HOW THE US COMMUNITY VIEWS CORPORATE NURSING HOMES

Families and communities across the USA are up in arms because of the neglect of their parents in corporate nursing homes.  They have formed groups to press for reform of the system.  They have identified the close links between politicians and nursing home owners as the prime reason why corporate nursing homes are not prosecuted and put out of business.  Regulatory authorities have failed dismally and the community are angry.  They have taken to the courts in large numbers.  Those who advocate for a market system in Australia should understand how those at the receiving end experience such a system.

The relationship between politicians and nursing home corporations in California is particularly obvious and has been exposed on national television.
 
One of the speakers at a meeting in California was a woman by the name of Janice Caldwell, who is the Director of HCFA for California.  The audience, families and lawyers who represented victims of the system were horrified at her statements.  Her statements were circulated on the internet and letters were written to her calling on her to resign.  These express the anger, which exists at the coalface - the real living experience when citizen's parents are confined in corporate homes.  Here is an account of what happened.

Referring to Janet Caldwell:-

I am going to try and quote her words as close as possible:  "We should not be increasing enforcement in California.  The indications are that DHS (our nursing home oversight system)  is doing it's job.  They are finding 30% of the complaints filed,  valid, which is much higher than in other states, so therefore we have strict enough laws."  An attorney, Mr. Thomas, yelled from the back of the room,  "That's Baloney".  A family member spoke up saying,  "Until you have gone into one of these nursing homes to see your mother, then gone into the bathroom, closed the door and cried your eyes out because of the condition your mother is in, you don't know what your talking about." Others spoke out also. One Ombudsman, was very effective in what she had to say. The Director of the Nursing Home Reform Advocate Group that sponsored this gathering, spoke right after Janice Caldwell, she did not address or speak against what Caldwell had said. 
 
Caldwell also stated, "She is tired of seeing all the hidden camera coverage of nursing homes on TV, ."

The writer had worked with Senator Grassley and the Senate Commission on Aging and quoted this statement by Grassley:  "At HCFA, we have cut off their branches, we have cut off their limbs but their trunk is still rotten."  
 
To the families of nursing home patients this was rather like denying the holocaust.   Ms Caldwell was flooded with angry emails calling for her to resign and these were widely circulated.  Some of these emails are included below.  They reflect the genuine anger and revulsion which decent people experience when they look at what has happened in corporate nursing homes.  They are unedited and in the order I received them.

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Janice, this is Sam Perlin from Houston.  I heard about your visit to a group in California and was shocked to realize that you are an apologist for the nursing home industry--still.  I realize you have to make a living, need a job, and sometimes one sells their soul to the devil to survive.  You and I have had many discussions about nursing home care when you were in charge of DHS here in Texas.  I was critical of your lack of enforcement for better care and gave you the benefit of the doubt that you cared but the political climate was holding you back.  The political climate at HCFA is no better and probably worse than in Texas.  I have been writing and talking about HCFA corruption and collusion with the nursing home industry for a long time and your remarks in California confirm my observations. I'm disappointed because  you are in a position to make some changes for the better; instead you are denying the obvious factual reports that nursing homes desperately need to adhere to the laws and regulations by government oversight and enforcement.

April 9, 2000
If this is the same Janice Caldwell that was fired from her job here in Austin, Texas; she should be "drummed out of HCFA & California"!!!!!!  This woman appeared to work for the nursing home industry  in Texas and did nothing to prevent my mother's ouster from a local nursing home here in Austin, Texas on April 30, 1992!!!  That Janice Caldwell is a traitor and has always been such.  Let's get rid of the scum-bag!!!!!!
Sincerely,
Marie B. Wisdom (Texas Advocates For Nursing Home Reform)
Austin, Texas
 
Dear Janice Caldwell,
My name is Mary Adams and I use to work for the Department of Health Services, so I know what really goes on.   You said that 30% of the complaints were found valid by DHS,  but what you failed to say, was over half of that 30% found valid, is dismissed through appeals.  You also failed to say that when your group reviews the citations you at HCFA dismiss half of  that 15% and then only half of the fines that are left, are ever collected.  That's some record.  How can any of you in this system state you are a deterrent to nursing home abuse and neglect?  You are the reason for the horrible care in these nursing homes.  If you and your entire group resigned, there would be no difference in the level of care, in fact it may improve.  Do us a favor and resign.
Mary Adams
San Diego
 
Ms. Caldwell,
We are families who have had residents in California nursing homes for many years.  We came to the California Advocates for Nursing Home Reform (CANHR)  conference in San Jose April 8th, 2000, well informed about what is now happening to residents in California nursing homes because we are in California nursing homes every day.  I came with pictures of horrendous injuries my Mother suffered in a Federally funded Walnut Creek nursing home to show you the level of care with which California DHS supervisors and administrators find no problem and take no enforcement action.

Listening to you describe how sick you are of seeing pictures of the conditions in California nursing homes on the news, and hearing you preach for public tolerance of these conditions, made me a little sick as well.  I realized that you aren't a part of a solution to what is happening in California nursing homes, you are a part of the problem.  From Texas families we now hear that this isn't the first time you have been a part of the problem, we hear of the misery that surrounded you and went uncorrected in Texas nursing homes while you were there.

Ms. Caldwell, would you please find something else to do.  Our Mothers and Fathers deserve someone of compassion in HCFA, someone who is willing and unwavering in her determination to use her office to the best of her ability to protect and to help our elderly and disabled live a civilized existence in California nursing homes.  I sincerely hope that in the beginning you were that person, today you obviously are not and from Texas we hear you have not been for some time.  Please resign your position.
August Kugler
Walnut Creek
 
Dear All:
Janice worked for Dr. Bernstein---the drunken bastard.  Senator Chet Brooks was another one of the corrupt team. (He) went on to be a lobbyist for the industry after he left office.  He should be about the age to be in a nursing home about now. Jerry Patterson ran against him and won.  I still say what goes around comes around.  These people are going to pay for all the harm they caused our elderly and the harm they caused the families who lost love ones and begged for help. 
(Anonymous)

April 10, 2000
Dear HCFA  (AHCA) Representative Janice Caldwell:
 After your words of wisdom at the Family Council Forum on April 8, 2000---I am urging you to tender your resignation.  Your resignation will save many of us much time and effort in petitioning all of our Congressional, Senate and Assembly Representatives asking for you to be removed from your position.  Your reputation has preceded you and after learning you were fired from your job in Texas, it boggles my mind how you could possibly slither your way into another position dealing with our helpless elderly.  I hold you personally responsible for the criminal neglect and abuse of my mother Rhoda Johnson who almost died at Creekside Convalescent in Vacaville, because over-sight of this nursing home by DHS was a joke.
 
How can you justify picking up your paycheck from us tax payers, knowing that at least 10,000 people know you fraudulently claim to represent elderly nursing home residents?   You certainly have caused much neglect, abuse and deaths for our elderly and we all know what you are, what you do and who you really represent.   I have to ask if you are an atheist?  
 
Please, bow out of your position and let someone with human compassion replace you.
Thank you,
Ila Swan
 
To: Janice Caldwell
I could not believe that you think the oversight of our nursing homes is working. It did not work when you were employed by the State of Texas and it is not working now.   Any person who thinks there is protection for the helpless human beings that live in nursing homes would have to be paid off by the industry.  It is people like you, who are responsible for the thousands and thousands of deaths that are happening in nursing homes across the nation.  I would hate to have all those helpless nursing home residents blood on my hands.

