How can I find a "good" nursing home (is there even such a thing)?

I asked the Google if there's a database about employee retention and turnover by health care facility and could not find one. And we all know it's the employees who make or break any organization. I was at our local hospital not too long ago and noticed that things had changed. Despite being old, it used to smell great and sparkle but on my last visit I was shocked that the place looked and smelled dirty.

I would ask specifically about staff turnover rates. I would ask how many new CNAs and nurses are working at the nursing home now out of a staff of how many. I would ask how many positions are currently open. I would ask if they have a difficult time retaining good employees. If they squirm, you know the answer.

I would ask if they have student nurses completing clinical rotations there which, in my opinion, would be a good thing because students want to learn.

I would ask if their food and nutrition services is run by a registered dietician. I would ask for a menu and then pick a day to show up and tour during lunchtime.

I would ask the director how long he/she has been working there, and where were they prior to coming there. And I would ask the same about other key personnel.

That said, some people stay at a job for the wrong reasons. If key personnel have been there since the stone age and seem unenthusiastic and lazy, leave.

I am not as good as answering these questions as some of the other people. But I recently went through your same issue. My dad and I put my grandmother in a nursing home in August. She passed away last week. Thank God she did not have to be there very long. Anyway, we went back and forth with your same issues. The food is horrible most days. I also brought food from different places that she ate from before she went in. I went there almost every day. I may be able to count the days I missed on 1 hand. Before we put her in, I spoke with a coworkers wife that told me not to do it and that there was not a such thing as a good nursing home. That is frustrating so I wont dare agree with that. She fell 4 times in a week and a half. We went back and forth with staff about food, changing her, washing her clothes, clothes getting stolen by other residents, meds, was she getting physically helped walking towards the end. Frustration is an understatement. But in the end, the very last night, they all stepped up and did an amazing job helping us with whatever we needed or wanted. That meant alot. I got to know the staff and the loss they had experienced that brought them to that place. Most knew exactly what I was going through. Of course, they had staff changes, for some I was thankful. But in the end, my thought is it is like any other job, you are going to have great people and you are going to have some that dont care. I would recommend to continue to visit, let them know you are watching every move. Take different food so she has something better to eat. Be her voice when you are concerned about issues. In all honesty, is any place really as good as home? I dont think so. I know this really does not help, but for me, in the end. I was thankful she was close enough that I could see her everyday and unfortunately when we are working with medicaid we don no get a lot of options. In the last week I have had a lot of time to reflect and I think they did what they could with what they had. I wish you and your family the best of luck Prayers going your way

https://www.newsweek.com/best-nursing-homes-2020/best-nursing-homes-wisconsin?fbclid=IwAR2SKsZdIruKSC1fRFdZ3CLe1zWbLz5Eq0mHiDNQ3pGkn45kPxcw63-JhsY (There's a drop down menu for the best nursing homes in your state.)

How close are you to her current residence? That will make the difference no matter which facility she chooses. Ask for a care meeting and come prepared to ask questions about her daily care. What care does she need that she currently does not receive. Food terrible? Are there other menu items that she can substitute instead of what they are serving? If that doesn't work, at least you will know what to look for when you visit other places.

When my sister was getting placed I read awful stories (reviews) online where she now currently resides.
Frequently I visit this nursing home, which has a rehab section as well as a LTC residential side. My sister has been living there now in LTC since end of June 2019, and I’ve found this home to be full of caring, helpful nurses, CNA’s, and even the chef and maintenance people are kind. Yes, occasionally a smell can erupt but it passes. The home holds
126 patients so something is bound
happen with peoples bowels etc., however I’m continually surprised and impressed on what I visually see and experience, so if you choose to read reviews my advice would be not to take it as gospel.
Many people have very high expectations Of nursing homes, and
think workers should be at there every beck and call. That’s just not realistic.

