I am living in a long term nursing rehab facility and I need....

I am living in a long term nursing rehab facility and I need help. There is so much abuse and I don't know what to do. Please Help! - Cristina

https://www.tiktok.com/t/ZP8RvbuW2/

"Hey friends if there is ever a video that you've watched please watch this one I need advice

I am unfortunately living in a long term nursing facility for rehab to learn how to walk and after all my spine surgeries and everything and unfortunately it's just one of the worst facilities that you could be at because of that there's so much abuse like that this is rampant there's just a culture of abuse that everybody's OK with it and it doesn't matter what you do they they don't care they just continue and it's just horrible to see for instance my best friend here recently unemployed she was on Hospice and the Hospice nurse would say that the pain was in her head and wouldn't treat her properly and they would abuse her and it was such a horrible condition and they would take it out on me because I just couldn't sit and ignore it I just I can't sit back and watch people agonizing pain and not help them and that's what they expected me to do and today I'm having the same issue situation I had to go back and re record that part because I used the word Pew Pew was so I'm sorry if I that's a part of it but basically the nurses keep laughing and saying ohh does he have a pew pew of course not so she's fine and just laughing and telling me to leave her alone and she is in so much pain and it's so much distress as a former paramedic firefighter and crisis counselor I I can't just sit and watch this kind of pain uh-huh but there I don't I just don't know what to do the nurses think it's hilarious there's no doctor's here obviously exists almost like there's no support we have horrible GNA named Jaime who is just pure evil even the director of nursing is even more evil. The people charge are just I don't even have words for how disgustingly awful they are how little they care and how funny they they think it is to cause all these patients just pain I think so if you have advice why I can do in the immediate situation with my friend who is extremely suicidal and just in so much pain and in the long term would just all the abuse. I would really appreciate it. I just. I don't know what to do and I can't sit here and watch this."

Dear Cristina,

We want you to know that we see you, we hear you, and we feel your pain deeply. Watching others suffer is a burden on our hearts too, and your story touches us in a way that demands change. It's painful to realize how much we, as a society, have let the system fall apart to the point where people like you and your friends are enduring unimaginable hardship.

What you're going through should never have been allowed to happen, and for that, we are deeply sorry. We know it’s not enough, but please know that your voice is important, and your pain will not be ignored. Awareness of this situation is crucial, and we will do everything in our power to bring this issue to the forefront, even when it feels like the forces pushing back are insurmountable.

We care for you, we love you, and we stand with you in this fight for better care and human dignity. Thank you for being brave enough to speak out—your courage will help drive the changes that are long overdue.

With heartfelt compassion and solidarity,

-All of us

Key Points:

Based on the content of the video, the following key points should be highlighted:

- Living Situation in a Long-Term Nursing Facility:

- The speaker is currently residing in a long-term care or rehabilitation facility to learn how to walk again after undergoing multiple spine surgeries.

- The facility is described as one of the worst due to rampant abuse and neglect.

- Culture of Abuse in the Facility:

- The speaker emphasizes a culture of abuse in the nursing home where staff members, including nurses and other caregivers, are indifferent to the suffering of patients.

- There is a lack of proper medical treatment, with nurses dismissing patients' pain as being "in their head."

- Specific Incident Involving a Best Friend:

- The speaker’s best friend, who is on hospice care, is not being properly treated. Nurses dismiss her severe pain, claiming it is imaginary, and she is subjected to mistreatment.

- The hospice nurse failed to provide the necessary care and instead caused harm, creating a distressing situation for both the patient and the speaker.

- Personal Ethical Dilemma:

- As a former paramedic, firefighter, and crisis counselor, the speaker is deeply troubled by witnessing the pain and suffering of patients without being able to intervene or provide assistance.

- The speaker struggles to remain a bystander, feeling morally compelled to act but facing opposition from the facility staff.

