How to read Georgia nursing home inspection reports

Georgia nursing home inspection reports

Nursing home inspection reports can be detailed to read and it is important to know what to look for. Particularly because the information can be very valuable for family members of nursing home residents.  In today’s episode, nursing home abuse attorneys Rob Schenk and Schenk Firm discuss nursing home inspection reports with guest Richard Mollot, Executive Director of The Long Term Care Community Coalition.

TRANSCRIPTION OF EPISODE

Schenk: Hello out there and welcome back. My name is Rob Schenk.

Smith: And I’m William Smith.

Schenk: And we are your co-hosts for this episode of the Nursing Home Abuse Podcast. Today we’re going to be talking about how to read inspection reports and reports by the government of nursing homes and how to understand what a statement of deficiency is and what that means in terms of the care that a resident at a particular nursing home receive.

And this is kind of like a to-be-continued episode. Actually this is the second part of a to-be-continued episode because we’re having again to the podcast Richard Mollot. Last week we talked about how you can use the website Nursing Home Compare, which is a website operated by the government that provides scores to nursing homes around the country, and if you didn’t listen, it’s a great episode, but we talked about how to use that website to maneuver through and discover information about nursing homes around the country.

And one of the pieces of information you can get from this website are the various inspections conducted by the Centers for Medicare and Medicaid Services that there are period inspections. You can access these through that website, and today – well that took a long time – today, we’re going to have Richard Mollot back on the show to guide us through what that inspection report looks like, how to understand what statements of deficiency are and what you can do with that information.

Will, please take the mic away from me and tell me, tell us about who Richard Mollot is.

Smith: So we’ve had Richard on the show numerous times in the past. He’s the executive director of the Long-Term Care Community Coalition, which is the LTCCC. It’s a nonprofit organization dedicated to improving care for seniors and the disabled through legal and policy research, advocacy and education. He also runs the website Nursing Home 411, which is a phenomenal website that if you a loved one in a long-term care setting, you have to go to Nursing Home 411 and check it out and use it in conjunction with other information that’s out there on picking a nursing home.

Richard’s a graduate of Howard University School of Law. He is an attorney and he’s a member of the Maryland Bar.

Schenk: Esquire.

Smith: Esquire. So we’re very fortunate to have him on here yet again.

Schenk: Richard, welcome to the show.

Richard: Thanks very much. Thanks for having me back again.

Smith: All right, Richard. Thanks for coming back. The last time you were on here, we went over the Nursing Home Compare site, which is the government website from CMS, from Medicare.gov that has the different data, that has the different staffing levels or the quality measures. But the other thing that it had on there was you can look at these statement of deficiency sheets that has got somebody’s made a complaint or for some reason, the state’s going out there to inspect, and you’re going to go over one of these now, is that right?

Richard: Yes I am.

Smith: Okay. And so what are we looking at here?

Schenk: Oh, and I haven’t mentioned this yet. I’m so sorry. This is another one of those picture pages episodes of the Nursing Home Abuse Podcast, so it’s going to be a treat for the viewer of the show because we’re going to be taken through, the screen will be lit up with the information that Richard is referring to, and again, if you watch this episode, you’ll be able to see everything that Richard is doing. Sorry, Richard, go ahead.

What is a Statement of Deficiency?

Richard: Great. No, thanks very much. So we’re looking at the statement of deficiencies for the Pruitt Health facility in Virginia Park, of course in Georgia. So these statements of deficiencies, as you guys were just saying, they are essentially the record showing what deficiencies were found when the nursing home was last inspected, and that could be for what’s typically an annual inspection or it could be an inspection or what we call a survey as a result of a complaint.

So what a statement of deficiency does is this is for every nursing home, and again, any time there is an inspection in which there are any what we call deficiencies, which is really a citation for a violation of a minimum standard of care, and the federal government calls them deficiencies, what you’ll see in these statements of deficiencies are an explanation of what the citation was for, what the standard was that was violated and how it was violated.

