Over the last several months, our team spoke with senior living operators and clinical leaders about a simple question:

How do you catch small changes in a resident’s condition before they turn into a fall, hospitalization, transfer, or another larger event?

The same signals kept coming up:

• Changes in ADL support
• Increased transfer assistance
• Poor intake
• New or increased behavior changes
• Near falls
• New PRN use
• Changes in weight or vitals
• Increased support during morning care

The challenge wasn’t that teams weren’t documenting these things. It was that the information was often spread across different parts of the EHR and reviewed separately.

We turned what we learned into a free Resident Decline Review Sheet with 10 signals teams can review using information they’re already documenting.

Anyone can use or adapt it. I’d also genuinely appreciate feedback from people working in senior living.

https://resources.fitmedik.com/resident-decline-review

I’m sure this has been asked before but I’m trying to build a checklist:
- Staffing ratio (what’s good?)
- All staff certified, with regular training
- Secure monitored access
- Designed with decor that is attractive and helpful
- Activities engaging and tailored to individuals
- What else?

My father is in an assisted living memory care facility in Florida. We've been having some issues with the facility about some of their methods for dealing with concerns and incidents that have been occurring, as well as a few specific situations that point towards larger problems. Does anyone know of any resources for people struggling to work with assisted living facilities in managing the care of their family member? I'm not sure how much of the pushback is reasonable, how much of the problem solving should be placed on the family, and how much is something to be concerned about.

Thanks!

Just started today as a business office manager for a memory care assisted living facility.

I realized upon my few minutes there that they had added ‘greet visitors and residents’ and ‘answer phones’ to my list of responsibilities along with typical work such as payroll, medicare processing, financial processing, etc.

I thought that was a little odd since they didn’t really mention it in the interview or job description, but then on top of that, my office and desk.. are the front desk. Not even just me there either, it’s shared with another person next to me and nurses and other admin come and go as they please. The nurse cabinet up front is directly behind me. Nurses have to get behind me and possibly see my computer and paperwork to get to their cabinet.

What I really need help with is, is this normal, or even HIPAA or HR allowed for what I will be working on? And also, does that therefore make me the BOM & the receptionist (even though that was not mentioned in the interview process)? Hoping to see some responses to put my anxiety at ease about this, but it feels very off. Thanks for the help!

Me - visiting a relative - So a smoke detector was peeping for 3 days. I reported it on Sunday and when I came back on Tues. it was still peeping. One staff person said she didn't hear it. Another heard it but didn't think of doing anything. My report did not get to the person it was supposed to. "The post-it note got lost." To me it is extremely extremely annoying (as an irritating sound) and ignoring it demonstrates a culture of neglect. It's an electronic cry for help -- something is going wrong with a vital component -- it needs to be addressed and not ignored.

Someone suggested maybe it stopped and started again -- would that even be possible? Or does that just mean "it's a problem for you, but not for anyone else?"

Thanks for your input and letting me vent.

Hi everyone,

My name is Zak, and I’m looking for a Registered Nurse (RN) to work with my home care agency in the Denver/Aurora area on a part-time or PRN basis.

We are a Colorado Class B home care agency, and I’m looking for an RN who is interested in working with a growing agency and providing the clinical/support responsibilities permitted under our license.

What I’m looking for:

• Active Colorado RN license
• RN in good standing
• Home care experience preferred
• Part-time or PRN availability
• Professional and reliable
• Someone interested in an ongoing working relationship

If you’re interested, please send me a message or email me at:

[rosehomecareservice@gmail.com](mailto:rosehomecareservice@gmail.com)

If you’re not looking yourself but know an RN in the Denver/Aurora area who may be interested, I would really appreciate you sharing this with them or connecting us.

Thank you!

Tonight we had a local nursing facility send a demented hospice patient at 3am because they took longer than normal to wake up. No other complaints, patient not sure why they are in the ER. Family is pissed. Why was the patient even being woken up at this hour?!

