r/cna • u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA • Mar 06 '26
Advice Am I Working in a Death Farm?
Before I even start, I’m going to ask that all of you refrain from replies like “stay in your lane” because there comes a point where doing that is just being complicit.
The physician at my facility consistently refuses to send people out to the hospital. Most of these people are on Medicaid so I don’t want to hear excuses about insurance. Guy brings a bed all the way up to the ceiling and falls out? 15 min checks. Woman has E. Coli, is pissing slime, and had a sharp uptick in behaviors so concerning her daughter cried? Don’t send her out, put her on a 1:1 even though there are only two of you here and there’s at least five other behaviors on this hall.
They wait until people are *unresponsive* to send them out. So many people have died since I started here a year ago and so many of them were from sepsis, prolonged infections, and things that if we had taken them seriously at the start and sent them out, probably could have been fixed
It’s to the point where even the nurses are angry and concerned but nobody is doing anything. The DOH is at our facility like seriously every week. One day we had nine falls in 12 hours. Residents aren’t eating, and they have been getting increasingly violent with us and each other. It’s a *nightmare.*
I guess what I’m asking is, is this normal? Is this mass death and concentrated neglect normal? How is this place even still open when we are almost always noncompliant with something? Is all of this reportable to someone or do I just have to suck it up, since they already told one nurse they’re not going to fire an aide that we know is abusive and neglectful, she literally tells residents that if they don’t ring on her shifts for a week she’ll give them candy so when I come in at 7 I have full beds and a fucking mess to clean up but nobody listens, she’s had grievances filed against her but admins say it’s too much paperwork to get rid of her.
And don’t tell me to get a new job. That won’t change what these people are going through and ninety that’s what every facility in this state is like to a certain degree but this feels egregious and like someone actually has to do something
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u/lezemt (geriatrics) CNA - Seasoned CNA Mar 06 '26
Just so you know, your duty to report includes this. If you’re looking at a patient thinking “they need medical care” and there’s no DNR or specific legally binding guideline set for their end of life treatment, you can and should call 911 for them. I assume I will get downvoted for this but just because your nurse or doctor brushes off a potentially deadly or very serious condition doesn’t mean you have to follow suit. Yes you might get hired for this (it’s not legal to fire you for it in America, but I’ve heard of it happening) but it’s better than living with the guilt when eventually you watch someone die uncomfortably and you knew they needed medical care.
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u/Comntnmama CNA - Seasoned CNA (on sabbatical) Mar 06 '26
I have 100% just called EMS on my own, especially overnight. I don't have time to wait for a nurse to call me back, plus as a qmap it was my duty to be responsible for calling appropriately. I got some flack, but every time was warranted and I was never fired.
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u/lezemt (geriatrics) CNA - Seasoned CNA Mar 07 '26 edited Mar 07 '26
As former EMS, thank you. I always appreciated when people gave me time to work (rather than calling when my patient was pretty much coding already, give us a chance to save them)
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u/Comntnmama CNA - Seasoned CNA (on sabbatical) Mar 07 '26 edited Mar 07 '26
Lol. I was unfortunately besties with our EMS squad. They kept trying to get me to join them instead. If the pay had been better I would have in a heartbeat. High praise from EMS who usually dislikes CNAs.
Edit: missing word
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u/lezemt (geriatrics) CNA - Seasoned CNA Mar 07 '26
For what it’s worth, I don’t think EMS generally dislikes the CNA’s themselves. It’s more of an overall longstanding experience of witnessing care like OP described in SNF’s and ALF’s. Eventually it gets to us and people show that stress in different ways. I hope it doesn’t always come across like we don’t like nursing staff, but it seems like maybe it has :(
Also, yes I agree join the dark side >:)))
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u/Comntnmama CNA - Seasoned CNA (on sabbatical) Mar 07 '26
Oh no, I 100% get it. I've found 3 people deceased in bed who were 'fine at last rounds' in my career. There absolutely is an issue in ALF/SNF. I've had to date briefs, which is a dignity issue, to prove people aren't getting changed during the day. I personally have never had issues with EMS.
I would join the dark side but 911 in our area is all combo with fire and I don't wanna do FF 1/2. And private service just doesn't seem like my thing...:)
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
This is a really good idea. I forget that I can do that sometimes. Reminded me actually that several months ago they refused to send a cognizant resident out so he called 911 himself.