It’s really important to understand as you approach these, we talked about these last week, that the Nursing Home Compare website has the last three years of the statements of deficiencies and it has the citations, etc., so you can see those citations, and as we’re talking about today, you can see the actual statements. But it’s a way to kind of dig a little bit deeper into what is going on in your nursing home.

It’s really important, as I mentioned last week, to note that the states tend to do a very poor job in identifying problems and in what we call scoping them appropriately. So just to take a moment to discuss that, as I mentioned last week, the nursing homes, most people – I can’t think of anyone who wants to go to a nursing home, to be honest, unless they absolutely have to, and the reason for that is because there are very persistent and very widespread problems that we and the government agencies and academics have all tracked year after year after year.

Nursing Home Compare Website

What this does, what the website does and here in the statements of deficiencies, you can see exactly what is going on, what was found to be going on – that’s very important – in your nursing home. The distinction I’m trying to make is that this may not have everything. It may not have every problem. It has the problems that the surveyor saw and that he or she was able to what they call substantiate. So I’ll talk a little bit more about that further on.

But now, why don’t we go to one of these documents? Again, this is the Pruitt Health – this is the last inspection for their Virginia Park facility. It took place on March 15, 2018, and if you’re looking, this looks to me – and I’ve been doing this for close to 20 years now – at first I remember being very intimidated by these statements of deficiencies, because you can see they’re rather dense. But what I have come to just in looking them over the years, I see them as telling a story and explaining exactly what was found when they’re citing a deficiency.

Why use the Nursing Home Compare website?

Why is this really important to residents and families and anyone who is working with them is that you can see exactly what problem has been identified. So again, you’re not seeing every problem that is identified. I just want to make that very, very clear, but you see when a problem was identified by an inspector, when it was substantiated and how.

So what I’m going to do is I’m going to skim through – as you can see in bold at the top of the page, it says, “Honor the residents’ rights to organize and participate in resident family groups in the facility,” and then in the left-hand column, there’s an F number – that’s 0565. That’s what’s called the F-tag. So for every provision in the federal regulations, there’s an accompanying F-tag. It’s basically the number that the surveyor assigned, and we use that number a lot. So we can see how many facilities were cited, for example, for F-tag 0565. And then underneath that, underneath the F0565 in bold, it says, “Level of harm and residents affected,” and that’s what I meant when I said nursing home surveyors tend to do a poor job in adequately scoping the level of harm and the effect that these violations have had on residents.

Review a nursing home’s statement of deficiencies

So what you’ll see is I’ve highlighted – the yellow you see is what I’ve highlighted for purposes of discussion. It doesn’t usually show up that way. But again, the statements of deficiencies are useful to see what has been identified as a problem in your facility and exactly what the facility is expected to be doing. So if you are a family member or a resident or if you’re working with residents and families or consulting with them, you can get an idea of what has been going on in this facility, at least what has been found, substantiated by the government as some of the problems, and then address them to the extent that you might be interested or concerned. So if you are a family member or resident participating in the resident or family council, these can be issues you can raise with the facility, things that you might want to be aware of. And if you’re an attorney working with residents or families or an advocate in some way, to know what is going on and what issues might be of concern.

So what I’ve done here is I took one of the shorter ones, frankly, because I wanted to make sure we had time to give it some framework. And this again was that the facility had failed, and it’s here in bold, to develop a complete care plan within seven days of the comprehensive assessment and to have that prepared and reviewed by a team of health professionals.

So I’m not sure where we caught up before, as I mentioned before, the planning, the assessment of a resident and the planning of his or her care are really essential, and they sound like they may be things that are not that important, but as I mentioned before, there was a major federal study that was done several years ago that found for Medicare beneficiaries specifically, that one-third of them were harmed within about two weeks of entering a nursing home. This was a national study.

Smith: Oh wow. Yeah.

