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Selecting A Nursing Home

How to Select A Nursing Home

Here’s our top 8 tips for selecting a safe nursing home.

Choosing the right nursing home may be difficult. There are a number of factors to considers—Medicare certifications, quality of care, recreational programs, staff-to-patient ratio and more. We’re here to assist in a smooth, informed selection process.

1. Research Certifications & Cost of Care

Funding nursing care can be expensive. Certain nursing homes, also known as skilled nursing facilities or residential health care facilities, are certified by Medicare and Medicaid, with potential coverage for long-term care and skilled nursing benefits.

  • Ask if they are certified to receive payments from Medicare, Medicaid, Quality Assurance Assessment Program and private payment options.
  • Get a list of the required financial documents necessary for the admissions process.
  • Ask if items are included in the cost of care and how extras are billed.
  • Understand the different pricing options between private rooms and semi-private rooms, with base level benefits and additional cost items.
  • Ask about how prescription drugs are handled.

2. Confirm Standards & Quality of Care

There’s no way to ensure that your loved one will receive quality care, or that the facility you chose will conform with accepted standards. However, there are several things that you can do that may help you understand what level of care you can expect from the facility.

  • Check to see if state websites can identify if the facility is properly certified by the state.
  • Check to see if state websites can identify who the operator is, the type of care they provide, the number of beds in the facility and the percentage of occupancy.
  • Check to see if state websites can identify if complaints were made against the facility, in addition to other data to help you understand the risks of certain types of injuries, such as bed sores, urinary tract infections, pneumonia and sepsis.
  • Talk with the Administrator or the Director of Nursing Services to ask care planning, the shifts of the CNAs and the ratio of CNAs to residents on each shift.
  • Ask about how the CNAs document the services they may be required to provide in accordance with the care (turning and positioning, incontinence care).
  • Identify the supervisors or nurse managers for your loved one’s unit, as that person will be responsible for addressing any complaints that you may have.
  • Discuss how a facility evaluates the resident’s needs and prescribes a comprehensive care plan.
  • Discuss specialty care and if the facility has a designated safety area for patients with special needs.
  • Ask about daily rounds and examples of personalized patient checklists.
  • Ask about hygiene, bathroom and bathing for residents who may need additional support.
  • Ask about the qualifications, bedside manner and frequency of in-house physician visits.
  • Ask about on-site medical equipment or options for transportation to partnered facilities.
  • Ask if the facility has a dedicated unit for patients with Alzheimer’s and dementia.
  • Ask about the use of restraints and/or other injury prevention methods.
  • Ask about physical therapy and occupational therapy as well as who you should contact to discuss issues pertaining to these disciplines.

3. Examine Location & Amenities

A centralized nursing home location results in the possibility of better excursions and more visits from family and friends. Additionally, in-house amenities also make a noticeable impact on a resident’s quality of life.

  • Calculate the facility’s distance from the friends and family who are most likely to visit.
  • Get a copy of the nursing home’s visiting hours and policies.
  • Tour the entire facility, including the rooms, bathrooms, dining hall, common areas and outdoor spaces. Make sure you see each floor and the residents who live there, in addition to the to see the cleanliness and the manner in which to residents are tended to.
  • Understand the roommate selection process and the options for changing roommates if applicable.
  • Assess if the facility is well-lit and takes safety precautions to limit environmental hazards.
  • Ask about the provided furnishings and the policies for bringing personal items.
  • Ask if the facility has partnerships with community events, shops and restaurants in the neighborhood.

4. Investigate Staffing & Employee Selection

A nursing home’s policies and procedures for recruiting, hiring and training staff are one of the most important components to providing quality care.

  • Ask if nursing assistants and other staff if they work a lot of overtime and double shifts.
  • Observe if the music is on the radio or programs are on the television.
  • Ask about the ratio of staff to residents during each shift.
  • Ask how employees screened for drug use, criminal records, and other potential problems.
  • Observe if staff are are they making time to sit and talk with the patients.

5. Assess Meals + Nutrition

Nursing homes should have a welcoming dining hall that encourages residents to eat and participate in the social community. Nutritionally balanced meals are an key element at quality nursing homes, in addition to being able to accommodate reasonable dietary restrictions.

  • Survey the layout, energy and atmosphere of the nursing home cafeteria.
  • Assess portion sizes and how the meal looks and tastes.
  • Ask about mealtimes in the communal dining room.
  • Ask about heating options for leftover food.
  • Ask how meals are served to residents in bed.
  • Ask about the availability of additional snacks.
  • Ask about dietary restrictions and accommodations for special preparation.

6. Evaluate Mental & Emotional Well Being

The attitudes of the staff and other residents can make or break a nursing home community. Nursing homes should have regularly updated event calendars with in-house activities and options for excursions to community events and cultural activities.

  • Ask about how the nursing home stimulates socialization and community.
  • Ask to see an example of daily activities, such as bingo, movie or music nights.
  • Ask if there are exercise classes or educational courses.
  • Ask about the availability of religious services.
  • Ask about options for therapy and other mental health services.
  • Ask about the presence of a facility library with large print and audio books.
  • Ask about a general store for personal items and snacks.
  • Observe how residents interact with each other and the staff.
  • Observe if there is an outdoor patio, garden or courtyard.

7. Discuss Protocol for Abuse, Injury & Falls

Nursing home abuse and neglect is extremely common, and facilities should have prevention, inspection and complaint procedures in place. When residents are neglected, falls, bedsores and other injuries may occur.

  • Ask about the staff’s protocol for filing and investigating complaints of abuse.
  • Ask about incident reporting and the reassessment of quality of care.
  • Ask how the staff handles wandering, falls and other injuries.
  • Ask about fall prevention and what changes are implemented after a fall occurs.
  • Ask about bedsore prevention and how often patients are being repositioned.
  • Ask how often diapers and sheets are changed for patients who need special assistance.

8 .Utilize Official Comparison Tools

State and federal agencies collect and publicly report nursing home data. There are multiple comparative resources to check the quality and enforcement history of a nursing home.

If you suspect abuse or neglect in a nursing home, contact our attorneys immediately.

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