The aide told me Mom was doing great and that I should feel good about the choice we made.<\/p>\n
That was March nineteenth. I stood in the hallway outside the dayroom while she said it, and I remember nodding because I wanted to believe her. The place smelled like lemon floor cleaner and something underneath it that I didn’t want to think about. Mom had been at Pinewood Manor for six weeks by then and I visited twice a week, Tuesdays and Saturdays, like clockwork.<\/p>\n
The aide’s name was Tricia. She was maybe thirty, blonde ponytail, always smiling. She told me Mom was eating well and participating in activities and adjusting beautifully to the routine.<\/p>\n
I drove home feeling lighter than I had in months.<\/p>\n
I didn’t know yet that my mother had started counting.<\/span><\/p>\n Mom is eighty-six. She raised four kids in a paper-mill town in Maine and she worked the register at the grocery co-op for twenty-three years before her knees gave out. She is not a complainer. She is not dramatic. When she tells you something, you can take it to the bank. So when she said to me on my next visit, quiet and steady, “They only give me two a day,”<\/span> I wrote it down on the back of a grocery receipt and I asked her what she meant.<\/p>\n “The underwear,” she said. “The protection. Two a day. That’s the rule.”<\/p>\n I thought maybe she was confused. I told her that didn’t sound right and that I’d talk to someone at the desk. She looked at me for a long time and then she said, “I’m not confused, Sharon. I counted.”<\/span><\/p>\n I didn’t talk to anyone at the desk that day. I told myself I’d bring it up next time if it came up again. I didn’t want to be the daughter who caused problems. I didn’t want to be the one making accusations when maybe Mom really was just mixed up.<\/p>\n But she wasn’t mixed up.<\/p>\n The next Saturday I got there a little earlier than usual, around ten in the morning, and I found Mom in her room sitting in the vinyl armchair by the window. She was wearing the floral housedress I bought her for Christmas and her hands were folded in her lap and she didn’t get up when I came in.<\/p>\n “I had an accident,” she said. Flat. No emotion. “I’m waiting for someone to come.”<\/p>\n I looked at her and I realized the dress was damp. Not soaked, but damp. Dark at the lap. She had been sitting there long enough for it to start drying at the edges.<\/span><\/p>\n I asked her how long she’d been waiting.<\/p>\n “I pushed the button maybe half an hour ago.”<\/p>\n I went out into the hallway and I found Tricia at the nurses’ station doing paperwork. I kept my voice calm. I told her my mom needed help and she looked up at me with that same big smile and said, “Oh sure, hon, I’ll get to her in just a minute.”<\/p>\n I stood there. I said, “She’s been waiting half an hour.”<\/p>\n Tricia’s smile got smaller. She said, “We’re short-staffed today. I’ll get there when I can.”<\/p>\n I went back to Mom’s room and I helped her myself. I got clean clothes out of her dresser and I walked her to the bathroom and I cleaned her up as best I could and I didn’t say anything about how wrong it felt that I had to. She thanked me. She said, “I’m sorry you had to do that.” Like it was her fault.<\/p>\n I asked her again about the two-a-day thing.<\/p>\n She told me it was written down. She said there was a whiteboard in the supply closet on her floor, the one next to the medication room, and the rule was on it in black marker. Two per resident per day. She said all the aides knew. She said some of the other residents had started limiting how much they drank so they wouldn’t need as many changes.<\/p>\n I felt something cold move through my chest but I still didn’t believe it. Not fully. It sounded too ugly to be real.<\/p>\n “I’ll look into it,” I said.<\/p>\n She looked at me the same way she did when I was sixteen and told her I’d be home by eleven and then rolled in at one-thirty. She didn’t argue. She just nodded.<\/p>\n I left that day and I didn’t look into anything. I went home and I made dinner and I watched TV and I told myself my mother was old and sometimes old people get things wrong. I told myself Pinewood Manor cost forty-eight hundred dollars a month and they had good reviews online and a nice lobby with a piano and framed watercolors on the walls. I told myself a place like that wouldn’t ration incontinence supplies.<\/p>\n But I also didn’t go back for nine days.<\/p>\n When I finally did, it was a Tuesday, late morning, and I brought a bag of the butter cookies Mom likes. I found her in the dayroom with three other residents watching The Price Is Right on the big TV mounted to the wall. She looked smaller than I remembered. Thinner. I sat down next to her and she smiled at me and said, “I wasn’t sure you’d come.”<\/p>\n I asked her what she meant and she said, “I know it’s hard to hear the truth about a place after you’ve already committed to it.”<\/p>\n That was when I started paying attention.<\/p>\n I asked her if she was eating and she said yes, mostly, but she was trying not to drink too much water during the day. I asked her why and she said, “You know why.”<\/p>\n I told her I’d check the closet. She nodded. She said, “It’s open. They don’t lock it.”<\/p>\n I stood up and I walked down the hall past the nurses’ station, past the medication room, and I opened the door to the supply closet. It was a narrow room, wire shelves stacked with latex gloves and disinfectant wipes and boxes of adult briefs. And on the back wall, clipped to a metal board, there was a whiteboard. Dry-erase. White with a black plastic frame.<\/p>\n It said: Incontinence supplies. 