Resident Rights in a Nursing Center

Social Services Series

Catherine Denlinger, DOSS, MSW, LSW
Director of Social Services
The GRAND of Dublin

Resident Rights in a Nursing Center

resident rightsIn 1987, the Federal Government enacted the Nursing Home Reform Act.  This law mandates that residents living in a long term care facility have the same basic rights of those residing in the community.  This law states that nursing centers “must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care”.  This law stresses the importance of a resident’s dignity, comfort and self-determination.  There are currently 32 resident rights.  These rights can be found on numerous sites on the Web.   In this SSS (Social Services Series) we will be listing all of these rights.  At this time, we look at the first 5 resident rights.

  1. Residents have the right to a safe and clean living environment.
  2. Residents have the right to be free from physical, verbal, mental and emotional abuse and to be treated at all time with courtesy, respect and full recognition of dignity and individuality.
  3. Residents have the right to adequate and appropriate medical treatment, nursing care and to ancillary services.
  4. Residents have the right to have all reasonable requests and inquiries responded to promptly.
  5. Residents have the right to have their clothes and bed sheets changed as the need arises.

Here at The Grand of Dublin, our staff strives to provide the best possible quality of care to each and every resident.  We treat our residents with respect and promote their independence as well as focus on their comfort needs.  Our center provides a home-like environment so that residents can focus on their medical improvement.  We treat each resident in a holistic manner and provide the necessary services for their physical, mental and psychosocial well-being.

The list of resident rights that we will be listing over the next several SSS can be found at the following site:


When and How to Wash Your Hands

by Frank Mackovine
Dietary Director
The GRAND of Dublin

When and How to Wash Your Hands


  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

wash hands, handwashing


  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your
  • hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse hands well under clean, running water.
  • Dry hands using a clean towel or air dry them.

With not much effort you can keep you and your loved ones safe from illness and yes, even those that you don’t like!

New Medicare Cards to Debut in April 2018

New Medicare Cards to Debut in April 2018

by Corey Ohalek
Associate General Counsel
Vrable Healthcare, Inc.

MedicareAs the technology world expands, so does the risk of fraud and identify theft. In order to combat “fraud, fight identity theft, and keep taxpayer dollars safe,” the Centers for Medicare and Medicaid Services (CMS) will be issuing new Medicare cards to Medicare enrollees beginning in April 2018. The previously enacted Medicare Access and CHIP Reauthorization Act of 2015 mandates CMS to remove Social Security numbers (SSN) from all Medicare cards by April 2019. SSN-based Health Insurance Claim Numbers (HICN) will be replaced with “a new, unique, randomly assigned number called a Medicare Beneficiary Identifier (MBI).” Congress’s belief is that the change from the SSN-based HICN will “better protect private healthcare and financial information, as well as federal healthcare benefit and service payments, from fraud.” Medicare Beneficiaries will not see a change in the “enrollees’ Medicare benefits, and the effective date of the new cards remains the date that each beneficiary was or is eligible for Medicare.”

April 2018

In April 2018, new Medicare cards will be issued through the mail with mailings occurring in phases based on geographic location dictated by CMS. CMS will provide additional details on the timing of the new cards as the mailing progresses. Providers, such as Vrable Healthcare, Inc., have been preparing their facilities for the upcoming change to ensure a smooth transition to the new cards. Lastly, as an effort to provide more protection to enrollees, CMS has made it clear that it will “never ask enrollees for personal or private information or charge a fee to obtain the new card. In fact, enrollees need not take any action to obtain these new Medicare cards.”

For more information on the upcoming changes to the Medicare cards, click here.

April 2018 Newsletter

National Volunteer Week
April 15th-21st

We would like to thank all of our volunteers that take time out of their busy schedules to come visit our residents. Volunteers range from conducting bible study, serving ice cream, playing games, reading, taking strolls or simply socializing with our residents. Our volunteers really make a difference in the lives of our residents, so please take time to show your appreciation through the month of April.

Occupational Therapy Month

As an occupational therapist or occupational therapy assist ant, you are part of a vitally important profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. Y our holistic and customized approach to evaluations, interventions, and outcomes help a child with disabilities participate in school and in social situations, assist a person recovering from injuries to regain skills, aid an older adult to stay as independent as possible, and offer the specialized support and services to people of all ages and in all circumstances that only occupational therapy can provide.