You know and I know when you worked for the Texas Department of Health the Nursing Home Industry made the rules and wrote the laws and they still try.  The public is finally getting educated. The industry is screaming they are going broke. I pray every day they will, then the communities could take care of our own.  The industry said they were going broke when there was unlimited amount of money they could charge Medicare for rehabilitation.  I hope to God these money grubbing slime bags will one day have to live in a nursing home without enough help and  with drug addicts and rapist taking care of them, just like so many of our love ones. Can you not say we are any better then the Nazi's when we kill our elderly for the almighty dollar?

Lady you too will get old one day and you better pray to God that you don't end up in one of these beautiful death houses that our large corporations own. Another thing I think there should be a camera in every nursing home resident's room and hooked up to the police station to be monitored.

The Federal Government has a long way to go before they get credit for protecting anyone.  After working as an Advocate for almost fourteen years you are not going to snow me on what a great job HCFA is doing.
Gay nell Harper
 
Ms. Caldwell,
In 1997 Congress gave us a beautiful law, with the intent of cleaning up nursing homes, called the Nursing Home Reform Act. I'm sure you are aware of it. What you may not be aware of, however, is the fact that most nursing home reform activists in this country now know the difference between that act, and what Congress intended by it's passage, and what your regulatory agency the HCFA gave us. We understand the intimate relationship that exists between HCFA and the nursing home industry's trade organization, the AHCA, and are very angry that HCFA has never known, or either forgotten, who they are really employed by, and serve. The consumer.  There would be no need for your agency except for the people that you are supposed to SERVE. In context, that would be our parents, grandparents, spouses, etc., that unfortunately have to call these hell-holes "home."

We understand that HCFA is "catching" it from the AHCA now, and have no sympathy what-so-ever for you. If between the years 1987-1992, when HCFA was given to "interpret" the Nursing Home Reform Act, had HCFA been anything but the weak cowards they still are today, we would not now be having all these problems in the nursing homes you are so keen to defend. I believe you have forgotten your reason for being a civil servant, which is NOT to defend the homes you regulate, but to speak and be a servant for the people. 

If you can't do your job, which is paid for by the people you represent, and not the nursing home corporations you defend, then leave. We have been in far more nursing homes, and faced far more reality than you can possibly imagine. 

You look for reality on paper, but you won't find it on paper--never have and never will. Paper isn't real. Someone hanging off the end of their bed, crying in a hoarse voice for help for eight hours, is. Someone being drugged with Haldol, without a doctor's order even, from the emergency drug box, and on Benadryl for the "kicker" is. The bone deep bed-sores that every nurse (but not HCFA) knows is preventable, except on paper, is reality. An orderly beating an 82 year-old man with Alzheimer's and arthritic knees is reality. Where are you going to find these things on paper? Get out of your ivory tower, the paper work you love, that keeps these things hidden >from you, and take a long look. Make no mistake, these things are happening as you read this, but will NEVER be substantiated by the state or HCFA, or the never ending paper work you use. It isn't real.

Please earn your keep, Ms. Caldwell, and inform the others like you that people are tired of the love affair between HCFA and the industry. (translate the AHCA) We demand, and are paying for better.
Thank you
Sharon Sharber
3909 East Coyote Lane
Flagstaff, AZ. 86004

My Dear Ms. Caldwell,
I understand that you are "tired of seeing all the hidden camera coverage of nursing homes on TV."  Why is that?  What is there to hide or be ashamed of?  And that you believe that "we have strict enough laws."  What enforcement measures are currently in place? Are they strong enough to ensure full compliance with existing statues?
 
The concerns I have, From our family's personal, first hand experience, is that there IS NOT enough staff in the vast majority of nursing homes to effectively care for the residents housed therein.  The staff that is there, is often very poorly trained.  The expectations placed on nursing home staff are highly unrealistic. Thousands of people, all over the nation, will tell you that from their own first hand, personal experience: as staff, or as consumers or consumers' families.
 
OUR STORY:
My father's medications were completely missed one evening, and the following morning, and if my brother hadn't HAPPENED to come in early that morning, before work, to learn that this had occurred, who knows how long it would have continued??
The nursing home staff made No attempt to contact anyone.  There were no less than four answering machines or voice mail services available to them, with no messages on any of them. 

The state investigating  agency claimed to have addressed their questions to my brothers during their inquiry, and stated such in writing on their report.  No such conversations ever took place.  When my brothers removed my father from this site, the administrators initially refused to apologize, and balked at refunding the balance of our payment. They refused to respond to our demand that there be some acknowledgement that something went wrong and they refused to say they would make any effort to correct what needs to be fixed SO THAT OTHER RESIDENTS AND FAMILIES DO NOT SUFFER FROM THE SAME MISTAKE.   This was basic and integral to our demands: that we help in CORRECTING THE PROBLEM.  
 
It was not until my brother found the electronic bulletin board connected with their stock valuation, and began posting messages on that forum, that action was taken toward refunding our money, apologies profuse, and requests that we not discuss the matter further publicly. WHAT DOES THIS SAY TO YOU?????????????
 
What it says to me is: This well known national chain is, by far and away, more interested in their profit margin than they are in correcting fundamental and potentially life threatening errors in their operating policies.
 
IT ALSO SAYS that the state enforcement agencies are slipshod in their work, if one is to think on it generously, and beholden to the NH industry if one is more cynically inclined. 
 
Either way: IT IS NOT RIGHT.  Pure-- and ---simple.   IT IS NOT RIGHT, IT IS NOT RIGHT, IT IS NOT RIGHT, IT IS NOT RIGHT, IT IS NOT RIGHT.
I beg you to look into your conscience and see if you can't come up with a similar conclusion.
 
My name is Carol Klammer
I welcome your response.

Ms. Caldwell, 
You were not misquoted unless 7 people who heard what you said all had a loss of understanding and hearing.  I expected you to at least have the courage to own up to your own beliefs, but it is apparent your honesty has gone wherever your compassion went.  Please,  we are all asking you to resign.  We would rather spend our time in a nursing home, giving water to a dehydrated patient or helping feed someone's mother who won't get fed because there just isn't enough staff due to the owners greed for more profit, than spending our time circulating a petition or contacting our representative, to have you removed. Help us use our time more productively than going out after your job.  You are an embarrassment to the human race and a joke as an enforcer of the regulations.  Do you want another history of being fired added to your already blackened record?  Resign or we will do everything we can to get you removed.  Ila Swan

Dear Madam:
Even if I believed your assertion that you were misquoted at your recent speaking engagement, your comments below are so alarmingly out of touch with CA nursing home conditions, I must obviously question your motivations and qualifications as president of a "care" association.  You remind me of a representative for the White Star Lines who attempted to describe the sinking of the Titanic as a "minor boating accident."

Your industry's players are similar to the townspeople of Auschwitz, who daily watched ovens burned, ashes dropping on them like snowflakes, as they raked leaves in their backyards.  Your industry is not suffering from enforcement and stiff penalties.  As someone who has personally reviewed the files of several "kennel care" homes here in NJ, you know very well how penalties are threatened, then rescinded.  Your industry NEEDS real enforcement and stiff penalties.  Please -- family councils, ombudsmen, other activities as EFFECTIVE ways to combat corporate greed?  

Corporate greed sanctioned by HCFA and state governing agencies?  Would you also like to convince me that our government is not for sale?  We're well aware that both Monica and Alan Solomont have visited Clinton's Lincoln bedroom.  It seems both got the prized cigar.
As a person who has observed the "system" for the past 15 years, let's not pretend that the nursing home industry can capably police itself.  

