I didn't meant to sound harsh and in re-reading my post and I can see where I did...so I'm sorry. In my nursing home..yes...we all accommodate tours at all times...pop-ins and all...but I also can't tell you how many times people have dropped in and demanded a tour right away...sometimes this does a dis-service to the tour-ee. In other words, if a member of the admissions department or social work department aren't available they are accommodated by members of different departments who often aren't able to answer the questions they may have nor give them any advice. They can end up walking away with incomplete information which can be quite frustrating. It is a fact of life, however, and we (meanng Nursing Home staff) are used to it but it can be a bit frustrating for us sometimes. In a perfect world everyone would make an appointment...but it certainly isn't a perfect world so that's ok. As for the discharge planner giving you that advice...it's common practice. And again, that's ok, too...it says to do that in all of the literature on "how to pick a nursing home", etc. but it's still, in my opinion, not necessarily the best way to go. And although you raise very good points, Fairegold I still strongly disagree about having individuals tour independently without escort. It's a HIPPA issue...a security issue...and a dignity issue. If your loved one was living in a nursing home would you want some crazy person wandering around un-escorted? You never know who can wander in looking around. And although I agree residents LOVE visitors it is the nursing home's responsibility to maintain their safety, privacy, and dignity. A tour can say hello and even stop and chat all they want...they just better have a staff member with them! I stand firm on that issue. Adrienne

Kath, I just don't understand how anyone could be rude to any VA employee. I'm so grateful for the great care Harry gets at our VA. I truly believe he wouldn't be here today without the outstanding care he receives there. Some patients don't even have to pay a dime for the care or their meds. We do, but it's nominal considering what it would cost anyplace else. I'm so, so very grateful for you nurses, doctors and PA's. Harry's been in and out of the hospital (not lately, knock on wood) and I try to take time to make the nurses a batch of cookies when I go visit him. Sure hate it that you were treated so rudely--and for no reason!

Having worked in a long-term care facility for several years, I must toss out my impression of lawyers who specialize in nursing home 'problems'. Please read on. Each facility has a medical director as mandated by law. There are some who are in the building regularly and know most of the residents; and then there are those who come in regularly and know only their residents. The second way is the usual way. If a doctor has a decent practice, then that MD doesn't have the time to spend in the facility poking around at charts and stuff. Where I worked, there were three nurse practitioners in the facility 5 days a week and those health care providers did all the quality day-to-day things, including the tapering of psych drugs (also mandated by the federal government and it is tracked by the nursing office and the consulting pharmacist in every Medicare certified facility). In the nursing home where I worked, there were about 200 long-term and short-term (rehab only) people. There was 9 physicians who were following those patients. Most of those 9 came in, but 2 would not come to the facility because of their busy office practice; their patients had to get to the doctor's office. Each doctor (or NP or PA - in states where they are allowed to write prescriptions) are responsible for only their patients and cannot address day-to-day issues for other people. For folks who are in a long-term-care facility and they are Medicare, then the government mandates that they be seen by a physician every 60 days. That's the law. Folks who are recent admissions or are there after a hospital stay will generally be seen more often. That is also the case with government mandated Care Plan Meetings. Those take place every quarter. Any nursing home has nurses who are there all the time, just like the nursing assistants (who do most of the grunt work) are there all the time. If they were not there, then they would have never been certified by the Public Health Department of the state. Those attorneys who claim that they are specializing in Nursing Home problems (med errors, falls, inappropriate diets, pressure ulcers, etc.) and what they represent are the equivalent of ambulance chasers. They are seeking clients who are upset with the perceived care that their loved one gets. If you really want to find out about what happens, then talk to the family members of someone who lives in the nursing home. Talk to some of the employees of the nursing home. If they have legitimate complaints, you will hear them. And remember that a nursing home is not the same as assisted living. If you aren't aware, then find out. There are not 'retirement homes' for elders. They are there because they multiple chronic medical conditions whose needs cannot be met any other place. One is in a nursing home because that is the most appropriate place for the person to be. Jim

My mother had purchased her interment site decades ago - in her hometown, where she hadn't lived for the decades since. She had also picked out a dress to be buried in, and had shown it to me several times in the years before her final illness. She was in a nursing home in my town, 115 miles away, with hospice. The nursing home (or hospice, I don't recall which) arranged for her remains to be picked up by a local mortuary after death was declared. I arranged the funeral with the funeral home in her hometown, that had been used by my family many times. They arranged to have the body transported to them, handled all of the paperwork (including obtaining the death certificate from my county), and placed the obit that I wrote in the local paper. 3 of my 4 siblings, my aunt and her best friend, and 2 of 5 my nieces came to the small service that we had in a parlor of the funeral home. There was no one else who knew or were friends with her (and I had no friends that I had remained in contact with) left in town. My niece's husband (they lived locally) arranged for the chaplain from his work to give a little homily and lead prayer; I found a musician to play 3-4 of her favorite hymns on guitar. Then all we went to the interment at the cemetery. One of my SILs arranged with someone she knew to prepare and serve a casual lunch in a facility at the cemetery for us. BTW, that was the only family member who did anything - the others never even offered - to arrange or help pay for it all. Mom didn't have any insurance benefit or funds left to help pay. ETA: I did all this really out of respect for my elderly aunt - that it pleased my sister and 2 of her daughters was nice but really not a consideration. My brothers wouldn't have minded either way, but I was glad that the oldest drove up from Tennessee - I hadn't seen him in many years, and probably never will again - I was 7 when he left home at the age of 18 and we were never close as adults. At the time it was rather a stretch for my finances. So, I did negotiate with the funeral home about the charges; in fact, I declined their caskets and found a company that sold and delivered lovely caskets in Cincinnati at a much lower cost.