Once you have pinpointed the type of care your loved one needs, you will want to make a list of possible nursing homes locally that will fit their requirements, preferences, and care level. The more choices you have in a nursing home, the easier it will be to find the perfect facility for your loved one.
If you are beginning to look for a nursing home, you may have questions about how to find the perfect one. The following are some frequently asked questions and things to look for as you prepare to find the right nursing home for your loved one.
Should I visit the nursing homes I’m considering?
Yes, but you do not need to visit every single nursing home on your list. Instead you should first make phone calls to find out if the nursing homes you are considering are actually accepting new residents, if they accept Medicare or Medicaid, and what type of care they provide. That should help to narrow down the list and make visits more manageable.
When should I visit the nursing home?
When you find a nursing home you’re interested in, plan on visiting three times. One visit should be in the late morning to observe lunch being served. A second visit should be during afternoon activities, and a third visit should occur in the evening for dinner and preparing for bed.
Your initial visit should be announced, and you should allow an administrator to take you on a guided tour. The subsequent visits should be unannounced so you can observe staff and residents when everyone isn’t always on their best behavior. If a nursing home does not allow you to visit while unattended, it is a sure sign that they are hiding something.
How do I know if a nursing home is certified?
Most nursing homes will have their certificates and licenses displayed for the public to see in their lobby. If they do not, ask to see them and ensure they are current. You should also ask for the latest inspection report or state survey for every facility you visit.
Do not use any facility that does not have their required long-term care facility license or does not have the required license for their nursing home administrator.
In addition to these certifications, a nursing home is also required to allow the public to inspect other documents, including:
- A copy of the statement of ownership;
- The personnel employed by the nursing home and their certifications, licenses, or registrations;
- A description of the services provided, the rates the nursing home charges, and a list of things a resident may be charged for separately;
- A complete copy of every inspection report for the past five years;
- A copy of every order issued by the Department of Public Health or a court in the past five years.
If a nursing home will not allow you to inspect these documents, or they do not have them of file, you can file a complaint with the Department of Public Health.
What should I look for on a tour?
There are numerous things that you should look for besides certifications when you tour a nursing home. These things include:
Cleanliness-A dirty nursing home is a bad nursing home. Some nursing homes may have a lived-in look, which is ok, but they should not have dangerous clutter or have a strong odor. The smell of urine may be present in a good nursing home as it is difficult to completely remove, but the smell will be slight, and they should not be using strong scented sprays to hide it.
If you see rodents or bugs, garbage overflowing, and blocked passageways, it is a sure sign that the nursing home does not take cleanliness seriously.
Bedrooms-Every bedroom should have a window, no more than four beds per room, and space to move around comfortably. Each resident should have a call bell for the nursing station, a reading light, fresh water, and their own closet or drawers for their belongings.
It is important to question the administration how they choose roommates and what happens if roommates do not get along.
Bathrooms-Bathrooms should be close to every resident’s room and have a sink with hot and cold water and a toilet that allows for wheelchair-bound residents to use it. There should be assistance handles and bars in each bathroom, as well as a call button for the nursing station.
Shower and bathing facilities for those in wheelchairs should be available, although they may not be available in every personal bathroom. Make sure the floors are non-skid and handles are present.
Kitchen and dining rooms-Dining rooms should have comfortable seating for residents and tables and chairs that can be moved easily for residents in wheelchairs. Both the kitchen and dining room should be kept clean.
Kitchen staff should keep refrigerated things cold and hot foods hot enough for food safety standards. Sample the menu when you visit to determine if they are providing the food that the menu claims; nursing homes that are trying to cut corners will often make substitutions to the menu.
Activity rooms-All nursing homes should have space for activities. Pay attention to what types of activities are offered and if residents are partaking in them. The activity room should be bright, cheerful, comfortable, and inviting.
Emergency exits-A good nursing home will practice fire drills and other emergency preparedness drills with their residents routinely. Make sure that emergency exits are clearly labeled and have a clear passageway and ask to see the most recent fire safety inspection report. Do not choose a nursing home that hasn’t been inspected in more than a year.