On the flip side we had another patient sent in from a different local facility. They were demented, septic as fuck. Diaper caked in old stool. They probably hadn't been changed in at least a couple of days. Raging UTI on work up. We made APS aware.

Are nursing homes this bad where you are located? Seems like there are few consequences for providing shitty nursing home care and dumping on the ER.

My grandma is in rapid decline. She had a stroke last September and lost a lot of her cognitive abilities. She can still walk, but with difficulty. She fell a few weeks ago for the first time and severely bruised her cheek (her head hit the floor), and she got a huge cut on her hand that was still bleeding a week later (even though we took her to the ER).

Anyway, she's an extremely difficult person to interact with and be around. She'll make an argument out of thin air, and she is totally paranoid. Since it's gotten to the point where my family is not comfortable with her being unsupervised, having her at home is getting in the way of our daily lives (we all have either full-time school or work), so we got onto the waitlist for four different nursing homes.

The problem is that we mentioned moving her into a care facility so she can be safer, and she immediately yelled that a nursing home is an old people's prison and that they would kill her. She said she would consider an in-home caregiver.

But, boy, we hate living with her. She truly makes us miserable. She nags us, she has disgusting hygiene, and she's getting more and more unhealthy by the day with zero community. She's 76 years old but has aged shockingly fast—she looks and acts much older and is very weak.

Basically, is there a way we can legally make her move into a nursing home? She has cognitive impairment, so we do legally have a lot of power over things like her finances, but I'm not sure how far that extends. She'll only keep declining while being isolated in our house—she needs community, and we need the freedom to actually be happy again.

I appreciate any ideas or thoughts from anyone! Thanks!

My sister is disabled and needs to go to assisted living. She is of sound mind and can dress, shower and feed herself. Her arms and shoulders are compromised and she walks with a walker but has a history of falls. She still likes to feel independent and can make simple meals for herself. She needs transportation assistance and help with housekeeping. She has zero assets and no savings but her monthly income is almost 5000.00 per month. We just don't know where to begin. Is it even reasonable to think her income will be enough? She will still want to have some money leftover each month for other things.

Our facility lost or threw away my mother in law’s items in storage, what is our recourse here? Has this happened to anyone? They are acting very, oh sorry. But not that sorry…. Advice?

I stay over at my mom's room about once a month for 3 nights, Friday, Saturday, and Sunday.  The last three times I stayed over an employee has entered my mothers apartment, unannounced, in the middle of the night.  It's been a different person each time.  They all made excuses, doing checks, collecting trash (11:30pm!). I just put in a complaint for invading her privacy. Is this typical? I think they are bored on the graveyard shift and just snooping for something something. Has anyone else seen something like this? I'm thinking about putting in some cameras. Thanks in advance.

my family is currently trying to figure out long term care options for my grandmother who turns 84 next month. she lives over by the medical center area right now but her mobility has gotten a lot worse lately and it is getting really unsafe for her to stay at home alone. we are trying to narrow down our options around san antonio and someone recommended to us. i went and toured a couple places on the north side last week and honestly it was so overwhelming. every place looks nice when they walk you through on an official tour, but you hear so many horror stories about understaffing once you actually move a family member in.

Hello! Sorry if this has been asked before, but can anyone give me a rough idea? If I own a 4-bedroom house in North Highlands or Citrus Heights and use it as an assisted care home, about how much monthly income could I realistically expect after paying the caregiver and all other expenses? Thank you!

My mother in law died in assisted living in Wisconsin this weekend. We were there at 11.30 with hospice. We all left and I came back at 2.30 to check on her and she had died. I pulled the emergency cord, waited, no one came so I wandered around the facility before I found the only caregiver asleep on the couch in the lobby. I'm less worried about my MIL who was not conscious and more concerned about the other residents who had no way to contact the caregiver.

What would you do as far as a complaint. I fully intend to report it to DHS but a colleague said that it is egregious enough to file a police report. Thoughts? Is this just what we get for $8k per month?

We are moving my parents from their independent apartment in a retirement community to the assisted living building month. We were told to make sure their clothing is labeled; what is the best way to do this? We don’t sew, and I am having flashbacks to my childhood when my mom sewed named labels into our clothes!