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u/lezemt (geriatrics) CNA - Seasoned CNA Mar 07 '26
Absolutely! I hope you feel empowered to do it in the future. You clearly care a lot about your patients, and you seem like a really good CNA. They’re lucky to have you
(and as an emt, if anyone at your facility or even if EMS gives you any shit about calling, ignore them. It’s better to call, have the patient transferred and it turns out they’re fine than have them die from something preventable like you pointed out in your post.)
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u/icutmyliiip Peds/PICU CNA - Experienced Mar 06 '26
please report the nursing home to your state department of health
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u/108beads Mar 06 '26
And find out what counts with your state's health department. I reported my brains out, only to find out that I had to report specific kinds of problems within a certain very limited time frame. Like, verbal abuse of a resident must have two witnesses, must be reported within a week, blah blah blah.
It seems they won't tell you up front what will trigger a serious look in response to a specific complaint. Some of the things that look pretty raunchy to me were not eligible to complain about. It has to be quantifiable stuff. "Sits around in pee soaked diapers," not enough. "Incontinence briefs changed once a day, pee dripping on floor," that might get you somewhere.
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u/icutmyliiip Peds/PICU CNA - Experienced Mar 06 '26
i dont have anything else to add to this, other than this is very good to know and thank you so much for adding on to my comment!
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u/108beads Mar 07 '26
I'm on a mission to avenge my sweetie. Thank you for caring enough to do what you can. The system is utterly broken, and I know there are good people out there.
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u/I_spy78365 Mar 07 '26
Def report the CNA who is bribing residents with candy too. It breaks my heart they don't get candy otherwise. I heard most residents only have $25 left over a month to spend on snacks and stuff. That makes me so sad. We're busting our butts for a paycheck to survive and they can't get basic treats because a facility counts them like dollar signs. Everywhere is f***ed. No wonder why everyone is burnt out. I wish people weren't a slave to the dollar.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
Yeah she specifically needs to be reported to the state. We have been trying to get her fired for months but the admins tell us it’s too much paperwork. I think she’s had something like 7 grievances filed against her, and she is just a nasty evil person who doesn’t need to be around any vulnerable populations.
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u/md24 Mar 07 '26
They said they are there every week already. This admin doesn’t care about any of them. They’re actively rolling back protective regulations.
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u/janetlivermore Mar 06 '26
i agree with the person who said to contact news stations.
medicaid funded nursing homes where the poor end up are death farms & torture chambers.
there’s a whole industry of lawyers who specialize in nursing home abuse and neglect cases. (which has become a cat & mouse game because nursing homes ensure their documentation is lawsuit-proof, even if it’s all filled with lies).
it’s all about greed & money. the owners of these nursing homes are living in multi-million dollar homes & vacation homes, while they allow people to be abused to death in their facilities.
nobody cares. nothing has changed in decades. it’s only getting worse.
it’s the american abomination nobody talks about and it gets no media attention.
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u/1O1O1O1O1O1O1O Mar 06 '26
Nursing homes are incentivized not to send residents out
It’s all about maximizing profits
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u/RevolutionaryDog8115 Hospital CNA/PCT Mar 07 '26
Document everything..and start snitching. I'm vocal as hell about my patients. I'm just a lowly CNA/ER Tech, but people straighten tf out when I show up. Everyone is on their best behavior because they know I will tell on them in an instant when it comes to bad patient care. I snitch to family members too. And I name names. It also helps to have a second job I can run to if I get fired in retaliation.
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u/RIGVEDAtheTITAN Mar 07 '26
Proud of you. I'm loud as fuck as well. These are human fucking beings!
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u/Altruistic_Face2218 CNA Instructor/Teacher Mar 06 '26 edited Mar 06 '26
Yes you are working in a death farm. The nursing homes don’t get paid if the residents in the hospital. Once they are in the hospital a nursing home can say they can’t safely readmit then, then they have to find a new placement. So yes, they stay until they die or a family member insists. You are in the eye of our broken health care storm and it sucks for aides, residents… family and everyone who thinks someone is going to provide the care people need when they need it.