- Inhumane Behavior by Staff:

- The nurses and other caregivers, including a Geriatric Nursing Assistant (GNA) named Jaime, are described as being cruel and abusive, both emotionally and physically.

- The staff members appear to mock and belittle patients, causing further distress. They find humor in patients’ suffering and fail to take complaints seriously.

- Absence of Medical Support:

- The speaker notes the absence of doctors in the facility, suggesting that there is no proper medical oversight.

- This lack of professional medical care exacerbates the already dire situation, leaving patients with little to no support.

- Suicidal Friend and Helplessness:

- The speaker's best friend is extremely suicidal due to the combination of physical pain and the emotional abuse she is enduring.

- The speaker expresses a sense of helplessness, not knowing how to handle the situation or how to alleviate the suffering.

- Immediate Need for Advice:

- The speaker is seeking advice on what to do, both in terms of helping their friend who is suicidal and in addressing the overall abusive environment in the facility.

- The situation has become unbearable for the speaker, and they feel they cannot continue to watch people suffer without intervening.

- Call to Action:

- There is a plea for help, not only for their own friend but for all patients who are experiencing mistreatment. The speaker wants to know how they can make a difference in the immediate and long-term situation.

- Systemic Problem in the Facility:

- The speaker implies that the abusive behavior is widespread and systemic within the facility, involving not just individual staff members but the leadership as well.

- Even the director of nursing is labeled as part of the problem, contributing to the toxic environment.

These points collectively paint a grim picture of a healthcare facility where patients are neglected, abused, and not provided proper care. The speaker's frustration, helplessness, and desire to help are central themes, along with a call for immediate advice or intervention.

Several recent cases highlight the troubling impact of private equity (PE) ownership in nursing homes and how this has contributed to substandard care and abuse in various facilities.

- Widespread Abuse and Deteriorating Conditions in PE-Owned Nursing Homes : Private equity firms have increasingly entered the nursing home sector, often prioritizing profit over patient care. Research has shown that private equity ownership increases short-term mortality by 10%, resulting in thousands of preventable deaths in Medicare patients. PE-backed homes tend to cut staffing and amenities, reducing the quality of care. For example, when Portopiccolo Group took over St. Joseph’s Home for the Aged in Richmond, Virginia, they reduced staffing, which was directly linked to increased deaths and inadequate care during the COVID-19 pandemic​(

Marketplace )​( Law Offices of Thomas L. Gallivan, PLLC ).

- Complex Ownership Structures : Many PE-owned nursing homes use a labyrinth of corporate entities (like LLCs) to shield themselves from liability, making it difficult for residents or their families to sue for negligence or abuse. This structure, often referred to as sale-leasebacks , management fees, and dividend recapitalizations, diverts funds away from patient care. Such practices were linked to worsening care outcomes, including understaffing, neglected hygiene, and medical negligence​(

Marketplace )​( Inequality.org ).

- Government Scrutiny and Calls for Reform : During the COVID-19 pandemic, nursing homes owned by PE firms experienced higher rates of infection and deaths compared to nonprofit and public facilities. This spurred greater scrutiny, leading to policy discussions around transparency in ownership, improved staffing ratios, and limiting how much money can be siphoned away from patient care​(

Law Offices of Thomas L. Gallivan, PLLC )​( Inequality.org ).

- The Role of Profit Motives : PE-owned nursing homes often reduce operational costs by outsourcing key services like restorative therapy, housekeeping, and dining. These cost-cutting measures contribute to a lower quality of care, further endangering residents​(

Marketplace ).

These cases highlight the dangerous effects of private equity ownership in long-term care, raising the need for stricter regulations and better protection for vulnerable populations in these facilities. For-profit nursing homes, especially those owned by PE firms, consistently exhibit patterns of neglect and abuse due to financial practices that prioritize profit extraction over patient safety.

If you're interested in specific cases, Atrium Health and Skyline Healthcare provide notable examples of facilities facing public and legal scrutiny due to these issues​(

POLITICO )​( Law Offices of Thomas L. Gallivan, PLLC ).