The guise of "confidentiality" is well planned to hold a multitude of sins, from abuse to sexual assault.  The industry has repeatedly shown that it can not be left alone in protest of its own innocence.  The right message -- is -- being sent to the public when clearly you fail to control abuse in 25% of our nation's homes leading to serious injuries and deaths of residents -- or have you not read your own government's GAO reports?  Let's say that again, because you seem clearly out of touch -- 25% is an alarming number!  As in critical!  If 25% of a business' production resulted in rejected product -- would that business reward those employees with raises?  Outrageously, in
the nursing home industry, you reward management teams from hell with new licenses to operate more homes -- as has recently happened here in NJ -- who persist with the same substandard management style.  I must ask the obvious question, if HCFA is supposed to regulate -- why aren't you regulating?

Finally, please don't pretend that consumers are not paying attention.  With the advent of the Internet is the government's undoing.  There's no longer places to hide.  The question remains, when proof of corruption is shown, will our government representatives continue in its willful disrespect of the integrity of the laws that bind them -- and will they continue to benefit from the Industry that enriches them?  What will it take to restore sanity to this crisis?  Past practices convinces me that government is out of control -- and can simply not be trusted to act in accordance with law.

When you benefit from the nursing home industry, whether with power, influence or money -- while you enjoy the perks of your position with your speeches and eMails sent -- please remember the peoples' faces whose suffering made it happen.  This industry is coming down -- with or without your "help" -- help as in "resignation."
Patricia Nelson
<mailto:quipsters@bigplanet.com>quipsters@bigplanet.com
 
Janice Caldwell---It is obvious by your recent comment during the CANHR meeting, you have no compassion, interest, or intent to improve oversight in nursing facilities in order to protect our vulnerable, helpless disabled, and elderly. You have proven you don’t care, if you did, you would see and hear the agonizing pain, day and night--screaming, pleading for help with out stretched arms from being confined and tortured in nursing homes. I might add overmedicated in an attempt to disguise this pain. 

For you to admit you have been wrong would be a humbling experience and you would drop to your knees. But you are cold and callused in your position. If you, HCFA oversight, were doing your job, efficiently, you would find 39 Flags violating Federal and State law, for one person in a Superior rated nursing home with three (3) deficiencies reported for the entire year of 1999. The balance of violations are a direct result of major ones. Hence, causing my Mother’s premature death. You are exterminating our disabled and elderly, at the same time, AHCA, the nursing home industry are profiting from neglect and abuse by prolonging a life of torture to eke every dollar they can from our system, defrauding our American government and tax payers. Is this not a national moral abomination and disgrace? God help those in Standard and Conditional rated nursing homes, because you certainly will not. I am asking you to give it up, resign, then try to wash the blood, guts, rotten stench and tears from your hands.                      Margaret Massey                                                                      Jacksonville, Florida

My dear Ms Caldwell, 
I had still not quite recovered from the infamous, unethical HCFA Listening Sessions in Chicago or the 5th Annual HCFA Midwest Conference on Staffing for the 21st Century in St.Louis, Mo. 1999, when I was made aware of your recent comments at the CANHR meeting in California.

At the listening sessions the key words PARTNERS and PARTNERING with the industry were the theme. Advocates were denied access until the eleventh hour when intervention by higher ups gained entry for only two of us via an overnight mailing. 

At the St. Louis meeting, HCFA, nursing home owners, state licensing personnel and ombudsmen were practically sitting on each others' laps. The mutual patting on the back and compassion and praise for work well done was nauseating. At that meeting I learned that HCFA is divided into two groups the WHITE HAT GUYS and the BLACK HAT GUYS. 

The white hat guys work to help the industry and the black hat guys go after them. This was told to me by a man whom I initially believed to be a paid photographer, so jovial and silly he was, but who turned out to be a HCFA big shot from Missouri. To date, I have not been able to find out who the BLACK HAT guys are so I can get in  touch with one of them. 

The "photographer" will not return my calls or answer my letters.                                                                          The US government, aided and abetted via agency persons such as yourself and all the other WHITE  HAT GUYS, is responsible for violating the human rights of millions of Americans who must live in nursing homes. Our appeal to the international community for human rights sanctions against the US will include your comments along with volumes of evidence.

If, God willing,  you have an opportunity to live in a nursing home of one HCFA's PARTNERS, as advocates we would be very interested in knowing how you will feel then about pulling back on oversight.                                                        Violette King, president                                            Nursing Home Monitors Inc.

Janice Caldwell,
Lou O'Reilly and I talked with you about lack of care in nursing homes in  Texas when you were here. You did not do your job to see that better care was  given then. You are promoting poor care now. Why? Why won't you use your  position in California to see that there is improvement in nursing home care ? HCFA should fire you immediately, that is, if you are not following their  instructions. 

Hidden cameras are a must until the nursing home industry decides to clean up  its act. The public must see what terrible things are happening in nursing  homes. Advocates have seen these things for much toooooo long!

Cameras should be in every room in every nursing home. Families could then  see what is happening to their loved ones. Resign immediately is my suggestion to you.
Beth Ferris
Texas Advocates for Nursing Home Residents

Madame, 
I live in California, and used to work in the nursing home industry. I know from first hand experience that the current "oversight" is clearly a joke. 

Your words at the recent conference were almost, if not more, ridiculous than those spoken by  the tobacco industry as they swore to God, that nicotine was NOT addictive!  You were obviously made from the same mold as these crooks! 

I believe you really should resign from your HCFA position, AT ONCE! Maybe your political "placation" bullshit was believed by a small group of ignorant concerned parties, but your bull did not fly with myself and the thousands of genuine nursing home advocates. The ignorant people are becoming fewer and fewer because of caring advocates like us, and your time is limited on how much longer you can get away with "baffling them with bull" before they are ALL aware of the corruption and thievery this "oversight" system and industry is.

I am curious as to your explanation as to WHY this issue is becoming more heated, if as you say, HCFA IS doing their jobs. One may believe you have a  monetary interest along with your cohorts!  I would like to see you put yourself behind your words and actually DO something besides talk a lot of crap. Oh yes, if you would PLEASE, post your professional resume online, so the public can see that you were fired in Austin, Texas and that you are the lying thief you appear to be!

As far as the families and concerned people getting involved, that is NOT a new concept, concerned families are the ones who started this awareness, coming to HCFA for help, as they are told to do, only to discover how little "help" you actually are!!  Families and concerned people ARE in there, doing what we can to help.  If there is an oversight system in place, that you so believe in, why are you trying to recruit the public to do for free what you are PAID to do? Sounds like
your just passing the buck! What EXACTLY is it that you earn a paycheck for? YOU are responsible for this nightmare!  RESIGN NOW!!!!!!! 

As far as your response on the ideas that cameras in the homes will only frighten people, I  say this: Cameras don't lie! If seeing the footage of what is on the tapes frightens people, they have a REASON to be frightened! I think the only people who are frightened, are yourself and your corrupt money hungry co-workers! Video is PROOF, which could require your association to actually punish these murderers! There could be no "dismissing" fines, or "unfounded claims" anymore, would there? 

I'm sending along some photographs of nursing home residents. Tell me HCFA is doing their jobs after seeing them! They are all (the ones who are still living) California nursing home residents.

You can bet this issue will only get more intense, and eventually you and your work will be revealed in more depth to the people.  If you have ANY common sense, resign now!

