East Bank Center

[Note: This post rambles on a lot, and is not in any particular order. It was started over a month before it was finished and edited and added to many times along the way. I originally published it last night and then realized there were some more things I wanted to say, and on reading it realized some more editing was needed. The editing ended up being fairly substantial in a few places so I changed the time stamp as well.]

[ETA: 6-21-11 yesterday while walking Wilma I noticed an EBC ad on the electronic billboard by Machesney Park Mall.]

East Bank Center
6131 Park Ridge Road
Loves Park, Illinois 61111
(815) 633-6810

Fran stayed here after she got out of Rockford Memorial Hospital on 4/26 until she went home on 6/17, except for her second stay at RMH from 5/24 to 5/26. She was here a long time, 50 or 51 nights, if my count is correct.

Like a lot of things, there is the good, the bad, the ugly, and the odd aspects of this facility. For me the bottom line is if I needed to be in a place like this, would I feel OK being here. For me the answer is yes. In some respects it is somewhat about the "devil you know", versus the unknown. Having spent a lot of time here, I feel pretty comfortable with the place, and even more comfortable with the people here. Especially the people. I spent many an hour here, and I came away impressed with the level of caring and kindness I saw the staff show to patients every day.

After almost 2 months of coming here whenever I was able to, I came to become rather familiar with the place.  I always felt welcome and comfortable here. I don't have that level of first hand observation of other similar places to go on. It is quite possible there are "better" places. But I am comfortable with this one.

It has its warts like everything does. Some of that is probably at least partially driven by what insurance companies are willing to pay, and the fact that it was an existing building. There is only so much you can do to fix up an existing building.

Fran might have a different opinion, and maybe she will voice it here as a comment, or maybe not. She might just wish to forget about it all together.

If one had the money to afford it, ideally one would just hire people to come to a person's home 24/7 and take care of a person that needed this kind of help. It would cost more, but it would be more comfortable. A place like this charges more than $300 a day. You could not hire 24/7 help for that. But if money was not a problem, it might well be the way to go.

Not many people in any hospital want to be there, so I would not expect most people to think real highly of their experience here. Overall, the experience almost has be unpleasant. Most people probably feel better about the hospital they started at. They were hurt or sick and the hospital got them on the road to recovery, and then sent them off to a place like this one, where time probably just drags on seemingly forever as the slow process of returning to health occurs. It has to be mind numbingly boring at times, and frustrating that one has lost most of one's independence for some period of time.

Most of the residents I ran across at EBC were mobile, either walker or wheel chair, even a few were walking unaided. I saw a few patients that appeared bedridden, but the majority seemed mobile.

Facility
The driveway at the front of the facility. The main entrance is kind of in the corner to the left in this photo. There is a wrap-around veranda on the left that starts by the main entrance and continues all the way around the front of the building. The slope to the front entrance is a little tricky with a wheelchair. There is no overhead cover for when it is raining. The front entrance has no automatic opener on the doors, a curious omission for a place where the majority of those living here are in a wheelchair or using a walker. There is a bit of a hump coming in from outside at the threshold, so in a wheelchair you almost have to come in backward, although going out is no problem, at least hump wise.

One of the odd things about the place. They have a temporary sign over the old sign. It apparently has been there since it was converted from a nursing home to a rehab facility six years ago. Perhaps it is better they spend money on other things and not worry about the sign all that much.

The facilities that used this site previously seemed to have had a generally poor reputation. East Bank seems to have a better one. According to the Internet, facilities called Fountain Terrace, Park Ridge Terrace, and River View Manor, Ltd (you can indeed see the river from the front of the facility) all shared the same address at some point in the past. They also appeared to have the same phone number. They had a 6th anniversary celebration June 15, so I am guessing it is under new ownership the last six years. The previous facilities seemed to have all been nursing homes as opposed to rehab facilities.

The sign out front refers to post acute rehabilitation. I think it qualifies as a rehab hospital as opposed to a nursing home, but they seem to take some nursing home type patients as well. I am not sure just what the difference is. The line between the two seems pretty blurry to me, based on this experience and the experience with my dad in various nursing homes and rehab hospital visits. One difference seems to be that a nursing home is where you go once they have given up hope you are going to get better, and a rehab place is somewhere to go when you need nursing home type care, but don't need a traditional hospital, and are expected to recover and go home. Another difference seems to be that health insurance does not cover nursing home care, but does cover a stay in a rehab hospital. The insurance angle may be the biggest difference.

