There are certainly plenty of guides and checklists published on
the internet and elsewhere for selecting a nursing home. Medicare has
an on-line pamphlet, and also a checklist.
Here are some of my own notes:
1. As I have suggested previously, check out the government
websites of nursing homes, and specifically the '5 Star ranking' score of the ones you are considering. As you
narrow down your choices you may want to look into the factors behind
the rankings. As an example, I see my son's employer received
only a mediocre ranking. That nursing home received 5 stars for
"Quality Measures" and 1 star for staffing levels, factors
that didn't surprise Martin. Remember also that the rankings are
averages of only selected measurements, during certain times.
Critics of the ranking complain that things like patient satisfaction
surveys are ignored. In any case, you won't want a place that puts more effort into 'passing the test' than in improving overall quality.
2. Have a look at the short list of USNews'Honor Roll' nursing homes. Also, watch for other articles and news
reports that identify other noteworthy facilities, like Miami Jewish Health Systems and Hebrew Home of Riverdale. Be
aware that the Honor Roll list is based on the government 5-star
ranking mentioned above. These are nursing homes that scored a
"5" in all three categories measured, and the list has the
same drawbacks as the ranking itself. Even if you don't select
one of these nursing homes, just visiting them probably gives you a
good reference for comparison.
3. See what the CNA's who are actually providing hands-on care
are saying, in their own forums. While they won't name employer names, you can get an
idea of their issues and frustrations. Try to get an idea if the
concerns you read about on-line, like inadequate coverage and
unrealistic expectations, might be concerns in the places you visit.
4. Before visiting any home, take just a little time to learn
some of the tell-tale signs of quality care. Also, remember to trust your nose. You won't always find bad news. In one nursing home I
visited, for example, the cleanliness standards and disciplines were
so impressive that I had immediate respect for the staff. In another
fancier place I was dissappointed.
5. Check out Elder Abuse Attorney websites, and avoid any nursing home owned by companies with
frequent problems in their other facilities. You may have to do some
research, because ownership is sometimes not clear. One national
operator of 200 homes, many of which have been cited by elder
attorneys and the AARP, operates under many different local names.
6. While this is not a critical factor in itself, you might check
to see if the nursing home is for-profit or non-profit. Although
individual institutions vary, staff salaries are typically higher in non-profits. In the past,
most 'honor roll' facilities were non-profit, though that may be changing.
7. As with any care provider, check references.
Besides families, professional care managers can be a help. Also, many states have
ombudsmen that look into complaints about nursing homes. For
example, Florida has regional ombudsmen who take consumer complaints. While
they usually get involved after there is a problem, it may be
worthwhile to check with them during the selection process.
Once you or your loved ones make your selection, consider having
your own private CNA, RN, or care manager visit. Ideally, it should be
someone who will not only give personal care and attention on a
regular basis, but will be thorough and able to identify possible
problems, signs of infection or developing sores for example, as well
as observe general conditions and care. Even with regular visits by
family members, you will want to verify
that all is really well.