Have a wonderful, peaceful sleep. Take comfort in knowing you can spend all the taxpayers money on your "things", but one day,  it will be your turn. If you know what karma is, you'd better start making changes in your life FAST!  

Do the country a favor, stop talking crap and RESIGN  NOW!!!
Thank-you,
Michele Rivero
Member APE-Association Protecting the Elderly

4 10 2000
Hello Ms. Caldwell.
Today I received your response to we advocates who strongly believe that it is time for the federal government to step into the disgraceful abuse that many ombudsman overlook. I am an advocate that fought the government Social Security laws since 1975. In reality I don't have time to advocate for loved ones in the nursing homes today.

I would like to tell you how I totally disagree with your side of this entity. I was a security guard in the University village retirement center & nursing home in Tampa Florida. For three years I saw the way the administration tricked the elders to enter the nursing home and die. I got involved with one case all the way to the courts that took his freedom rights away.

The retirement center tried twice to fire me, because I advocated for the gentleman who was a city building inspector that fell off a roof. the building inspector crack his head, leaving him with a slight loss of his memory. The gentleman's wife had Lupus disease and the wife and children wanted to take full control of his estate worth more than eighty thousand dollars in assets and cash..

Workman's comp. stepped in and their lawyers had the court incapacitate all of his rights. The next step was to incarcerate this man into a nursing home. When he came to me during my work hour shift, I listened to his side of the story. I then wrote to the chief judge in Hillsborough county to investigate the case with what I had found out.

The spark of fire I lit began to spread. In the next few months all hell broke loose. The family tried to get me fired. I went before Human resources and cleared all charges. I came up against the ombudsman and the legal guardian who tried to tell me to mind my own business.

It took three months to get the gentleman out of the University Retirement village and nursing home center. Suddenly the head administrator was dismissed. Later I found her at the head of the administration nursing home where the courts transferred the gentleman I was advocating for. At that second nursing center I was barred from seeing my client.

Across the street from the second nursing center was the veterans building for disabled. I went in and got them to investigate the nursing home across the street. In thirty days my client was moved to a private hotel. His telephone was taken away from him when the ombudsman found out he got in touch with me.

As the case progressed the gentleman's wife died of the Lupus disease. and the gentleman wanted to leave the state of Florida. Still being fully incapacitated of all his rights to freedom, he could not, leave Florida.

Dis-Abled News U.S.A. has a policy of twenty five working hours on any one case is free. After the twenty five free working hours I charge ten dollars per working hour on any case. or, The client must give community hours for our services, or pay the full amount.

To date I don't know what happened to the gentleman because he did not honor the agreement.

My findings in the nursing home industry warrants full investigation because the system fails from beginning to end. We lost our mother in a nursing home. I listened for three years how Mother was treated. We had to transfer her two or three times until we found a nursing home that would treat her as a human being.

People in general are very difficult to satisfy their many whims. When they are to old or they can not handle their own way to live, they are forced to give up an awful lot of their own free ways of life. It takes a lot of patience and nursing experience to work inside any nursing home. The industry will not, pay the price for the best workers.

Laws are needed to place one attendant for a certain amount of persons to handle on each shift. Records of care need to be open to the family of the person in the nursing home for weekly reviews. Ombudsman need reform to stay neutral. I find that they are to friendly with the industry caretakers and administration.

Any person with full leadership and authorization found to be guilty in cover-up,while working in nursing homes, should be barred from entering a another nursing home for a certain amount of years.

People living  in nursing homes need a lot more protection by law to be free to complain to proper arbitrators that ask random questions uninvited on the premises.

I do agree that the system used to reveal the horrors that happen in nursing homes today, should come out of the closet. The way to do it would be to  invite the families to OPEN FORUMS ONCE A MONTH, until the nursing home satisfies all major complaints. Then have the open forum perhaps quarterly per year with the families.

Ms. Caldwell. Government employees and both houses of our states and federal governments have turned their backs on the thousands and thousands of complaints they heard for many years about the nursing home industry nationwide.That is why the news industry has taken action to bring this disgrace of nursing care into the open.

When the government forces compliance in, every nursing home individually. Then it will be the right time for the news media to return to the nursing industry and take away the fear of people who must leave loved ones in the nursing home care.

What the congress should advocate is to arrange low interest loans for families that want to build additions to their homes that will be used to care for the aged in the entire family tree. Hospice does a real fine job. They come to the home and care for the loved one in front of the family. Traveling nurses visit the sick at home.

Government needs to open a new door to caring for the elderly. Why should a giant corporation own 100 nursing homes? Make millions of dollars in profits and continue to abuse fine Americans.

Finally because we advocates took up the challenge to wake up America to all of its wrongs Great action is advancing the progress of a new American way of life. Yes the pen is still mightier than the sword.
Tony Danusa.

Dear Ms. Caldwell,
I was recently e-mailed comments from a speech you gave in San Jose at a conference on family councils.  I understand at this conference you made the statement that you are "tired "of seeing all the hidden camera coverage of nursing homes on TV.

Much of the camera coverage I have seen has shown the public many of the abuses and neglect in these nursing homes. A reality that often the oversight system calls "excellent care".  

In fact, in a recent special on CBS, a video was shown of a frail and very fragile elderly lady being beaten by a woman hired to care for her. When I saw this video  I fell to my knees. A picture after all is worth a thousand words.  A picture after all  is not as easily denied.  

I am sure the families of these abused elderly  go through much emotional trauma each time these segments are aired but allow it so that others can be helped through their pain. I am sure seeing their elderly loved ones beat up on national television is not exactly comfortable either.  I have no doubt these family members feel something much more than "tired."

Certainly these families deserve a different kind of statement from someone who is supposedly hired to protect these elderly from having to experience such abuses.  Certainly these families deserve something from their so called advocacy representatives than "I'm tired".  This comment seems to go way beyond lack of political correctness, or even blatantly tacky.

This comment deserves a public apology to those family members who, out of a sense of caring for all humanity, share their videoed saga of personal horror and pain.  It deserves a public apology  to the advocates who must take their time to video and take photographs because no one will believe or help unless they "prove" it.  Then, even then the oversight system's rhetoric is a dialogue of  self centered egotism.  The best they can do is say "I'm "tired!" 

Thus, my concerns lie with the measly 30 percent of the complaints that are found valid in your state. An even lesser percentage, if one is privy to the more accurate percentage of assessments that advocates who have worked in the system report.   I am sure there are many families and residents who are more than "tired" of seeing, not to mention experiencing  these kind of abuses.  I am wondering what exactly are you "tired of seeing?"  The horror of these abuses or the lack of ability to keep these kind of abuses from happening thrown in your face so publicly.

These statistics seem to be showing that the majority of the people who come to you and your office with concerns are not getting satisfaction and resolution of their concerns.  Certainly, the use of videos in nursing homes saves some family members who watch their elderly suffer horribly in these conditions,  from having to suffer themselves when no one believes them or simply dismisses their complaints as "unsubstantiated."  

The public use of these videos showing abuse certainly brings home the point that 30 percent is not adequate.  Is that why you are "tired" of seeing them?

I thought it quite revealing that your choice of words was not that you are tired of seeing these abuses because they are horrifying and that elderly human beings should  not have to suffer such atrocities but that you are tired of seeing them "aired" on TV, you are tired of seeing reality come in to your living room of denial. You chose to be concerned about the publicity of such atrocities not the atrocities themselves.   

