Nursing Home Selection Notes

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.