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Crazy but our healthcare in US has definitely declined in quality. Even more so since Covid which showed how much we needed more healthcare workers especially skilled nurses but also how understaffed our hospitals are now. Unfortunately instead of taking measures to increase their nurses and improve care - the staffing is even worse these days. Even before this it was bad . I think a lot has to do with insurance - for some reason insurance companies have been allowed to make their own rules which often puts patients at risk. People tell the govt to “keep their hands off our healthcare” but are okay with insurance executives doing the same . “Bean counters” decide your treatment not medical professionals. Avoiding admission benefits the hospital because there are requirements once an admission takes place such as even the room facilities like having a window and a bathroom. Most ERs are not equipped for longer stays - no privacy , lots of noise sometimes always light and no bathroom except one shared. We had a similar situation with my late mom- we brought her to ER suspecting a second stroke, she had recovered nearly 100% after her first. The doctor almost entirely dismissed our concerns blaming moms symptoms on a high calcium level. They told us they would keep her for “observation “ and we thought they were going to watch her closely for a stroke . ( I told them that her left lip looked droopy and her voice was exactly what it had been after her first stroke which was not her usual one) she was also weak and shaky- and even tho a nurse didn’t notice it - her left arm lagged behind her right when she was instructed to raise and lower them. She did acknowledge the lag when I pointed it out and she repeated that. No tests - they told us an mri was not an option since she had a pacemaker put in a few weeks prior - honestly we would have signed consents for it - they wouldn’t even consult doc who put it in at same hospital to check if it was okay. Meanwhile a man across the hall - prolly 30 years younger was being strongly encouraged I have one done with similar symptoms. Anyway - we left Mom after she ate a full dinner and was assisted to the bathroom . Next am my sis arrived to find her slumped in bed with a meal tray but food coming out of her left side of mouth and confused and wild eyed. Her left side not functioning and difficult to swallow - no one had even noticed ! After sis went to hallway shouting for help the nurse voiced that they thought this was her condition since last stroke ! We said - just yesterday she walked and talked just like you and me! Unbelievable ! Her cardiologist was absolutely appalled when he arrived and was flabbergasted that they hadn’t instituted at least a stroke watch ! He was livid ! She had been moved to a room but just for observation due to “weakness”. It was too late for any clot busters. When we got her records later - the er reports had absolutely no mention of our stroke concerns …?!???!!!!!! She never e regained that function. So definitely make some noise- I feel that hospital are sometimes between a rock and a hard place. Don’t blame the docs and nurses tho - go to administration and also do tell them if staff has been doing their best in a bad situation for him. Later also write your representatives and let them know we deserve better and this needs to stop. Good luck - alsoake sure to educate yourself and find a good rehab - we had a nationally recognized one nearby and yet the SW didn’t even include that when giving us a list - but tried to steer towards the hospital affiliated one !
Maybe OP means Observation Department? I believe there, the "patient" can stay a few days without being admitted (personal experience) and still get the same amount of care as if he/she was admitted.
Dlounder: Something is majorly amiss! Any ER does not have the capacity to keep a patient in the Emergency Room/Department for eleven days since they will need the bed for another patient. Your father suffered a stroke. An Emergency Department physician may not have the skill set that a cardiologist would have when the patient is ADMITTED. While certainly the ER physician can administer a tPA shot for the stroke, it is preposterous to hear that your father received below subpar care.
Advocate for your dad. Call down the dogs. All of them - out of their little hidden offices. Get them into the room and show them what's going on. Tell them he needs admission and a room immediately. Document everything that's said. Document their names.
Oh how I wish this were not happening in the US. However, I have seen enough negligence and incompetence in US hospitals to last a lifetime.
I have had nurses and doctors say things to me about my loved ones that are cruel.
I've learned the hard way that hospital patients must have an advocate - if possible, 24 hours a day.
And I have had to lower the boom in order to get a proper room and care.
Two different times a nurse has told me "I'm going to call the doctor", to which I reply - "Good - get 'em in here." Funny, they never did show up but my demands were met.
This isn't a new problem, just more common. Years ago I had to threaten to call the police and have the resident arrested for abuse of a patient. It was amazing how fast we got attention!
Speak with an Elder Law Attorney ASAP. Advise the hospital administration that you are doing so, if you wish. Or first meet with the Elder Law Attorney, get his/ her direction and proceed.
