Review of Signature Pointe on the Lake Healthcare Community

Signature Pointe Rehab Review -

My Aunt was on the 4th floor of the Signature Pointe Skilled Nursing Care/Rehab part of the Facility for 5+ days. (She is not part of the permanent residency so this review is Not about the Assisted Living apartments). There are serious issues with some of the medical staff & aides not doing their basic jobs. The call signal went unanswered, sometimes for ~30 minutes (the room was right next to the nurse's station). They would not come to help her to the bedside toilet, and several times would leave her sitting alone on it - totally against the rules due to possible injury from falls. We spoke with the Director of Nursing who twice briefed the staff (we heard her) but the aides ignored her. We spoke with the various Head Nurses, the Social Worker, the Admissions Office, and tried to catch the director. We never had a visit from the facility’s Doctor during the entire time, despite our requests for his attendance. When we asked if she had been given any of her particular medications, the staff’s answer was "we don't know". Is it time for more Tylenol to reduce her fever, "we don't know". When someone comes to their facility from a hospital, after being treated for congestive heart failure and fluid/infection in the lungs, you would expect them to take medicating more seriously. We hired private-pay Care Sitters to sit with her 24/7 and the majority of the time a family member was there as well - that to say that we are informing you from firsthand knowledge which is logged below. We finally had her moved to another facility due to the absence of necessary basic care by the medical staff aides and the fact we had communicated many concerns with several levels of supervision/management with no results. When we moved her, the room temperature was over 81 degrees and had been hot for days.

INFRACTIONS By SIGNATURE POINTE ON THE LAKE:

Unnecessarily long response times to call bell

Staff repeatedly left room while patient on bedside commode

Unnecessarily long response time to request for pain relief

Confusion over medications given, lack of records

No communication with or from Doctor

Lack of required basic medical care

Our Aunt, 91 years old, was admitted from Medical City Hospital on Wednesday, 1/30/13, for skilled nursing rehab after congestive heart failure, and discharged Monday, 2/4/13 to be moved to a better facility.

Wednesday, 1/30/13: Aunt was admitted to room 431. Air conditioner not working, toilet not flushing properly and ran water all the time. Staff continued to work on the AC every day through our departure on 2/4, room very stuffy and uncomfortable at 80+ degrees, family complained many times. Aunt was very weak. We were never offered a different room. Admissions Director said that the family and hired sitters could not assist Aunt in and out of bed, that we needed to push the call bell and wait for staff assistance due to liability.

Thursday, 1/31/13: “Mom's Best Friend” agency sitter reported 10-15 minute response times to call bell, Aunt was having to wait too long to use the bedside toilet and Aunt was being left on the bedside toilet without staff attendance. Aunt's niece spoke with Director of Nursing and she assured niece that response time would be shorter and staff would remain in the room while Aunt was on the bedside toilet. She said this was their policy even if family members or sitters were in the room and that she had already spoken to the staff about it. Admissions Director told niece that family and MBF sitters could assist Aunt onto the bedside toilet if wait time was too long after pushing call bell.

Friday, 2/1/13: Aunt still being left on the bedside toilet. Niece spoke to Director of Nursing again. Director of Nursing asked Niece to start writing names for staff who left Aunt. Aunt complained about continuing ear pain with no response. Niece asked nurse to contact the facility’s Doctor

Saturday, 2/2/13: Aunt continued to complain about ear pain. MBF sitter rang call bell because Aunt was nauseated. After 5 minutes, RN stuck his head in the door to see what was wrong. MBF sitter was holding Aunt over a plastic tub as she wretched. When the MBF sitter asked for help, RN did not come into the room, just said he would send a CNA. Call bell remained lit from 1:10pm to 1:47pm before a CNA came to assist. MBF sitter called Aunt's niece who called Signature Pointe and asked to speak to Director of Nursing. Was told only person available was the Nursing Manager on duty, and call was sent to voice mail. Niece left a message about the incident and Nursing Manager to go up to room 431 and find out what happened, that niece was on her way. When Niece arrived, Nursing Manager had left for the day, no action taken. Niece questioned RN and he said he misunderstood the MBF sitter, he thought Aunt was “OK”. He said he did ask a CNA to come to the room and that the MBF sitter should have left the room to go and find someone. Niece told him that the sitter was hired to stay in the room with Aunt and that the call bell was on from 1:10pm to 1:47pm. Niece told him he should have come into the room to assist Aunt and asked why no vital signs had been taken. RN said he was very busy and that Aunt seemed OK. Niece asked him to take temp and blood pressure but he said it was not necessary, they had been “fine all day”. Niece asked if Facility Doctor had been to see Aunt about the ear pain, RN said no but he would put a note in the chart.

