POOH: NO GOODBYE

POOH

The morning had begun as most mornings. I had gotten up, shaved, dressed, and prepared myself to face the day. The events of the past week and the decision I had made the previous night preoccupied my mind.

POOH'S PORTRAIT

Pooh, my Bengal cat and my sole companion for the past 10 years, patiently waited on the counter top for whatever was to be her breakfast snack. I could tell by her excitement that she had smelled the bacon cooking in the micro-wave. This morning she would snack on the little, crispy pieces.

I sat at the table trying to relax, drinking my coffee, my mind flashing back to the past week, and trying to anticipate the events that were about to unfold.

I had cleaned up the breakfast dishes and was about to resume watching the morning news with another cup of coffee, Pooh soft and warm in my lap, when I heard the anticipated knock at the door. I went to the door to let them in, and Pooh, as usual, scurried to the bedroom to evaluate the situation from a distance before making her introduction.

The EMTs positioned the gurney in the middle of the living room, “…you ready?”

“Yeah.”

I backed towards the gurney, placed my hands palms down on the side rail, and boosted myself on to it. I saw Pooh, cautiously trying to assess what was going while standing in the bedroom door.

There was no way of knowing what the future was to hold; the emotional scars and emptiness that would be left.

Pooh would never see me again.

 

bc

RESIDENTS AT RISK

OPINION:

Sitter and Barfoot continues to place residents and employees at risk through its poor hiring practices.

In the last three months, new hires have been put through five days of orientation and worked on the floor caring for residents only to be let go after failing background standards.

Most recently a new hire, not even completing his fifth day of orientation, was caught sleeping shortly after clocking in.  When confronted with his indiscretion, he became belligerent and confrontational to the extent that the Richmond city police had to be called to escort him from the building. Because of his erratic behavior co-workers had become fearful for their safety.

City police complained that they had to take a circuitous route because the main gate to Sitter and Barfoot was locked closed. The gate is secured every night and twenty-four hours a day Saturday, Sunday, and Holidays. This causes unnecessary and dangerous delays in all emergency response times, further putting residents and employees at risk.

These conditions are exacerbated by the anticipated opening of a new forty-bed unit and the rush to get it opened on time in July.

Sitter and Barfoot has a history of poor hiring practices and keeping quality personnel for the non-traditional shifts. This condition has worsened in recent months.  Going back as far as 2010 and 2011, Sitter and Barfoot has shown a lack of concern in their hiring practices.  The Virginia Department of Health, the ineffective agency that inspects nursing homes, noted in their June 10, 2010, annual surveys that: “At time of job offer the H.R. Department will confirm verification of license/certification is in the personnel file.”  The Department of Health further stated that: “If the verification has not been obtained/confirmed the new employee will not be allowed to work.”

Those directives had not been addressed a year later. On June 23, 2011 the Health Department cited Sitter and Barfoot again with the following:  “This requirement is not met as evidenced by:  Based on staff interview and facility documentation review, the facility staff failed to operationalize [sic] policies for screening employees for 3 of 5 employees (CNA A, LPN A, other B) in the survey sample.  The facility staff failed to conduct background check, reference checks, and timely licensure verification.”

Apparently, the leadership and the administration of Sitter and Barfoot did not take the safety and security of residents and employees seriously in 2010.  They took the recommendations of the Health Department and did nothing—they provided no action or follow-up.  Now, five years later, it appears little has changed.

The Department of Veterans Services, the state governing authority over Sitter and Barfoot, continues to collect state paychecks oblivious to the risks at their nursing home. They too are complicit in the neglect of veterans and in doing so, should be held accountable.

bc

ONCE AGAIN WE MOURN, ONCE AGAIN WE’LL FORGET: RE-POST FROM MAY 31, 2014

 

OUTRAGE

MAY 31, 2014 LEAVE A COMMENT EDIT

OPINION:

Public rage today is impotent; it has no mechanism to produce consequences.

Glenn Greenwald, With Liberty And Justice For Some, Picador, New York, N.Y., 2011, p. 152.