Richard: So why is that important? One, it indicates that there is a – it shows how important it is to have a proper understanding of what a resident’s needs are through an assessment and how important it is to have a care plan that appropriately and adequately addresses the needs that have been identified either clinically or by speaking to a resident or his or her representatives in that process, and the care plan must be, and the assessment, both must be updated whenever needed. So there’s a change in how a resident is functioning – if there’s a clinical change, etc., that those things are to be addressed in this way. That’s part of the federal requirements, which is what we’re talking about here.

Schenk: Right. And so I see we have the violation of those federal requirements is highlighted, but then take us through – and I was going to ask this before, but there’s a whole lot of dialogue underneath the bolded citation and you’ve highlighted a portion of that starting with “During an interview.” Take a through what information is this and who is putting this in here.

Richard: So this is all done by the state surveyor. So just to provide a little backdrop, the Centers for Medicare and Medicaid Services, the federal agency, they pay for all Medicare and Medicaid services, no matter where they’re provided. And in nursing home world, if you what we call participate in Medicare or Medicaid, you have to meet these standards for every single one of your residents. So once you’re in the Medicare/Medicaid world as a facility, all of your residents, whether they’re private pay, whether they’re paid for by Medicaid, whether their care if paid for by Medicare, whether they’re Uncle Jack pays for their care, it doesn’t matter. Every resident has a right to every service that we talked about in the federal requirements. So this really tells you exactly how those rights are not being realized for the residents.

So the statements of deficiencies are written by the state surveyors. CMS contracts with the state agencies – in Georgia, it’s the Department of Community Health – and so they essentially contract with those states to ensure that nursing homes are meeting the standards of care 24 hours a day, seven days a week, 365 days out of the year.

The way that they do it is through annual inspections and through responding to complaints. Now as many people realize, the reason why we’re here is because unfortunately the states don’t do a really good job of quality assurance and too much nursing home care is, to put it nicely, not very good.

So brings us to where we are today, which is, okay, let’s see, what we’re looking at is what did the state identify when they came in? And how did they identify it? And how is that instructive to what we are seeing and are concerned about in the facility?

So here again, in this one deficiency, and there are 11 that are covered in this because they had a lot of deficiencies this past March, but this is one, and it relates to the comprehensive assessment and care planning, which are, again, so important.

So what they did here is they said that this is the first paragraph, that they failed to provide this for two of a sample of 24 residents. And they described what they found for each resident and how they what is called substantiated the deficiency, substantiated the facility was out of compliance with the minimum care standard.

And you’ll see, it’s a little difficult, I try to ignore it but they want to make sure that they don’t divulge anyone’s personal information, so you’ll see a lot of information is redacted. They never use anyone’s name, so the first one, number one, is Resident No. 46. They just assign a number to that person, and essentially what I highlighted here is during an interview conducted with Resident 46 in her room, March 12, she stated that she had not been invited to attend a care plan meeting to discuss her plan of care since her admission the previous October.

Schenk: Wow, okay.

Richard: That’s right. Resident 46 stated that she had never had a conversation with any of the staff members regarding care plan meetings – her care plan. She did not know what they were. Resident 46 is listed as her own responsible party, and it said in the paragraph before that I didn’t highlight that she is cognitively intact and able to make decisions about her daily living, so there’s no reason…

Schenk: Yeah, I was going to say, in short, there’s no reason not to believe what she’s saying.

Richard: Yeah, no reason not to believe what she’s saying and also no reason to not have been included in those conversations. And this gets at as part of that care planning and as part of the resident – both the care planning and the resident assessment is that federal law requires that the resident and/or his or her representative are there and able to take part in contributing. It should all be centered on them, particularly on the resident, but again, if the resident can’t speak or if the resident wants someone else to represent her, that’s fine, but that all comes from the resident. The whole point of the nursing home standards is that it’s resident-centered and it’s focused on the resident, not focused on what we too often see is a top-down approach, which is that, “This is our facility. This is how we conduct certain things, A, B, C, D – we check it off and we’re done.” No. That’s not good for a care plan. That’s not good for actual care, etc.

