changes to diet would be required - that might address the dehydration but not necessarily the bed sores.

They should be able to come up with remedial plans that address ALL issues, especially the dehydration and bedsores. If not, start looking elsewhere.

But document everything in the event you have to file any complaints against them.

The fact that the admission fee is so high, coupled with the fact that your father's not doing well makes me suspicious of this place, especially since presumably they've already got their $100K. Honestly, I don't understand why they would need Medicare with $100K in their bank account. Nor should they be taking your father's SS check.

I can't help but think that there's something really strange about all this, but I'm not familiar with any private (and public) pay facilities.

I also wonder how he became dehydrated (don't they have IVs?) and got the bedsores.

Do you have any independent doctors who've evaluated him and given you a frank prognosis? Perhaps your father is at an end stage of life (you write he's eligible for hospice), but I wouldn't rely on the nursing home staff to make that conclusion.

BTW, did you check out any complaints against the facility before placing him there? I assume the facility is licensed?

For the siblings who don't want to move him again, would they prefer that he continue declining vs. moving and getting different, and hopefully better, treatment? What's their real concern - moving or your father's well being? I think it really depends on a thorough assessment from one of your father's treating physicians not affiliated with this nursing home.

Good luck; I do hope you are able to work out a solution or find a placement that is more suitable for him.
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If family does not check and check often - that is, visit - they will be subject to abuse and neglect.
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