Perception versus Reality

Did my eyes deceive me?  Was Mom receiving good quality medical care in her facility?

What exactly is "good quality" medical care?  

What are the standards, who creates them, who oversees them and who enforces the standards?

Standards are set by individual States. They must adhere to Federal Standards and Regulations. These are broad and open to interpretation and if you read them, you'll see what I mean.

Why are they so broad?  Good question.  Could it be money for the programs flows (some would say trickles) down from the Federal Level to the States and as it moves through channels there's a "loss" due to Administrative and other costs generated through this passage.

How many people are employed within the Senior Services Sector administering programs through Federal and State departments?

How many of these actually have any contact directly with the people they are supposed to be "serving"?

What are their job requirements for their positions?
Usually minimal. Some not requiring a college degree much less one in a specialized area.

What authority do any of them have directly to take or cause action to be made when violations are suspected?
Very little. READ YOUR STATE'S STATUTES and their Rules and Regulations for the actual content. 

Look closely and you'll see a very wide berth of "interpretation" is given and when violations are found -- well, try to find out what the consequences are. If you can find this "hidden" information, let me know -- I'm still looking.

THE DHSS IS THE BOTTOM LINE.  That's each State's Department of Health and (according to where you are) Social Services or Senior Services.

In Missouri, there are one/two mandated yearly "inspections". They're supposed to be "unknown" but it's guaranteed someone at the facility is usually aware of the upcoming "visit" and many coincide with the anniversary of their yearly recertification so within a month a facility is aware of this visit.

What about the general public, you and me?  Do we receive any notice of this visit so that we can meet with a representative and voice our concerns?

NO.  Only once at three facilities have I ever seen a posting of the DHSS being "on site" and available for friends and family of residents and even the general public to meet with them.

WHY NOT?  Are these "inspections" similar to the health inspections at many restaurants where it's "in and out" and "who you know" that gets a rating?

WHAT ARE THE RULES? THE REGULATIONS? What are the questions asked, the specific details of the requirements in the areas the DHSS investigates?

We can't see clearly because information is not transparent and readily available.  Why not?  Well, if we truly saw and understood the conditions that are tolerated, overlooked and set aside in Long Term Care Facilities due most probably out of a fear that closing one means fewer places for those who need them, we would be picketing in the streets.

ALAS, we continue to "park" our parents and grandparents, aunts and uncles and tell them "we'll see you again soon" and "have a nice day".  

What if they don't? 

Who really cares enough to do something -- night or day, weekday or weeknight? 

In Missouri, and possibly your state, no one. 

Perception -- seeing their world through rose colored glasses-- the way you want it to be.

Reality -- clear lenses magnifying the view to show the reality of neglect that grows in many cases to be abuse; unrecognized and untended because there isn't enough vigilance and transparency to ensure safety and well being.