This non-functioning fountain may have a connection to one of the previous names of the place. Too bad it was not on. The running water sound might have been pleasant.  There is a nice veranda that wraps around from the main entrance around the front. It has tables and chairs for sitting at and enjoying some fresh air. There is also a gas grill there.

There is a parking lot across the street. Maybe 25 spaces, and perhaps another five or ten on the street out in front. I was there every day Fran was, sometimes multiple visits in a single day, and at various times ranging from 7 am till late in the evening and I never had any trouble finding a convenient spot to park. There are a few employee spots on the north side of the building, with space for perhaps a half dozen cars. You can see the river past the parking lot in this picture if you look closely (a connection to another former name of the place).

This entrance to the basement is right along the driveway near the main entrance and is not especially attractive. Kind of looks like the entrance to someone's root cellar. Takes away from the nice landscaping they have in the front. I was told the kitchen and laundry are in the basement, along with food and other storage areas, and an employee break room.

It's not a big place. Three wings (they call them halls), probably no more than 10 patient rooms on each hall. One of the women Fran ate with was in the one deluxe room. It has a small fridge and microwave, and only one bed. I looked inside it. Not a huge room, but it did have a sofa in it. As best I could tell all the other rooms had 2 beds and a visitor chair per bed.

The rooms are not real big, and some of them are laid out a little oddly to my way of thinking. One room Fran was in had the beds a few feet apart with the privacy curtains between the beds and the call button reset located so the nurse or CNA had to navigate between the beds through the curtains to reset the call button. For some reason I never took a good picture of any of the rooms. There was a nice amount of natural light in all three rooms Fran lived in and the rooms were freshly painted and well lit. Some of the rooms had a confusing array of light switches, and one room Fran was in had a light switch with no discernible function, perhaps a switched outlet.

You can see all three halls here from this picture of the courtyard that can be accessed by walking around the south side of the building along a sidewalk. 100 hall is to the left, 200 hall in front, and 300 hall to the right. The sidewalk on the south side of the facility continues around to the east side of the building behind 300 hall.

I did notice a fair number of rooms only had one patient, even though there were two beds. Sometimes it was kind of self explanatory as there would be signs on the door indicating special precautions were required for visitors (gown, mask, and gloves). Not sure if they were trying to protect the visitor or the patient. Other times there was no obvious reason for a single room.

While Fran was there it was never really cold out side. But it was in the upper 90s several days and the A/C seemed to work fine at keeping the temperature comfortable inside.

Nursing Staff
The nursing staff appear to all work three 12 hour shifts a week. It seems to work pretty well for the employees and the facility. I am too lazy to work 12 hour shifts anymore, but I never noticed anyone dogging it. I think there was adequate staff for the patient load, although at certain times there was a longer wait for a call button response. First thing in the morning and right after supper seemed to be the worst. Not too surprising.

I heard a woman loudly telling a staff member one night that her mother had been waiting 45 minutes to go to the bathroom. I don't think it was anywhere near that long. When any call button is pressed it beeps in the hall and at the nurses station. If the room door is open you can hear it very clearly. It was rare that it was on for more than a few minutes continuously while I was here. It became very annoying if it stayed on for very long so it was pretty noticeable to me.

Each hall seems to have a CNA and an RN or LPN assigned to it. Sometimes there seemed to be two CNAs and/or RNs, so maybe it is based on how many patients are on the hall, or maybe just some overlap, or someone came from another hall to help out for a short time. OTOH, it is not like I carefully tracked how many staff were present. One of the staff once told us that they are allowed to have a maximum of 14 patients in a hall, but there was usually fewer than that. I think I saw somewhere that their license allows for 64 patients, so I am not sure quite what  that means. It may be that they are allowed a maximum of 14 patients per hall with the one nurse and one CNA. Three halls at 14 patients per hall is only 42 patients. A pretty small place.

I started referring to the LPN/RN on the hall as the "drug lady", even though at least two of the nurses were male, because they come around with the drug carts and dispense the various medications the patients are taking. At first it seemed like they took an inordinate amount of time doing so, but I realized after a while they were just being careful and meticulous about it, and keeping detailed records. Better they take their time and get it right. Between rounds with the drug carts they come around and check each patient's vital signs and make sure they are doing OK. There were probably a dozen different drug ladies, plus the two guys. They hired another male nurse near the end of Fran's stay.