Where do you live? - this means a lot

However it is a chronic complaint by many seniors that they want 'better' to live - what is 'better' is another question - who at age 50-60 said "I want to end up in a nursing home" - many are ostriches who keep their heads in the sand to avoid making proper choices that effect both them & their kids

Said as one who took care of both parents to age 92 & 94 [basically sis was a no-show] & I'm 70 now [the first line of my autobiography will be "At the age of 69 I became an orphan"] - I personally will  buy a first class ticket to wherever I can control my own health so that I come back in a coffin in the belly of an airplane

Your mom isn't super happy where she is, but will she be any happier if she moves - probably not so ask her what she isn't happy about - this might be the fact that nurses check on her during the night or that she doesn't control her own meds anymore - it is very important that your know not only that your mom is unhappy but why .... if you can't fix the 'why' then don't move her HOWEVER if you can fix the 'why' with a move then look into it with educated eyes to solve her issue

The Nursing Home that my late mother was in was not good, but I suppose that there may be some good ones out there - IF one has the time and effort to look for one. Good luck and prayers sent.

Nursing homes are usually understaffed & food never good enough for residents. When you visit, is she clean? Is she eating? Is her bones showing & losing weight? Does she have bed sores? Can you inspect her skin when they do diaper change? Do the other residents get out of bed & into their wheelchairs? Do staff ignore residents whose relatives don’t come often? Does the place itself smell clean or stink? Do they have activities & socializing? Do they have physical therapy? Religious services? Ask other residents how they like it. If she is at SNF, she’s never going to be happy & always going to ask to come home. Good luck. Hugs 🤗

Really no "good" nursing homes, sadly

I am sorry you are in this tough situation. Given that she is in a nursing home now she would be low on a waiting list at another community. Especially since she is on Medicaid. Beds are often offered on a needs basis.

My MIL is also in a nursing home on Medicaid. For the most part it is good - not perfect- but good. That you live close by is a big plus. If she is being well cared for, and you like and trust the staff, I would not be in a hurry to try to move her. On the other hand if you witnessing neglect or seeing something you don't think is right contact your state's Department of Health. I work in an upscale retirement community that includes a nursing home. It is strictly private pay big $$$$ and it is no better in terms of care (maybe even not as good) as where she is on Medicaid.

I've found it helpful to stop by at different times. This lets the staff know that you are an involved family and also puts them on notice that you may drop in at any time.

I am sorry you are faced with this ... when I was looking for a home for my husband I looked at all of the "facilities" within a 25 mile radius from where we lived. I found nothing decent. I started going to the organizations referred to as adult placement companies. Many would find both private pay and medicaid placeents. They seemed to have many more options, including private homes that would accept medicaid. My husband was not medicaid - however I inquired about it as he had to become medicaid after 4 years of spin down. I developed a criteria to use as ideal to help friends who were looking ... and knowing you might not find the ideal, still good questions to ask. Happy to send it to me if you wanted to give me your contact info. Or, you might know it all already... it's pretty common sense - except when you are going through it sometimes it's hard to think of it all.

I agree with everything NeedHelpWithMom said. No nursing home facility is going to be perfect, ever. It took me a while to a accept that and look at the most important things; #1 - is she safe? #2 - is it clean? #3 - Are you or another family member close enough to visit often and be her advocate when/if her needs are not being met? Everything else is secondary.

My mom is very soft spoken and will not speak up for herself. After almost 4 years I have learned to pick my battles carefully and not complain about every little thing. I am respectful when issues arise. I have lost it a couple times, but the situation was very unusual and I wanted to be very clear that it was unacceptable and would not be tolerated no matter what their excuse was.

They have care plan meetings with me every 3 months, but I don't wait until then to discuss issues unless they are relatively unimportant. I chat with the charge nurse and have her occasionally "remind" caregivers of the care plan in effect for my mom if I notice things not being done on a regular basis. They are very busy and if they can cut corners at times, they will. Staff also changes and may not have been informed of all aspects of mom's care. Most caregivers in these settings are very caring and certainly are not in it for the money, but nursing homes are like any other place of business; they have exceptional employees and they have those who do the bare minimum to get by. It certainly doesn't hurt to let them know you are watching!

The food is acceptable, but not great all the time. I bring take-out from mom's favorite restaurants occasionally to break up the boredom. I give mom manicures occasionally, put lotion on her face, arms and hands, give her a shoulder massage, brush her hair and clean her teeth. Her caregivers do these things too, but it's not always consistent. It's important for her to feel the touch of a loved one. She loves it when I do these things and talks about it for days! I talk to her......a lot. LOL She won't carry on a conversation with me, but loves when I and others talk to her. She likes to just listen.