That unfortunately says a lot about you as a person and as an employee of the people.  It sounds as if your sensitivities simply want to pretend these things don't happen and that you want to shove them under the rug.  It sounds as if you are more bothered that your denial system might be slightly shattered if you view these abuses on your television scene.  Or perhaps, it bothers your ego.

Advocacy for the elderly and the office of ombudsman is not a "garden party", Ms. Caldwell, where the real world can be shut from our "oh so sensitive eye" and we can bury our heads in the sands  of denial.    It is not standing in front of concerned family and advocates and whining about your personal sensitivities to what is on television.  I, nor many others simply do not give a damn that you are personally "tired".  What we care about is that these kinds of horrifying atrocities are happening and we have to get them television coverage to try and get it stopped.  These kind of terrifying and abusive situations are happening all over and the oversight system is simply not "seeing", nor making effective dents in stopping the abuses. Too may families are reporting too much neglect and abuse.  

It does not surprise me the least that viewing these situations "tires" you, as hearing the nursing home abuse stories from families and loved ones and advocates in your state, you do seem to be asleep at the helm anyway.  

Well, wake up "Little Susie" and instead of spending your time "tap-dancing" a song and dance con job in front of an audience of caring people... start doing your job.  Believe me , there is enough work out there protecting your state's elderly that you won't have much time to get "tired" or if you really are doing your job, you might not get time to even watch television.  After hearing from some of those people whose loved ones have been videoed experiencing horrible abuse, I can only say about how "tired" you are..........  OH WAH! 

The rest of us who are working hard for our own elderly loved ones and those who are working hard for  our nation's elderly that they have never seen nor known, simply do not have time for your belly-aching.  We have the job to do that you are simply too "tired" to do!  Like I said,  "Wake up Little Susie."

You owe a public apology to say the least to the families whose beatings and abuses have been on the air.  They deserve more than your "tired" comments.  How tacky, to say the least!

One more question, are you also one of those who happen to also believe that the Holocaust was just a giant lie? 
Please keep yourself from getting "tired".  RESIGN!!!!
Sincerely,
Linda Blare
Wyoming 
 
Dear Ms. Caldwell,
 
Your comment about nursing home oversight in this state of California by the DHS is very disturbing.  You are happy with 30% of complaints filed being valid?  Let me see, that means that about 1 out of every 3 complaints filed actually had some violation to complain about?  The rest were making it up just to cause you grief?  What about those elders who have not filed  complaints with the DHS because they have no idea how to do so, they have no family to help them or who are so drugged with Haldol that they couldn't think straight to call?  Frankly, as a nurse if ANY patient that I served filed a complaint about me for poor care  THAT would bother me greatly.  I would have a very hard time sleeping at night.  Your job is to ensure that our elders get safe, appropriate care.  A good director would go into nursing homes and look with his own eyes to see if good care was being given. When is the last time you actually went into  nursing homes unannounced and looked with your own eyes?  To me that would be the measure of a good director in your position.  Look Don't Listen would be my motto.  I urge you to go look.
 
Patricia L. Cota R.N.
 
Ms. Caldwell:
I just read your reply to Ila Swan and fellow advocates re: your remarks at the CANHR conference.  I was not at the conference ... just heard about it and read many letters to you from advocates.  
 
We advocates, most of us having lost loved ones due to neglect and abuse in nursing homes, are very focused in our work and feel that comments made by government employees, as yourself, who are empowered to do something about  nursing home abuse and who make remarks that appear to be a cover-up for an inadequate regulatory system are unconscionable to say the least.  

I have been doing this advocacy work as the Founder of the Foundation Aiding The Elderly (FATE)  since 1982 when my aunt died in a California nursing home and the District Administrator of the Licensing and Certification Office destroyed my complaint pertaining to her untimely death from bed sores.  (That was my first clue that something was wrong with the system).

California is notoriously laxed in its efforts to cite nursing homes.  Listen to all of us advocates who file complaints and follow the due process to document outcomes.  We know what's going on and we are not afraid to talk about it.  You should also refer to the several scathing reports published by California's State Auditor regarding substandard practices of the Licensing and Certification Division, as well as the numerous published studies by California's Llittle Hoover Commission  regarding an industry not being held accountable for its crimes against our parents.  
 
Your statements regarding hidden cameras and the sensational stories on the news  instilling fear into families and not sending the right message to the public was ridiculous....this is the right message .....people are at risk  in nursing homes ..one should be fearful for their loved ones and should be vigilant in their advocacy and the press has been more than helpful in exposing and warning the general public. 
 
It's because of you and other government officials who continue to make light of this "disgrace of the century" that we advocates took up the cause and continue to do everything possibly to make it better for all of us who some day will end up in one of those places.
 
Carole Herman
Founder/President
Foundation Aiding The Elderly (FATE)
Sacramento, CA
<mailto:caroleh@4fate.com>caroleh@4fate.com
 
HCFA, Mrs. Caldwell,
For two days i have sat at my computer and typed one message to you after another.  My disabled daughter has been in 4 different nursing homes in 4 years. On previous messages i wrote to you then disgarded them, i listed  the what all had happened to her.  It took me sometime to do this because i was typing through tears and had a hard time reading what i wrote. 

I have prayed that God will bring you into just one of the 4 nursing homes where my daughter lived and suffered.  Her suffering was so easy to fix,  just a drink of water or change her diaper to stop the burning in the sore on her bottom. Taking time to move her from her wheel chair to the bed instead of just throwing her.  Even patting her little hand or wiping off her drouling from her chin that was so raw from being wet always. 

Yes i called the department of health and i complained and each time they said nothing was wrong.  The flesh on her little bottom eaten away by her own body waste, the open raw bleeding sore on her chin because no one would wipe her face, the bruises and cuts on her arms and legs from being thrown around, but nothing was wrong and you believe we do not need stronger enforcement.

For shame on you,  shame, shame, shame.  you don't want to see the reality on tv that happens every day in these places, your tired of it.  if your really tired of it, then use your position to fix it then it will go away and you won't have to see it on the 6 o'clock news again.  isn't that the news time you mentioned in your 16 minute talk. Can you imagine what happens when no one is taking the pictures,  please if you refuse to watch over our loved ones, can you find another job some where else.  my daughter is innocent and she does not deserve the negleet and abuse.  a loving mother. 

Dear Ms. Caldwell:
Since you're the "head" overlooker for these nursing homes in California, where are you looking???  Certainly not in the homes.  My husband just died and I can thank a local nursing home not only for hastening his death, but for making him miserable, in pain, and emotionally abused during his last six months or more with them.  

Did you ever see a burned scrotum???  Try  sitting in your BM for many hours and even your bottom will burn - for my husband it was agony for a week while trying to heal.  Try laying in your own vomit and inhaling it - I managed to find him in time to save his life but not keep him from having aspiration pneumonia.  

Try watching your neighbor across the hall going without food because no one cares or has time to feed her.  Watch her turn into a pack of bones, totally unresponsive until her son insisted they hospitalize her.  

Try watching your friend with cancer going without meals; laying in her urine and BM when she was nothing but bones and waiting hours to be changed.  

Finally, try watching your husband totally congested and running a temp for days (we'll give him Tylenol and get his temp down), with brown urine with mucus in it, and be told there's nothing wrong with him in spite of the above and 103 temp, at which point I insisted he be put in my car and I TOOK him, broken leg and all, to the emergency room.  

