4 Questions to Ask When Choosing Nursing Home Care


My mother is a practical woman. Ever since I was a teenager, she has been giving me instructions on how to take care of her as she grows older. "Put me in a nursing home," is one of her dictums. As a teenager, I balked at the idea. But as I have learned more through my work with the Association of Skilled Nursing Providers and North American Health Care, I realize that, if I love my mother, a skilled nursing center—either for short-term rehabilitation or long-term care—is where I want her to stay when her health declines.

Currently, approximately four percent of the senior population lives in a skilled nursing facility, and the choices available are as varied as the people who live in them. Patients and their families often encounter difficulty when choosing a home. Frequently asked questions weigh on their minds.

"Where will I receive the highest quality care?"

"Where will I be treated like a resident, not just a patient?"

"Where is the cleanest nursing home with the best food?"

In an effort to lighten the burden of such an important choice, U.S. News and World Report recently released its 2015 "Best Nursing Homes" report. Using data from the federal agency that sets and enforces standards for nursing homes, U.S. News awarded the "Best Nursing Home" designation to homes that recently earned an overall rating of five stars, highlighting the top nursing homes in each state and nearly 100 major metropolitan areas.

But professional rankings alone can't determine which nursing home is best for your loved one. Here are a few questions to ask before selecting a nursing home:

Where can I find accurate information on nursing homes in my area?

One of the main concerns families have is ensuring their loved ones will be safe and receive high-quality care in the nursing home. A reliable resource for gathering information on potential facilities is the Medicare website. Using the nursing home compare tool, a patient or family member can easily compare past ratings and performance of skilled nursing facilities as well as areas of concern and/or specific complaints. The five-star system is used to measure quality, health inspections and level of staffing.

Do I need short-term rehabilitation or long-term care? And which facility specializes in my diagnosis?

Are you having a total hip replacement? Are you recovering from a heart attack? Are you healing from a wound that requires supervision? These are all examples of diagnoses that require a short-term stay for rehabilitation. If you are looking to move into a skilled nursing facility permanently, then this is considered long-term care. Keep your diagnosis in mind, too. Certain facilities specialize in caring for certain ailments. It's also important to be aware of the difference between skilled nursing and nursing home care.

How will the staff communicate with me and my loved ones?

Nothing is more important than communicating well with your health care providers. You need a nursing home that will not only inform you of your loved one's progress but also work with you to build a comprehensive care plan. Make sure that you have the ability to have constant contact with the nursing home. In fact, some facilities even have a live chat option on their website to access a facility representative immediately. Discover which skilled nursing home staff members will be most important to your loved one's care.

What amenities are provided?

Skilled nursing homes vary widely in the amenities they offer. Some provide individual televisions for each person. Some provide daily social activities. Some hire chefs and dietary supervisors to take care of their residents' nutritional needs.

I'm still going to try to persuade my mom to live with me. But if she decides a nursing home is right for her, or if it's medically necessary, I feel comfortable knowing that there are great places out there that will provide excellent care in an informed, compassionate environment.

(For more tips and tricks, see this Checklist to Find a Nursing Home.)

Dr. Amy Osmond Cook is the Executive Director of the Association of Skilled Nursing Providers, Marketing Director of North American Healthcare and a health/wellness columnist.

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The first thing to remember is that there is no perfect nursing home. When looking for information regarding citations, complaints and overall quality of care indicators it is important to put things in perspective. Focusing on one complaint or report doesn't really give a clear picture of a nursing home's quality.

Quality changes for a variety of reasons and can change quickly. Look for patterns and issues that occur often. For example someone may see a citation for "pressure sores" or "abuse" and fear that it reflects the overall care at a nursing home. This is not necessarily the case. If there is 1 case of either that only happened one time and there are no other indicators, then it may be a one time incident that was resolved appropriately. When a nursing home is cited they are required to provide a plan of correction. In some cases it prevents future incidents, in other cases it isn't enough.

The 5 -Star rating can be helpful with providing information. Keep in mind however that much of the information is self reported by the facility.

There are 4 main sources that can be helpful when it comes to information:

1. Medicare website: http://www.medicare.gov/nursinghomecompare/search.html
-----(this will have the 5 star rating)

2. Local Long Term Care Ombudsman: You can always find their number on the poster of a local nursing home (as they are required to have it posted) or you can contact your local Area Agency on Aging.
---- Long Term Care Ombudsman have a regular presence in the nursing homes. They do visits and advocate for residents. They keep a record of complaints and should have a good sense of the quality of a nursing home. They should also be able to help you with the State Health Department's annual surveys, complaints and citations---which is number 3 on this list.

4. Nursing homes are required to provide access to their state surveys to visitors and residents of the nursing home. Generally you will either see it on the table in the lobby as a binder. In some cases there will be a notice that says who you can ask to see it (most often the receptionist). If you do not have access to this information online then this can be a great alternative.

When touring a nursing home, visit during different times of the day. Use a checklist as mentioned in an earlier post and most importantly if possible include your loved one with the process.
Thank you for sharing these 4 questions to ask when choosing nursing home care. My father is growing old and has been living alone for 5 years now. My siblings and I are always worried about his health and how he lives by himself. We wonder if something serious is going to happen when nobody is there. Just like you said about your mother, we do not want our father to go to a nursing home either since he is still functioning. I will have to keep looking for an assisted living agency. Thanks!