Saturday, November 19, 2011

How to Choose a Nursing Facility

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As baby boomers age, it's vital to be aware of  what to look for when you are in a position to place a loved one in skilled nursing. Skilled nursing is available to adults if they are not ready to return home after being in the hospital or if they have been living at home and they require too much care to maintain independence.

It is important to do due diligence when considering potential skilled nursing facilities for your loved one!

Before You Visit
Check out the following website, Nursing Home Compare.  Click on the tab that says "Find and Compare Nursing Homes." You can search facilities by the name of the city, zip code, state or the name of the building. This website will reveal recent state survey results and will post where the building was deficient in giving care to its residents. It also provides a 5-star system to rate the quality of care in each home, with 1 star symbolizing underaverage care and 5 stars indicating exceptional care.

That being said, I've been assigned to 2-star homes that gave better care than homes with higher ratings. You have to look deeper than the 5-star system to make a good decision!

Call the prospective building during the day and in the evening. Count how many times the phone rings before someone picks up. If you get put on hold, does someone get back with you? Does the person who answers the phone sound friendly and professional?
When You Visit
Scan the outside of the building. It is the first impression! Check your gut feeling.

What is the atmosphere like when you walk in the door? Calm, friendly, chaotic, stressful? What do you hear? Make note of it - overhead music, people calling out, laughter, you hear overhead pages? Door or wheelchair alarms going off?

Look at the lobby furniture. Does it look clean and comfortable, or does it look like hotel furniture from the 1970's?
Walk past the nursing station. Stand there for a there a buzzer beeping to indicate that a call light is going off? If so, how long does it ring? This reveals a potential response your loved one may receive when he or she hits the call light.

Look at the seats, the wheels and the frames of the wheelchairs. Are they all clean and well maintained? Are they dusty, covered with crusty food or other substances?

Check out how well groomed the residents are...
  • is hair combed?
  • are faces clean?
  • are teeth brushed?
  • are fingernails trimmed and clean?
  • is there food from the last meal on the residents' clothing?
These are good indications of how nurse aides would give daily care to your loved one.

If it is mealtime, observe the dining room. If music is playing, is it generation appropriate? Are the aides talking to each other, or are they addressing the needs of the residents?

What is the volume around nursing stations? Is it loud or quiet? Remember, this is a home - there should not be so much noise that people cannot rest.

Ask to look at the showers. This is where your loved one will be taken at least twice a week to be bathed. Has it been sanitized and tidied between showers? It should be.

Look in the bathrooms. How many people will share this bathroom with your loved one? Is there enough turning radius to get a wheelchair in easily if your loved on is wheelchair bound?  Look at the cleanliness of the visitor's bathroom. (It's like checking out the bathroom of the restaurant; you get an idea of what the kitchen is like, too!)

How large are the rooms, and how many roommates will your loved one have? I am currently assigned to a building where most of the rooms house three residents. They have very little personal space.

Ask about the rehab team. How many therapists are in the building? If your loved one is on Medicaid, will the building provide rehab to Medicaid patients?

If your loved one is a younger adult (under the age of 60) who has had a catastrophic accident or illness, and who is on Medicaid, I recommend talking to the Administrator or Executive Director of the building to determine how invested they will be if you wish your loved one to have access to rehabilitation. In some cases, the building may be compensated for providing therapy to your loved one, and in others, the building will have to provide it at their expense.

There are other things I will add in the future. Other SNF OTs, please feel free to add on to this list! I'm working on a checklist, will publish soon...

Family members,
what are the issues you are facing?

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