What questions should you ask when interviewing Nursing Homes?

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Observation is key. ARe the employees treating each other with respect no matter what their job is? (such as nurses with CNAs)

People who are happy in their work are going to be better caregivers. Also, there is less turnover in staff which is very beneficial to the residents.

So they treat the residents as individuals?
Nearly all are understaffed, but can you see they care about each person?

The tips from everyone above are good. Lots of defined questions are necessary, but your gut is not to be ignored. Be realistic (this isn't one-on-one care), but check the pulse of the place. The staff is more important than fancy surroundings.
Carol
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It is SO important as the other writers have said to research, research, research.

Also, what is the per diem on your mother's long-term care insurance. Different plans pay different amounts. Every facility has a per diem, and as you know any difference would come out of her or your pocket. It's very important you know the per diem allowance you will have as you're looking at facilities. I'm assuming Medicaid is not involved.

The first thing you want to notice as you walk into a facility, is does it smell. If it does, I would walk out. Bad smelling facilities are poorly run. It means that the patients are not being changed and cleaned routinely. It also means the staff and director are willing to tolerate that -- which raises concerns about what other poor care they are willing to tolerate.

I would ask to meet with the Director of Nursing, not just the Admissions Officer who is basically the sales person. If the DON is not willing to make an appointment to meet with you, I would also go elsewhere. It is unusual for the request to be made, most people don't know to ask. But he or she is the person who runs the facility, if it is skilled nursing, so it is very important to learn from them.

Ask the DON what the staff turnover rate is, what is their proportion of CNAs, LVNs (who give medicine) and RNs per patient. How many charge nurses are on duty (those who sit at the desk) during each shift. This should also be posted somewhere on a wall in the entry way by law in most states.

Many facilities have trouble finding quality nurses to work in their facilities. Often you will see that they don't even have every shift covered by one nurse. That is also a bad sign.

You should also look at the most recent state health board report on the facility. Look at how many negative notices there are made against it. Often times, they will be cited for not giving medications at the proper time (very important) or skipping them altogether. Ask also what is the turnover rate of staff.

Stop in some time during the week when they are not typically expecting family visitors and ask to take a tour -- look through the entire facility. Is there water and a pitcher by each person's bed. Is there a television, telephone? Ask to look into the shower areas and see how clean they are.

And, of course, as recommended above, ask other family members of other patients. But make sure you make a surprise visit during the week to really see what happens when the facility is not typically expecting visitors.

You need to fully understand what your long-term care insurance plan covers. I would start with that and not take them at their word that every facility is okay. Will there be extra charges for diapers, gloves, wipes, laundry, medicine -- if you have to purchase these, they can be brought in from the outside; don't pay the rates the facility charges, that's usually where they make extra money. Go to Costco or WalMart.

There are also outside mail-order pharmacies for any medications not covered by Medicare or secondary insurance. A good facility will help you arrange for that. If not, you can also do it on your own.

Finally, find out about doctors. Does the facility have a Medical Director who visits or is on call. Typically, only the highest-end facilities do. So, you need to make sure that your parent's physician will come to the facility or that it's easy for you to arrange for transportation to the doctor.

Finally, meals. Some facilities do not want to serve individuals in bed because they want them up and out, they say, it's more social for them, but it's also more work for the staff. You should find a facility that will allow meals to be served in the room, at the patient's discretion. There may be days or come a time when your parent will want/need to be served in bed.

Hope this helps. Best wishes on this journey. You have lots of support out here!

Jane
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You can never ask too many questions of too many people as you're going through this process. Parents like yours are blessed that you care!

Blessings to you, Jane
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Victoria, I was wondering if you are looking for short- or long-term care for your Mom? Has she already been medically qualifies for a Nursing Home, or are you just seeking information for future use? What are yours and her needs? This will make a difference what questions to ask the Nursing Home. Thanks for asking this question.
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Long term care, still waiting to be medically qualified but they want me to start interveiwing Nursing Homes. They said they are not seeing any problems so far.
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We have had our loved ones in several different types of facilities. A couple we just did not like, for a variety of reasons. Dad was hospitalized, and when they said they were placing him in a Nursing Care facility, we drove down 200 miles to search for a suitable one. We visited everyone within a 80 mile radius, and got a good idea of what's available. I was not impressed with a single one of them, but the pressure was on, so we chose from among them, what we thought would be at least, "tolerable." Some were actually hideous! I swore to oppose his placement into such a place as that. So I suggest you "shop" a few, and that will begin to give you a comparison. Ask questions about their philosophy on medications, behavioral management, staff to patient ratio, and state ratings. All are ultimately governed by the state's control, but different types of facilities have different standards to adhere to. Some facilities are definitely better than others. Do you have many options to choose from in the area you are looking for placement? Find out how they care for someone with your Dad's specific condition. Visit on Saturday or Sunday, when family visits are heaviest, and talk to family members are their experiences and level of satisfaction with a facility you are considering. And if you are uncomfortable with one, trust your instincts. There's many more questions to ask, but hope that gave you a little to think about.
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My husband added, "If it smells bad, it probably is bad." His Dad was in a lovely ALF, but felt isolated. His next "home" was a for-profit Nursing Home, and lived there for almost two years. We visited often, and had no complaints. But after my Dad was moved to a fabulous place, we became dissatisfied because we had something better to compare it with, so moved his Dad there. Our present, and favorite choice, is a County-funded facility. They are probably one of the country's finest available, and it's close, so we are extremely blessed to have that choice. We made several visits, and specifically asked for a tour on two occasions.

Of coarse, they will "sell" you on their positive attributes. It's sometimes hard to find out the negatives, until you become more familiar with a place, and learn as you go along. No place is perfect. For us, how the facility handled residents with Dementia and Alzheimer's Disease was a primary consideration. After the 8 months Dad has been there, I am still highly satisfied with the care he receives. Do I agree with everything they do? No, but the major things are well-cared for. Things continually change in the medical field, and governing regulations. We can't control everything, but often can have direct impact as an advocate for our loved one's care. Hopefully, your journey will be fruitful and rewarding.
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Excellent input and suggestions, Carol, naricinfo, and Jane! (Wish we had your knowledge about 10 months ago.)
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Observe the interactions of staff with residents a key to the culture of dignity and respect throughout the facility.
Ask about therapeutic recreation programs. How do the activity care plans support the efforts of the ordered therapies like PT and OT?
Ask about restraint policies, initiatives for resident safety such as fall prevention and infection control, what is the "continuous quality program" and customer service philosophy.
Ask for testimonials or references.
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There are no wrong questions ask as much as you can think of!!!
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