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HOW TO EVALUATE A NURSING HOME

Looking for a good nursing home can be a difficult task. It is vital that you spend a considerable amount of time researching the nursing home before you decide. It is important not to judge the nursing home on the basis of a guided tour or the nice furniture and wallpaper in the lobby. You must remember that, especially in a for-profit nursing home, a lot of effort is put into marketing to convince you to bring your family member to their home. The brochure pictures of happy seniors, nice dining rooms and landscaped entrances do not give you a realistic idea of the quality of care that your family member will receive.

 

Here are some suggestions on getting past the marketing efforts to see what type of care that your family member will receive at a specific nursing home:

  • Try to find at least one resident that you can visit in the facility. Walk up and down the halls and talk to bedridden residents and residents who are wheelchair-bound. Check out their grooming, skin quality, nail care, and oral care. See if the residents appear to be upbeat or if they are depressed or lethargic from drugs. If almost everyone you talk to is confused and unable to have a normal conversation, there could be malnutrition or dehydration problems, or the facility may be overusing medication.
  • Avoid facilities where access is restricted, and you are directed only to residents who are willing to talk to you.
  • Pay attention to strange odors. The halls, rooms and residents should not smell of urine or feces. If they do, the diapers may not be changed often enough and this can lead to life threatening illnesses such as urinary tract infections or bedsores.
  • Visit the facility at different times of the day. Sometimes a facility can look adequate in the morning when the staffing level is usually at the highest. Try going in the evenings or weekend afternoons. Nursing homes usually are the worst on the weekends or between 4:00 and 8:00 p.m. on the weekdays.
  • Visit during mealtimes and find the dining room where the residents need assistance eating. Check to see if the residents are rushed or if they are given enough time to eat. Often, the aides are so rushed that they feed residents too quickly, and the resident does not have time to swallow and is reluctant to eat more.
  • Lack of Certified Nursing Assistants, or CNAs, is a common sign of lack of care and abuse. Ask about the level of staffing for each shift, morning, evening and overnight. Ask how many nurses and CNAs are on duty. Compare that to the number of residents. If there is less that one CNA for each 5-8 residents, there may be a serious quality of care problem.
  • Most states require that facilities have the latest state survey available for review. Read it and see if there are concerns that deal with basic nursing care and basic medical care. Go down to the State Licensing and Certification office and look through at least several years of these surveys.
  • Federal law requires that all patients have a "Plan of Care" developed for them. Ask to see the plan of care and keep it with you when you visit your family member in order to verify that the required care is being provided.
  • Meet the administrator -- don't just listen to what the marketing director has to say about the activities and facilities available for the residents.· Determine how frequently the Medical Director sees the residents.
  • It is good to get references from others who have had loved ones in the facility, but trust your own instincts.
  • Read the State Survey Report - Nursing homes participating in the Medicare and Medicaid programs are required by federal law to undergo an annual survey and certification process. State surveyors make unannounced visits, talk to residents, observe care, check sanitary conditions, and investigate complaints. They then issue a report that may contain a statement of deficiencies plus a plan of correction that the facility has agreed to. The report is known as Form 2567 from the Health Care Financing Administration. If a nursing home is found to be out of compliance, federal law sets forth enforcement options such as denial of payment for new admissions, fines, revocation of Medicaid and Medicare certifications, transfer of residents, and the imposition of temporary management.

In general, when you are researching and evaluating a nursing home, let the facility know that you are watching them. Don't be afraid to let them know that you are aware of the state and federal regulations and expect the facility to follow them. Visit our Rights & Legal Information page for details on the laws that apply to nursing home residents.

If you suspect a loved one may be in danger in a nursing home or elder care facility, call the police, and then call an experienced nursing home negligence attorney.

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