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assisted living facilities

  • 1.  assisted living facilities

    Posted 11-23-2018 17:35
    I would like to pick your brains
    Maine is the oldest state in the Union We are seeing more and more assisted living facilities Patient love them Activities  and meals and company and clean new living spaces.
    but only some of them have RNs and only sometimes
    S o then we get these calls about sob and low oxygen sats or pain or etc Verbal orders cannot be given to the unlicensed personnel that work there One must send a written order.
     Even  if there is a RN she or he can execute the order(  they have to be on site) but cannot give it to an unlicensed personnel to  administer.
    The   civil servants at the State have told us that we must take care of these people just as well as if they were at home But at home I can tell them or their spouse etc to give them  an extra inhaler dose etc I cannot do that when I am called by assisted lving people So I get called but I cannot help
     Other docs just as frustrated here They think these facilities keep people who  are too sick to live there When they  get very sick the staff always wants hospice to come in so they get help when the person needs  nothing more than to  be comfortbale and pass away peacefully
     it is all seeming like  a bureaucratic tangle Any comments?

    Jean Antonucci

  • 2.  RE: assisted living facilities

    Posted 11-26-2018 06:59
    Good points.  I agree that the whole assisted living idea has not turned out to be very helpful.  I don't have many patients that can afford it, so I don't deal with them much, but I agree with Jean's points... they are less helpful than a competent spouse.


  • 3.  RE: assisted living facilities

    Posted 11-28-2018 10:40
    It would seem to me that if the facility and state laws require an RN to accept and carry out an order, then an RN must be "on-call".

    Why not ask that the RN call you?   Ideally, they have more info and history on the patient.

    Michael S. MD

  • 4.  RE: assisted living facilities

    Posted 11-29-2018 05:30
    There is no Rn at one facility at all  That is the point   One can  only order anything in writing So- Sat night ,  bs up  ,one cannot say give X units insulin  Has to be in writing

    In some places there is an Rn there sometimes she can take VO and  administer it Cannot take VO and have  unlicensed personnel administer it  So I get called and cannot help  drives me bats

    Jean Antonucci

  • 5.  RE: assisted living facilities

    Posted 11-29-2018 09:32
    To all:

    So...assisted living can be thought of as a patient living at home. The staff are the "caregivers" and aren't hired to be nursing staff. They should be regarded as equivalent to a family member calling with a bad pulse ox or acute problem. If further assessment seems necessary, you'd have to refer them to ER/urgent care. 

    Assisted living patients also qualify for home health services, which would be the same as if they were at home. 

    Michael R. McLeod, MD

    Sent from ProtonMail Mobile

  • 6.  RE: assisted living facilities

    Posted 11-30-2018 05:25
    To Michael
     oh come on!!!
     I f they are living at home I tell the spouse give 10 units insulin  and call me  with a bs in2 hrs

     the ER???!!! 600.00 for a    minor problem?? This is why we are in trouble

     Doctors are constantly supposed to fix all the problems    Find a fax  in your  phone while at th emovies on Saturday becasue a written order is needed and THEY have no RN   How frankly ruide

     It is a system  problem that is why there is so much waste of money and everyone is so stressed

    Jean Antonucci