August 11, 2009
Hearthstone or Heart of Stone?
By Bob Wilson

American author and humorist, Samuel Clemens (Mark Twain), once stated, “The public is the only critic whose opinion is worth anything at all.”

Based on what you are about to read, I will let you judge whether Twain’s statement rings true.  If you have ever dealt with an assisted living facility or may be considering an assisted living facility for a loved one or yourself, you may find the following information interesting.  In writing this piece, let me say that I have no ill will towards the staff at the Hearthstone Assisted Living located in Birmingham, Alabama.  But, I do take issue with Hearthstone/ Carestone Assisted Living (the company) and their handling of this issue following my Dad’s death.

Background

I live in the Birmingham metro area.  My Mom and Dad lived in Enterprise, Alabama.   Due to health issues, Dad became a resident at Hearthstone in Birmingham on January 2009 and mom became a resident on February of that same year.  Each had their own separate bedrooms.  As only those who care for elderly parent(s) can relate, these can be difficult times for the parent(s), the family and the caregiver(s).  It is because of these difficulties that it is imperative to find the right assisted living facility and staff to care for them. 

with her own health issues and it was best for her to stay there.  They said their “goodbyes” with the assumption that all would be fine.  A couple of days of recuperation in the hospital and they would be back together again.  In 2008, Dad made several trips by ambulance to hospitals.  In fact, his previous ambulance trip before to this one took him from their home in Enterprise to a nursing home in Birmingham.  His stay at the nursing home was for rehabilitation due to gall bladder surgery.  He continued his rehabilitation at Hearthstone.       

As with most ERs, it was a busy place, yet Dad was taken immediately to a room.  He spent all morning in the ER waiting on test results.  He was given an IV for his dehydration and although extremely weak, his spirit was up.  He was allowed a little cup of coffee which brought a smile to his face.  Dad loved his morning cup of coffee, “The day isn’t right until you have that morning cup of coffee.”  We talked; we joked; and we waited.  He talked and joked with the ER staff, too.  Also, he worried.  He worried not about himself, but about Mom.  He was worried about her health and how she was doing alone at Hearthstone.  He spoke of how much he loved her, how blessed he was to have her as a wife.  Occasionally, he would take very short naps.  With the IV, his color came back to his cheeks, but he still was extremely weak.  It looked serious, but I wasn’t worried. He would bounce back. 

Why?  Because that is what Dad did, he always bounced back.  No matter that he recently celebrated his 84th birthday in February; no matter that he had a serious heart condition; no matter that his memory was fading; no matter that he appeared tired and weak; Dad would bounce back.
 
Why? Because that is what Dad did, he always bounced back.
 

After hours of waiting, the tests results finally came back.  The tests indicated that Dad may have a touch of pneumonia.  Treatment began for it and arrangements were made to admit him into the hospital for a few days.  I recollect it was after 12 PM when Dad was taken to his room.  I answered some questions asked by the nurse and sat with Dad.  He asked me to close the window blinds because he wanted to take a nap.  I closed the blinds and told him I was going to eat lunch and head on to work. I told him I loved him and would see him after work.  Little did I know that I would never talk to him again on this side of Heaven. 

While having a lunch with my wife, I received a call from the nurse that Dad had suffered a cardiac arrest.  He was alive but not conscious.  She asked me to come back to the hospital as soon as possible.  He was being moved to the Cardiac Intensive Care Unit (CICU).  I contacted my only sibling, my brother Michael, who was at a work site in Georgia and told him about Dad.  He was shocked to hear of Dad’s sudden turn for the worse.  He was going to make his way to Birmingham.  We agreed in prayer that if today was Dad’s Home-going, Dad would not leave until Michael could be at his side.  And we agreed that we did not want him to suffer.

When I arrived at CICU, I briefly saw Dad in his room surrounded by a doctor and several nurses, then I was directed to the head nurse.  I was informed by the head nurse that Dad had suffered another cardiac arrest at CICU, but they revived him.  He was still unconscious.   Dad’s doctor happened to be on the phone with the head nurse when I arrived.  I spoke to his doctor and he told me that Dad had suffered a cardiac arrest and that the prognosis was not good.  Dad had no Living Will.  (All adults need to have a living will). 

It is not a pleasant experience seeing a loved one on life support.  You see tubes, wires, and monitors.  Things seem to be in slow motion.  You are aware of what is happening, but it’s still hard to grasp it all.  Due to my Dad’s situation, they had to tilt his bed (head up/head down) in order to keep the blood flow going throughout his body.  His heart was that weak.        
It was difficult to contact my children and let them know about their Grandpa’s condition.  But, it would be a more difficult telling Mom.  Michael and I decided to wait until after he arrived to tell Mom.  We were concerned about her health.     