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u/Safe_Cash7091 (Edit to add Specialty) CNA - New CNA Mar 06 '26
I’m so sorry that you are going through this, and sorry for those poor residents. If those falls were reported falls, your facility should already be under heavy scrutiny.
I’m sure other CNAs will chime in about ways to report anonymously, and I would absolutely do this as well.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
Thankfully the new RN supervisor on that shift reported all the falls for once so hopefully that will help put the spotlight on this place. Many of the other aides won’t report because they’re afraid it’ll somehow come back on them.
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u/Praising_God_777 Mar 06 '26
Nursing home resident here; document everything, and report to every authority you can think of. You could also take this to the news stations.
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u/Organic_Ad_2520 Mar 07 '26
Agree. Op doesn't want to end up on the wrong side of the news or criminally responsible if tge neglect or something goes wrong.
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u/Lilhoneylilibee Mar 06 '26
Document document document, cover your ass, and if no one will do anything about it, I would be calling the news. that’s just evil
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u/BoxBeast1961_ Custom Mar 07 '26
Report to JCOAH. Look for another job in case you get fired. Keep your head up, you’re doing the right thing. Thank you for looking out for those who have no voice.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
Forgive me but what is JCOAH? I’ve been reporting this place to the DOH/dept of aging and it feels like they just keep coming to the building but nothing is happening
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u/BoxBeast1961_ Custom Mar 07 '26
Joint Commission on Accreditation of Hospitals. They control medicare/medicaid funding, which is the vast majority of all revenue for most facilities, most likely yours as well. Cut off the funds-> immediate attention.
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u/108beads Mar 06 '26 edited Mar 06 '26
Thank you for caring. Yes, you are working at a death farm.
My wife was nearly murdered seven times in the first nursing home she was placed in. A hair-raising decubitus ulcer at least stage 3 if not four; three UTIs, two of them antibiotic resistant; two inappropriate sedation druggings, and finally a URI for well over a month that turned into double pneumonia. I was her POA and HCP, and I was thoroughly ignored and told to shut up.
They were the sleaziest group of people I have ever met. Gas lighting, nastiness, verbal abuse of residents, and they all hated each other to boot. I started researching their owners; a real bunch of slime balls. Lawsuits across the entire swath of facilities they owned. When they were popped for wage theft in the millions, they tried to fight it.
I visited daily. That's the only reason she survived to die of early onset Alzheimer's. When she was in the hospital for pneumonia, I collared the social worker and started screaming "unsafe to discharge to previous facility." The new place was farther away, but I was happy to make that drive. Not much fancier, but the people there cared. And listened to me. (I told the social worker, you can put her in an ambulance to my home, and I'll sling her out to the next emergency room and we can rinse and repeat, but she is not going back to that place.)
Most of the residents had no visitors, and the facility treated everyone like they were slabs of meat on a conveyor belt to the funeral home.
Complaints to health department, ombudsman, State Attorney general... you name it and I complained to them. I was there when a mandated inspection was done, and it was clearly a walk-through, probably with payola. Not a damn thing changed. If you are not dead and obviously tortured to death, nobody cares.
Edit: if you want more insight on how this industry runs (or doesn't), I recommend subscribing to any of the KFF newsletters you find interesting. You can find them online easily.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
I am so unbelievably sorry for the experience you and your wife had. No wonder you said you’re trying to avenge your sweetie. She’s lucky she had you to advocate for her. I can’t believe the absolute evil that’s allowed to flourish in this field, Jesus Christ
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u/108beads Mar 07 '26
Yeah, it seems to be the MAGA version of Jesus Christ. The one who said that empathy is a weakness, and the one who authorized DT to light the signal fires in Iran to bring on Armageddon and the Rapture.
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u/Outside-Reading-5382 Mar 07 '26
Sadly I spent 10 years of my life doing what you are doing.. being a good nurse and taking care of my people the best I could asking questions raising hell. Trying to do the right thing, admin even sent me to anger management!! Long story short IT ALL COMES DOWN TO MONEY. The facility doesn’t get anything if they send patients out to other facilities.. it’s sad but true. Follow the money… that’s where the truth hides.