Schenk: Right. So Richard, if I can interject, again, from a broad standpoint, you’re looking at the statement of deficiencies. That statement of deficiency concerns the admission. And underneath it is basically the investigation that was conducted and placed underneath the actual deficiency as a chronicling, as a record of how the inspector came to that information, which in this instance that you’ve highlighted was an interview with the resident. Sometimes it can be looking at the records of the resident. Sometimes it can be interviews with the staff, that kind of thing. Is that kind of how…?

Richard: Exactly. Yes. And I didn’t highlight it all, but they did talk to the receptionist. They talked to the director of nursing. They talked to other people on staff to find out, “Well what is going on?” And essentially, no one really knew, to summarize it. They were sending out invitations to care plan meetings to families, but they had completely bypassed the resident, who is cognitively able to participate. It just didn’t make any sense.

Schenk: Sure. And in reading these, Richard, do you get a sense that – does the inspector – is there anything in terms of slant or bias in this, because it seems like it should be taken down kind of like a police officer would, like I’m just taking down the facts. Is that how these investigations are recorded or do you see that the inspector is saying things like, “This is ridiculous,” or anything like that? Can you tell me about the tone generally about the actual recording of the inspection?

Richard: The tone is always very neutral. In fact, frankly from our point of view, the tone tends to favor the position of the nursing home. So what we’re looking at here in terms of a violation of a regulation is different than a violation of the law. And that really gets at why so many of these problems we see in nursing homes are not cited adequately because so many surveyors, they operate as if they were Perry Mason, and they have to have proof beyond a reasonable doubt, when in fact, that is not true. If it were a court of law, that might be different, but here we’re talking about substantiating whether there was a violation and who was affected by that violation.

Smith: Okay.

Schenk: Right.

Richard: And so everyone I’ve ever seen – I’ve never seen one that objected a personal opinion or that were subjected.

Schenk: Right. I think I’ve seen some where I feel like the inspector is definitely putting in some facts to make it – even though it’s objective – to make it look like it’s for one side or the other. I remember one where the individual made sure to note down that one of the nurses did not know how to use the hospital bed to lower or raise it.

Smith: Oh right.

Schenk: And then said, “Called over staff member XYZ who also could not do it,” even though it might not have anything to do with what the actual deficiency was.

Richard: Right. And that raises a really good point because we talked about staffing and I mentioned in the last week in the program how important staffing is, and I think anyone who’s been in a nursing home knows that, but there are really two aspects to that – one is having sufficient staff and the other one is having staff with the appropriate training. And nursing homes are required to do both. It’s really important for people to remember that they’re not running a YMCA. It’s not a hostel that they set up two beds in a room and they replace the toilet paper every couple of days. That’s not it. They’re getting paid a significant amount of money to meet these care requirements for a population that is very vulnerable.

Schenk: Right.

Richard: And that’s why these rules exist, and that is why it’s so important, and I’m an advocate and I say, “Well what are we doing to implement those protections and those residents’ rights for residents. So this one again is – one of the reasons why I chose it, there are some really horrible deficiencies that I’m sure you’ve seen and I’ve seen as well, but I think this gets at, in a very brief way, some important standards that are being violated and gives us an opportunity to think about what that means.

Now if I may, the second person who they spoke about here, this person, Resident No. 2, she has been documented as having highly impaired hearing. And what this shows, everything that they’ve found – you’ll see this in every statement of deficiency, it goes day by day by day of who the surveyor spoke to, what records he or she looked at, and what she found. So here you can see they reviewed the resident’s care plan from February 18th – they documented that she had severe hearing loss, that certain things needed to take place, to give her plenty of time to respond, to rephrase words if she misunderstands, make sure writing utensils are available and a writing board is present when communicating, stay patient when speaking with her – so all these things that just make sense.