Full Pink Moon

The full pink moon occurs on April 29. Herb moss pink, or wild ground phlox, is one of the earliest wildflowers to bloom during this time of year. As the name infers, the flowers are pink in color, thus the name for April’s full moon. Other names sometimes used are full sprouting grass moon and egg moon.

See full newsletter here

What You Need to Know about Skilled Nursing

by Jada Palm
Hospital Liaison
Danielle Batdorff, BSHA/HIS
Director of Admissions
The GRAND of Dublin

What is skilled nursing?

Skilled nursing is a type of intermediate care in which the patient or resident needs more assistance than usual. This setting is designated for physical, occupational, and speech therapies, to aide in strengthening the patient who has a goal of returning to their home at baseline. Skilled nursing services are offered to patients who need IV medications administered, who may have wound care needs, or who may need teaching on medication management. (Newly diagnosed diabetics, for example)

What is the difference between short-term care and long-term care?

Short term care is a temporary solution that may last from a few days to a few months. Long term care is typically utilized for in-house placement for the duration of the patient’s life.

What social activities are offered?

Skilled nursing facilities offer a full calendar of social events and activities. Residents are encouraged to join in as many activities and social events as they like. Some examples include; art classes, bingo and cards, game and movie night, quest performers and church services.

In addition, they offer wellness programs, exercise classes, beauty salons, small dining areas, café and restaurant style dining rooms, and outdoor sitting and walking areas.

Here at The GRAND, we offer weekly ice cream socials, wine and cheese nights, and happy hour to our social calendar.

What should I bring with me?

It is recommended that you bring comfortable clothing for working out in therapy along with good fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork). You may bring snacks to keep in your personal mini fridge.

What are the rooms like?

Some facilities offer both single and double occupancy rooms. Each facility has its own characteristics which make it unique and sets it apart from the other down the street. An example; The GRAND offers single occupancy rooms with walk-in showers, individual heating/cooling units, refrigerators, Wi-Fi and cable. Patient’s medications are locked securely in each patient room and we strive to provide a home like atmosphere.

What does Medicare cover?

Medicare part A covers skilled nursing care under certain conditions for a limited time.

  • You must have a qualifying hospital stay. This means you meet the minimum 3 night inpatient hospitalization requirement.
  • You have part A and days left in your benefit period.
  • Your doctor has ordered skilled services due to a medical condition which requires the need for 24/7 nursing care and therapy services offered 5 to 6 days a week.

Medicare covered services include;

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical and Occupational Therapy
  • Speech-Language Pathology Services
  • Medical Social Services
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers ones health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary Counseling

Medicare part A will pay as follows;

  • Days 1-20 – pays at 100% with no patient responsibility
    • (Remains $0 co-insurance for 2018)
  • Days 21-100 – patient responsibility of $164.50 per day co-insurance
    • (2018 co-insurance will be $167.50)

Additional information can be obtained through

How do I find out what my insurance will cover?

Insurance benefits and eligibility will be checked prior to admission to the building, but you may also call the member services number on your card and a customer service representative will provide you with details of your coverage options.

What is the next step and what can I expect once I select a facility?

Once you have selected a facility you will notify your hospital social worker and he/she will send the referral to the building for review. You may choose to tour the building. Your clinical is then reviewed by the admissions and nursing team to make sure we can clinically manage your stay, and then the hospital liaison will visit you in the hospital to answer any questions you may have. If you need an authorization from your insurance to admit, our corporate case manager will start that process.

What are your staffing ratios?

In our skilled setting, our ration is 1:12 or 1:13, with an STNA on each hall. Our staffing ratios are significantly below average.

How often is therapy provided and will I have a schedule?

Therapy is provided at the discretion of your ordering physician, the therapy team, and your needs. You can ask for a specific schedule if that works better for you. Our therapy team will meet with you upon admission and plan your schedule based on the recommended physicians order.

What sets your facility apart from the others?

The GRAND offers several amenities that set us apart from competitors. From the Digger and Finch pub, our ice cream parlor, movie theater, beauty salon, pharmacy, chapel, licensed in-house therapy team and team of dedicated nurses and STNA’s and low patient/staff ratios.  We offer outstanding services to our residents.

What are your visitation hours and/or restrictions?