Call bell lit from 5:53-6:20pm, Aunt needed to use toilet, when CNA came she told Niece that a different CNA should have come but she was busy with other patients. CNA left Aunt on the toilet unattended while she went to find other CNA.

5:30pm, Niece told RN that Aunt's feet and ankles were swollen and asked him to call Doctor due to Aunt's history of pulmonary flash edema. RN said would give Lasix which was due at 5pm but had not been given, then he came back and said Lasix had been given at 2pm but he did not know why. Propped ankles on pillow, said he would wait till the morning to call Doctor.

Sunday, 2/3/13: When Niece arrived at 7:45am, MBF sitter said Aunt had taken a Tylenol due to eye and ear pain. At 8:30am, Niece told CMA that pain was getting worse and asked if glaucoma eye drops had been given the night before. She said she could not tell from the medication record but she would find out. At 9:30am, Niece told RN that pain was getting worse and asked again about the Lumigan eye drops, also asked what time Tylenol had been taken. RN said there was no record either medication had been given and he did not know if they had been given or not. He brought Tylenol and eye drops at 10am and Aunt went to sleep. Niece asked if Doctor had been to see Aunt about the pain, RN said the Doctors do not usually come on weekends and would probably come on Monday.

9:35-9:58 am call bell lit because Aunt needed to use the bedside toilet, CNA left the room with Aunt on the bedside commode after Niece asked her not to leave and explained what Director of Nursing had said about staff remaining in the room

12:30-12:35pm CNA left the room while Aunt was on the bedside toilet after Niece explained again that Director of Nursing had said not to leave Aunt unattended.

2:45-2:50pm CNA left the room with Aunt on the bedside toilet, even after Niece explained what Director of Nursing had said about staying in the room.

Monday, 2/4/13:

Aunt still complaining of ear pain. At 8:30am, RN told Niece that Aunt had been running a fever all weekend. Niece asked RN when Doctor would arrive. She said that Doctor would not be coming, that the Doctor's PA usually comes on Mondays. Niece asked if Doctor had been notified about the ear pain, RN said she did not know. Niece asked for Doctor’s first name and phone number but RN said it was against policy for her to give out that information. Since family had asked every day if the Doctor had come and were told no, it appears that Doctor never saw Aunt during her whole admission. Around 9am, someone introduced herself as the Assistant to the Doctor's PA and listened to Aunt's chest with a stethoscope. She said she did not have a scope to look in Aunt's ear and left the room, never returning. Toilet in room 431 still not fixed, AC still not working and room was 81 degrees. Both Nieces met with Director of Nursing, to talk about all of these complaints and to say that we were moving Aunt to another facility.

The new facility we moved to, immediately responded to her complaints about the ear pain and found blockage and removed it. The new facility responded to her weakness by doing lab work and finding her sodium levels low – they corrected that and had her up showering and feeling much stronger. The new facility responded to her nausea discomfort and found reflux – which they treated with medication. All this in the first day at the new facility. This is the kind of Doctor directed medical care we expected at Signature Pointe, but they seem unable to provide it. Safety procedures were repeatedly not followed even with a private-pay professional and a family member observing. It is disturbing to us to consider patients who are alone.

Signature Pointe on the Lake is a place I would DEFINITELY NOT recommend for medical recovery from a serious hospital stay. In my opinion, it borders on dangerous, as instead of my aunt’s health improving, it kept deteriorating while there due to negligence and inefficiency.