As always, I want to say that good/bad people and systems exist everywhere. Reno has a unique relationship with Carson City, (Nevada’s Capitol), which makes it easier for bad social service systems to maintain legitimacy.
What follows in bold type is an excerpt of an e-mail. It comes from a high-ranking member of the Nevada Division of Aging Services. She was going through her own cancer battle, something close to my heart. We developed a deep friendship from understanding this disease, and she has been good enough to allow me share some of her e-mail’s content:
Just wanted to send a heartfelt thank you for spending your precious time and spirituality with me, for your kindness and empathy. Perhaps even more so than my daughter and best friend, I think you understand why I must die at home, why I cannot give up my house and go into one of those places.
I am fortunate that I receive both PERS and SSD. I can fill in gaps that others, especially those on SSI, cannot.
I don’t think I’ve told you that I was one of the people responsible for getting the medicaid waivers into place. And Charlotte Crawford just sat on them.
During the 2001 legislative session, Sen. Rawson–a good man, one of the last of what I call the old school Republicans, defeated by neo-con Beers in 2005 (?)–shredded Charlotte. She just lied and was caught in her lies. The regulations were in place, the funding had been appropriated during the 1999 session, and Charlotte did nothing. Meanwhile, people who could have stayed in their homes were forced into SNFs. Unconscionable. Charlotte took me off the legislative committee, but Sen. Rawson still called me to see what was going on.
2001 was the last great year for Nevada social services..
It helps greatly to have these words from an agency insider for the insight it provides. I do receive e-mails from other people in the system, but they are still employed by the state of Nevada. Makes it difficult, but I respect anonymity. As I’ve said before, e-mails from the state are parsed out like Manna from heaven. I recently left as co-chair of the Council for Adult Day Care, and didn’t even receive a “thank you.” I’m sure they were happy to have a burr in the saddle out of there. Sure as heck, they didn’t want to acknowledge anything by e-mail … too much of a paper trail.
Looking at a few things that stand out to me, and not those familiar with this terminology, SNFs is Skilled Nursing Facility. A person on Medicare is entitled to the highest level of care if they’ve had a three day hospital stay, and show improvement. A doctor, of course, has to approve it. What she is saying here is that no way did she want to end up in a skilled nursing facility in Reno. She’s seen what happens there, and this comes from a member of the Division of Aging staff!
An insider tip for you: A lot of skilled nursing also double as Medicaid residential living. A facility gets in the range of $1800 per month from the government when they house someone (seniors) on the Medicaid program. On Medicare, (ending in care, not aid), they get about $8000 per bed.
Is it clear enough to see that Medicare would be greatly preferred over Medicaid? And, if a facility houses many seniors at the $1800 a month rate, is it understandable what the potential for neglect can be?
Please digest this information, ask questions as you wish. I’ll work to give a cogent response.