There are many risk factors in this situation, both medical, financial, legal , patient rights, emotional, psychological.
The situation is unacceptable and, you need legal counsel for your father and your best protection.
Go through some of the steps others have suggested (e.g. patient relations; social worker). If you are not getting anywhere, contact a medical malpractice lawyer and have them contact the hospital.
Go to the payment office and raise a ruckus! My dad had a stroke and was taken to emergency then moved to a hospital room for 10 days for tests and procedures. My parents got a bill for $12K, the insurance wouldn't pay since he had not been admitted as a patient. They were private pay, not yet on Medicare.
I would also check with Medicare, if your dad is covered there, and see what their policy is.
Ask for the ADON (Assistant Director of Nursing) to be called. Then demand an explanation. If he cannot be moved to a room immediately. You may have to get loud. That is unacceptable. He is not getting the care he needs in the ER.
Ask to speak to the Risk Management director if the ADON does not satisfy your father's needs.
This is really terrifying. My Mom was admitted to the ER in March and laid in a bed in the hallway for almost 9 hours because they're so understaffed. She wasn't offered any food, I brought her water and finally I did have to start yelling. I am so sorry you're going through this this sounds awful what is happening?
My first move would be to contact your health insurance company. As others have commented, if he is not admitted, I would be concerned that Medicare/other insurance would cover this stay. Next, I would go to the Patient Advocate in the hospital. I would demand to be told why he is still in the ER, and what his patient status is. Is there one physician who is managing his care? Find out who this person is. Take copious notes to document what occurs.
I am retired now and have never worked in a civilian facility. I have never encountered this before. There are such things as "short-stay" units where the patient is kept less than 24 hours. But this far exceeds anything like that.
Ask for copies of ALL the paperwork associated with this emergency stay. And, be sure to get all the MDs names.
I would imagine that the insurance company 'can't' do anything until a medical provider assesses the need for different services/hospitalization as this is what the insurance company would need / rely on - ask for - (although I do not know how these procedures work).
After this is resolved ... I would write a letter outlining the situation to your Board of Supervisors, mayor, and governor. They all need to know what is going on and address the issue - understand how things like this happen - and explain why. Someone needs to be held accountable.
Same thing happened with my 94-year old mom in Edmonds, WA. My brother and I were with her in the ER round the clock, talking with the doctors, nurses, patient advocate, anyone we could snag. (The social worker actively avoided us for two days.) This involves a Medicare maze of approval and payment, which I only partly understand. In order to qualify for Medicare-funded rehab, she had to have a 3-day "admitted" hospital stay, which the hospital was reluctant to commit to (short-staffed, plus a renewed Covid outbreak that kept more staff at home and shut down a wing). (Hospital can treat you, even give you a bed, without officially "admitting" you.) She had fractured multiple bones in her pelvis, lower back, and hand (but nothing operable - all just fractures that had to heal on their own). Without rehab she was going to be totally bedridden. She was in the ER for just 2 1/2 days (felt longer!) and they did try hard to make her comfortable, but it was a terrible time, and of course she was in a lot of pain. Finally did get officially admitted, then stayed another couple of days, for a total of about 5 or 6 nights, which qualified her for admission to a rehab facility.
Best thing you can do: rally everyone you know, everyone who can support you, to take shifts and be with that patient at all times. Make friends with the nurses and doctors. Learn where to go for water, towels, pillows, whatever your person needs. Be a friendly nuisance.
Ask To speak with a case Manager or social worker. Sounds Like he is being Care for . I know when My Dad was admitted he was in Intensive care unit for 4 days after His stroke to check on his brain Bleed .
Just got some calls from staff at two hospitals in Arizona and one in Utah. Yep .... it's happening. They are so short on staff and beds that they often have to keep patients in the ER ............. for days! You need to check with the doctor and social worker to find out if your Dad has been officially admitted (they can still keep him in the ER even if he is admitted). That's the key because without the admission insurance may not pay all of hospital bill and Medicare certainly will not pay for any needed rehab. Good luck!
My mom, in the US, went to the hospital and remained in the ER for her entire stay. Like 8 days. When I questioned the nurse, she said that they were short staffed everywhere in the hospital and had to keep her in the ER to ensure she received the care she needed.
So it does happen.