Each facility will have set hours of operation. The most common hours of operation most facilities follow are 8am to 8pm, 7 days per week. The GRAND’s hours are 8:30am to 8pm, Monday through Friday and 9am to 8pm, Saturday and Sunday. There may or may not be restrictions on when visitors can be with their loved one. The GRAND does not have such restrictions and provides security 7 nights per week.

NeuroGym Sit-to-Stand Trainer

NeuroGym Sit-to-Stand Trainer

by Jeanne Seliskar, MA, CCC/SLP
Director of Rehabilitation

The GRAND of Dublin

With The GRAND’s focus on the best outcomes and discharge plans for our patients, the NeuroGym Sit-to-Stand Trainer has become an integral part of many of our therapy sessions at The GRAND.  With the action of coming to a fully upright standing posture being a significant  factor in returning  home, it is essential that this part of a patient’s mobility be prioritized and addressed effectively to achieve a functional level.

NeuroGymThe NeuroGym Sit-Stand Trainer uses a counter-weight mechanism to provide a safe and effective way to strengthen weight-bearing muscles and increase standing stability and endurance.  Unlike other tools that passively lift people to, or maintain them in, a standing position, the Sit-to-Stand Trainer enables an individual to actively initiate the motion of standing up, even with weakened or seemingly unsuccessful efforts.  Through continued training and gradually reducing the counter-weight, a patient can relearn the skill for standing up.  Equipped with a weight-stack and a locking pulley system, the counter-weight can be easily applied to the Sit-to-Stand Trainer.  Because it is mounted on wheels, early steps can be attempted in all directions.

NeuroGymThe Key Benefits of this equipment are:  1) early weight bearing and active mobilization at the hips and knees; 2) improvement of standing balance and stability; 3) Significant improvement of transfers; 4) improvement of patient rehabilitation with reduced physical strain to the therapist.

The GRAND is using this equipment routinely in many case to progress patients who would otherwise not ever leave the wheelchair to stand and walk leading to a significantly improved quality of life.

Polypharmacy In Older Adults

By Andrea Hartley, CPhT
Pharmacy Technician and Central Supply Manager
The GRAND of Dublin

Polypharmacy In Older Adults

polypharmacyPolypharmacy is defined as the use of more medications than are medically necessary or the use of too many medications. This is a growing concern for older adults: nearly 50% of the population age 65 and older takes one or more medications that are not medically necessary.  Not medically necessary means a medication is not needed, not effective or that it is a duplicate of another medication.

You may be at risk if you take 5 or more medications at home or 9 or more medications in a nursing home setting.  At home, medications for high blood pressure and high cholesterol are some of the most over-prescribed drugs.  In a nursing home setting, laxatives, diuretics and medications for heartburn or GERD were the most over-prescribed.

Polypharmacy can result in negative consequences such as adverse drug events, drug interactions and medication non-adherence.  Taking too many medications also causes healthcare costs to rise for companies and consumers.  Serious health issues can also come from this problem, like functional decline, cognitive impairment, and increased risk for falls and incontinence.

At The Grand, a consultant pharmacist looks over every resident’s drug regimen monthly and makes recommendations to the physician on unnecessary drugs.

Preventing Polypharmacy

To prevent polypharmacy in the home setting make sure you or your loved one uses only one pharmacy whenever possible.  Stick with one primary care doctor as well.  If a specialist visit is necessary be sure to have a list of all the drugs you or your loved one takes in hand for the appointment.  Be sure to include over the counter medications or supplements on the list.

If you believe you may take too many medications, most pharmacies and primary care doctors will look over your medications and counsel you on some you may not need.  Use the resources you have to prevent you or your loved one from becoming a victim of polypharmacy.


March 2018 Newsletter

National Social Worker Month
In March we recognize our Social Workers for all the hard work they do by being the primary advocates for our clients’ needs. They work closely with families, significant others and nursing home staff to provide our residents with the quality of care they deserve. Join us on Friday, March 23rd for cookies and punch to help celebrate what a great job our social workers do!

Employee Appreciation Day March 2nd
Today is a day we get to recognize, support and reward our staff for all the great work they do! We will have a complimentary soup bar in the café from 11am-1pm for all of our staff!

Who Was St. Patrick Anyway?
St. Patrick was a British bishop who was the first to bring Christianity to Ireland. He lived in Ireland for nearly 30 years, preaching the religious values of Christianity. It is said he used a shamrock, the three-leafed clover, to explain the Holy Trinity to the Irish people. To this day, St. Patrick is highly revered in the Irish church.

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