Allegaters VERSUS Justice

There's allegaters at Homeland. Recently the faceless entity designed to torture skilled nursing facilities, called "The State," cracked down on phoning in to The State every thing that ever happened to anybody at the facility. Bruises, falls and complaints, mostly. Anyway, that's Homeland's interpretation of the rules.

Suddenly, karmaically, this situation has mysteriously attracted a multitude of complaints and accusations, which were rarely mentioned before. I think it's the scent of blood.

Homeland is turning into a police state. Anytime one of our residents, who all have at least some amount of short term memory loss, God bless 'em, opens their mouths and mentions that they thought it took too long for staff to answer their call lights, or they thought the staff performed a transfer wrong, or forgot a medication, bam, there went four hours of somebody's time filling out investigational paperwork and calling The State. And worst of all, an accusation is treated as fact.

Mrs. O'Hunnie couldn't remember two hours later getting her inhaler, but twelve hours later she can still remember that the nurse supposedly forgot it. Mr. Dunnfore claims that someone assisted him to stand by the bedside commode using the walker, but the nurse just walked off and left him there instead of completing the transfer to the commode.

I've noticed that the personnel hearing these allegations are usually the contracted therapy staff, and I've come to the conclusion that the next time one of them comes trotting up to the nurses station to mention one of these allegations I'm going to point to the paperwork and say, "Go ahead, there's the investigation form."

The Forms: the first page of which I am quoting an excerpt is cribbed from the incident report form, so most of it doesn't apply. It is an "Occurrence Report Checklist:
X Check off all items completed.
X All questions on the occurrence report must be answered.
X Review the resident's care plan--was care provided according to plan of care?
X Caregiver/Witness Report MUST be completed at the time of occurrence by the person reporting the occurrence AND the person assigned to care for the resident . . . etc etc etc. REMINDER: Washington State requires (RCW 74.34.035(3) you to notify the DSHS Hotline 91-800-562-6078), if the occurrence involves Abuse/Neglect, Abandonment, Mistreatment, or Misappropriation. Facility Protocol requires you to notify the DNS and/or Administrator of any occurrences of Abuse/Neglect, Abandonment, Mistreatment or Misappropriation.
State Hotline Notified? _____No ______Yes, Date/Time:_________.

LN is responsible to complete the following for all ALLEGATIONS OF Abuse/Neglect, Abandonment or Mistreatment:
X Intervene, immediately, and provide safety for the resident(s)
X Remove perpetrator immediately (employee, visitor, family, another resident, etc.)
X Initiate the Occurrence Report, obtain witness statements from all staff on duty
X Notify the DNS &/or Administrator: Date/Time:_________
X Notify Tacoma Police: Date/Time:_______________ (non-emergent Phone Number 253-798-4721)
X Notify Physician:________ Date/Time:___________
X Notify POA/Responsible Party: Who:__________ Date/Time:__________
X If appropriate, arrange for immediate transport to hospital/ER for evaluation
X Complete occurrence report, initiate alert monitoring/charting."

I will stipulate that we care about our residents, they are in our care and vulnerable, and that all the staff must do the utmost to keep them safe and secure and healthy. That is our goal. However, the process involved in dealing with these issues leaves something to be desired.

I'll spare the reader the rest of the extensive paperwork, except for the "CONCLUSION" section. I ask you to remember that nothing that someone claims to have occurred is actually proven to have occurred. Here is the dictionary definition of the word "allegation":
"The act of alleging; also, something alleged; an assertion made by a party in a legal proceeding, which he undertakes to prove; an averment; sometimes, a mere assertion without proof."

Listen to the language of this portion of the form:

Who was involved in the allegation?
What was the allegation?
When did the allegation occur?
[When was the complaint voiced, or when did the supposed event happen?]
Where did the allegation take place?
[Where was the complaint voiced, or where did the supposed event happen?]
Why did the allegation happen?
[Why was the complaint voiced, or why did the supposed event happen? Which, as you can see, the form assumes actually happened.]
How did the allegation occur?
CAUSE/REASONABLE CAUSE of the allegation was:___________.

Okay, the dictionary does say that an allegation could be "something alleged." I have issues with language that uses the fact of someone saying something interchangeably with the idea an event actually occurred. As soon as the questionaire is asking the staff to say when the "allegation" occurred, where it took place, why it happened, and how the allegation occurred, and what was the cause of the allegation, a line has been crossed. The language of the form is now assuming that an actual event took place. Guilty until proven innocent.

I have major issues with that.

"The best beloved of all things in My sight is justice."

~Baha'u'llah