Unacceptable loss

For years I followed nursing home ratings.

How many complaints had been filed? How many investigations completed? What percentage of those were found to be warranted?

I counted fines and averaged them, dollar/cost style. Divided by the monthly receipts, which were daunting, and came up with an equation that was almost too painful to acknowledge.

Acceptable loss.

For me, it was personal. For a time, my mother resided in the nursing home that currently has the most cases of the novel Coronavirus in Columbia County. It took us years to get her moved.

The thing I remember most about interactions with staff at that first, worst placement, was their instance that problems didn't exist at the facility because management didn't allow them. Problems, they explained, meant people got fired.

I couldn't argue with the logic. It wasn't worth it. All one needs to do in such situations is to lift the rug and locate all the problems that have been swept underneath it.

Of course, the rug is a heavier lift than we had imagined.

Wet garments may have been visible, but the bedsores, weight loss, and dehydration all came to light during subsequent hospitalizations.

Of course, there were no beds elsewhere. There were just complaints and fines and the steady trickle of temporary staff.

Pay a fine, pass the costs, business as usual.

When we finally managed to get her a placement elsewhere, the difference in her care was enormous. She was clean and dry. She was properly fed. She was more alert.

And it all seemed to stem from the administration's admission of problems. They had them, every institution does, but they understood fixing issues as they arise is the best way to minimize harm.

Governor Andrew Cuomo's initial Covid-19 response requiring nursing homes to take patients who tested positive for the virus or whose status was unknown was a costly mistake.

No doubt.

I can only guess that our collective belief that all health facilities are stringently regulated and adhere to a hospital's standard of care factors into how we might expect such a triage could be successful. Medical professionals are, in fact, medical professionals. Only now, with Pandemic pulling back curtains, we can see that some medical facilities might just have a bean counter in the center, shifting the levers. 

Honestly, I did not imagine an infectious disease spreading through the country and burning through healthcare facilities like wildfire would cause some of our "leaders" to ask that we discount the most alarming numbers (like those coming from nursing homes) in an effort to get back to a semblance of normal. 

But here we are.

At what point do we not just shrug our shoulders? At what point are we going to admit that these lives are not -- and never should have been counted as -- an acceptable loss?

Will a pandemic do it?

At what point will we investigate nursing homes and how they are regulated? 

Unsurprisingly, there is plenty of blame and finger-pointing going around right now. Blame is a consistent and effective distraction. But it doesn't usually fix problems. It just weaves a heavier rug to cover them.