How to Pick a Nursing Home

Are you looking for a nursing home facility for your parents, your spouse or yourself?  You may feel overwhelmed.  There are approximately 16,000 nursing homes in the United States and they vary widely in quality.  When possible, it is a good idea to do advance research on the ones in your area so you have two or three in mind before you or someone you love needs to move into one.  Nothing is worse than hurriedly trying to find a skilled nursing facility during an emergency.  It can be too tempting to choose one simply because it is close to your home or seems convenient, rather than because of the quality of the care. Below are some of the things you need to consider while doing your nursing home research.

What Questions to Ask When Looking for a Nursing Home

1.  What is their Medicare rating?

Before you do anything else, you will want to know which facilities in your community are rated the highest by Medicare.  You will also want to know the specifics about their rating.  How did they score on issues such as staff attentiveness, health inspections and nurse-to-patient ratio?  One source of this information is the Medicare website at:  medicare.gov/nursinghomecompare

2.  What is the Shower Schedule?

In some states, such as California, the staff is required to help their patients shower at least twice a week.  You will want to confirm the schedule and find out if it possible for a patient to receive showers more frequently, if requested.  If so, is there an additional charge and how much would that be?

3.  What is a Typical Daily Schedule?

People stay in skilled nursing facilities because they are no longer able to care for themselves due to old age or because they are recovering from surgery, illness or an injury.  In most cases, the daily resident schedule will include some type of rehabilitation therapy.  However, if that is the only time the residents are engaged in an activity, they are likely to become very bored and feel lonely.  It is important that residents also have social activities, entertainment, exercise classes for those who can participate, and hair salon services for those who have an extended stay.  The photo above shows a group singing and enjoying a voluntary spiritual circle. Having activities and companionship is very important for the well-being of all of us, including the elderly.

4.  What is on the Menu and What Options Are Available?

Today, large numbers of people have a variety of dietary restrictions because of the nature of their illness, their religion, ethnic background or food preferences.  Consequently, it is important for the residents' health and emotional well-being to have input regarding their food choices.  Ask if special holiday meals are available and what options are available on normal days.  If possible, ask if you can go to the dining room and enjoy a meal with the residents.  This will give you the opportunity to try the food yourself and will enable you to observe how attentive the staff is when assisting people who need extra help.

5.  Are You Being Shown a Typical Room?

Most skilled nursing facilities are happy to give you a tour.  Make sure you take the tour and do not consider a facility if they will not show you around.  However, during your tour it is important to ask a lot of questions and be a little skeptical. Are they showing you a typical room, or is their model a little larger and fancier than the rooms of most residents?  Are the rooms private or semi-private?  Can the residents bring along a few pieces of their own furniture, especially if the move is likely to be permanent? Do the residents have access to Wi-Fi and computers?  Are there in-room televisions, or is TV viewing only available in the central lounge area?  Are there telephones in the rooms?  Are the facilities clean and attractive?  Are there outdoor areas where the residents can relax?  Does the facility smell pleasant? Is it reasonably quiet and cheerful?

6.  What Additional Costs Can You Expect?

Nursing homes often quote a price per month for basic care which includes room and board, as well as essential care.  However, you may be surprised to discover there are usually extra charges for things such as patient medications, having someone dispense the prescriptions at the appropriate times, and assistance with bathing, dressing or eating.  Ask if there an extra charge to drive residents to doctor's appointments.  Do they charge for other special services such as changing bandages or providing adult incontinence supplies?   These expenses add up quickly and can turn an affordable nursing home into an unaffordable one.  You will also want to ask how often the rates increase and how much they have historically risen.

7.  Can this Nursing Home Meet Residents' Future Needs?

While you or your loved one may initially move into a skilled nursing facility because of the need for physical care as you age, what happens if residents develop more complex problems, such as dementia?  Is this facility capable of handling all future needs, or do residents have to move somewhere else when their needs become more severe?  Moving can be very upsetting and disruptive to an elderly person with dementia.

8.  What Safety Measures are in Place?

Are the floors non-skid?  Are there handrails along hallways and stairways, as well as grab bars in the bathrooms?  Are the walkways and emergency exits clear?   Does the facility have an emergency preparedness plan?  Is there a back-up generator in case the electricity goes off?  What happens if the facility needs to be evacuated in the event of a natural disaster?  What contingency plans are there, especially for the weakest patients?  Are there emergency supplies in case the facility decides it is safer to shelter in place?

9.  How are the Caregivers Recruited, Trained and Screened?

Are the caregivers given continuing education classes?  Are they subject to background checks before being hired?  What is the employee turnover rate?

10.  Can You Chat with a Few Residents and Visitors?

Ask residents if they are happy in the facility.  Most of them will be extremely honest, but recognize that some people will complain no matter how good the facility is.  Try to observe if the staff seems to have a good relationship with the residents. Do people generally seem happy or disgruntled?  Does the staff greet the residents by their name?  If possible, ask the residents if they like the food, activities and staff.  If you run into family members who are visiting, ask what they think of the facility.  Ask everyone if there is anything else you might want to know ... such as unusual rules or expenses you might not expect.

Once you have visited several facilities and answered all the above questions, you will have a good idea which skilled nursing facility is most likely to meet your unique needs.

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Photo from public Facebook page of Serenades Assisted Living in Florida