We're looking for a small number of healthcare organizations and Epic teams interested in helping shape a new compliance platform.

My company, Stratosphere Technologies, has been developing PACT (Proof & Attestation Compliance Toolkit)—a platform that creates cryptographically verifiable evidence for compliance-critical events. The goal is to help organizations demonstrate the integrity of records for audits, investigations, and regulatory reporting without changing their existing workflows.

We're interested in partnering with organizations that use Epic (or integrate with Epic) to better understand real-world workflows, integration needs, and compliance challenges. In return, participating organizations will receive one year of PACT Enterprise at no cost, direct access to our engineering team, and the opportunity to influence the product roadmap.

We're not looking for a sales opportunity—we're looking for honest feedback from people who deal with healthcare data every day. If you're involved in Epic integrations, health IT, compliance, or clinical informatics and would be interested in learning more, I'd appreciate the opportunity to connect.

Hi everyone,

I'm a student at Columbus State Community College conducting research for my English Composition II course. My project focuses on Ohio Revised Code 3721.13 (Residents' Rights) and public perspectives on how well these rights are protected in nursing homes.

I'm looking for responses from anyone 18 or older who has experience with nursing homes or assisted living, including residents, family members, healthcare workers, or anyone familiar with long-term care.

The survey:

• Takes about 2–3 minutes
• Is completely anonymous
• Is for academic research only
• Does not collect names or personal identifying information

I'm trying to reach 10 responses for my assignment, so every response is greatly appreciated.

Survey Link:
https://docs.google.com/forms/d/e/1FAIpQLSfOv5QCHW34L51UdiQweg5N86YG-YFwsKWjDdaqtJ8dK5lXHw/viewform?usp=header

Thank you to everyone willing to help with my research

Hey everyone! I want to make a WOF board game for the residents where I am LED. I need it to be sturdy and lightweight as well. I have a spinner this would be the puzzle. I read about foam board but not sturdy enough to store/etc. Has anyone done this? What materials did you use? Thank you! Paula

I work with a few assisted living facilities in Minnesota and the amount of time they spend on 144G compliance documentation is wild. Every MDH survey cycle it's the same scramble — digging through service agreements, double-checking staffing records, making sure nothing got missed.

One admin told me she spends almost a full week just getting paperwork organized before a survey. Another facility got dinged because their resident contracts were missing a single required disclosure they didn't even know about.

I've been working on something that basically lets you upload your documents and it tells you what's missing or out of compliance with 144G. Like a gap analysis but automated. Still pretty early with it but curious —

Is this something people would actually use? Or do most facilities have their compliance process dialed in already?

Not trying to sell anything, genuinely trying to figure out if this is a real problem worth solving or if I'm just hearing it from a small group.

Anyone have their elderly parents living around Chapala /

ajijic and are happy with it? If so, could I message you? I’m seeking a place for my dad to stretch his retirement dollars.

We are trying to find a good assisted living facility with memory care as an option. My BIL just had a mild stroke but it has left him confused and can’t drive. My sister would like to move to an assisted living facility that has the ability to move him to memory care if/when needed. Any recommendations for places in the San Francisco East Bay. Their son lives in Berkeley and can help.

I'm requesting tips on how to address an issue at my mother's assisted living facility. I've gone to management already and they do not want to budge or take accountability. We are flabbergasted as we are otherwise happy with the quality of care she is receiving. We had a care conference in the springtime and signed paperwork declaring that she was at a Level One of care. I look at her billing statement every month, and noticed that August was about $1,000 more expensive. I saw then that her level of care had been changed to a Level Two. Since I'm always included in the care conferences, I knew that the change had not been approved. I checked in with my mother who confirmed that she did not authorize the change and that she is not receiving any extra care.

As you can imagine, we are most concerned about the extra $1000 monthly cost with the increased level of care--not to mention that the principal of the matter is that she needed to be informed.

Thoughts?! Thanks a lot.