Outside grounds-A good nursing home should encourage its residents to spend time outside. The grounds should be kept well-maintained, have adequate comfortable seating, and possibly have gardens that residents can garden in.
What services will a good nursing home provide?
A good nursing home will have many services available to its residents. These services include:
Medical services-A good nursing home will allow a resident to be treated by their own doctors but should also have emergency staff available either on-call or on staff. Prior to admission, a resident will be required to have a complete physical and have a care plan developed. A good nursing home will adapt this plan as your loved one’s health changes.
If your loved one will require eye or dental care, find out who the nursing home uses for this care and what the added cost might be. You should also find out what hospital the nursing homes uses in case of an acute emergency.
Nursing services-Pay special attention to the attitude of the nursing staff that works with the residents. Ask about the training their certified nursing assistants receive and if a Registered Nurse is on duty round-the-clock. Licensed Professional Nurses should be on duty both day and night.
Rehabilitation services-Residents should have access to whatever type of rehabilitation services they may require, including help with walking, talking, and dressing.
Activities-A good nursing home will not let its residents remain in isolation but will not be pushy about participation. Activities should be planned both inside and outside the nursing home, with field trips and the ability to visit family and friends. Volunteers should be welcomed, and outside services should be invited into the nursing home, such as libraries, museums, hair dressers and barbers.
Each resident should have an activity plan geared towards their likes and interests, and games, arts, crafts, and social functions should be included in the itinerary.
Religious services-Nursing homes should offer the ability for all its residents to practice whatever religion they are accustomed to, but should never force any resident to take part in religious services.
Food services-Each resident will have different nutritional needs and a dietician should be available to ensure their diet is healthy, varied, and palatable. Meals should be served at normal times and snacks should be available. Staff should bring food to those residents that are bed-bound and assist them in eating as needed.
Social services-A good nursing home will have a social worker available for its residents. If a resident is struggling or has concerns, a social worker should help them to adjust to nursing home living and answer their questions.
What other rights does my loved one have?
Just because your loved one has entered a nursing home it does not mean they have to stop being themselves. Every person is unique and should be treated as such. They should not have to give up their basic human rights and a good nursing home will be flexible to their wants and needs.
Nursing home residents should be allowed to be involved in their own care and allowed to manage their own finances if they are able. Nursing homes should provide privacy for each resident and married couples should be granted privacy and allowed to reside together unless it is prohibited.
Residents should be allowed to dress in their own clothing and decorate their room as they see fit. If a resident wishes to do chores, they should be allowed to, but never forced into it. A resident should never be moved from a nursing home without advance notice and a nursing home is not permitted to discriminate against a resident for any reason.
For more information on a resident’s rights, you may review the “Residents’ Bill of Rights” provided by Medicare and Medicaid that all nursing homes they certify must follow.
And, for any nursing home you’re considering, ask for the names of other residents’ families and contact them on their experiences with the nursing home. They will often give you an honest opinion about the nursing home and its care.
What about the cost?
The more services your loved one will require, the more they will likely pay. When you tour nursing homes, be sure to ask what the normal monthly charge covers and what extras they may have to pay for. Prices will vary from nursing home to nursing home, so you should outline exactly what your loved one will need and get an estimate on monthly cost for those needs.
You should find out if your loved one is eligible for Medicare or Medicaid and if they are not, you should determine what personal insurance may cover. If your loved one will be paying privately, the nursing home will want to know exactly how long they will be able to afford care and when Medicaid will begin making up the assisting in payment. A good nursing home will help a resident with paperwork regarding Medicaid as well.
The Nursing Home Care Reform Act requires a written contract between the nursing home and the resident upon admission. This contract must state what services will be provided, their cost, terms of service, any supplemental services that will be provided and their cost, who is liable for payment, the amount of a deposit, and the rights, duties, and obligations of the resident. Before the contract is signed, it should be thoroughly reviewed and anything that is not clear should be explained fully. Once the contract is understood, both nursing home representatives and the resident or their guardian must sign it.
If there is any question or confusion, an experienced personal injury lawyer can review the contract and advise you accordingly. America’s Consumer Lawyer is prepared to help and ensure your loved one is receiving everything they are entitled to in regards to a nursing home and it is done fairly.