Three of the LPNs told me they had graduated from RN school while Fran was here, and that a 4th had also graduated at the same time. I like the idea that someone has enough drive to go back to school while working a full time job and having a family and life on top of all that. It says something very positive about a person willing to put forth that kind of effort. I think it also says something positive about the facility that they hire people with that kind of ambition and drive.

To me, the CNAs are the real heroes here. They take care of the patients directly. Dressing them, bathing them, helping them go to the bathroom, etc. I never ran across a mean one. I was impressed with the patience and kindness they showed while working with the patients, some of whom are a bit "difficult". Near the end of Fran's stay I noticed a number of new CNAs. I wondered if they were there to replace people lost in a staff raid by another facility, or just normal attrition. One CNA told me she was in the RN program at RVC. There is just something I like about people who are willing to put forth that kind of effort.

I saw many acts of kindness on the part of staff while visiting, both toward Fran and to other patients. I relate only a few just because I remember them more vividly.

One evening there was a tornado warning. I have pictures of the downed trees around the house in another blog entry. When the storm hit, I was at East Bank. The CNA on the hall Fran was on came along and got all the patients out in the hall, closed the blinds in the rooms, and the doors to the rooms. We all stood out in the hallway until the warning was lifted. One of the elderly patients was visibly scared. Carol (the CNA) went over to her and quietly held her hand until the warning was over and the patients could go back in their rooms.

When Fran first came in she was pretty frazzled. Probably not that unusual for an incoming patient at this kind of facility. She was checked in by John (one of the male RNs). His kind manner and confident professionalism while he checked her over, got her settled in, and answered her questions helped to noticeably calm her down. It made me feel a lot better about her being here as well. I talked to John later and found out he had only been an RN for about 4 years. Before that, he worked installing flooring. I think he may have found his true calling.

Jessica (another CNA) made this complaint box for Fran out of an empty Kleenex box one evening when Fran was feeling grouchy. She has an infectious good mood that makes one feel better just being around her. Jessica and Fran both like NCIS. Fran prefers Mark Harmon, while Jessica likes Michael Weatherly. [I favor Ziva. :)] It turned out Jessica's aunt is Fran's surgeon's nurse. It is sometimes a very small world.

There was a doctor who came in several times a week and made rounds. Also a nurse practitioner. I never saw the doctor, as he seemed to come in during the day when I was at work. I did run across the NP a couple times. She spent at least 20 minutes with Fran one time I was here, and I saw her in the hall or nurse's station several times.

A podiatrist visits periodically for those who need foot care. One of the staff told us they are not allowed to cut toenails on diabetics. The podiatrist has to do that. A foot doctor came a few days after Fran got here and cut her toe nails.

Food Service
I would have to rate the food service as pretty good. It seemed above average for an institutional kitchen to me. There was a good variety, and no one seemed to have any trouble with the quantity of food. They were quite willing to make a patient something special like a sandwich or a cheeseburger if the scheduled meal was not to their liking. The food looked good, and smelled good to me, although I never ate any of it except once a couple pieces of broccoli out of a bowl of soup Fran did not like.

Most of the patients seemed to generally approve of the food service, although Fran said sometimes that a lot of the patients did not especially like a particular meal. There seemed to me to be a deliberate attempt at producing a better tasting set of meals than the typical institutional food. I would say it is not an unqualified success. A lot of the patients seem to prefer a blander diet, so often did not eat the food on the daily menu. I am pretty sure you cannot please everyone with the same dish, especially when dealing with so many people with a variety of health problems. Probably they do about the best thing they can do short of running their kitchen like a short order grill like RMH does. And to some extent they almost do run a short order grill. They seemed very accommodating to the patients' special food requests.

Patients who did not want to come to the dining room, or were unable to, had their meals brought to their rooms.

There was a table at the entrance to the dining room where they had a tray of snacks, coffee, ice water, and hot water for tea all the time. I drank many a cup of their coffee. It was pretty good. John pointed it out to me to one evening.

In the evening the snack ladies (as I called them - they were the same people who served food in the dining room) would come around offering snacks. They usually had an assortment of sandwiches, milk, ice cream, yogurt, fruit, and cookies. Probably a few other things as well now and then. They offered visitors including me snacks as well as the patients. A nice gesture. I never accepted any of the snacks as they were not well suited to my low carb diet.

Another odd thing - there was no salt or pepper shakers at the tables. The servers had little packets of salt and pepper for the asking. The packets have to cost more than having some shakers, so maybe they are trying to discourage salt intake.

