COVID19 4/17/2020 EMS Conference call summary

[TriGuy]

In a very sad way this explains why the skilled nursing homes are the outbreak epicenters and it Validates what those of us in the field have been saying for years.

The staff at skilled nursing facilities are the folks that no one else will hire. They have a lack of knowledge and skills and due to low pay no followup training, low staffing and as a result general apathy.

It Alameda County 65% of the hospitalizations and 50% of the deaths for COVID 19 are from these facilities. Public Health and EMS went in and found a complete lack of accountability in patient tracking, Infectious disease control, proper sanitation and PPE use at the vast majority of locations. Staff members would go from one room to another without changing PPE. In other words taking the infection from one resident to another. In some instances even though every resident had been tested for covid no one in administration told the staff who they were. Total Cluster Eff. Public Heath and EMS are embedding folks to train and enforce proper procedures.

I have a strong suspicion that the situation is similar all around the USA. DO NOT let anyone put you in one of those hell holes for post surgical or physical rehab ever...

[Mike]

Several years ago my wife had a major back surgery and was transferred to a hell hole for rehab afterward. We arrived around 8PM one evening and were placed in a room with no A/C. It was damned hot! I immediately said this is not going to work and was told the repairman could not get the part because it was Thanksgiving day. I told them to find a different room and after about thirty minutes they did.

That was just the beginning of the nightmare there. After 2 days I told them we were going home and to do whatever they had to do to check us out. I also called the doctor and told him what was going on at the place. He said we could do home rehab if insurance would pay. So, I called the insurance company and told them how bad the facility was and they agreed to pay for home care. I'll bet it was cheaper anyway.

Ben, you know of the place, it was where Marc was staying before he passed.

[Dave Grubb]

Back in the latter 70's the State of PA passed a law which required all nursing homes to be sprinklered. We had an ongoing relationship with a sprinkler company and did all their outside work. For ones with public water available, the time on site was a matter of days to extend the service into the building. Many, however, were on wells, in which case we had to construct a building with a large pressure tank and booster pumps. The largest required stand pipes or water towers. The net result of that was that we would be onsite for those projects for extended periods and we got to know both the managers and some of the clients. They seemed to fit into two groups, either very nice and client centered or absolute jerks who at times would actively deprive the clients from any enjoyment.

One example of each:

There was an old gentleman that would pull himself (in his wheel chair) up to the window to watch us---and we got to know him and would often talk to him through the open window. One morning a worker of unknown status came in, saw what was going on, closed the blinds and walked out. The old man was unable to open the blind on his own. I took out my pocket knife, cut a hole in the screen and opened the blind to a grand smile on the old fellows face! That same place had an odor when you walked through the door. The lobby was a big open rotunda and they would wheel patients out there in their wheel chairs---tied in place with sheets and leave them for hours, many half falling out of their chairs.

The other---I developed a good rapport with the head nurse. She would come out on Monday mornings and ask me what we would be dong that week---and of course I answered as best I could. This installation was one that required a full pressurized system to be added. Where we used large pressure tanks they would have to be installed prior to the roof going on--and commonly before we took the walls up. The day we poured the tank supports and saddles, which we were pumping, the staff began wheeling out patient after patient---all dressed for the chill in the air. I found out they had asked if anyone wanted to go out and watch the pour and this was our "audience"---we all thought it was great. About two weeks latter we set the tank, with two cranes---and our audience was back out cheering us on I need to add that nursing home had no foul odor.

All that to say---like everything else there are good and not so good---but sadly I have to say in my somewhat limited experience more were of the not so good kind.

[Truckman]

Ben, you know of the place, it was where Marc was staying before he passed.

Yes I remember it, but I can't recall its condition...I will studiously avoid all nursing homes no matter what they call them, just as my Mom did...Fortunately for all concerned, we found out about hospice care at home in her final months...She got the finest care available, and Medicare covered 100% of the cost including doctors, home visits by nurses, all prescribed drugs, a hospital bed, walker, wheel chair and oxygen generator...She declined the food because my nephew who lived next door brought it to her everyday...They would have paid for a housekeeper, but that was unnecessary,,,Another nurse came in every other day to bathe her, fix her hair, etc...We were thankful......Ben

[Honda]

I hear these sad stories all too often. When my Dad had to go to a nursing home I was lucky enough to get him in our local VA nursing home. The place was literally like the Ritz Carlton. Professionally staffed, eat off the floor clean and very compassionate and professional staff.