I’m going to approach this from a different angle..... So mom is “lonely & bored” with nobody to chat with.

Now if that is what’s driving the I wanna move conversation, (& it’s not an awful level of care issue), I’d suggest you go a meet 1-on-1 with the activities director of the NH. Tell activities director what your mom is like & may find of interesting. Find out what’s on the calendar and you volunteer to help with activities. Believe me there’s Halloween, Thanksgiving & Xmas on the horizon as well as football right now that activities will have stuff planned for. Pick a couple you can be at and get there early to get your mom all ready and you take her to the activity. Once there you help the activities director behind the scenes, you do NOT helicopter over mom. This will let you see how accurate mom is in “nobody talks to me” & also how she is in relation to what the other residents can or cannot do. You do this a few times & you’ll get to know the staff way way better & the residents & who mom might be pals with. AND you yourself become pals with other residents families. You know their names & can make it a point to chat by name however briefly w/them & their elder. Believe me doing this will pay off for both you & your mom.... & what your likely going to hear is OMG your 5 minutes away how beyond lucky is your mom.

Personally I am not the sorority social chair type.... but I got involved with helping the activities gal at my moms NH & scheduled trips over when there was a bigger event planned (I live in another state). It was a wonderful & often beyond funny experience.

Google - Hannah b Shaw . 0rg. It’s in middleboro Mass and it shows that there can be a “Great” nursing home. We toured this facility when looking for a place for my mom. In 2015, it was winter but when we walked in the front door it was warm and welcoming. And never ever a bad smell.
My mom is still on the list. It’s a very long list. But I am the daughter that live in AZ. So I’m not her closest advocate. The place she is in is good- she is clean and thriving in end stage Alzheimer’s.
If Hannah B Shaw can do it - more places should be able to. But we all know greed and making money is the bottom line with our health care.
Hugs I hope you find a suitable facility.

I visited several nursing homes in my area when it was clear I couldn’t keep my Dad at home.

what I found was....for a large sum of money (+$5,000 per month) the places looked nice and people were engaged in activities. But, no Medicaid need apply

amoung the Medicaid accepting places I found

most smelled badly of urine.
most had people sitting around in wheelchairs doing nothing
most were understaffed leaving people crying for someone to help
most had people sitting watching a community TV...looking quite obvious to it all.

do not call in advance to announce your visit...just show up and look around. The home director will quickly come and grab you to take you on the approved tour. Not once did I ever see anyone actually in the gym or rec. centers on those “official tours”.

after seeing that (I visited 6 places in this area) I vowed to never allow my parents to be admitted to one.

now...there is one place that looks really nice, interior very clean, seems to be in order. My Mom stayed there for rehab. Zero rehab was actually done for her. She wasn’t permitted to go to the gym or the lunch room. After one week....she checked herself out after waiting more than 24 hours for a meal. (Thanksgiving day...she had nothing to eat).

so..don’t go by the look of the building or the state of the art gym....see what people (staff included) are actually doing

As other's have said when you visit places, you'll also want to see if the residents are busy. Make sure there is an activity director and ask them to put your mother on the list. They will make sure to remind her or come and get her for the activity.
I think you also need to look into the doctors that are available. My mother's doctor didn't visit any of the facilities, so I had to choose a new doctor for her. Having to do this made me very anxious. The staff can't refer any of the doctor's, but they can probably tell you who comes in the most to see their residents.
I also used one of her dresser drawers to keep seasonal decorations, word search books, etc. and I stashed cleaning wipes and spray in it. It made me feel better to do a little extra cleaning and helping out.
Try to find out exactly why she wants to move and then see if you can address that with the staff. One little change in her day might make a difference in how she feels being there. Good Luck :)

I check then out with the state, have any complaints been filed against the home? How were they resolved? I have found one thing, if the foyer smells when I walk in the door, I turn around and walk out, it is even worse behind closed doors.

They aren’t all the same. The best advice I received was to look at what they offer but also look to see which facility had the busiest staff.

