Is the facility certified by Medicare and Medicaid? (It should be.) For how long? (The longer, the better.)
Does the facility have an Alzheimer’s unit or other special care area restricted to patients with special care needs? Is the specialty unit separated from other areas of the facility?
The quality of care is often better if the facility staff knows that someone who cares is watching and involved. Visits can be the high point of the day or week for the nursing home resident. Choose a location that makes it as easy as possible for family members and friends to visit.
Is the facility well lit, clean, safe, and welcoming? Is it homey or does it look and feel like a hospital?
What is the ratio of staff to residents during each shift? (One to twelve is good. One to eight is better.) Will your loved one get the appropriate amount of attention?
What kinds of activities are planned each day for the residents? A good activities program should have regularly scheduled events such as a weekly movie or concert, religious services, and physical exercise activities. Is there a library? Is there a “store” for purchasing personal items, such as shaving cream, hair care products, and snacks? Is there a safe place for residents to enjoy outdoor areas, such as an enclosed garden? Are plants, pets, and other natural elements added to the residents’ environment?
Room Sharing and Furnishings
Do residents have a choice of private or shared rooms? If shared, how are roommates selected? If the resident is dissatisfied, can roommates be changed and how is that accomplished? Can the resident bring some of his or her own furniture and furnishings from home?
A resident of a nursing home must be under the care of a licensed physician. The physician must evaluate the resident’s needs and prescribe a program of medical care, including therapy, diet restraints, and medication. A plan for your loved one’s care must be set out and then implemented when he or she moves in. How often is this care plan reviewed and changed? Ask questions of the nursing home administrator or nursing staff as well as the person marketing the facility. Make sure you are comfortable with their responses.
How are employees selected? Are they screened for drug use, criminal records, and other potential problems? What is the turnover rate for skilled employees? What is the turnover rate for employees who perform ancillary services, such as meal preparation and financial record keeping?
Are meals served in a communal dining room or is each resident brought meals in his or her room? If communal, how are tables assigned in the dining room? How long does it take for a meal to be delivered to a bedridden resident? Sample the food.
Is there a physician that most of the residents use? What are his or her qualifications? How often is the doctor on the premises? What is his or her bedside manner with residents?
What financial information will the facility require during the admissions process? Can the patient or his representative have copies in advance of all admissions documents and contracts for review? How long does the process take?
How much is the monthly cost and what is included in the cost of care? What items are extra and how are they billed? Can laundry be taken off premises and does this save the resident some money? How are prescription drugs handled?
If non-emergency services are not available on the premises how is transportation arranged? What about transportation to other places, such as local stores, religious services, outside entertainment?
Ask the facility to provide the names and contact information of family members of residents who have been there for at least 3 months so you can ask them about the care provided in the facility and the staff’s responsiveness when the resident or relatives raise any concerns.
Don’t necessarily be impressed by a fancy lobby or depressed by an older, more rundown facility. What matters most is the quality of care and the interactions between staff and residents. It is also advisable to try and get a tour of the facility that is not prearranged. While this is not always possible, it does give you the opportunity of seeing an unrehearsed atmosphere.
One other tip is that you should check certifying agency reports on nursing homes. CareScout is an unbiased source for ratings and reviews of eldercare providers nationwide. Detailed reports are available for a small fee, and include information on quality, resident population profiles and health violations. They also have state surveys on facilities as well as customer satisfaction surveys. Another source for nursing home reports is HealthGrades. Click on Nursing Homes and, for a fee, they will provide you with a report that rates the nursing home and provides information on inspections and complaint investigations. You can also get a report that compares the nursing homes in your area.