And then it goes on to well how was this violated? The review of nursing notes dated October – so first it was February 18th of 2017 – in October, the review of the survey, the review documented, excuse me, the resident had returned with a new hearing aid to the right ear. In March, the resident was observed by her surveyor sitting in her wheelchair in the hallway. When the surveyor tried to communicate with the resident, the resident pointed towards her ears and said she could not hear. The resident did not have any hearing aids in her ear. The resident was severely hard of hearing and did not have any hearing aids in her ears. Then they talked to a certified nurse aide. The nurse aide stated, “I don’t know if the resident has hearing aids in place. No one has told me if she does,” again, getting back to staffing. The staff should know the needs of their residents and the staff should be addressing the needs of the resident. It’s not a YMCA. It’s not a hostel. It’s a care environment.

The surveyor goes on – the next around the same time around mid-day, the resident was again observed working on a word find puzzle in her room. The resident again did not have any hearing aids in her ears. The resident’s roommate was present and stated she used to go to some activities, but quit going as much due to the fact she couldn’t hear what was going on.

Schenk: That’s terrible. I mean you get more and more isolated the less and less you hear.

Richard: Exactly. A couple hours later, the surveyor observed that she was sitting in a wheelchair in the hallway when the surveyor started to speak to the resident. The resident again pointed to her ears and said, “They did not put them in. I cannot hear you.”

The next afternoon, the surveyor spoke to the licensed practical nurse. The unit manager was interviewed at the nurses’ station. The unit manager was asked why the resident was not wearing hearing aids. The LPN informed that the nurses’ notes documenting that the resident had got the hearing aids last year. The LPN reported the resident’s sister had talked to her about it a couple hours ago when she picked her up for a visit. The LPN stated, “I went downstairs to the laundry to see if maybe they were down there,” the hearing aids, “And they were not, so we’ll continue to look for them.” And they’re completing a form to give to social services that will take care of replacing the hearing aids.

And then the next day, on March 15th in the afternoon, they spoke to the NDS coordinator for the facility, and she asked if the care plan had been revised, so the staff would know if the resident had hearing aids and to put them into the resident. The NDS coordinator told her she could not find the care plan, however she believed the resident had two sets of hearing aids.

Smith: Let me ask you this, Richard, over on the side under the F-tag, it says “level of harm.” What are the different levels of harm?

Richard: That’s a really good question. So when a surveyor goes into a nursing home and they find a violation, they rate it in terms of it’s scope and severity. So the severity can be from no harm or minimal harm or potential for harm up until the highest be that there was harm or a resident was put in immediate jeopardy. And then the residents affected, that’s the other part of what we call the scope and severity matrix, are either none, few, many or widespread. So it’s again a matrix of how it’s ranked.

Now the problem here – I’m so glad you raised it – is that our research and other research has shown that even when they find a healthcare violation, the states rarely identify resident harm. That’s 95 percent of all healthcare violations – no harm is identified. And in Georgia, actually, when I studied this in 2015, it was even worse. They only identified resident harm 3.5 percent of the time when there was a healthcare violation.

So if you look at this one, just to bring it back to this example, they found no harm. Now could you imagine you were in a nursing home for months, you were totally unable to hear? You lost interest in going to activities because they just failed to provide you with the hearing aids?

Smith: It also looks like they said level of harm is minimal harm or potential for every single one of these so far. They’ve said the same thing.

Richard: Yes. And that gets again at, for Georgia, when we studied it, it was 96.5 percent of these violations are no harm. So make sure, if anyone’s looking at this, not to take that as meaning there was no actual harm. We actually have a new newsletter called the “Elder Justice No Harm Newsletter” that we capture these from around the country and give examples of citations where no harm was identified when we would say, I think a reasonable person would say, “You know what? If this happened to me, I would say it was harmful.” If it happened to someone I loved, I would say there was harm here.