It took them 10 days to stabilize him with tubes suctioning his lungs which intruded on a slow growing tumor and caused his death, but after a nurse who didn't know up from down, that's all we could do to save his life then.  A couple months later, she did the same thing to another patient and we lost that one too.  It's constant.  Walk in the door and you don't have to ask about the care.....   Can't you people even smell????

Fortunately, before my husband's demise we went from HELL to almost Heaven at Napa Nursing where he was beautifully cared for until his death 7 weeks after the last horrific hospitalization.  Am I mad???  I work, legally, for insurance companies, but I have seen, personally, what goes on, and no matter how many times I called the state and other powers that be, I heard nothing until after I had left the Vallejo facility. 

Obviously you and your staff can't do the job - there must be others who can, and probably at a whole lot less than we pay your office.
Barbara Truax
22 Alta Loma
Vallejo, CA 94589

Dear Ms. Caldwell,
As a professional investigator who has worked with government officials for 20 years, I am shocked at your remarks made at the most recent family council meeting in San Jose. I have been investigating California and other nursing homes across the country for the past four years. I have made over 150 nursing home visits and I am shocked at what I have seen. I have watched surveys in process and seen what they missed and what has been hidden from them. Your attitude is unacceptable as an official in an oversight role of our Medicare and Medicaid money, as well as the health of our elderly.

Since I worked with Senator Grassley for many years in Washington, I was so troubled by the evidence that I had gathered from advocates and others that I took him the information. This lead to the GAO report and his congressional hearings. HCFA headquarters assured him that they were toughening their oversight role. I am sorry to say that I will have to forward your unfortunate remarks to his staff and ask them to have HCFA comment.

I invite you to visit our website to see the evidence that we have gathered and given to the press and Congress. Maybe you will change your attitude. I work in the San Francisco area and would be happy to meet with you to show you evidence and give you information to show you how wrong you are.
Sincerely,
Dina Rasor
Bauman & Rasor Group
<http://www.nursinghomeabuse.com>www.nursinghomeabuse.com
<http://www.quitam.com>www.quitam.com

Janice Caldwell,
Reference:  what you meant to say in San Jose April 8th
We heard what you said.  That is why we are outraged.  That was a litigation attorney who shouted at you from the back of the room.  Did you not hear his outrage?  He expressed what we felt listening to you, but the word we all wanted to shout was "bullshit" not "baloney". 

Many in the audience you spoke to on Saturday spend a lot of time in California nursing homes and have no tolerance for bureaucratic smoke and  bullshit in light of the truth.  It is outrageous for anyone to propose to keep the film record of atocities in California nursing homes from the public lest the elderly and their families be forewarned and afraid to have someone in a nursing home.  Lambs to slaughter!  Why aren't you instead outraged that those atocities filmed with hidden cameras are happening?  The people suffering are no less human than you or I, or do you think at least a few are expendable? 

We had looked to you for hope, but after hearing from you, now know your record speaks for itself.  Your record in California is in the GAO report, and we didn't hear your resolve to do any better.  You aren't recognizing and correcting the problems because you are part of the problem.
Please resign.  Someone else can do better.
Gus Kugler

To: Janice Caldwell
You state in your  e-mail tougher rules and higher financial penalities are NOT the only effective way to ensure quality of care.  You know as well as I do there has been no enforcement or accounability of our laws and very few penalities paid by nursing home owners.  The industry has the laws so  ambigous they have been getting away with murder for years. Even if the  nursing home is accessed a fine their high paid lawyers appeal and keep it on  the books until HCHA and the State dismisses it or they pay pennies on the  dollar.  If these owners have it so bad why don't they go out of business  like any other failing business would do.  They keep complaining and  threatening to close down, we should be so lucky.  

There are many ombudsmen that has the same mentality as you.  These people  are suppose to be protecting the residents and I find they are defending the nursing homes owners and managers JUST LIKE YOU. 

Has a nursing home killed your mother or father?  Maybe that would change your mind or one of your children if you have children.
I wish there had been a camera in my dad's room and my father-in-law's .  Both of these men died because of substandard care in a nursing home. One died in 1986 when you worked in Texas, do you remember all the letters and trips I made to Austin to talk to you and Commissioner Bernstein?  You people did absolutely nothing to help me.  In fact six years after my dad died I took his autopsy to the Forsenic Institute in Dallas, Texas and they said he would have lived with medical attention. 

Do you even remember he was embalmed with out permission by the funeral home at the request of the nursing home?  The other one died in February 2000 of dehydration.  Lady I have seen the show twice and neither one had a happy ending.  Is this what you call quaility of care?  This is just two human beings out of thousands and thousands who have died needlessly.

You  have the nerve to tell us we should modernize the nursing home data systems?  How is that going to give quality of care?  What we need is trained employees, and enough of them to give quality of care. We also need  caring compassionate nursing home managers and owners. Instead of the maggots that feed off of the system.

We need criminal laws for the owners, managers and employees who are responsible for the rapes, neglect and abuse that kill our love ones, then we could lock them up for the rest of their lives like we do the other criminals.

I would just love to tie you and some of our legislators to a bed in one of these substandard nursing homes where no one knew you, and leave you for about six months.  I can assure you, not being fed half the time, lieing in your own urine, and feces, getting a few bed sores that rot off your leg or buttock would give all of you a different mind set. 
Gay Nell Harper
Corpus Christi, Texas

Ms. Caldwell:
 
On a day to day basis I receive information from families and employees about nursing home abuses: physical, mental and insurance in long term care facilities. These abuses do not go unreported, they are however dismissed by the DHS. I have just received a plea from a family member of a recently decease patient in Pennsylvania. His families cries for help were unheard and his Mother died after only a few days in a nursing home. In spite of obvious negligence on the part of the facility it only received a mere citation. In the case of my own Grandmother the DHS was there on several occasions, in each occasion the nursing home administrator was notified before their inspection of my Grandmothers condition. (She also died of very peculiar circumstances.......... they administered Morphine to her despite the fact that she was never in any pain.) 

In both of the these cases each patient was put on psychopharmacological drugs, neither patient was in need of them. The adverse reactions were reported by both families to the DHS and in both cases nothing was done. Both patients died, both patients had the same reactions to the drugs, both patients families have tried to attain legal help, both patients families are questioning the system. 

In another case a woman was put on Demerol for diarrhea, in less than two weeks she died. That family also managed to get a citation out of the DHS, but no fine was incurred by any of these facilities.........these travesties are endless and they are an abomination to humanity and our "Civil Rights"...... HELL LADY...........Who is paying you off???????? 

Try to tell those of us who have lost loved ones in these hell holes that you are as straight as an arrow, that won't wash. A real test sister, would be for you to offer to go into a facility of our choice, incognito, for three months. We'll allow them to drug you up, leave you lie in your own excrement, starve and dehydrate you, throw you around and scream at you. After all you won't be allowed special treatment.   

I wonder if you'll sing the same song. We'll even call the DHS for you if you fall out of bed or they drop you on the floor or scald you in the shower.  ( Hell, I would be happy to pay the bill just to watch as you struggled to get help and be heard., Oh, you may be too weak to speak up or we might think that you are in a state of dementia and are really just making the abuses up. ) Just think Janice, if we do decide to call the DHS they might even issue a citation to the facility in your behalf. Neat huh!!!! Of course you may be dead by then, but at least they did their job. RIGHT!!!
 
The thought that keeps me motivated every day is that people like you are getting older. And you have a 60% chance of eating your words in a long term care facility. Unless of course the system decides to put you down because you are useless to society. But then they could do that now, couldn't they!!!!  Think about this every night Janice......what goes around, comes around and  your turn is coming.
 