The problem here is, no admission means no rehab and that is not okay with a stroke.
Dlounder, you need to advocate for your dad and find out what the real story is, then act like an angry momma bear if they are screwing him around.
Best of luck with getting your dad the care he needs.
This is unheard of in the US. Your father is more than 11 days in the ER and he was not admitted? Something is definitely wrong here. You need to ask the ER doctor about this.
What?! No ER I have ever heard of will keep you 11 days without admitting you. They need that bed for emergencies. That sounds insane. Are you in a very rural area with a small hospital or something?
At times, they keep patients in the ER if there are no beds in Step Down ICU because they can be monitored closer than if in a regular room. They did this for my husband. The key question in any of this, has he been officially admitted which can happen even without being in a room.
This IS also happening in the US with all the short staffing and heavy case loads. Sad as it is, at least it is better than still being in the waiting room which many others are dealing with.
HI - there's a dept in hospitals for you to file a patient complaint and ask to be connected to the Director- you need to speak to the head of social work there as well as the hospital administrator. You need to make yourself known - and state that this is a HUGE risk and liability to the hospital for mishandling your father - it's negligence. And, if you are able to, be present there, if you live near your father.
Today you need to push hard however you can - seriously (even if you state that this type of neglect should be brought to the media). No hospital wants negative exposure. Explain that your father is declining and the hospital is liable and held responsible. It is totally unacceptable. It's also impossible to sleep while being in an ER and being exposed to other illnesses, like Covid. You need to be your father's voice and advocate - be very assertive and forceful. I've had to do this for my father prior after the hospital kept him in the ER for 2 days - claiming it was a trauma center and the rooms were filled. If there's a better hospital to transport your father to, the hospital needs to take care of this in advance to ensure that he would receive a room asap.
Your dad is in the ER--as is, he's still in the 'acute' part of the ER where they bring you for assessment initially?
This sounds bizarre and awful, both.
The average ER stay is 4-6 hrs, and then a decision is usually reached to either admit or release to home. I can't fathom being in the ER for 11 day? They're just not set up to do long term care!
Contact hospital accreditation committee, which is JCAHO (Joint Commission Hospital Accreditation) The Joint Commission https://www.jointcommission.org/ and www.jointcommission.org/contact-us emergently. Call the hospital social worker in and tell them you will be seeking to remove hospital licensure if this isn't handled at once. Tell them you know about JCAHO, and that they will be in danger of losing their licensure by the State and Federal Government for this behavior.
I would think this is Medical abuse, malpractice comes to mind. Is he being treated? Is he being cared for? I am not a litigious person by any means but this is screaming for a lawyer. That said have they given you a reason that he has not been admitted? Have you talked to a Patient advocate, Social Worker to find out why he is being treated (not being treated) the way he is?
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Did you contact a lawyer?
We had a similar situation with my late mom- we brought her to ER suspecting a second stroke, she had recovered nearly 100% after her first. The doctor almost entirely dismissed our concerns blaming moms symptoms on a high calcium level. They told us they would keep her for “observation “ and we thought they were going to watch her closely for a stroke . ( I told them that her left lip looked droopy and her voice was exactly what it had been after her first stroke which was not her usual one) she was also weak and shaky- and even tho a nurse didn’t notice it - her left arm lagged behind her right when she was instructed to raise and lower them. She did acknowledge the lag when I pointed it out and she repeated that. No tests - they told us an mri was not an option since
she had a pacemaker put in a
few weeks prior -
honestly we would have signed consents for it - they wouldn’t even consult doc who put it in at same hospital to check if it was okay. Meanwhile a man across the hall -
prolly 30
years younger was being strongly encouraged I have one done with similar symptoms. Anyway - we left Mom after she ate a full dinner and was assisted to the bathroom . Next am my sis arrived to find her slumped in bed with a meal tray but food coming out of her left side of mouth and confused and wild eyed. Her left side not functioning and difficult to swallow - no one had even noticed ! After sis went to hallway shouting for help the nurse voiced that they thought this was her condition since last stroke ! We said - just yesterday she walked and talked just like you and me! Unbelievable ! Her cardiologist was absolutely appalled when he arrived and was flabbergasted that they hadn’t instituted at least a stroke watch ! He was livid ! She had been moved to a room but just for observation due to “weakness”. It was too late for any clot busters. When we got her records later - the er reports had absolutely no mention of our stroke concerns …?!???!!!!!! She never e regained that function.