As the hours passed waiting on Michael, I was visited by the Outreach minister of my church and by the hospital chaplain.  Their visits were very comforting to me.  I prayed.  I sat with Dad.  I walked the halls of the hospital.  Michael arrived around 8 PM.  I prepared him for what he was about to see, but I guess, you never can be fully prepared.  It was a somber moment.  The nurse informed us that if Dad survived the night, they would do a CAT scan on him in the morning.  If the CAT scan results confirmed their prognosis, a decision would have to be made concerning the life support.    

Around 8:20 PM, while Michael and I were discussing when to tell Mom, Dad decided for us.  He held on all day and night waiting for Michael.  I believe his spirit knew it meant a lot to him.  With little fanfare, his heartbeat and blood pressure slowly began to drop. With Michael and me by his side, Dad quietly left our presence to be with the Lord.  At the end, God honored our prayers.  It was a peaceful Home-going and we were blessed to see Dad off on his journey, "to be absent from the body is to be present with the Lord. “   
        
After making the appropriate arrangements for Dad, Michael and I left the hospital for Hearthstone.  It was time to tell Mom.  This was the most difficult thing we had ever had to do.  She had had difficulty sleeping at Hearthstone, but she told us that a peace came over her that night. She had had a very restful sleep.  In fact, we had to get a staff member to let us in her locked bedroom because she was sleeping so soundly.  The news of Dad’s death understandably shocked her, but even in her grief, she wanted to see him at the hospital so we drove back to the hospital.  When she saw him, she commented that he look like he was just sleeping.  It was difficult hearing her cry out to him to “wake up, honey…you wake up”.         

From the moment she left Hearthstone that night, Mom would no longer reside there.  From the hospital, I took her home to my house.  The next few days were spent making the arrangements for the funeral and removing their items from Hearthstone.  My father had served in the Armed Forces since WWII.  He was on Yorktown (US Navy) during WWII and joined the US Army after the war.  He retired from both the military and Civil Service.  Most of Dad’s adult life was in service to God, to his family, and to his country. 
 

As requested, on March 9th, I sent an e-mail to Hearthstone informing them (what I had verbally told them days before the funeral) that Mom would not be returning to Hearthstone.  Most of their possessions had been removed from the facility prior to the funeral.  All that remained was some refrigerated items and their bedroom furniture. 

By March 25th, theirs rooms were completely vacated.
 
The Issue

The family had no contact with Hearthstone since March 25th.  Therefore, I was extremely surprised that in late May to receive a bill from the company for $574.03 charged to Mom.  The bill was for 4/1/2009 thru 4/9/2009.  It was a bill for cable, assistance with medication, and the room.  A bill for days not occupied and services not rendered.  Also, the bill had stamped on it in bold red the following verbiage, ““PAST DUE INVOICES WILL BE TURNED OVER TO COLLECTIONS”. (MAY bill)  Remember, this is the first bill I received from the company.  
   

Immediately, I contacted a staff member at the Birmingham location to discuss the bill and my displeasure at receiving this unexpected bill with the “Collection” threat stamped on it.  The staff member stated she would forward my grievances to the company office.   A few weeks later, I received another bill, but this time the “Collection” threat was not stamped on the bill. (JUNE bill)

Again, I contacted the same staff member at the Birmingham location to discuss the bill.  Again, I voiced my grievances of Mom being charged for days not occupied and services not rendered.  In July, I was told by the staff member that the company would reduce the bill.   I informed them it didn’t matter, any charges for days not occupied and services not rendered were wrong no matter how the company attempted to justify it.

The last bill sent was for $574.03 and yes, the “Collection” threat was stamped on it.  (JULY bill)

I am disappointed to hear from the Birmingham staff member that the company’s handling of this issue is an industry standard/practice. Whether this company’s action is an industry standard/practice or just this company hiding under guise of “we do what all other assisted living companies do”, I will let you decide.  But, I would imagine that within the industry, some companies (hopefully most companies) would have handled this issue far differently. 

To an industry and to this company that promotes compassion as a key selling point, I find that when the rubber meets the road, this company’s compassion is tied tightly around the money - your money.  It is all about legality and not morality.   It is about whatever they can financially squeeze out of you because “that is what’s written in our policy.” 

►It is a policy where this company feels legally and morally justified to charge a grieving widow on a fixed income $574.03 for services not rendered. 

