I have cared for my 97-year old mom with Alzheimer's at home, for the past 12 years, However, I am now searching for a long-term-care nursing home. I was originally considering only facilities with an above average rating of 4 or 5 stars (5 stars being the top score). However, the RN who assessed my mom for the PRI highly recommends a nursing home that only has a 2-star rating. She says that she knows the place very well and they're excellent. She said not to pay too much attention to the Medicare ratings. I would like to get others opinions on this. TIA!
This is long but what I did. I use the ratings to start. Others claim they are worthless based on their experience. If you drill down on each link you can uncover the incidents. Also check yelp, etc. You can also find a guide to help you assess the NH on that site. But I would listen to the RN as well. The #’s can be manipulated to a degree and RN may not have current info. Each level of staff matters. You need a drs order to make things happen and your advocacy.
The state only rates certain aspects of care and while the ones they rate are important, health inspection, quality measures, staffing, they aren’t the only factors that matter. They rate short vs long term. Look at the NH website often. See what staff they are hiring for.
The first time my mom went to a rehab I chose a 5 star. It was near my home. It turned out to have many problems but the therapy was excellent so we tried to tough it out. She wound up back in ICU and then finished her therapy at the hospital rehab.
When I chose the NH for my DH aunt, I had two criteria that were most important to me. The OT therapist she had through home health and that my mom had used for years worked there. Plus they would accept aunts hospice group. This group was very important to me. We had worked with them for years through home health and then hospice. Aunt has a hospice aide daily and I felt like that gave me an inside track on the NH care. Choose your own hospice as needed so you have better contacts.
I have had problems (as do much of the staff) with the long time DON and ADON but I work around them. I am able to do that due to the hospice company connection and also I kept aunts geriatric doctor who she sees via Telemed. If I’m concerned about something, I contact the geriatrician and she helps me sort it out. I like the administrator. The Nh aides have a high turnover. They matter because they provide the hands on care … aunt is bed-bound and totally incontinent and must be fed. But again, I have her long time hospice aide each morning so that keeps me sane. Plus her hospice RN is a good communicator.
There was a better rated place I probably should have gone to but in spite of being clean and well run it was old. I knew that mattered to family at that time and I was concerned about PT. Neither matter now but I hesitate to move her.
I have a friend who recently placed her sister for rehab. Sis has a difficult advantage plan. The first place looked nice, had tasty but not healthy food. The therapy was not good and the rating was a 1. While she stayed there it actually received the red hand warning. She ended up back in the hospital. Then an IV incident (chemo) occurred that caused her sis to have to seek a higher level of care in a metro area. After sis being in the hospital several weeks friend was again challenged with finding a rehab in the new city. This time armed with all she had learned, my friend visited 5 or 6 places and ended up choosing a place that was not rated all that well presently but had been in the past. It had a very good reputation in the community, perhaps like the one your RN recommended. The food is horrible but it was closer for my friend. Her sister is there for wound care and rehab. To augment the healing, my friend takes her fresh fruit and salads and protein drinks. It has worked out for them. She’s glad she took a chance on them.
Two other things that helped is I kept aunts insurance and I do her laundry.
She has original Medicare, Pt B, a great supplement and part d for drugs. Even though she is on Medicaid now, she was allowed to keep those insurance plans by Medicaid and they have been used as needed.
Doing her laundry (sheets too) gives me clues on her care. If she’s wearing her food on her pjs, I know she isn’t being fed properly. If it reeks of urine, I know she isn’t being given her water and she wasn’t changed. Aunt is 98, dementia, in care for 3 yrs. It’s hard. Good luck❤️🌹
My Uncle went to one very well 5 star rated rehab and it was atrocious. I should have done more due diligence since he was improperly cared for that resulted in flare up of an infection that landed him back into hospital and I demanded replacement. I wouldn't pay for the days to hold his bed at the first rehab and it is a good thing. That entire facility has now closed do to mis management since my uncle was IP rehab in March 2024. Such a tragic scenario for all the residents and patients.
Do not judge a SNF by a CMS rating. Go there yourself and check out the facility and speak to the RESIDENTS. Had I done that, I'd have seen the horrible conditions these poor souls were living in. And btw, this place STILL has a 5 star CMS rating! Suspicious? You bet it is.
I myself would be concerned about a 2 out of 5 and I would want to discuss with admins at the facility what the complaints are that led to this low rating. Often it can be ONE ding, but a BIG DING such as a bedsore developing. The rules and regs are horrific for nursing homes. One "unsafe discharge" could do it. And one decubiti or one person escaping out the door is going to get them a ding on their license to operate and get their rating lowered. I am not saying the development of a decubitus ulcer is "OK". Clearly it isn't. But in a really debilitated, emaciated or ill resident it may literally be impossible to prevent.
Really, I don't know the answer to your question, and this would make me uncomfortable as well. I hope you will update us how/if you proceed here.