To return, press the appropriate x button above to close this tab or window.
Letter to the Editor
November 2009, at www.westsideobserver.com
I would just
like to comment on the article Laguna Hondas Unkindest
by Jennifer Serafin
I would just like to comment on the article Laguna Hondas Unkindest Cut, [sic; commas go inside quote marks] by Patrick Manette-Shaw [sic; its Monette-Shaw, not Manette-Shaw, Ms. Serafin], published in the October 2009 issue. I have worked for over 10 years as a Nurse Practitioner in another Long Term Care facility in San Francisco, and I would like to clarify some of the comments made in the article. First, there is effort underway in all nursing homes to reduce costs, so Laguna Honda Hospital (LHH) is no exception. During this economic downturn, most hospitals and nursing homes are slashing staff positions to cut costs. However, the author feels that these cuts would be detrimental for the types of patients that LHH contains. He mentions the Ja Report is an incomplete analysis, and feels that their data is flawed. First, [sic; just how many firsts is Serafin relying on? And whos on third?] there are no studies in any literature that I have read that states that reducing the number of physicians and replacing them with nurses, social workers, and psychologists will worsen patient care, especially in regards to substance abuse treatment [sic; Serafin ignored my October notation that Dr. Paul Katzs research in the literature that the quality of care in nursing homes is directly linked to physician practice].
Secondly, the article voices concerns that losing staff physicians and using traveling physicians instead will cause patients to have to wait weeks for medical care. [sic; periods want to be inside quote marks] Let me assure the public that this absolutely not the case. While it is true that federally mandated visits (every 60 days) are required if the patient is stable, if a patient becomes medically ill or needs more medical attention, then more frequent visits are warranted, and can be provided by physicians and other health care professionals that come in to the nursing home. In fact, this is how the great majority of nursing homes across the country operate. Most nursing homes do not have staff physicians [sic; Serafin failed to note most nursing homes dont employ seven clinical nurse specialists on staff, as LHH does costing almost $1 million annually; Serafin ignored another $5 million LHH spends on Nursing Administration]; all medical care is provided by outside doctors. The reason for this is that most physicians bill Medicare/Medicaid directly for their services, and most nursing homes cannot support a large medical group as LHH can. Therefore, LHH is lucky to have this kind of set-up, as it is expensive, so this is why there is talk of cutting this extra expense out.
I would also like to clear up the concerns the author has about the CNAs in LHH. First off [sic; heres another pesky first, not followed by a second], CNAs are not considered skilled-care providers. Most CNAs train for just a few months to be able to provide care to patients. In fact, the care they provide is the basics, like feeding and bathing, not management of behavioral or substance abuse problems. On the other hand, nurses, social workers, and psychologists are all positions which require more skill and training, which should improve the quality of care [sic; Again, Serafin ignores that MDs also improve the quality of care] for most patients with behavioral health problems.
With our current health care system, unfortunately cost cutting
is a necessary part of life. However, I do not agree with
the authors comments that losing physicians and CNAs while
replacing them with nurses and other health care professionals
would be a negative move [sic;
Finally, Serafin completely ignores that the U.S. Department of
Justice has been continuously monitoring LHH for a decade, since
1998; the DOJ has had concerns all along that the uni-disciplinary
nursing model of care provided at LHH in past decades
may have led to substandard care].
Jennifer Serafin, RN, GNP
Copyright (c) 2009 by Committee to Save LHH. All rights reserved. This work may not be reposted anywhere on the Web, or reprinted in any print media, without express written permission. E-mail the Committee to Save LHH.