►A policy that charges a grieving widow on a fixed income for cable services, assistance with medication, and lodging from  April 1 – April 9, 2009 when she no longer lived at the facility.  

►A policy that charges a grieving widow on a fixed income $574.03 for cable services, assistance with medication, and lodging when an e-mail notification was forwarded as requested to an appropriate staff member two days after her husband’s funeral on March 7 stating her intentions to vacate the facility. 

►A policy that charges a grieving widow on a fixed income $574.03 for cable services, assistance with medication, and lodging when all furniture was removed from the facility on March 25. 

►A policy that is so narrow minded and heartless that it never even considered reimbursing the grieving widow for days vacated, but instead demanded payment for days not occupied and services not rendered.  (From a public relation viewpoint, they must have figured it would look bad to charge the deceased for April, but hey, "we can still stick it to his grieving widow on a fixed income.  What is she going to do...take us to small claims court...yeah right.")

►A policy not built on their website’s motto, “Where caring counts”, but on an Ebenezer Scrooge business model and mentality. 

 ►A policy so selfish and so inconsiderate that the first bill sent to the family had stamped in red “PAST DUE INVOICES WILL BE TURNED OVER TO COLLECTIONS”.  Nothing like a threat to give a grieving widow on a fixed income and her family that “Where caring counts” down-home warm and fuzzy feeling. 

►A policy that contradicts their standard operating procedures (SOP).  The company pro-rates the bill at the beginning.  Why? They don't believe it is the right thing to do to charge a new resident for days not occupied.  But, as a resident, as in the case of Mom, if your departure is strictly due to a unexpected death of your husband of over 50 years, well, they are perfectly comfortable charging his widow for days not occupied and services not rendered.   

In attempting to explain their policy to me, the Birmingham staff member stated that this policy is just like if you rented an apartment.  But, I beg to differ with that staff member.  When one rents an apartment that is basically what you get.  There is very little interaction with the apartment manager unless (1) your behind in the rent or (2) you need something fixed in the apartment.

As I stated earlier, finding the right assisted living facility for your loved one or for yourself is very important.  The staff can be the most compassionate people you will ever meet, but you must go beyond that to the company’s policies.  No matter how the staff may feel about an issue, they are bound by the company’s policies.

The company received their ill-gotten gain for days not occupied and services not rendered.  I believe my Mom was wronged by them.  I likened it to legalized thievery.  I find their actions without honor. 

I wondered…do federal agencies pay into this industry in the form of VA and other federal benefits?  How about state agencies?  How about insurance agencies?  With such emphases on Healthcare these days, the time may be now for Federal regulations and stronger local/state regulations of this industry.  The time may be now for these agencies to take a closer look into the industry.     

Options

If you have grievance(s) against an assisted living facility, do everything you can to resolve the issue with them.  If that fails and if warranted, seek legal advice especially if you suspect abuse or negligence.  As always, you can contact your local and state representatives; the Better Business Bureau, the Chamber of Commerce, consumer protection agencies, and other governmental/non-governmental agencies.  Below are a few agencies:

  
www.ncea.aoa.gov  = The National Center on Elder Abuse (NCEA)
www.60plus.org = 60 Plus Association
www..aarp.org = Association for the Advancement of Retired Persons
www.ripoffreport.com = Ripoff Report (by consumers, for consumers)
www.va.gov = U.S. Department of Veteran’s Affairs

www.va.gov/health = Veterans Health Administration
www.alfa.org = Assisted Living Federation of America
 
Also, the internet is a marvelous tool.  With the click of the mouse button, volumes of information are available at ones fingertips.  With the click of the mouse button, websites, forums, blogs, Facebook, MySpace, Twitter and other internet communities are available at ones fingertips.  The internet is an endless source of information.  It is a powerful communication tool and it can serve as a medium that can reach people, market areas, and businesses around the world.

Assisted living is a highly competitive market.  It is the little things that give a company the edge over its competition. In the Birmingham metro area alone, it is my understanding that two new assisted living facilities have opened this year.  It is so easy to SEARCH for the assisted living facility in or near you using the internet.  Go to a SEARCH engine like Google and enter, assisted living <city> <state>. 
 

Final Thoughts

If you have elderly parents or aged loved ones, take the time now to research every facility in your area.  Don’t wait until you need a place quickly.  There is too much at stake.   Whether you chose Hearthstone or another facility is up to you.

God Bless,
Bob

The opinions, beliefs and viewpoints expressed are those of the author and do not necessarily reflect the opinions, beliefs and viewpoints of this publication or website.