The reason why it’s so important to me and to my work as an advocate is that when a nursing home is cited, it is extremely rare they will face any penalty unless harm or immediate jeopardy is identified. So what that means is for all these violations, for any violation that you see where there was not actual harm or immediate jeopardy written there under level of harm, likely it is that the facility did not have to face any penalty whatsoever. And what does that mean? That means that you are telling the facility that this is okay. You are telling this facility essentially that it’s okay to not have an appropriate plan of care, to not be inviting residents to their own care planning and not to have a hearing aid for them. They have a hearing aid but not in any way they could use for days and days and days and possibly months. We only know what the surveyor found, but presumably she’s been coming in the first day – in fact, we know that from what the roommate says. The roommate said to the surveyor, “She used to participate in activities but she doesn’t any longer because she can’t hear.”

Schenk: Well Richard, those are good points. My question now is you’ve pointed out a couple of ways in which this document would not be an accurate reflection of what happens. So my question now is putting yourself in the shoes of, again, someone who has a loved one in a nursing home and you’re trying to investigate and you look at a document like this, what are some tips from actually calling and getting something useful from it? How can we use this document and understand what we’re looking at and what we’re looking for?

Richard: So I would say, especially if you’re a family member or a resident or you’re working with people in a specific facility, it is really useful to see what kind of problems have been identified, so that they know. What have they been doing to rectify them?

Now the federal government has required that every state not only publish the statement of deficiencies, but also that they publish the facility’s plan of correction. And I’m been looking and actually had a very hard time finding that on the Georgia website, but that is required to be there, and we’ve been working with CMS to try to get them to hold the states accountable, because that would be extremely valuable.

So right now, just having the statement of deficiencies, you can see past citations, and those past citations are all too often, they indicate persistent problems. We did some research a couple years ago and we found that nationwide, 42 percent of facilities had what we call chronic deficiencies. They were cited for the exact same regulatory deficiencies, the exact same F-tag three times in the three years that are covered under Nursing Home Compare.

Smith: Oh yeah. Yeah.

Richard: So it’s constructive in that way to see what is going on. And I’m not necessarily saying go in and say this is going to be a bad facility, but go in and say, “What are you doing now to ensure that residents are included in care plans and that those care plans are followed?”

Schenk: So in short, you can use these documents, get the statement of deficiencies reports from the Nursing Home Compare website, look at what in general they’re being cited for, and that’s one piece of your decision whether or not to put your loved one in there. And obviously, if you’re seeing things that are repetitive or you’re seeing things that are major, then you go to the next facility.

Richard: Yeah, certainly if I was seeing – looking and seeing that they had 11 deficiencies, and I think what the statement of deficiencies does is let you get a sense of what that actually means, because Nursing Home Compare only tells you the number, but this gives you a sense of, well, this person didn’t have her hearing aid, and there are other deficiencies here that really spell out that – the next one that I just scrolled down to is they failed to provide care and assistance to perform activities for daily living for residents who were unable to, meaning they had residents who as many residents needed significant help with basic activities – bathing, dining, getting dressed, etc., and that they have failed to do that. And you can see how they failed to do that.

Schenk: Right. And I just want to say to the audience who might be looking at this or maybe not, just listening, these survey reports, the statements of deficiencies, they look jarbled. They look like they’re, from an official logistical standpoint, look like they’re incoherent, but when you actually read, it’s not that difficult to understand and get a gist of what is being said. This isn’t like reading some type of legal document. It’s literally reading sometimes what somebody said to another person. It’s not hard to digest. It looks hard to digest, but it is not when you get in and start reading it.

Richard: Yes, and I think that’s a really good point. As I said at the beginning, when I first started, I thought these looked so complex and they looked so dense, but each one of them tells a story. The one we just talked about, you can imagine the surveyor was there, and she saw the resident sitting in the hall, and the resident, she tried to speak to the resident as surveyors should be doing, and the resident couldn’t speak because she didn’t have her hearing aid. And every day the surveyor came back and every day it was just more – it was clear the resident wasn’t being given a hearing aid and hadn’t had a hearing aid for a long period of time, that it had very seriously affected her quality of life and ability to communicate. I mean imagine what it would be like if you couldn’t hear and how unpleasant that would be for those of us who have hearing, and imagine if you’re stuck in a nursing home where you can’t really watch TV, you can’t really hear what’s going on. It affects your communication with people who are providing care to you. It affects your communication with other residents. The nursing homes tend to be so isolating to begin with that it’s compounded so much. And people recognize that. The rules recognize that. The rules make sense to address those needs, and the fact is they didn’t and they’re not being held accountable.