Only sort of food service related - every few hours during the day and into the evening someone would bring each patient a glass of fresh ice water and take away the old one. Most of the time it was a plastic glass with a straw and a disposable cup lid on it, but sometimes it came in a foam cup. I found out they have a fancy ice and water dispenser on one of the halls and would go there now and then to refill Fran's glass or get some for myself. Sometimes the snack ladies distributed the water, sometimes the CNAs did.

A couple of times I brought in some cheeseburgers for Fran. There is a sign on the front door directing one to present all food for patients to the nurse at the nurse's station.

I would just wave the bag in their direction and they did not object. Fran was not on an especially restrictive diet so it did not matter much in her case. They fed her cheeseburgers several times anyway, so apparently they were not forbidden food. Contraband food always tastes better so I would make a show of "sneaking" the food into Fran.

The dining room is big enough to fit all the patients in at one time, along with their guests. The wheelchairs and walkers can clutter it up a little, but it is not bad.

On Memorial Day they cooked on the gas grill out on the front veranda. Brats, burgers, etc. Fran said it was good. They even made some extras so people could have them for supper.

Visitors can eat a meal with a patient for $5.

I have been on a low carb diet for almost 2 years, so I would not deal real well with the menus they have which are more along the lines of what is considered to be a "well balanced" meal that consists of lots of carbs. But I suspect they would be able to accommodate my preferences in that respect without a lot of trouble and probably would if I made those preferences known were I to be a patient here (I would probably refer to myself as an inmate anyway).

I would probably want a bottle of hot sauce.

Cleanliness
The facility seems clean to me. It is not spotless though, as the patient rooms are carpeted, and there were some stains. But it was not dirty. I was only in three of the bathrooms in the patient rooms but they were all tiled floors, and none were dirty. I seem to recall a few rooms had some kind of vinyl flooring, but most were carpeted. Perhaps an economy measure, maybe a comfort measure.

The housekeeping staff were constantly cleaning. It seemed like there was someone in the room removing the trash and doing some miscellaneous cleaning every few hours while I was here, and the carpet was vacuumed at least daily. The hallways are tiled in the center, with carpeting along the walls, and the dining room floor is vinyl. It would seem to me a lot easier to keep vinyl or tile clean than it would carpeting.

I saw a guy cleaning the carpeting in Fran's room(s) a couple of times. One time he told me they clean all the carpeting twice a week. Unfortunately the carpet cleaning results in the carpet being damp for some period of time afterward. Fran usually went barefoot and did not like the damp floor. I would think the dampness might lead to mold problems, but I never noticed any unusual odors.

Shortly after Fran got here they moved her roommate out. After the roommate left, housekeeping came in and performed a very impressive cleaning to that side of the room. She even pulled out the drawers of the dresser and closet and cleaned them inside and out.

I saw no evidence of insect or rodent infestation, although Fran told me once she had seen a spider in her room, a roommate reported killing a bug in the room, and I got a large ant once in a bathroom on another hall. Fran also told me she saw some small ants congregating around a small piece of potato chip she had dropped on the floor. She reported this and the ants and potato chip were promptly vacuumed up. I did see a gnat or mosquito once as well.

A couple of times the toilet in Fran's room clogged up. Housekeeping responded with a plunger within a few minutes of my telling the nurse or CNA on duty. I suspect someone (CNA or roommate possibly) tried to flush the wet wipes they use cleaning up patients rather than throwing them in the trash. The practice seems to be the CNAs remove them from the room immediately and take it to the dumpster if they put them in the trash. The housekeeping staff puts multiple garbage bags inside each other in the trash cans to facilitate this practice. Probably a good idea.

Activities and Amenities
Each bed has a TV and a DVD player, but a common complaint I heard was that the channel selection is not real good. I don't watch much TV so it does not matter much to me. They have some kind of satellite TV instead of cable, so that may explain the channel selection. In fairness, there were probably 60 different channels available. The local channels seem to come from an over the air antenna that is mixed in with the satellite channels and they were not working for 3 or 4 of the days Fran was here, and one local channel did not work for an extended period of time. I watched bull riding and the NFL channel with Fran a number of times while she was here, so at least those channels were present. There were some issues with the remotes for the TVs and DVD players. They seemed to be short on remotes sometimes. Maybe over time they have lost a few.

Each bed has its own phone. Many of the patients had their own cell phones, as did Fran, and most seemed to prefer using them. Probably a little more convenient.