2 per resident per day. No exceptions.<\/span><\/p>\n It was dated March third. Three weeks ago.<\/p>\n I stood there looking at it and I heard someone behind me say, “Can I help you?” I turned around and it was one of the floor nurses, a woman I didn’t recognize, older, gray hair in a bun. I asked her what the whiteboard meant and she looked past me at it and then back at me and said, “That’s an internal staff guideline.”<\/p>\n I said, “My mother is sitting in wet clothes because of that guideline.”<\/p>\n The nurse’s face didn’t change. She said, “If you have a concern about care, you can schedule a meeting with the administrator.”<\/p>\n I took out my phone and I photographed the whiteboard. The nurse told me I wasn’t allowed to do that and I told her I just did. Then I walked back to the dayroom and I sat down next to my mother and I didn’t say anything for a long time because I was trying to figure out what I’d just learned.<\/p>\n That night I went through the file box in my basement where I keep all of Mom’s paperwork from Pinewood. I pulled out every invoice they’d sent me since she moved in. I laid them on the kitchen table under the overhead light and I went through them line by line.<\/p>\n Incontinence supplies: $310 per month. Billed as six per day per resident.<\/span><\/p>\n Six a day. Not two.<\/p>\n I sat there doing the math. Forty beds on Mom’s floor. If they were billing for six per resident per day but only providing two, that was four per resident per day they were charging for and not delivering. Four times forty residents times thirty days. That was forty-eight hundred supplies a month they were invoicing for and not using. I didn’t know what they cost wholesale but even if it was two dollars each, that was ninety-six hundred dollars a month they were pocketing just on that one floor. Just on that one item.<\/p>\n I called Pinewood the next morning and I asked to speak to the administrator. Her name was Diane. She had a smooth voice, very calm, very professional, and she told me she’d be happy to meet with me the following week to discuss any concerns.<\/p>\n I said, “I have a photograph of a whiteboard in your supply closet that says you’re rationing incontinence supplies to two a day. My mother is eighty-six and she’s sitting in wet clothes because of it. And you’re billing me and Medicaid for six a day.”<\/p>\n There was a pause. Then Diane said, “I’m not sure where you’re getting your information, but I can assure you we follow all state guidelines for resident care.”<\/p>\n I said, “I have a photograph.”<\/p>\n She said, “I’d be happy to discuss this in person. Let me see what I have available next week.”<\/p>\n I told her I’d be there in an hour.<\/p>\n When I got to Pinewood, Diane met me in her office. She was maybe fifty, dark blazer, pearl earrings, very put-together. She offered me coffee. I said no. I showed her the photograph on my phone.<\/p>\n She looked at it for a long time. Then she said, “That’s an outdated staff note. It shouldn’t still be up.”<\/p>\n I asked her what it was doing there in the first place.<\/p>\n She said, “We had a temporary supply issue in early March. It’s been resolved.”<\/p>\n I said, “My mother says it’s still happening.”<\/p>\n Diane folded her hands on her desk. She said, “Your mother is a lovely woman, but she does have some cognitive decline. It’s possible she’s misremembering the situation.”<\/p>\n I asked her if she could show me the current supply logs. She said those were internal documents and not available to families. I asked her if I could speak to the nursing supervisor. She said the nursing supervisor was off-site today.<\/p>\n I left her office and I went back upstairs to the supply closet. The whiteboard was gone. The metal clip was still on the wall but the board itself was gone. I stood there staring at the empty clip and I felt something harden inside me.<\/p>\n I went back to Mom’s room. She was sitting in the same chair by the window. I sat down on the edge of her bed and I told her I believed her. I told her I had the photograph and I was going to take it to someone who could do something about it. She looked at me and she said, “Good.”<\/p>\n Then she said, “I stopped drinking water three days ago. I didn’t want to be a burden.”<\/span><\/p>\n That was April second. I reported Pinewood Manor to the state ombudsman that afternoon. I filed a complaint with Medicaid fraud control. I contacted a lawyer. It took seven months but the state did an audit and they found what I found. Systemic billing fraud across four facilities in the state, all owned by the same management company. Pinewood shut down last November. Diane and two other administrators were charged.<\/p>\n Mom’s in a different place now. Smaller. No piano in the lobby. They give her as many supplies as she needs and she drinks water whenever she wants.<\/p>\n But I still think about those nine days I didn’t visit. I think about the fact that I didn’t believe her at first. I think about how easy it was for me to assume she was confused because that was easier than believing a place I paid five thousand dollars a month to could be that cruel.<\/p>\n She didn’t say anything about it after. She didn’t make me feel bad. That’s not who she is. But I know. I know I looked at that invoice every month and I never questioned it. I know I heard her say “two a day” and I didn’t take a single step to verify it until I saw her sitting in wet clothes in a chair.<\/p>\n The photograph is still on my phone. I didn’t delete it. Some days I look at it just to remind myself what I almost let slide because I didn’t want to cause problems.<\/span><\/p>\n <\/p>\n