Schenk: That’s exactly right. Thank you, Richard, for guiding us through this. For those listeners that don’t already know, even though you’ve told who you are six different times on this podcast, but let our audience know how they can get in touch with you and where they can further information about understanding these documents.

Richard: Sure, my name is Richard Mollot with the Long-Term Care Community Coalition, and our website is NursingHome411.org. And we actually – we have a lot of information. We tried to compress it down as user-friendly as possible for people to see what kind of violations are going on and then nursing homes, how often the state fines nursing homes, what antipsychotic drugging rates are and nursing home staffing rates in separate nursing homes, etc., so you can kind of see what is – get a different sense of what is going on as easily as possible. We really want people to have the tools that are available.

And if I may, we actually have a number of fact sheets and a dementia care tool kit on our website, and for each one of the fact sheets, we take a standard, which is the one that you see here, and we give you the F-tag number, we give you the citation to the federal code, but what we do is then just explain it basically. This is what the resident right is, this is what you can do to understand and to advocate for your resident to get their right in his or her facility. So please, they’re free. All the resources are free.

Schenk: Yeah, I was going to say it’s very user-friendly. Exactly, well Richard, thank you again for that very much. We look forward to having you back on the podcast in the near future.

Richard: Great, thank you both.

Smith: All right, thanks, Richard.

Schenk: Have a good one.

Richard: Thanks, bye-bye.

Schenk: Bye-bye.

Smith: All right, well that was – as always, it was really helpful having Richard on here. Richard is somebody who’s been working with long-term care issues for a very long time, and the LTCCC, the Nursing Home 411 website, Consumer Voice, so it’s good to have someone like him break down what to look for, and it’s also good advice. Go online. Go to Nursing Home Compare. Don’t just look at the star ratings, but also go there and download those statements of deficiencies.

Schenk: Yeah, go get those statements of deficiencies.

Smith: And read them.

Schenk: What the surveyor says.

Smith: See that there may be situations, like the one that we looked at where they didn’t put the woman’s hearing aids in or somebody wasn’t invited to a care plan meeting. So know what types of problems are out there. But yeah, it’s really good information, very important. Very good having Richard on as always.

Schenk: That’s right. Well great. Well I guess that’ll conclude this particular episode of the Nursing Home Abuse Podcast. As always, there are two ways you can consume each and every episode, which come out Monday mornings. The first is to go to your favorite application where you download your podcasts, such as Spotify, iTunes, Stitcher, Google, whatever Google has now – I think it’s Google Play?

Smith: Yeah, Google Play.

Schenk: Google Play something, and then Podcast Pound Puppies. You can do it that way. Or you can watch, and we always suggest that you watch, particularly this episode. I mean of any episode to watch, to put on your 3D glasses, you put on your 3D glasses now, this is the episode because there are some documents you want to see as Richard was talking.

Smith: Yeah, so you can go to NursingHomeAbusePodcast.com.

Schenk: Or our YouTube channel.

Smith: Or our YouTube channel.

Schenk: And with that, we will see you next time.

Smith: See you next time.

Thanks for tuning into the Nursing Home Abuse Podcast. Nothing said on this podcast, either by the hosts or the guest, should be construed as legal advice, nor is intended to create an attorney-client relationship between the hosts or their guests and the listeners. New episodes are available every Monday on Spotify, iTunes, Stitcher or on your favorite podcast app as well as on YouTube and our website, NursingHomeAbusePodcast.com. Again, that’s NursingHomeAbusePodcast.com. See you next time.