Choosing the Right Nursing Home

4. Is the staff overworked?

Ask the nursing assistants and other staff if they work a lot of overtime and double shifts. If so, that’s a sign of short staffing that can affect patient care.

“If the staff are overworked, then they are overstressed,” says Boals. “It’s a lot of giving, and they’re working in a difficult situation.”

Ask the director of nursing for the home’s staffing ratios or check their staff ratio rating on the Nursing Home Compare tool at Medicare.gov. If you believe your loved one is being neglected because of poor staffing ratios, file a complaint with your state agency that regulates nursing homes.

5. How do residents spend their afternoons?

Don’t be alarmed by the crowd of residents circling the nurses’ station or watching people come and go through the front door. This is actually a good sign, says Boals. “I’d rather see that than see people tucked in their rooms, the television on, no one with them,” says Boals. A quality nursing home is going to have a daily calendar of activities in which your parent can participate. If your parent is room-bound, activities should be brought to his or her room.

6. How does the staff interact with each other?

Eavesdrop on the aides and nurses, says Somers. “If the staff is rude to each other, they’re going to be rude to your parent,” says Somers. Also listen for what music is on the radio or programs are on the television. “The music should be for the clients who are there, so if you’re hearing hip-hop or hard rock then you know the administrator doesn’t have a clue as how to deal with old people,” says Somers.

Also be aware of how staff spends its time once all the charting and direct care has been finished for their unit. “Are they gossiping with each other or are they making time to sit and talk with the patients?” says Debra Stang, a former nursing home social worker. “That’s something that I would always look for. Any time you come in and you’ve got three nurse’s aides giggling over a book and a bunch of residents sitting around in wheelchairs looking bored — that’s not a good environment.”

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