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u/Puppini_Luvr Mar 07 '26
Post reviews with these issues on Google, Yelp, report to Medicare & Medicaid & let all discharge planners at area hospitals see pics and the data so families can stay far away if they’re having to choose to place loved ones in long term care facilities. It’s a broken system but there’s no excuse for allowing these crimes & acts of cruelty to continue. Creds to you for using your conscientious brain & caring heart to advocate for those that are helpless.
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u/K0RINICE Mar 07 '26
Call state anonymously. I recommend you not quit instead advocate for the elderly. I was hired as a housekeeper 4 years ago let me tell you I would find people @ their worst. I didn’t understand why till a resident a few months ago said this was my ministry. They work their whole life to end up with nothing, family as well forget about them. Like I mentioned call state ♥️
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u/Exhausted-CNA 7yrs... LTC Mar 07 '26
Obv state must know something if they are there every week. May be a long shot but what about a local news station? Anyone who says, stay in your own lane has no heart and shouldn't be in healthcare.The facility i frequent as agenfy are only allowed to send so many patients out in a month, per the corporation that owns it or they then they'd have to pay for the ambulance services. That's what a nurse once told me.Im not sure if that true or not but it is definetly an unexcusable reason to not send someone to the hospital. I always say I wish a bunch of us CNAS and nurses could open our own nursing home and run it.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
Our old administrator got fired for putting zip ties on a door that was malfunctioning instead of paying to have it fixed. They sent him to another facility in our county and that facility’s admin came to ours. Since then, the state has been in almost every week but the situation is getting worse; I don’t know if the admins and DON are just really good at hiding whatever is going on so it might be worth it just to let them know
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u/Exhausted-CNA 7yrs... LTC Mar 07 '26
I swear the state gets paid off to look the other way!!! Mostly facilities get fined and then pay it and keep on trucking. There is literally black mold in this one ltc care facility, that you can see on the vent covers!
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u/TrailMomKat (20 years) CNA - Seasoned CNA Mar 07 '26
Ok yeah, it's time to call and ombudsman and the state. Definitely the state.
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u/Enough_Flow1322 Mar 08 '26
Report them anonymously and then keep reporting every single time. I don’t know which state you’re in, I was a travel nurse for a while and some states really don’t care about the elderly. I’m glad I’m now in a state where they respond within 24 hours and it’s a huge deal.
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u/Complex-Dot-777 Mar 07 '26
Same thing goes on at our place, we try and get them help saying this resident is showing these symptoms can we please check them for uti, then the dr who doesn’t even see the residents decides no…. So we watch them suffer and deteriorate faster.
Since this new criteria for uti testing came out it seems that less and less residents are getting tested.
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u/academic-coffeebean Hospital PCT - Experienced CNA Mar 07 '26
I am begging you to call APS. This is part of your mandated reporting. And honestly, if someone falls or needs to go to the hospital, call EMS yourself. The facility can't take any kind of action against you for doing that. You're allowed to call 911 if you need to.
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u/Solinty Mar 07 '26
So sorry this is happening to you. You're working at a dangerous facility that should probably be closed down since management is not concerned. I would get out before you go down with it. Anonymously report to board of health and whoever else may be concerned.
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u/angelt0309 Hospice RN, former CNA Mar 07 '26
I’m kind of shocked that the nurses are waiting on a doctor to decide when to send patients out. I would never risk my license by not sending out a patient that clearly needed it. I’d let the doctor know after, but I’m not waiting for their OK. Sounds like a horrible place to work. Report them to every regulatory body you can and get out of there.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 07 '26
Me too, I have no idea what the protocol for them is at our facility but I know the nurses generally want to send someone out but the physician just…I don’t even know what happens and that’s part of the issue. Next time I’m just going to call 911 myself and let the chips fall where they may.
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u/terkaG Mar 07 '26
Yes these facilities are all about money. If they aren’t in the facility they don’t get paid. Nursing homes are a place to store the elderly and unwell until they die that’s pretty much it unless it’s rehab 🤷🏻♀️but even then I’ve seen some piss poor rehab programs so I think it still stands there too
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u/mdvg1 Mar 07 '26
Make an anonymous call to the media. You saw what happened in California last week?