So definitely make
some noise- I feel that hospital are sometimes between a rock and a hard place. Don’t blame the docs and nurses tho - go
to administration and also do
tell them if staff has been doing their best in a bad situation for him. Later also write your representatives and let
them know we deserve better and this needs to stop. Good luck - alsoake
sure to educate yourself and find a good rehab - we had a nationally recognized one nearby and yet the SW didn’t even include that when giving us a list - but tried to
steer towards the hospital affiliated one !
Oh how I wish this were not happening in the US. However, I have seen enough negligence and incompetence in US hospitals to last a lifetime.
I have had nurses and doctors say things to me about my loved ones that are cruel.
I've learned the hard way that hospital patients must have an advocate - if possible, 24 hours a day.
And I have had to lower the boom in order to get a proper room and care.
Two different times a nurse has told me "I'm going to call the doctor", to which I reply - "Good - get 'em in here." Funny, they never did show up but my demands were met.
Peace.
There are many risk factors in this situation, both medical, financial, legal , patient rights, emotional, psychological.
The situation is unacceptable and, you need legal counsel for your father and your best protection.
I would also check with Medicare, if your dad is covered there, and see what their policy is.
Ask to speak to the Risk Management director if the ADON does not satisfy your father's needs.
(copy and paste)
https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud#:~:text=Report%20Health%20Care%20Fraud,contact%20your%20health%20insurance%20provider.
I am retired now and have never worked in a civilian facility. I have never encountered this before. There are such things as "short-stay" units where the patient is kept less than 24 hours. But this far exceeds anything like that.
I would imagine that the insurance company 'can't' do anything until a medical provider assesses the need for different services/hospitalization as this is what the insurance company would need / rely on - ask for - (although I do not know how these procedures work).
After this is resolved ... I would write a letter outlining the situation to your Board of Supervisors, mayor, and governor. They all need to know what is going on and address the issue - understand how things like this happen - and explain why. Someone needs to be held accountable.
Gena / Touch Matters
Best thing you can do: rally everyone you know, everyone who can support you, to take shifts and be with that patient at all times. Make friends with the nurses and doctors. Learn where to go for water, towels, pillows, whatever your person needs. Be a friendly nuisance.
Good luck!
So it does happen.
The problem here is, no admission means no rehab and that is not okay with a stroke.
Dlounder, you need to advocate for your dad and find out what the real story is, then act like an angry momma bear if they are screwing him around.
Best of luck with getting your dad the care he needs.
I have had nurses and doctors say things to me about my loved ones that are cruel.
And I have had to lower the boom in order to get a proper room and care.
Today you need to push hard however you can - seriously (even if you state that this type of neglect should be brought to the media). No hospital wants negative exposure. Explain that your father is declining and the hospital is liable and held responsible. It is totally unacceptable. It's also impossible to sleep while being in an ER and being exposed to other illnesses, like Covid. You need to be your father's voice and advocate - be very assertive and forceful. I've had to do this for my father prior after the hospital kept him in the ER for 2 days - claiming it was a trauma center and the rooms were filled. If there's a better hospital to transport your father to, the hospital needs to take care of this in advance to ensure that he would receive a room asap.
Wishing you the best of luck ~
Your dad is in the ER--as is, he's still in the 'acute' part of the ER where they bring you for assessment initially?
This sounds bizarre and awful, both.
The average ER stay is 4-6 hrs, and then a decision is usually reached to either admit or release to home. I can't fathom being in the ER for 11 day? They're just not set up to do long term care!
The Joint Commission
https://www.jointcommission.org/
and www.jointcommission.org/contact-us
emergently.
Call the hospital social worker in and tell them you will be seeking to remove hospital licensure if this isn't handled at once. Tell them you know about JCAHO, and that they will be in danger of losing their licensure by the State and Federal Government for this behavior.
Is he being treated?
Is he being cared for?
I am not a litigious person by any means but this is screaming for a lawyer.
That said have they given you a reason that he has not been admitted?
Have you talked to a Patient advocate, Social Worker to find out why he is being treated (not being treated) the way he is?
If they don't have the wherewithal to treat him, they should transfer him to a hospital with a stroke center.