Shooting rampage in Isla Vista, California

Richard Martinez, the father of mass shooting victim Christopher Michaels-Martinez, speaks to the media on Saturday. Photograph: Michael Nelson/EPA

It saddens us to see the outrage of the father of one of the victims. A victim in the most recent killings in California. An image falling on eyes with short memories. Unfortunately, we don’t share his outrage for long, if at all.

We are not reminded of his permanent emptiness on a daily basis. The empty bedroom; the bed not slept in; the bicycle leaning against the garage wall; the toys no longer strewn all over the living room floor. It’s when the victim is a family member or friend that we express our outrage. Then we feel the anguish, the sorrow, and the daily reminder of loss.

We barely showed our outrage over the killings at Sandy Hook. The horror of Sandy Hook was not strong enough to produce a sustained dialog. Those thoughts were quickly replaced by the joys of our own Christmas experience. Soon the faces were forgotten. The families eventually tried to move on. Some started campaigns to stop the senseless violence, but not many supported the effort to curb the killing that has become an everyday occurrence.

The reality?

Few people care. We are too embarrassed to show our outrage; too politically correct; too afraid to express our deepest feeling; too insensitive to share in the emotions.

We are a nation of people that don’t care. Unless it happens to us, our family, our friend, our neighbor; we don’t care. We have insulated ourselves. The constant barrage of death and despair in the media acts as an insulator. Once we get tired of it, we turn it off, move on, and forget.

The anger and raw emotion demonstrated by the father of a victim may open the wounds of those that have shared his experience, but, in fact, his passionate expression of anguish will quickly be forgotten. Just as those faces from Columbine, Aurora, and Sandy Hook. Images that have faded and been forgotten. Their sadness and outrage are forgotten until the next tragedy.

We are confident that the mainstream media will remind us of the next tragedy in infinite detail.

The next time you walk past your kid’s bedroom and see it a mess, smile and be grateful the child will be safe asleep there tonight. The next time you find the bicycle in the middle of the driveway, get out of your car and move it. Be grateful it’s rider is safe inside the home. Show your love and gratitude, not your anger.

Share Richard Martinez’s sorrow for a brief moment and be thankful it is not you. Be filled with hope that your loved one will not be the next victim of the senseless wave of violence. Then, turn off the thought like the TV, and move on.

Media has conditioned us to forget. We forget because we are helpless.

bc

OUTRAGEVIOLENCE

VETERAN DENIED DIGNITY AND RESPECT: Repost of my thoughts, facts, and opinions expressed on December 29th, 2014. bc

PERSONAL

VETERAN DENIED DIGNITY AND RESPECT

DECEMBER 29, 2014 LEAVE A COMMENT EDIT

Sitter and Barfoot Veterans Care Center has exposed its hypocrisy toward the principles that a veteran served to protect. Dignity and respect are the foundations of trust and credibility. The state run Veterans Care Center has failed to embrace these principles.

SITTER AND BARFOOT SIGN (4)

After back surgery and therapy at McGuire Veterans Medical Center, I was admitted to Sitter and Barfoot on Friday afternoon, December 9th, 2011—unable to walk or stand. I was transferred under the pretense that it was for “therapy.”

Ten days later, the Director of Social Services, Dana Rivera, gave me a document informing me, “We have reviewed your case and decided that Medicare coverage of your current services should end.” Sitter and Barfoot had made this decision after five days therapy and observation.

The Director of Social Services told me, “You will spend the rest of your life here.”

This unsigned paper ended my Medicare Coverage. The change made it necessary for me to liquidate all my assets and to convert my medical coverage to Medicaid. The appeals process was the only option offered. All my petitions were denied without explanation.

Half-truths and memory lapses confuse the circumstances around the change from Medicare to Medicaid. How could Sitter and Barfoot come to the conclusion that services should end without the input of a medical professional—in only five days of observation and therapy? Repeated inquiries have resulted in different responses.

I pressed Ms. Rivera to name the person who had given her the document. The director replied, “Diane Handler.” I had never heard the name.

