My mom's place used to have an LVN and new ownership took over and now there's just a med tech on staff. My mom has long term care insurance and I would have thought if they're paying there would be a requirement of a nurse on staff. There was recently a medication mistake with my mom who has advanced dementia. Caregivers gave mom milk of magnesia for a week daily, instead of as needed for constipation. She had gushing diarrhea for a week and didn't tell me until the week was over. They told me about her bleeding rectally, but come to find out, it was caused by the gushing diarrhea and she had to be double diapered for a week, and diarrhea, etc was spilling out of that. I told them to stop the milk of magnesia and she was better the next day (no more diarrhea or bleeding). I complained to the owner, but I was told there is only a med tech on staff. I recommended having at least an LVN on premises. There is only an off-site RN to talk with over the phone in cases like this.
Is a med tech only on staff normal? Obviously the med tech did not dispense the medication properly.
I went through some of your old postings & your mom has a healthcare plan that is pretty involved….. dementia is kinda at a 5, incontinent, cannot transfer on her own for toilet or bathing, has fallen, has a pessary (which you take her to an outside MD appointment for it), and on the Purewick system. Socially your mom had “happy hands” (taking things from others) and that was dealt with by her being in a private room…. but realize this is in her chart which new owners can review.
Payment wise she’s 2K for life via a LTC insurance policy plus $ from annuities, house sale $ and the usual SSA income. Right? So the MC knows she can move to a NH/SNF and has $ to pay for it. And they also know there is a son who came in-state to visit who took her and paid caregivers out to a $$$ Airbnb in the desert for a “outing”. There’s $ & resources, so MC can safely tell you she needs a higher level of care of her staying there becomes bothersome for them.
The only issue - which I imagine they don’t know about - that could happen would be if she ever ran out of nonLTc insurance $ so would need to file for LTC Medicaid, is might be gifting issues with $ mom gave to out of state son if the time period is in the lookback period.
Any MC who uses an internal telemed approach to staffing for basic nursing oversight is going to want to do things and provide all services as low cost as legally feasible and have residents who are as easy care as possible. That is not your mom. And she now does not have owners who have known her and you for years and gone through Covid times together to want to do best for her.
You might want to proactively quietly be looking for a SNF for her.
This is for discussion now with the admin of your loved one's facility of course, as we cannot be privy to the details.
Back couple years ago, when the mom appeared to be quite ill, the OP took her it seems to an UrgiCare where she was dx’d with pneumonia, got RXs which then the staff administered to her mom. Seems to be outside doctors for care. It’s not coming from an on staff MD or even a PA or NP at the place who does bedsides. (No shade meant to PAs & NPs).
An AL is not skilled nursing. A nurse can recommend but a doctor gives the order. Even then, your mother should not have been allowed to have gushing diarrhea for a week. If she did not replace the water lost, she could have dehydrated herself. You had the right to take her to her own PCP.
I would hope that if my mother had gushing diarrhea for over two days the RN would recommend she be taken to her doctor.