There was an activity cart with some board and card games. I never looked real closely at it. I saw people playing cards or board games in the dining room quite regularly during non-meal times. I brought magazines to Fran sometimes and after she was done with them, they would be given to a staff member to put on the activity cart.

The dining room features a big screen TV on one wall.

The facility gets multiple copies of the local newspaper every day. Fran took to saving me one so I could read it in the evening while I was here and do the crossword. There were often one or more copies still sitting by the receptionist when I came in the evening. They also get a local free newspaper in quantity that I would read and do the crossword in.

A number of the patients mentioned there was not much to do. Boredom seemed to be a big issue to them. Several that I talked to did not know about the activity cart, although others said they had been told about it when they got here.

The facility has WiFi. I could not connect to it with my wife's older laptop until I got a new WiFi adapter for it. It was using a newer security protocol that her laptop's existing adapter did not support. There seemed to be plenty of bandwidth. I did not see any other patients with laptops early in Fran's stay, although John told me some have had them in the past, and her last room mate had one.

Live music is featured in the dining room during at least some evening meals. It was pretty good, if a bit loud. The ladies sitting at the table with Fran and me asked that I go tell them to turn the volume down a bit one Sunday night when a couple guys were playing a keyboard and a sax. I felt a little guilty, but it was sort of loud so I did as asked, as politely as I could.

You can get your hair shampooed for $5. Someone comes in once a week. They gave Fran two coupons when she checked in that she could use either for shampoos or for a visitor meal. There was a sign at the front desk indicating massages were available with physician approval, no doubt at an extra fee. I think you can arrange for other beauty shop type services as well.

One day when I was here, some volunteers were doing nails in the dining room. One of the volunteers was the daughter of one of the CNAs. They offered to do my nails, but I declined.

Insurance
They seem to accept the usual insurances including at least some Medicare and Medicaid patients. By the time Fran got here we were well past our insurance deductible and max out of pocket. I don't think that we ever got a bill from EBC for anything. I think it was all 100% covered by insurance.

Some patients complained about other patients being allowed out on day passes while they were not. One of the patients told me that they were told that some insurance companies think that if you can leave the hospital the company feels you do not need to be there at all. Another told me that Medicare patients can leave for four hours. Not sure if that is per day, or just for doctor appointments, or what.

Another patient told me that Medicare had told her that she would have to leave after 20 days, as that is all they cover for stroke rehab. She seemed to be coming along OK, so maybe 20 days was going to work out for her. She left before Fran did.

I think the insurance angle was almost as bad as any of the medical issues. Somehow medical care has to be rationed, or we will all go broke. One would think there just has to be a better way to handle it, but I do not know what it is. I suspect government rationing of medical insurance will make the system worse, so maybe the current rationing system is about as good a system as we can get.

Therapy
The facility has 3 rooms that have been made into a single room on 300 hall for use by the physical and occupational therapists (PT and OT). It has what looks like the same kind of equipment I have seen in other PT/OT rooms. It is not huge but seems large enough for the number of people I saw using it simultaneously.

The PT seems oriented toward strengthening and stretching. The OT seems oriented toward teaching people to take care of themselves and using the equipment they will be depending on such as wheelchairs and walkers. The line between the two is not always clearcut.

I saw a fair number of people engaged in strengthening exercises - stretchy cords, barbells, etc. I also saw a lot of people being taught to walk again. Sometimes it took two therapists - one walking along side the person and a second coming along behind them with a wheelchair, I suppose in case they needed to sit down quickly. It looked a lot like the PT my dad went through multiple times while he was rehabbing after hospital stays.

One of the therapists helped Fran learn to get in and out of the car one day. Very exciting! No more medivan.

This kind of therapy seems like a critical part of getting out of the place. You can't just put these people in a wheelchair and roll them out to the curb and expect them to function.

I think the therapists actually work for some outside company that staffs the place for EBC. In any case, I think they did a fine job on Fran and the other patients, based on my admittedly amateur observations. What they do may well be as important to the ultimate outcome of the patient as the medical care.

Administration
I think the place has some work to do on the administrative side. I am not sure I would blame the actual administrator. I don't know just how much of what I lumped into "administrative" is really Edna's job. She is in the very difficult position of dealing with the insurance companies who seem mostly interested in getting the patients out of the place as soon as possible and spending as little money as possible (not a completely unreasonable thing for them to be interested in).

