I had to demand that he get an air mattress also he’s supposed to be repositioned every two hours but that’s not happening, that’s how he got the bedsore in the first place. Anyway the nursing home took the air mattress away from him without telling me! I noticed it was gone on one of my visits, the nursing home said it was because his bed sore is better. My question is did his Medicaid or Medicare pay for the air mattress and how can I find out? Because if Medicaid or Medicare paid for it, then I want it put back on his bed...

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As POA, you have access to his insurance statements, yes? What is indicated on them?

It would appear that your brother requires an alternating pressure mattress for PREVENTION of bedsores.

When was your last care meeting? Ask for another one, immediately. In the meantime, call the Director of Nursing and ask what the plan is for prevention of bedsores and why the mattress was removed.

If you are not getting satisfactory answers, or care, call the Ombudsman.
Helpful Answer (17)

When you say the NH said they took his alternating pressure air mattress away "because his bed sore is better"....

I'm just trying to visualise the scene. You got this explanation from a member of staff face to face? Or somebody said that somebody said...? Or, somebody was trying to think of a reason why, maybe, could have been..?

The reason I ask, is that this is such an absurd, idiotic, inane statement I can't imagine how your response wasn't "are you out of your minds? Put it back. Now! Morons." So I have to assume that this was more of a rumour you heard from, maybe one of the aides, a person who clearly wasn't able to do anything about the situation; rather than an explanation given by a person in authority during a purposeful conversation about your brother's care.

In addition to looking at who funded the mattress, you also want to track down who prescribed it and ask that person whether he or she is aware that the mattress has been removed. If that person is aware, and indeed gave further instructions that it was no longer required, then that person had better be able to justify the reasoning. I would be fascinated to hear what it is.

But if your brother's physical needs include repositioning every two hours, then an alternating pressure air bed is so obviously essential that I think it's more likely that something else happened - a complaint (perhaps even from your brother?) about the noise, damage to the mattress itself which meant that it has to be replaced, failure to clean it properly so that it began to smell; something like that. These mattresses are supposed to be supplied with spare covers so that they can be routinely changed and laundered at high temperatures, because wiping them down is not enough and they pong to high Heaven; but I happen to know that getting *hold* of the spare covers is a labour of love, pig-headedness and several hours on the telephone. The maintenance instructions are right there in the user's manual, but you may begin to suspect you are the only person who has ever read them.

I would raise Cain over this. Good luck to you, please let us know how you get on with getting it back.
Helpful Answer (14)

Just because a bedsore is "BETTER", does not mean that the person does not need the air mattress. Anyone with a bedsore or who has a tendency for developing bedsores should have some type of alternating air mattress or the main mattress on the bed should be one that was specially built in such a way to minimize bedsores.

Follow Barb's advice and ask for the air mattress to be put back on the bed. If the nurse working on the unit will not put one on the bed, ask to see the doctor's order for the air mattress and the policy regarding air mattresses. Also ask if the facility has a "Wound Care Nurse" and if that person has seen your brother's bedsore.

Some large nursing homes (150+ beds) have "Unit Nurse Managers" who are in charge of a floor or hallway or unit. Talk to them first as they know more about what is going on with your brother then the Director of Nursing (who is more of a Chief Operating Officer of the nurses).

Also ask that for a Care Conference meeting as soon as possible so that you can discuss your brother's care. (Your brother should have a Care Conference every 3 months while in the nursing home.) Someone from Nursing, Dietary, Social Services and Activities should be at the meeting. If your brother is coherent and understands what is going and can get up in a wheelchair then he should attend the Care Conference also.

Superman (Christopher Reeve) died because the bedsore that he had on his coccyx became infected.
Helpful Answer (10)

Stage 4 bedsores are life threatening due to infections and actually requires a surgical consult for debridement and treatment--bedsores are considered preventable and can involve lawsuit. You most likely need to get your brother hospitalized for treatment. Let me emphasize just how serious a Stage 4 bedsore is life threatening.  You really need to report this as nursing home abuse--look up the toll free number on the Internet and do it *now*.
Helpful Answer (7)

You wrote that you have proxy authority for your brother. Would this be for legal/financial or for medical issues? If the latter, contact Medicare and ask if they'll accept a copy of the document. They may want their own form completed.

If so, get one, have your brother complete it, and you can in the future just contact Medicare directly to get information.

In the meantime, you've already gotten good information on following up.
Helpful Answer (4)

My daughter was an admitting RN. There are certain things she looks for when she examines a new resident. Bedsores of course can be seen. But she looks for pressure points. These mean that bedsores, blisters are eminent. She immediately orders an air mattress. When my Dad was in rehab my Mom remarked about the blisters on his heals that he got there. Dad was a diabetic. My daughter came in an looked at the blisters. There was already dead tissue. She read his chart and it mentioned pressure points upon admitting. She marched out to the DON and told her an air mattress should have been ordered the first day he was there. That they better take care of that wound, blah, blah, blah.
So, I would want a good reason why they removed the mattress. If you get nowhere with the head nurse ask to speak to the doctor who ordered the mattress.
Helpful Answer (4)

Get your brother to the hospital...NOW! Stage 4 is life threatening bedsore. Call 911 -- do it!
Helpful Answer (3)

Wasn't fire retardant, Citygirl, or just didn't have the right label saying it was, I wonder?

It might be worth ringing round a few suppliers and asking them to check their stock. I'd be surprised if you can't find one that complies with fire safety requirements.
Helpful Answer (3)

Please take the advice of all these good answers.
My wife had a stage 5 (unstageable) on her coccyx where the infection tunneled to the tail bone causing osteomylitis. This thing was the size of a softball after it was opened up and cleaned out. Took 9 months to heal with daily intervention for debridement use of a wound vac (awesome tool for wound care) and IV antibiotics. This "healed" area is more susceptible to future breakdown which is why she will ALWAYS continue to use a pressure relief mattress. A stage 5 is nothing but a stage 4 that they do not know the depth and needs serious attention!!
Helpful Answer (3)

Call either insurance company while in brother's presence as they can accept a verbal OK to talk to you. Now ask them. Next, ask them to send you their form on POA as many insurance companies will not accept your version, they have their own. This way you can freely discuss your brother's matters. Good Luck.
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