Westland House is a peaceful santuary amidst pine trees near MPC. We heard it was the best rehab facility. It needs improvement to protect patient rights, improve quality of care and promote patient safety. Maybe we should have known care had declined at Westland -- half of their beds were empty.
First, Westland is very clever at dancing around Medicare rules to discharge patients it finds difficult. Fortunately, I have Medicare rules on speed dial. They attempted to discharge my mother inappropriately not once, but twice. On the first occasion, they almost allowed my mother (who was looped out on medication and whose dementia progressed during surgery) to discharge herself to CHOMP. I had to threaten the nursing staff and tell the Fire Department I declined emergency services as her durable power of attorney. The dirty little Medicare secret is that Westland doesn't have to take a patient back once they discharge to the ER.
On the second occasion, they had the surgeon sign discharge orders before developing a discharge plan with the family (the nurses couldn't contain themselves and ran around spilling the beans to family members who promptly called me). Discharge planning is a Medicare requirement. Westland made us believe they were going to have a discharge meeting but behind our backs were processing the discharge the day before. Once you are discharged in the Medicare computer, there goes the public dollar. Westland would have had leverage to get Mom out lickety split. The Director of Nursing explained it away as a mistake when called on the carpet and said she would take care of it. We never saw this person -- sort of the Great Oz.
Third, with a few exceptions (shout out to C and ML), the Westland nursing staff are not trained to handle difficult situations or crises. The evening my mother was very aggitated was because she was given the wrong drug (approved by the Director of Nursing); the nurse on duty called me in a panic. God help the patients if there is a fire.
Fourth and perhaps the most eggregious is Westland's complete mismanagement of pain medication despite information from the family about drug reactions and mother's repeated complaints of pain post-surgery. By day two, we learned that Westland was not providing any regular dose of pain medication even after we had requested it. Unbelievable. They were relying on an 88-year old woman to tell them when she was in pain. What's even more concerning is that she was constantly articulating pain and they did nothing. The family requested and was assured a regular dosing schedule would be followed but it took nursing staff two days to implement it. I know because I called the nurse station when meds were due to find nurses unaware of the dosing schedule. Note: the last Westland Medicare review dinged Westland on pain management -- more people complained of having greater pain at Westland than the national average.
Nursing staff mismanaged mother's pain medication which exercerbated her anxiety and aggitation. We said no MS-Contin. The Director of Nursing approved MS-Contin. We said no valium. The nurses threw valium at her. Etc., etc., etc.
Fifth, Westland House is understaffed. On the night shift, there was one or two nurses on duty, dispensing pain meds, handling patient needs, etc.
We won't mention the two-month old expired foods Mom was served -- November 2014 juices.
Older patients who are aggitated or have difficulty advocating for themselves are not easy to care for. But if a rehab facility doesn't want to bother, they should reconsider why they are in the business of healing in the first place. Frankly, I think the only reason they accepted my mother -- who did receive excellent PT -- is because I called the care manager on their rep for being selective in who they take during a tour prior to my mom's surgery. Even then, they would only take mother if the family paid for 24 hour around the clock sitting services at $21 an hour. We agreed, once watching Mom's growing aggitation at Westland, that rehab at home was a good goal. But Westland's poor quality of care and non-compliant practices were unconscionable. The Medicare Ombudsman explained that Westland really isn't equipped to provide care for certain patients. Yes, but if they accept Medicare dollars, they are obligated to meet Medicare access and quality of care standards as well as honor patient rights. The CHOMP Board should review the practices at Westland for compliance. read more