I noticed Edna there late in the evening on a number of occasions and she went out of her way to try and help us a couple of times, something that may have contributed to the late nights. Like the other employees, she seemed to be genuinely trying her best.

I was told the "unit manager" is responsible for arranging appointments and transportation for patients when they need to leave the facility. I don't know what else they do, that might be a full time job in itself. I don't recall meeting anyone described to me as the "unit manager".

Fran missed a doctor appointment because of some SNAFU in arranging her transportation. The book said a ride was arranged with a medivan service but it did not show up and when John called them they said they had no record of the ride being requested. I do not know which end screwed the pooch, but suspect it was on the EBC end. IMO, getting this kind of stuff right and confirming it ought to be a high priority, but other patients mentioned similar problems.

Another time the ride called and said they were going to be late. Not the fault of EBC, but the doctor was unable to take her later that day so the appointment had to be rescheduled.

They used several different services to transport Fran to her appointments before I started taking her myself late in her stay. Medivan service is not covered by health insurance as emergency ambulance service is, and it was about $80 round trip each time.

At least once a scheduled dose of some kind of medicine for Fran was not available. I don't understand how in this day of computers on every desk that can happen. I know they get drugs delivered pretty late so it may have come later in the evening.

They seem to have an assortment of both paper and computerized records. I noticed computer monitors in alcoves in the halls, but never saw anyone using them. Perhaps they are in the process of transitioning from paper to paperless and just have not gotten all the way there yet.

They do not seem to have a web site, at least not one I could find, although they were listed in several nursing home type directories. One place gave them a 5 star user review without a single word as to why, and another place gave them a poor user review based on the claim that they promised a private room to a patient and did not deliver one. Really not much to go on. A couple of places rated the facility pretty mediocre, but without supporting documentation it is hard to know what the criteria for the rating was, or whether the rating is meaningful.

This article from 2008 http://www.rrstar.com/news/x79611673 indicated the place intended to be an "upscale" facility with private rooms and gourmet meals. Perhaps they found the private room goal to be unreachable in the current economic climate, although they do seem to be trying very hard on the meal side, with at least some success, IMO.

One time Edna told Fran that they had not been able to get approval from the insurance company for her to stay and that the previous approval had expired. This was about 3 or 3:30 pm on a Friday. She gave Fran the option of going home or staying with the understanding that if the insurance company did not approve it that we would have to pay. It may not have been handled in the best way and Fran was pretty upset about it, even though by about 4:15 pm it was resolved when the insurance company approved it. It may be that there is not a good way to handle this kind of situation when the service provider does not know whether they are going to be paid or not because the third party doing the paying is not forthcoming. And the patient really needs to be kept informed of this kind of thing. A tough situation for the person who has to do the informing, especially when it is really a problem the insurance company created.

Once a nurse mentioned to her she had seen her on the list of people going home at the end of the week. That also upset her, being as she was unaware of her impending release. It turned out that they put people on the list as leaving when the current insurance authorization expires, and our insurance company was only approving her stay on a weekly basis, so she was on the list to go home most every week. Another irritant, but understandable. The people taking care of the patients need to know when they are leaving to help get them ready to leave, and when you do not know just what the insurance company is going to approve, you are almost forced to assume the patient will have to leave, ready or not. Another insurance company issue.

Another time a promise was made to move her to a different room when Fran did not like the room she was in. It took two or three days before she actually got moved. I was told patient room assignments were handled by the administrator. Better not to make a promise until you are willing and able to fulfill it.

The people who own EBC also own a similar facility in Belvedere and seem to be trying to upgrade it as well.

 http://www.rrstar.com/news/x55307284/Nursing-home-gets-acute-care-makeover

Unfortunately a small facility like this does not have the same capability to deal with a giant insurance company as a much larger entity like RMH does. But some of the facilities owned by larger entities in the area have a pretty bad reputation care wise, so IMO size and quality do not necessarily correlate.

In fairness, RMH did not seem a whole lot better organized on some occasions and they have computers and bar code scanners in every patient room.

Another oddity. For some reason patient mail was delivered in the evenings by the evening receptionist, rather than during the day. Maybe they get their mail delivered late in the afternoon by the post office, or possibly it goes to a P.O. box and whoever picks it up does it at the end of the day.

Selecting the facility
We started with a printout of the rehab facilities in the area that worked with our insurance company. There was quite an assortment. My mother crossed a few off the list based on what she had heard about that facility from her elderly friends and their family members. My brother's GF who is an RN crossed off some more.