I learned that she was a therapist in the rehab department. Finding her office, I asked her, “Who wrote this?” She said she had, and I asked her to sign it.

I received a contradictory email on January 19, 2012.The Director of Rehabilitation, David Mansolino, stated that he, in concert with his Certified Occupational Therapy Assistant, Charles Evans, had made the decision.

It remains unclear why Diane Handler signed a document she hadn’t authored.

On January 17, 2013, Robyn Jennings, Director of Nursing, told me that she had conversations with Mr. Mansolino. Mr. Mansolino told her that he conferred with therapists, and physicians at McGuire VA Medical Center, yet he cannot remember any names.

After several emails, Ms. Jennings confirmed my suspicion—David Mansolino couldn’t remember with whom he may have spoken.

A judgment he made that had a devastating effect on my life. Stripping from me a lifetime of accomplishment.

David Mansolino has also shown careless record keeping by losing an email I sent him on April 30th, 2012. The email was a request to determine whether I needed approval from his rehab department to make transfers. An OK that would allow me to make slide board transfers from wheelchair to bed and back, without supervision.

He never responded. When confronted with his mistake, in front of the administrator, Sandra Ranicki, he maintained that he couldn’t find the email. Perhaps he’d given it to his Assistant, Charles Evans—once again, a memory lapse.

Since my arrival at Sitter and Barfoot I’ve repeatedly asked for the go-ahead to use an external catheter. The device would allow me to return to community activities with comfort, confidence, and dignity. Sitter and Barfoot had blocked all attempts to provide me with the device despite the recommendations from three medical doctors at McGuire VA Medical Center.

I received excuses when I made requests. “They weren’t intended to be used in a long term nursing facility.” Or, “You run the risk of UTIs [urinary tract infections] and skin breakdown.” Finally, it was just, “against policy.”

The attending physician, Doctor Philip Boulanger, finally gave consent to use a catheter for up to eight hours. However, my community activities would have exceeded the eight-hour restriction.

On February 12th, 2012, I sent an email to the administrator requesting information on the policy. The email was ignored.

In desperation, I contacted the ombudsman to see if I could gather additional support to reenter the community with comfort and dignity.

I requested a meeting with Sandra Ranicki, administrator from Sitter and Barfoot; Robyn Jennings, the Director of Nursing; Debbie Kopacki, the ombudsman from Senior Connections, and myself. The meeting was scheduled for February 24th, 2012.

Ms. Kopacki was aware of my personal needs and expectations; to regain an activity level close to what I’d had experienced before—to return to the community, and to be productive.

As expected, Ms. Ranicki and Ms. Jennings voiced their resistance to the external catheter, mentioning their experiences, concluding that it was against Sitter and Barfoot’s policy.

I expressed my reasons for the device—I had volunteered for the Wheelchair Games to be a greeter at the Civic Center, and I couldn’t attend without one.

I then looked to Ms. Kopacki for support. To my surprise, she related conditions from her previous nursing duties and sided with the administrator and the director of nursing. My supporter was echoing the same denials that I had already heard.

I was furious.

I continued to pursue the policy source. I was told that it was the policy of the Medical Director and the attending physician. They both denied responsibility.

The policy seems to be the making of everyone’s imagination. The Centers for Medicare & Medicaid Services (CMS) conducted an interview on 07/11/2012. A Central Supply Staff member (Other F) is quoted as saying they, “used to have two residents several months ago that used them [external catheters], but there are currently no residents who utilize them.”

I have never received nor has anyone been able to produce a policy. Ms. Jennings justified my skepticism in a meeting 1/17/2013. She couldn’t provide a written copy from the manual saying, “It must be in storage.”

Ms. Ranicki expressed her insensitivity towards resident’s dignity and respect. In 2012, my personal mail was opened twice; two different checks diverted and deposited into the wrong account without my knowledge. Ms. Ranicki’s defensive stance was that Sitter and Barfoot was doing it as a “convenience.”

