One thing I didn't delve into in my rants yesterday and I want to be upfront and honest about is that there are too many nursing homes out there that are pieces of shit. In the two years I consulted in this area I seen them upclose and personal. One in Detroit that I had to work for one day I was centered out of a room inhabited by mice and God knows what else. When I left there that day I had flea bites. People live there still do.

All I have to do is remember these places and when I hear about crimes against humanity in places like Iraq or where ever and it even further disgusts me. I'd like to slap a few people and say take a look at what is going on in your own back yard. Fools.

The current survey process of nursing homes in this country is useless. The rule in a nutshell states every nursing home will have a surprise visit every year within 9-15 months of it's last survey. They come in spend 3-5 days and think they've got a good picture of what is going on. If they come in and decide to cite a deficiency it can have different scopes of severity, to an isolated incident to widespread. No actual harm to actual harm. It's all in the surveyors and their bosses - who might not even come into the buildings- determination. A lot rests on how knowledgable the surveyor is. I've seen many that are lazy and don't know shit. We are talking state employees here. Wouldn't it be a good idea to hire someone to survey that actually knows the business? Finally in this century they are just beginning to grasp the concept but nepotism and knowing the right person will probably always prevail.

I could write volumes on this, but this is where I get a little squeamish while I am still employed. If anyone in this large department would find out who just wrote the above would be finished in this business. No matter how well the facility is ran. So yes, surveys can be tainted and driven by ass kissing. I think that's called politics isn't it? The American way.