Take Care,
Mary Ann Miller               Advocate in Pennsylvania 
<http://www.longtermcare-hotline.com>www.longtermcare-hotline.com
 
Do me a favor and take Gail Wilensky with you. She would make a great room mate.
------------------------------------------------------------------------------------
Mary Ann Miller
ABR/Owner/Land and Construction Consultant
Cyber-Link Realty, Ltd.
717-812-1900
<http://www.cyberlinkrealty.com>http://www.cyberlinkrealty.com 

Ms. Caldwell:
Our national organization, Association for Protection of the Elderly (APE), was started because we saw the system in place to protect the nursing home residents didn't work.  We have a California (West Coast) office to handle the flood of calls and pleas from residents, family members, nursing home workers and state employees in your state concerned about the poor care.

When you are employed in such a high level position you are buffered from the pain, suffering, urine, feces and rotting flesh odors.  Have you ever walked the hall of a nursing home and had a frail trembling hand grab your skirt and beg for mercy?  My personal experience and the cries and pleas we hear daily from other residents and their families makes it difficult for me to sleep at night for fear that if I rest too long, we could loose ground and more will suffer.

Hearing your statements from the California conference makes me realize that the ground we have lost may never be recaptured, at least not in time to save thousands more residents from this insidious disease of abuse and neglect that spreads because those in power don't, won't, or can't do anything.

If you would get in the trenches and hear the cries and smell the odors you would not be able to sleep at night either......

Judy Murphy
Executive Director
Association for Protection of the Elderly (APE)
<http://www.apeape.org>www.apeape.org
"Speak up for those who cannot speak for themselves, for the rights of all
who are destitute." Proverbs 31:8

Dear Ms Caldwell,
I am the daughter of a gentleman who received substandard care in a Delaware nursing home.  Knowing that what happened to my family member was not an isolated incident, I attended the hearings held by Senator Grassley on the quality of care in California nursing homes.  

The findings brought shame on this affluent nation.  If representatives of HCFA will not promote stricter enforcement, who will protect the elderly in nursing homes?  I hope you're not counting on the long-term care industry to police itself.

Phyllis Peavy

Ms. Caldwell:

It makes my skin crawl to read mail which was sent over the internet to you Ms. Caldwell.  The crimes are worse and bigger than I could ever imagine.  My mother suffered 4 1/2 years in a nursing home here in California, she was booted out of one after 6 months due to my legitimate complaints to the State in order to be rid of me.  

Although my mother was on M-Care & M-Cal, she was refused admission back into the nursing home and when I complained to the State, the Ombudsmen, the State Senator, and the doctor, no one came to our aid.  How can you live with yourself.  You don't belong in the position you are in. Get out of California.  We don't want you. But please, don't seek employment of this nature in another state.  We will know if you do. You are not wanted. We know what you are like.  You don't fool us.  We are no fools.  And we aren't going to put up with the likes of you.  So do yourself a favor, get out while you still can and save face.  Retire.  Do something else.  There are many janitorial positions out there, where you would fit the bill.  Whatever, just resign. 

I hope you will think this over and realize that we will not give up one
minute and we are going to do all we can so that you will resign.  This is
loud and clear,  RESIGN!  RESIGN!  RESIGN!
Paula Wagner

Ms. Caldwell:
When I hear comments like the ones you made at a recent Family Council Conference, I understand why the current system of long term care does not work.  The nursing home corporations don't care, the nursing home owners don't care, the state survey agencies don't care and the Health Care Financing Administration doesn't care.  The system is broken, beyond repair.

You should be ashamed of yourself.  Innocent, frail, helpless elderly and disabled people are depending on you and others in your agency to ensure that nursing home regulations are upheld so that residents are properly cared for.  Clearly with the attitude that you have, you are unable to properly perform your duties.  I encourage you to find a different line of work.  I suggest the American Health Care Association, since your philosophy matches theirs.
 
Barbara Hengstebeck
Coalition to Protect America's Elders

Dear Janice:
I would like to refresh your memory, if I may? Way back when you were "head" of LTC under TDH here in Austin (before you went to the children's program).  My mother was in a local nursing home here, in the Austin Area.  She was a handicapped person, confined to a wheelchair and needed assistance getting in & out of bed also with her bath. she entered this particular home in 1988 and was there until April 30th 1992.  

At this point in time she was wrongfully discharged from this home.  Not for anything that she had done!! Nor, had her doctor signed discharge papers.  In fact, the doctor REFUSED to sign the discharge because she knew it was illegal.  The only problem was the insufficient staffing at that home, which became quite obvious as mother required more help later & the help was NOT there; not only for MY Mom but for approximately 25 more residents in that home.  

The insufficient staffing was so obvious that we, the family members formed our own family counsel which met outside of the nursing home.  The family counsel which met inside the home was led & run by the nursing home industry with the social worker leading it.!!!! Family members felt uncomfortable & finally refused to meet any further in the industry family counsel.  The owners did NOT like the idea, nor did the social service person & Administrator.(most likely controlled by the owners).  

We kept complaining about the shortage of staff but each time the State investigators came; the home would have adequate staffing on board.  The most scant staffing was on the eleven p.m. to seven a.m. shift: allowing only one LVN & two nurses aides for at that phase of the new home had 100 residents!!!!!!  Families complained constantly.  

The home & owners began to blame me.  Especially, after they were caught on public TV, after a new year's eve party at the home in December of 1991.  The TV station interviewed our whole family counsel, at the family member's home where we met each month.  The cause of all of this publicity was the fact that a woman had strangled to death in her bed rail that evening, & when the nurse aide found her & screamed, the nurse came running, told the aide to be quiet & rearranged the body in bed (to pretend she died in her sleep).  A male worker there saw the whole thing & called the police.  

The woman had a broken bone in her neck, her body was originally swinging over the rail.  She no doubt had attempted to get help to the bathroom, or something & when no one came, she attempted to get out of bed & accidentally became caught in the bed rail.  I would have to assume that industry blamed me for all of the publicity, when actually, I first heard of the incident after the fact & publicity!!!!!  

Sooooooo, they began to plot & plot & plot, as to HOW they could get ride of me.  The only obvious way to do that was to kick my mother out.  Bruce Bower, at that time was working for The Legal Hotline for Older Texans, (I knew him before this episode, as he attended some of our first advocate meetings, in earlier years). It was with the help & assistance from Bruce that I began my trek to prevent my mother's discharge.  

I followed the law all of the way making my appeal, etc.  I came to you, Janice, with a letter and hoped that I would receive the help I needed.  Instead, you proceeded to inform me of a daughter ( in Houston, I think) , who was a trouble maker & how her power of attorney had to be taken away from her, etc., etc.  I GOT NO HELP FROM YOU!!!  DHS responded with a letter to me assuring me that mother would remain in the home until after the hearing & final decision of the hearing officer.  

I was soooooo relieved because I knew that now, I could rely upon DHS to back me up.  Weeeeeeeeeeel, it so happened that on the very day of my mother's imminent discharge, DHS rescinded their letter of protection and left me high & dry. (the appeal had not occurred, as yet). A department who was supposed to protect the innocent, frail nursing home residents had betrayed me as you had.  I was still on my phone trying to get help when a taxi cab pulled up in front of my lake house (split level); inside the cab was my mother IN SHOCK & one nurse aide & LVN.  