Transitioning for-profit nursing homes, particularly those owned by private equity firms, into nonprofit, government-funded entities could address many of the problems currently plaguing the industry, but it would require careful planning and policy adjustments to ensure success. Here's how such a transition could unfold and its potential impacts:

1. Transition to Nonprofit and Government-Funded Model :

- Higher Care Standards : Nonprofit nursing homes typically reinvest their profits into improving care, staffing, and facilities rather than paying dividends to shareholders. Studies have shown that nonprofit homes generally provide higher-quality care than for-profit ones​( Law Offices of Thomas L. Gallivan, PLLC )​( Inequality.org ). Emphasizing superior quality care would need to be a core focus in the policy, with measurable benchmarks set by agencies like CMS (Centers for Medicare and Medicaid Services).

- Government Oversight with Independent Capital-Raising Ability : A hybrid model where facilities receive yearly budget approvals from Congress but retain the ability to raise their own capital (through fundraising, bonds, or endowments) could provide the flexibility to upgrade facilities, improve staffing ratios, and offer competitive wages. Nonprofits often rely on philanthropy and public grants, which would give them additional financial flexibility without compromising care quality.

- Budgeting and Accountability : Having a yearly budget approved by Congress for each facility would ensure that funds are allocated based on need and performance. A part of this budget could be earmarked specifically for maintaining high care standards, with independent audits ensuring compliance.

2. Fines and Penalties for Private Equity Firms :

- Accountability for Negligence : There is growing evidence that private equity ownership has led to decreased care quality and even higher mortality rates in nursing homes​( Inequality.org )​( Marketplace ). Imposing hefty fines on PE firms that have been found responsible for such decline in care would act as both a punitive and preventive measure. These fines could be used to fund the transition to nonprofit models.

- Clawback of Profits : PE firms that have siphoned off funds through dividend recapitalizations and other methods could be forced to return ill-gotten gains to support patient care. The Private Equity Stakeholder Project and other advocacy groups have raised alarms about these practices​( Law Offices of Thomas L. Gallivan, PLLC ).

- Use of Fines to Support Transition : Fines collected from PE firms could help fund the transition of facilities from for-profit to nonprofit status, covering initial costs associated with restructuring, staff training, and facility upgrades.

3. Challenges and Considerations :

- Political Will : Moving toward a government-funded, nonprofit model would require substantial political support and legislation. Lobbying by the nursing home industry, particularly for-profit owners, could present obstacles. The largest lobbying group, the American Health Care Association , has previously opposed efforts to mandate better staffing ratios​( Marketplace ).

- Regulatory Reforms : In addition to funding and transitioning ownership models, there would need to be comprehensive reforms in the regulation and oversight of these facilities to prevent future degradation of care standards. This could include stricter transparency requirements regarding ownership structures and more frequent inspections.

- Equitable Distribution of Resources : Ensuring that nursing homes in underserved areas are prioritized for capital improvements would be key to addressing disparities in care. Rural and lower-income communities often suffer from fewer high-quality care options​( Inequality.org ).

4. Emphasis on Superior Care :

- Minimum Staffing Ratios : Studies consistently show that staffing levels are the biggest predictor of care quality in nursing homes​( Marketplace ). Any transition plan would need to include enforceable minimum staffing ratios to ensure that residents are well-cared for.

- Incentivizing Quality Care : Facilities that meet or exceed care benchmarks could be rewarded with additional funding or recognition programs, encouraging other homes to prioritize patient well-being over cost-cutting.

In conclusion, transitioning America's nursing homes from for-profit to nonprofit government-funded models could improve care quality and mitigate the harm caused by private equity ownership. The imposition of fines on PE firms responsible for degrading care would not only hold them accountable but could also generate revenue to support these transitions. However, such a shift would require strong political backing, robust regulatory reforms, and a deep commitment to patient-centered care.

