Are skilled nursing homes able to release a patient with a stranger ,not family with documented power of attorney

Very helpful article.

Check for Medicare/Medicaid Certified Facilities.
Unfortunately it is the caregiver's responsibility to check on the relative on any give time and day. Don't create a pattern. Show up when you want to. It's your relative. I told the last place I only saw one person smiling. Seems when I made eye contact with the staff I had to be the one who spoke first. Really? There were some residents who made eye contact with me and I said good morning. Hello. A burst of sunshine came through. I hate seeing them sitting there, but unless they have an activity going on, they just sit there. There was another section or wing created for memory care and I did like the signs at the front door. Made you ensure that you closed the front door behind you so none of the residents would get out. And make sure their Dr. is involved in their nursing home care as well. I have a social worker and nurse coming and I have my list of inquiries. They can also find out what avenues through Medicaid/Medicare for which you maybe eligible. Avenues the naked, inexperienced eye may not see.

Excellent article. Many helpful tips. Could you provide tips on applying for Medicaid, please?

Excellent article, Tony. I particularly liked your "parking lot test." Over the years I got to know many families who had loved ones in the nursing home where many of my relatives had lived (or were living).

I learned from chatting with them that some people will never be satisfied because they want the impossible, but most people will be willing to share their experiences. Many will have had a chance - like you - to see how more than one facility operates so they have a good perspective. Some will not have any perspective but they know good care when they see it.

My own formula is that if most of the remarks from involved family members are positive, the facility is likely a good one.

Realistically, some parts of the country have over-all fine nursing homes where as some communities (and whole states) have mid-level to poor homes. Finding the best of the poor homes is a dispiriting position to be in, but even under those circumstances, research helps.

Thanks so much for your excellent input.
Carol

DaveyHiltz, for your grandfather I would recommend looking for a place that has some male CNAs on staff on the unit where he will be living. My dad seems to tolerate them more and I've seen him smile at a few of them which is a good sign. Despite the Alzheimer's he still really can let you know if he doesn't like someone or something that's going on. :)

Very informative and helpful!

I can share some ideas about how I went about getting my dad out of a bad NH and int a good one. But first, I want to tell Tony Revere that I could have written virtually this exact same story about our experience with my dad who has Alzheimer's. The first home we placed him in Dec. 2013 came as a top recommendation from a geriatric care manager that my mom hired to help us navigate the process. Within 24 hours of moving in, he was combative with a CNA who was trying to get him in or out of bed. So they shipped him off to a psychiatric hospital to have his medications adjusted. (The NH administrator actually said to me later: "Your dad did something he really shouldn't have done." Excuse me, he has Alzheimer's!. Unbelievable.) The hospital sent him back to the NH after 9 days. He was on such a high dose of Haldol that he became catatonic and was too unsteady to walk. In fact he had walked into that nursing home on his own two feet and within a week became permanently confined to a wheelchair. We were told he would get PT to strengthen his legs and allow him to get up again but that never happened. He then contracted a chronic UTI which took months to treat. The he got C-Diff, a highly contagious intestinal infection that left him confined to his bed alone for hours while awake. I started to look for a new place for him after about 4 months. The Nursing Home Compare ratings on medicare.gov turned out to be worthless--this place had FIVE stars. (I understand that an investigative journalist with the New York Times exposed the problems with the rating system and that DHHS has taken steps to improve it.) Ultimately I found him a new NH by doing the following. I made a list of 10 facilities for which I could find even the slightest bit of positive information on Yelp, Angie's List, Caring.org, and general online searching. I called the admissions staff at each of the 10 homes to see if they could accept him. The first 5 did not have beds available. So I asked each admissions staff person I spoke to to tell me which of the places on my top 10 list would they consider placing their own parent if they had to. Three of the people gave a thumbs up on 2 or 3 of the places I listed. One person said he couldn't answer the question, and the fifth person was nervous that iI would be angry with her if we moved him to a place she suggested and it didn't work out. I assured her that she'd never hear from me again no matter what :). There were two nursing home that were recommended by at 3 of the four people who were willing to answer. Long story even longer, we moved my dad to one of the recommended places within a few days. He's been there since Aug. 11, 2014 and has not been sick once. The CNAs there understand he can be combative when being moved or changed but they reassure us that it's typical and they can handle it, and they have. He is very alert and while he can no longer have a regular conversation his face lights up when he sees people he knows. There are some things we wish were difference, e.g., staffing levels at night time, but overall it's like night and day. One final thought, the place he's in now is in a suburb and my mom lives in the city. It was important to widen our search range and consider places a little farther from home.

