How to Select a Nursing Home

The decision to place a loved one in a nursing home is one of the most difficult tasks a family member ever faces. Prospective residents and their families should have the best information possible to make this decision. The purpose of this article is to help guide you in making an informed choice.
CONDUCT YOUR OWN INVESTIGATION

Once it is certain that nursing home care is necessary, determine which qualities of a nursing home are most important for meeting the needs and expectations of the resident. Each nursing home in your area will have unique strengths and weaknesses. Some issues to consider when evaluating your choices include quality of care, bed availability, provision of services that the resident will need, cost, quality, and location in an area where friends and family of the resident can visit often. It is critically important that you visit any facility on your list. Speak with other residents and families. Take a look at staffing levels on weekends or evenings – all of these first-hand observations are critically important. We have attached to this article a rating guide or checklist for your use as you survey each nursing home facility.
Look to the Experts:

Long Term Care Ombudsmen and Citizen Advocacy Groups
A state or local Ombudsman and/or citizen advocacy group can assist you in piecing together the different sources of information to make an informed decision about nursing home care. To find your Long-Term Care Ombudsman, go to the National Citizens Coalition for Nursing Home Reform (NCCNHR) website at www.nursinghomeaction.org and click on the button labeled "Ombudsmen."
An Ombudsman:

• Educates consumers and long term care providers about residents' rights and good care practices


• Provides information to the public on nursing homes and other long term care facilities and services, residents' rights, and legislative and policy issues


• Investigates complaints and advocates for residents' rights and quality care in nursing homes, personal care, residential care and other long term care facilities


• Will be familiar with the homes in your area and often with the staff and residents who reside in them.


• The Ombudsman can help you find and interpret information from state inspection reports (discussed below) and the resident characteristics or quality measures.


• Many states and/or communities have active Citizen Advocacy Groups that are knowledgeable about nursing homes and can be very helpful in evaluating advice and information you receive. To find a local citizen advocacy group go to the NCCNHR website at www.nursinghomeaction.org and click on the button labeled "Citizen Groups."

• Pay attention to the number of Certified Nursing Assistant (CNA) staffing hours. CNAs provide 90% of the hands-on resident care.


• Visit the facility and ask staff and families about the actual numbers of staff available to directly care for residents on each shift.

• Beware of choosing a facility with a very high number of deficiencies compared to other facilities in the area and the state average.


• Don’t assume that a “deficiency free” rating necessarily means that there are no problems with care at a particular facility.

• Visit frequently and encourage others to visit;


• Speak up to raise concerns and compliments;


• Participate in family council meetings if a family council exists, or seek out other family members to organize one;


• Attend quarterly care plan conferences and advocate for individualized care;


• Get to know the staff and help them get to know the resident. Share details about the resident’s likes, dislikes, and daily routines;


• Follow up on the agreed upon care plan. Make sure the resident’s doctor knows what is in the plan. Notice if the plan is not being followed and request another meeting if necessary;


• Make contact with your community's long term care ombudsman, any local citizen advocacy groups and become familiar with the state and federal laws and regulations that apply to nursing homes and;


• Document (date, time, persons involved) any problems you might observe so that managers, the ombudsman, or state survey agency can investigate.