The nurse aide pushed my mother up our VERY STEEP driveway in her wheelchair & deposited her on my back porch ( that door was too small to get mom in.)  We always had to move things out of our laundry room to make a way for her wheelchair when we brought her out for special occasions of celebration.  The first night mom was in our home; after going to bed, she did not recognize me & kept asking for her bell.  I finally gave her a small "dinner bell" to hold, so she would feel secure.  Every night, for the entire week we had her, well, almost two weeks; she would NOT recognize me.  She would urinate in her bed, due to shock.  Do you know, Janice, how much hell my mother suffered and not only my mother but my husband and me??  I lost ten pounds.  

ooohhhhhh, Yes,  I failed to mention that WE WON OUR APPEAL but unfortunately, thanks to people like you & DHS, it was too late!!!!!! OH, the home finally invited mom back but do you actually think I would have put her back in that place??  The administrator actually told mom, as she wheeled her out to the curb that day; if she ever came back there she wouldn't just have Marie Brown as her aide who bathed her but she would have any white man or black man who was on duty!!!!!!!!!!!  Needless to say, that after that episode, my mother (her real self) never returned.  Yet, some of those traitors at DHS are STILL there as I speak!!!!!!My mother died on August 25, 1996. 

I will never forget the betrayal and the fact that SHE WAS OFFERED UP AS THE SACRIFICIAL LAMB TO THE NURSING HOME INDUSTRY; just to be rid of a strong advocate!!!!!  YOU REMEMBER THIS, JANICE, take it to your grave.
Sincerely,Marie B. Wisdom, President
Advocates For Nursing Home Reform
Austin, Texas

Ms. Caldwell,
Last week, I received an e-mail >from you where you tried to make three points. You spoke at a Family Councils conference with these beliefs?   We are tired of hearing the same bueacratic answers and lies.  Why do you think so many advocates responded to your remarks so quickly?  Because we know BS when we hear it. I was unable to attend this conference; however, I am compelled to respond to your one-sided thinking.  

First of all, it is up to the nursing home industry to insure that quality care is provided to its residents.  And when it is not provided, then they SHOULD be held responsible.  Unfortunately, quality care is being replaced with neglect.  Too many of us have seen this too many times.   Enforcement of rules and higher penalties WILL bring about changes.  When the industry has to start paying for  their mistakes, it will start to add up fast.  So, they will either have to change or go out of business.      As it is now, the nursing home industry fears nothing because they know nothing will happen to them.  

You mentioned "public involvement".  Why are you looking towards the public? 

Why are you not looking at the industry itself?  Just remember, everything  starts at the top.  Unfortunately the industry chooses to spend its money on politicians rather than trickle it down to increase staffing in their facilities.  If the nurses and the aides truly believe in their profession and providing quality care to their residents, then they would try to make a difference.  But again, too many times we have seen them cover things up and/or provide neglect for a paycheck. 

Public involvement will not change things.  If the laws and fines can not make the industry change, what makes you think that public involvement would?

 Most of the time, when I hear this mentioned, the person is referring to the public coming in to visit, help with feeding, etc.  But this is what the  employees get paid to do.   What you are really saying is, 'we are short of  staff and we know the corporation is not going to do anything about it, so  we'll ask the public to help us out.' 

The Ombudsmen will not make a difference either.  Again, too many times we  have seen them do nothing.  The majority of them are on the side of the staff  not the residents.  If the Ombudsmen would investigate like they are suppose  to, Licensing would be flooded with complaints.  Unfortunately, instead of  doing all that  paperwork, they just listen to residents and visit. 

Family councils could bring about a change in the staff.  But that's is only  if the facility did not run the meetings.  Again too many times we have seen  nonproductive councils due to the staffs' involvement.  Isn't that something?

 The facility will say they are short of staff, but they have the time to sit  in on a family council to stifle family members.    The relatives of the residents should be able to meet and discuss issues without the threatening  presents of staff. 

Read the many letters sent to you.   These advocates have been on the front line fighting elder abuse in and out of nursing homes for a long time.  The  majority of them are not paid for their dedicated vigilance.   Remember,  change comes from within and until the industry cleans up its act, nothing  will change.  Let's take care of our elderly the right way.  Start speaking from your heart, not for the industry.
Kathern Puckner
<mailto:karegiverk@cs.com>karegiverk@cs.com

To:  Janice Caldwell
As an advocate and family member, I am appalled by your attitude toward the pain and suffering of residents in nursing homes as was so clearly demonstrated by your recent remarks made in California.  

Aren't bed sores, understaffing, cold food, soaked sheets, injuries, intimidation and daily neglect enough without the added burden of 'protection' by a government employee with such disdain for their plight?  As investigations have proven, taxpayers have supplied millions of dollars to the nursing home industry for services never provided to helpless, frail residents in facilities.  But, we also waste money for salaries to 'public servants' such as you, who seem to ignore the SERVICE aspect of their position.  How much did your California visit to share your opinions cost?  It seems that Texas nursing home residents did not benefit from your work there, and obviously your attitude hasn't changed.  Do us all a favor and simply resign.  Perhaps you will be replaced by someone with true concern about the horrible situation in nursing facilities across the country, and a desire to make critically needed improvements.

Immediately, you owe an apology to the families who have been willing to share their pain from the treatment their loved ones received, documented on film, to bring about improvements for others and alert others of the dangers.  They have the respect of advocates.  They deserve your respect also, not your criticism.  The residents' suffering shown so sadly on film is not sensatinoal, IT IS REALITY, and information consumers need and deserve to know.  Those in government especially need to be reminded. Pathetically, if such terrible treatment did not occur, the families would not have gone to such effort to get help.  Why do you not agree with public accountability for the nursing home industry?

The care actually being provided demonstrates that the rules aren't tough enough, are not being followed, not being monitored, and not enforced.  If you question this, I'm certain advocates could suggest MANY, MANY facilities around the country where you could spend a few weeks as an ordinary resident and become enlightened ---- after your resignation.
Janet Clayton
Missouri
Member: APE- Association for Protection of the Elderly
 <mailto:greatdadape@yahoo.com>greatdadape@yahoo.com

Ms. Caldwell
I think it shameful, just shameful, cameras are necessary to keep our citizens of the "Wisdom Age" protected from the evil minds and actions of those who have chosen the guise know as a "non profit organization," to maintain a tax free income. 

I think it is shameful, just shameful, the Director of the HCFA cannot perform tax supported income and serve the tax payers rather then create more problems. 

Certainly there should be more cameras and probably a guard posted in each room to be sure the cameras get all the details. 

If Ms. Caldwell was performing a service a servant of the people should perform she would be proud to have any form of surveillance only to prove her ability and the love she has for those that need care.  This is called, "job security."

Recommendation is, drum Caldwell out and stir up a recall on the rest of the gang.  Maybe this will cause the next Leader (?) to handle with care. 
Sincerely, Janis Mills  California
<mailto:JanisAnne@aol.com>JanisAnne@aol.com

Ms. Caldwell
How dare you to think that you are qualified to handel such a position. We have been working years to get rid of jokers like you. You people seem to think you are taking care of a bunch of fools. I will have you know that they are our mothers, fathers, brothers, sisters and friends, that you and your cohorts are talking about and mistreating. I wish they were someway you misfit of justice could be sent to jail. Our better yet incarnated for a long sentence in any Medicaid nursing facility.
JC Beverly
New Mexicans for Quality Long Term Care
<mailto:jbeve1@hotmail.com>jbeve1@hotmail.com