Thank you so much. This is a big help.

Very good advice.

Excellent article; extremely useful information. Thanks.

We're really concerned about my grandfather. I hope we can find a nursing home to take him. He has really bad PTSD and has bad outlets. I just hope some people will be understanding of him.

this is really inormative my grandmother is in the nursing home and we visit her every Thursday morning, Now we know how to heck of how they treated elders in the nursing home I wish they are not Nursing Home Abuse Kentucky

Excellent piece that describes what many residents and families endure when dealing with nursing home care. These are excellent recommendations for choosing a nursing home but let's keep in mind that many residents are sent to nursing homes chosen by a hospital social worker based on bed availability. These residents have no one to move them to a better facility. The bigger answer here is that we need extreme reform in nursing home care. Corporations are not using the money they're paid to hire, train, and fairly pay caregivers. That is why 30% of nursing home residents suffer harm during their stay.

Ombudsman information is supposed to be posted, but grossly improper care is reportable to the Department of Health and/or Adult Protective Services. Especially when there is photo documentation. Actually the nurse who showed you the pictures is probably a mandated reporter but may or may not have called anything in. You try to pick a place based on all the right things, but you never know whether they will have to cut back on staffing, be in the process of finding out and documenting that someone they have is not doing their job, or whatever. Looks can be decieiving - a pleasant, bright, clean, quiet place might be that way because they care more about appearances than the people they are caring for. Or it might be as wonderful as it looks. If you have to place someone, make sure they see you coming and going and being observant, while you make friends with them too. If someone just needs access and not and overwheming amount of physical help, modifying the home for wheelchair use would be a good alternative. Don't underestimate what someone can do safely and independently just because they cannot walk, and also don't overestimate what a person with poor cognitive adn judgement skills can do whether or not they can.

My aunt, age almost 98, has been in a skilled nursing home for almost three years. Never has she been admitted to the hospital. Everything is being done for her 24/7. She looks better now than she did almost three years ago. She receives proper medications and there is an evaluation of her progress every four months, in which both she and I attend. She is intelligent, can speak for herself, and is respected. It is wonderful to know she is cared about......marymember

Finding a nursing home can be a daunting task and even if you take all the necessary steps to ensure the best care possible, the possibility still exists for nursing home neglect and is an issue which has recently drawn attention. The nursing home negligence lawyers have always been on the forefront of assisting and championing the victims and families of nursing home abuse.

Thanks for sharing. I am going through a very similar experience now! Mom had to have an aortic and a stomach aneurysm repaired and now after these surgeries she will not be able to return home due to complications with her arthritis. She has started to fall due to her knee giving away and will probably need a wheelchair to move about most of the time. We too had decided on the SNF where she received the initial therapy. Well it turned into a nightmare once rehab was over and she moved to the long-term care unit! I am in the process now of trying to move her. She qualifies for Medicaid but a lot of nice facilities only want private pay residents. I did find a place based on referral and we are hoping it works out and she can move soon. This whole process is very stressful and confusing. One day Mom is fully independent and living alone without any problems and babysitting the grand kids, the next month and 1 surgery later her life and ours has changed forever.

This is excellent information. Thanks

just curious to hear if the UTIs were stopped at the new place? also wondering why the hospital didn't notice the catheter inserted improperly on the first two ER visits?

Thank you for sharing this experience!