Opening personal mail has been—and continues to be—the practice at Sitter and Barfoot since my arrival. On the survey done July 17, 2013, “Employee-B stated that she sorts the mail that comes into the facility. Employee-B stated that mail that is addressed to residents goes to the resident except for mail that has anything to do with money then it goes to the business office.”

Ms. Ranicki’s callousness towards me was revealed in her response to the Department of Health surveyor on July 18th, 2013. When the administrator was questioned about the unannounced searching of my personal space, she is quoted as saying: “she did not perceive that what the CNA [Certified Nursing Assistant] did was a violation of Resident #5′ s [sic] privacy.”

These are examples of deception, distortion, and controlling character at Sitter and Barfoot; all at the expense of one veteran that has served his country. My experience, I fear, is “the tip of the iceberg.” I’m just one resident of a possible 160.

*

Sitter and Barfoot Veterans Care Center has shown that it is incapable of self-governing.

There is no operational oversight from the Department of Veterans Services. Sitter and Barfoot operates unsupervised and with impunity—held accountable only to the Department of Health once a year and an annual survey done by the Department of Veterans Affairs. Both inspections are superficial exercises to meet administrative requirements.

Ask most any long-term resident if they’re happy, most will say “yes.” Why? Residents are intimidated and are afraid—afraid knowing that Sitter and Barfoot is the last stop.

Most family members don’t know what to look for, don’t have the time to ask, or just don’t care. Family members take for granted their loved one is getting proper care.

The Veterans Care Center, for many, is the last sanctuary for veterans just waiting to die—just waiting to fade away and be forgotten.

Sitter and Barfoot is just another nursing home; no better, no worse.

Absent is the direction, leadership, and moral code to set Sitter and Barfoot apart; it has neither the desire nor the incentive to excel. Just maintain the status quo and cover its tracks on the backs of heroes.

*

Sadly, the Director of Social Services may have been right—I may spend the rest of my life here. However, I’m not giving up my dignity, and I’m not giving up my deserved respect.

bc

OPINION: DIGNITY, RESPECT, AND FREEDOM OF SPEECH DENIED

OPINION:

On April 30th, 2015, the administrator of my long-term care facility, and the nurse manager requested entry to my room.  The administrator had an envelope in her hand.  She extended the letter towards me, and I took it.

I read the letter, and I was stunned.

The letter informed me that she had been made aware of my website and took offense. She was requesting that I take the site down from public access.

She was asking that I take down a website that had been up for over a year with many posts of no interest to her. Some were opinions expressed; some were about my adjustment to my new environment, some personal. She was asking me to remove over a year’s worth of work product.

Her letter stated, “Several employees have voiced complaints as the information is inaccurate and employees are mentioned by name in a derogatory manner.” She was careful to add that she had, “discussed this concern with legal counsel in the Attorney General’s office.”  She also gave me a deadline: “I ask that this be done by Monday 4 May.”

The tone of the letter speaks volumes. It was intended to intimidate.

It begs to question: Is it appropriate for a state employee, in an administrative position—a position of power—to exert that power to silence opinions and facts she finds objectionable?

To position one of the Virginia’s most revered institutions off-limits for discussion and criticism is manifestly immoral.

*

My basic needs are being met with a few additional conveniences. There is no refuge—no place will offer asylum for those that are labeled as one-hundred-percent disabled.  Fear is the curse placed on those that choose to speak up in a long-term healthcare environment.

The use of intimidation is all that is required to suppress objectionable voices.

I have done nothing wrong.  I have the right to “free speech” and can freely express my opinion.  The assertion that my December 29th, post contained “inaccuracies” is false.  What it did contain are facts, observations, and opinions.

The administrator must know because you don’t agree with the narrative that doesn’t mean that it’s inaccurate. The quotes were taken directly from public records. Poor record keeping can be documented by a trail of emails—or lack of emails. There has been no follow-up, no accountability, no consequences, and no dialogue.

*

The intent of the administration is apparent.  They fear being held accountable and will use every measure available to avoid it…even testing the boundaries of free speech.

Nothing is beneath them.