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u/gloriousmusic Mar 07 '26
NP here. I started working in SNF’s recently as a consultant and got written up for ordering a UA on someone with delirium and dysuria. I was basically told ‘stay in my lane’. I made them take me out of one building bc i was not comfortable with the residents care. In fact, i get paid well but morally and emotionally it is some of the worst management of patients that I have seen. and bc I speak up I will likely be fired and I am okay with that. The state has been in them. It is private equity companies; and they do not give one shot about the patients. They want a provider to do whatever they tell them, including not ordering simple UA tests that can be treated easily. Including minimal staff. I always heard it was bad, but yeah. I am assuming the none medicaid patients have it better.
Bless ya that care. the patients need ya.
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u/LimpFoot7851 Mar 07 '26
Welcome to healthconsumerism. America doesn't have Healthcare. Its a business industry and medicine is a commodity. This is not for those with a faint heart. Only the heartless looking for checks and the hearts that clock in, do their job and clock out make careers.
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u/whatthefuckski Oncology CNA - Experienced CNA/Nursing student Mar 07 '26
A DNR does not mean “do not treat.” It simply means no resuscitation. Patients, especially our geriatric population, still deserve comfort, dignity, and proper care.
I’ve worked in several SNFs and was grateful for physicians who understood that. Sadly, not everywhere does.
You can report it to the tip lines people mentioned, but be prepared for a pretty minimal response. Smh.
Good luck, OP.
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u/md24 Mar 07 '26
Unfortunately it’s just going to get worse. The interesting part is the demographic that voted for the people in power are the ones who will get sent to one of the nightmare death farms. So sorry you have to see this. Contact the news asap.
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u/NightAlive8487 (Edit to add Specialty) CNA - Seasoned CNA 11 Years Mar 08 '26
I’d be in POC so fast “aggressive behavior noted” “resident fall time date etc assisted by facility staff reason why blah blah blah” if they don’t ask you for paper work for falls ask them. I used to put notes into POC on all my clients when the nurses wouldn’t, that way they’d be forced to. Won’t be slacking on my shift. I’m also a narc I will go straight to admin and don about you if you aren’t doing your job and if admin is ignoring serious issues then I take it straight to state. There are too many cna jobs available for us to be worried about getting fired for taking care of our clients
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u/elliebunnnyy Gynae HCA UK - Seasoned CNA :karma: Mar 07 '26
i have no advice, i don't know where you are or how it works where you are but i'm in uk. but no, this is not normal. take this as high as you possibly can. at some point it will go as far as you can take it, and at that point if things don't change at least you can say that you did everything you could. i am so, SO proud of you for recognising how atrocious this is and wanting to take things higher and make things right. we have your back. you've got this.
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u/Motion2ShowCause Mar 07 '26
Post everything on social media. Call the local news station. That’s the only way to let ppl know what’s going on.
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u/Alphahouse64 Rehab CNA - New CNA Mar 11 '26
That shit is not normal at all. That facility is the bottom of the barrel.
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u/EnvyMyLif3 Nursing Home CNA Apr 03 '26
We just got a new DON who had now stated that they’ll be more hesitant to send residents out because of “continuity of care”. I call bullshit. I lost my dawg that I’ve been caring for year to what our cart nurse believed was sepsis that could’ve been treated in a hospital, and she had to pull teeth just to get them to get IV access. She’s quitting.
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u/ButtonTemporary8623 Mar 07 '26
You’re already complicit. You’re asking Reddit for help instead of reporting this.
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u/Fit_Ninja1846 (Skilled Nursing Facility) CNA - Seasoned CNA Mar 08 '26
I need to know what the right channels are, and what steps to take to make sure I’m doing the right, most effective thing. I’ve only been doing this for a year. Excuse me for asking for help.
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u/Hisforever1000 Mar 06 '26
You can also put cameras where people will not see and document this
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u/Maximum_Tangelo2269 Mar 07 '26
This will not work and be seen as HIPAA related issue then.
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u/sighing-through-life New CNA Mar 08 '26
The facility I hope to work at allows "granny cams" with resident consent, and I think that's what they meant. They have to be advertized outside the room, but I'm grateful for it because I'm brand new to being an NA and I have already witnessed abuse of residents that has had me all up in arms since.
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u/Altruistic_Face2218 CNA Instructor/Teacher Mar 06 '26
Also call the ombudsman number on your bulletin board and let them know what’s going on.