EBC was one of two that we sort of highlighted based on suggestions I had gotten from a couple of former EBC patients and what my brother's GF said. In addition, it is only three miles from our house, so it kind of went to the top of the list.

We asked Fran's ankle surgeon about it. He said he was prohibited by state law from recommending a rehab facility . When cornered he did say both of the facilities (one being EBC) we point blank asked him about were "good".

A woman from EBC (kind of a cross between a sales lady and a social worker) visited us at the hospital after we tentatively selected EBC over other options. She seemed nice enough, and was able to answer our questions, but I think she was kind of new to EBC. She took Fran's information down and the next day it was announced to us that the insurance company had approved her transfer to EBC. I don't recall she had much in the way of written information such as pamphlets or brochures about EBC. Might not have made much difference. At that point we had all but settled on EBC as a first choice and it was mostly between EBC and the insurance company.

The wet air cast incident
Some might think of this incident as a deal breaker. I am not so sure. I am kind of in the "no harm no foul" category on this one. But, you can make your own call. Fran got a shower one day. To keep the air cast on her ankle dry, a plastic bag was put over it, and it was taped in place. The same procedure had been followed the previous week without incident. This time however, somehow, it got wet anyway, and no one, including Fran noticed it until Fran did late in the evening.

She reported it to the nursing staff who at first seemed puzzled by how to handle it. The doctor had given Fran firm instructions that the air cast was not to be taken off and not to get it wet.

Being as there is no way to dry it with it in place, they took the air cast off and dried it out with a hair dryer. The Ace wraps under the air cast were also damp but the dampness was on the back side, and not encroaching on the incisions. Fran had her leg propped up on a pillow so I put a towel under the leg to soak up as much moisture from the wraps as possible. The wraps never got completely dry, but once the air cast was dry they put it back on.

The next day I took Fran to the doctor. Fran's surgeon was not happy about what happened and contacted the director of nursing (aka DON) at the rehab place and told her what he thought, I gather in no uncertain terms. They replaced the wraps and the air cast with new ones at the doctor's office.

After we got back to the rehab place, it became apparent they were taking this pretty seriously and the DON and the person in charge of therapy talked with Fran at length several times about what happened.

Having had some time to think about it I suspect the correct course of action might have been to dry out the air cast, take off the damp wraps, let the skin and wraps dry out (or get new wraps), replace the wraps, and put the dried out air cast back on.

I am not sure just how the course of action that was actually followed came to be. I do know a nurse came and checked the wraps to determine where they were damp. They were not damp at the incision sites. Since they were not damp at the incision sites and they knew Fran was going to the doctor in the morning is it possible that those were factors in the decision making process? I don't know.

It was late in the evening. Was that a factor? Quite possibly. There are a lot less convenient options at 9 pm than at noon. In any case, stuff seems to happen on 2nd and 3rd shifts everywhere that does not happen during the day. I think people who work on 2nd and 3rd shifts get used to having far less immediate resources to call on and get comfortable with the idea of just waiting for 8 am to come to do something out of the ordinary if that appears feasible.

Is the real answer not to shower people who have casts on? Fran was pretty miserable having not had a shower for almost 5 weeks at the time of her first shower that went without incident, and she had some skin irritation that seemed to be related to the lack of  bathing. Sponge baths just are not a substitute for a real cleaning. After her first shower she felt a lot better.

In any case no harm was done other than maybe to the air cast that was replaced. Hopefully the facility will take it as an opportunity to learn rather than to engage in some knee jerk reaction that might be counterproductive. From my perspective, I think they handled the situation about as well after the fact as they could.

Fran said someone from the health department came and asked her about the incident. She said they seemed mostly concerned that it was malicious in nature. Fran said she assured them she was certain it was unintentional. I believe it was just one of those things that sometimes happens.

The following are just some random observations and anecdotes, in no particular order.
They seem to move patients around a fair amount. I asked once and was told that patients get moved for various reasons such as not liking the room, because they need to be isolated for some reason, or because they don't get along with their roommate. They have moving them down to a science. They moved one of Fran's roommates just by rolling her out of the room on her bed. They moved Fran's stuff to a different room once by putting her stuff on her bed and moving it all at once while she was at lunch.

Wilma went to visit Fran several times. I was told other dogs visited patients on a regular basis, but never saw any. Fran was always glad to see Wilma, and the staff and other patients seemed to welcome her as well. Here is a picture of Wilma on one of her visits.