Talk to the residents if you can. Also the visiting families. Talk to people you know who have placed family members in facilities and ask if they would recommend that facility or have heard of other acceptable homes.

This advice came from a wonderful worker at a nursing home. He saw all the behind the scenes stuff that went on. He went on to say if the workers are spending a lot of time ‘chatting’ with each other in the hallways, then residents were being neglected.

That’s how I selected the nursing home that my mom did rehab in. Was it perfect? No. Is anywhere perfect? No. You just have to look for the best that you can find.

Address an issue politely as soon as it arises. Be kind to the staff. Show appreciation. It’s a tough job. Don’t interfere with their jobs unless it absolutely necessary.

Best of luck to you and your family.

Even the places you say are full will have openings on a fairly frequent basis. I’d go visit all the nearby places. Nothing replaces a visit where you get to see, and smell, a place, and get a feel for the atmosphere. You can always place your mom on a waiting list if you find a place that seems like she’d like it better. My mother spent four years in a NH, quickly going from private pay using a LTC policy to being on Medicaid. There was no difference in her care at all when she was private pay vs medicaid. The staff had no idea who was paying which way. Look for places where the staff is up and involved, not sitting around, where the residents are as busy as they’re capable of being. Look for no bad smells as there shouldn’t be any. You’ll quickly see how places compare and whether there’s a better choice. If you choose to leave your mom where she is, perhaps a care meeting is needed, to see if there are ways to help her be more content.

"There is a place about half an hour away that will take her, and I don't think it's a whole lot different, but I have considered moving her there anyway just so she can see what I'm talking about."

So you'd be giving in to her in this situation. And then you'd be much farther away. Will you also be giving in and spending as much time with her as you do now, but spending MUCH more traveling back and forth? She might SAY it's okay for less frequent visits to the farther place, but when she gets there and keeps calling you to come visit, will you be able to enforce your boundary of less frequent visits if she is farther away?

Just how often do you visit her at the closeby NH?

Make this move if it is convenient for you.
If the place she is in now is closer and you can visit more often or for longer rather than the place 30 or 40 minutes away, maybe you can not visit as often or for as long.
Ask her what she would prefer.
Has she been to the other place for a visit...talk to the residents and see what they have to say.

Unfortunately, most places even the best homes are understaffed. the best option is to be proactive and if its possible visit very frequently and get to know her roomate and the attendees. you may need to get involved (quietly) on helping her with keeping her room cleaned bathroom and making sure she has snacks and things to liven up her. room. otherwise i have noticed the most facilities are over staffed, under paid and treat patients with an emotional distance approach, its not their fault. at a facility i worked at briefly as an admission s person, i also notice that the patients that didnt have a family member visiting on a frequent basis languished and had depression on top of it all, they actually place bracelets for patients that wander or want to escape and to me that was the toughest. the food is always awful. the cooks are nt really trained to cook semi appetizing food its mostly institutional and tastless

The difficulty that you have is she is on Medicaid and while you can tour any number of facilities and choose one she would not be able to move unless or until a Medicaid bed opens up. That could be next week, next month or next year.
Why does she want to move someplace new?
Is she taken care of where she is? Have there been any injuries or falls?
Most facilities seem understaffed. You could look up the state codes for staff resident ratios. What I found with just a quick look and I do not know if this is just here or nation wide is day time ratio is 1 staff to 5 residents nighttime 1 to 10 and there should be a nurse 24 hours. These are minimum standards.
If it is the food that she does not like despite the food you get on a "tour" I think the food is pretty much all the same no matter where you go.
I think that it would be pretty much the same no matter where you go. Underpaid and over worked staff, food that is meeting minimum standards for nutrition made by staff that is given a minimal budget to buy the ingredients. So that means lots of canned vegetables rather than fresh or frozen. Lots of gravy that contains a lot of fat to stretch the protein further. Not to mention they are working with a variety of diets from a regular meal to soft processed meals.
Keep in mind these facilities are in the business to make money and unless you can find a small independent home type facility or one that is "non profit" they are all the same..and much like unicorns are fantasy. (OK I will admit there are small independent home type facilities but they are rare.)