To address the systemic issues in nursing homes and bring about reform through Presidential Executive Orders, the following steps can be taken. These orders should have clear timelines to ensure timely implementation and accountability. Here's a structured approach:

1. Executive Order on Nursing Home Ownership Transparency

Objective : Mandate the disclosure of all nursing home ownership structures, including private equity (PE) ownership, related parties, and management companies, to the Centers for Medicare and Medicaid Services (CMS).

- Timeline :

- Within 90 days : CMS will publish a database of all nursing homes in the country, including detailed ownership structures, so that families can make informed decisions about care.

- Within 180 days : Require yearly audits of financials to ensure that funds are directed toward resident care, not siphoned away for profit​( Inequality.org ).

2. Executive Order on Minimum Staffing Requirements and Quality of Care

Objective : Establish mandatory minimum staffing levels for direct care in all nursing homes, enforceable through CMS.

- Timeline :

- Within 60 days : Mandate a CMS rule requiring minimum staffing ratios based on resident acuity levels.

- Within 120 days : Increase federal funding to support hiring and training additional nursing staff.

- Within 1 year : All nursing homes must meet minimum staffing levels to avoid penalties, including reduced reimbursement rates and fines for noncompliance​( Marketplace )​( Law Offices of Thomas L. Gallivan, PLLC ).

3. Executive Order on Nonprofit Conversion and Government Funding

Objective : Create a pathway for converting for-profit nursing homes into nonprofit or publicly funded models.

- Timeline :

- Within 180 days : Develop and implement a plan for the voluntary conversion of nursing homes from for-profit to nonprofit status, offering incentives such as tax breaks and government-backed loans.

- Within 2 years : Offer federal matching funds for states that support nonprofit nursing home operations. Ensure facilities receive budget approvals through Congress for additional care quality improvements.

- Within 5 years : Establish that 30% of all nursing homes nationwide must be nonprofit or publicly funded​( Inequality.org ).

4. Executive Order on Fining Private Equity Firms

Objective : Impose fines on private equity firms and for-profit nursing homes that have been found responsible for widespread neglect, abuse, or the degradation of care quality.

- Timeline :

- Within 90 days : Direct the Department of Justice and CMS to investigate private equity ownership in nursing homes, particularly in facilities with high mortality or infection rates during the COVID-19 pandemic.

- Within 180 days : Implement a fines structure for PE-owned nursing homes that have violated care standards, with the fines used to fund improvements in care and facility upgrades​( Law Offices of Thomas L. Gallivan, PLLC )​( Inequality.org ).

5. Executive Order on Strengthening Whistleblower Protections

Objective : Protect employees who report abuse, neglect, or unsafe practices in nursing homes from retaliation.

- Timeline :

- Within 60 days : Strengthen whistleblower protections through the Department of Labor and CMS, ensuring that nursing home workers can report violations without fear of losing their jobs.

- Within 6 months : Establish a dedicated CMS hotline and enforcement unit for nursing home abuse complaints​( POLITICO ).

6. Executive Order on Emergency Funding for Nursing Home Infrastructure

Objective : Provide emergency funding for facility improvements, particularly for homes in rural or underserved areas, to meet new quality standards.

- Timeline :

- Within 90 days : Allocate $10 billion in emergency funding for nursing homes to upgrade infrastructure, especially HVAC systems and patient rooms, to meet health and safety standards.

- Within 1 year : Ensure that all nursing homes undergo comprehensive safety and infrastructure audits​( Marketplace ).

7. Executive Order on Task Force for Long-Term Care Reform

Objective : Establish a federal task force to oversee the implementation of long-term care reforms and recommend further actions.

- Timeline :

- Within 30 days : Convene a task force made up of healthcare experts, patient advocates, and government officials to assess ongoing needs in nursing home reform.

- Within 6 months : Release a national strategy for improving long-term care that includes stronger regulatory oversight and federal investment in care innovation​( Inequality.org ).