It did seem kind of noisy at times. I realized that it was the TVs after a while. A lot of the patients seem somewhat deaf so to hear their TVs that are on the wall opposite their bed, or up on the ceiling, they turn the volume up. At RMH, the TV sound comes thru the call button so it is right at the bed, making it much quieter. The call buttons at EBC do not seem to have a speaker built in. It would not be real hard to add a speaker behind where the beds are (probably not real cheap though). But the speaker volume could be much lower and still be heard, reducing the noise level, especially for the roommate.

There is a sign on the front door indicating visiting hours start at 10 am end at 8 pm. They do not seem to enforce this. The receptionist leaves at 8 pm, and sometime after that they lock the front door so you can get out but not back in. One time I went out well after ten pm and set off some kind of alarm. Most of the time I left before that and usually they had not locked it yet. I tried not to stay real late during the times Fran had a roommate as it did not seem fair to her roommate. I went in a few times before 10 am, once about 7 am. I think they consider the posted visiting hours to be mostly a suggestion.

One evening the fire alarm went off. A staff member came around and shut all the doors to the patient rooms and announced a fire drill. I don't know if the drill was intentional or not. The fire department did not come so they either called them off or it really was a drill. Afterward I thought about it and just closing the doors is about all they can really do. The rooms are reasonably fire resistant and the doors are solid and fire rated. No way you can evacuate that many semi-mobile people quickly, and there is no place to evacuate them to. Best to just wait for some help to come if there really was a fire.

One of the patients who was in recuperating from double knee replacement went out for a doctor's appointment. He caused a bit of a stir as he apparently did not tell the nurse on the hall before he left and they started looking for him when they noticed he was not around before realizing he had gone to his chiropractor.

One evening I went out of Fran's room for some reason and there in the hallway stark naked was one of the patients. I saw a staff member coming down the hallway to take care of her so I just went back in Fran's room for a few minutes. It did not bother me all that much. Most of the patients are on narcotics for pain and various other psychoactive drugs, so I can understand why they might get confused. OTOH, if the staff started walking around naked, that would bother me. I never saw that patient again. I don't know if they moved her, or she went home, or maybe she went someplace else.

Near the end of Fran's stay she was trapped in her bathroom. Some older fellow got confused and tried to get in her room, probably thinking it was the therapy room next door. Fran was trying to get out of the bathroom at the same time and the bathroom door is behind the room door, not the best arrangement. She could not get the bathroom door open enough to get out because the the other guy had the other door open, but he probably could not get the room door open far enough to get in because Fran had the bathroom door open part way. It may seem humorous now, but Fran ended up pulling the cord in the bathroom for help as she just could not get out of the bathroom.

Several times I heard door alarms go off when a patient went out a fire exit. I would see a staff member hurrying down the hallway shortly thereafter. I suspect it was the same guy.

I think it was the day after the wet cast incident when a visitor to the facility fell on Fran while she was eating in the dining room. Thankfully no one was harmed, although having someone fall on you while you are eating breakfast and falling on the same side as your broken arm had to be a shock to the system, and Fran was a little sore as a result. IMO the facility handled this incident about as well as such things can be handled.

I did Fran's laundry while she was here. The place will do it but several of the staff suggested it is better to have a family member handle it. Fran is allergic to some common laundry detergents so I had planned to do her laundry anyway.

The facility has packages of large wet wipes (they are wash cloth size) they use for cleaning patients in various ways. I think someone who was very hungry must have been eating them. They would bring a package (of 50 IIRC), and it seemed like the package would be empty the next time I looked for some. I wonder what their bill for wet wipes looks like.

I was told once that in previous incarnations as a nursing home that some rooms held three patients and at least a couple had four. I can't imagine how you could get four beds in rooms of this size with any kind of working space. They must have had a lot more patients when it was a nursing home, or a bunch of empty rooms.

While Fran was here, a fellow I have known for almost 30 years died there. I think he may have been a longer term resident. I did not know he was even here. I had not seen him for a few years so had figured being in his 80s that perhaps he had passed away and I had missed it somehow. Just by chance I ran across his obituary in the paper and on reading it noticed that he had died at EBC. They told me he had been in a room around the corner from Fran. I wish I had known so I could have stopped by to visit with him. Jerry was a sweet guy. There is no patient directory posted (understandably), and I did not walk by his room while visiting Fran as he was on another hall, so no way for me to know he was here. I must have walked within 20 feet of his room 50 or 100 times. Goodbye Jerry. RIP.