Nursing Home Decisions: Part I – Choosing a Nursing Home for a Loved One

I and other Sommers Schwartz attorneys regularly encounter people who have become victims of nursing home negligence and abuse at the hands of poorly trained staff. In many cases, those patients and families could have avoided the pain and suffering they experienced if they had only asked the right questions before selecting a nursing home facility.

Featured in a recent New York Times piece, Joanna R. Leefer, author of “Almost Like Home,” a user-friendly guide to choosing a nursing home, explains that “[t]he biggest mistake people make is waiting until the last minute, when faced with a crisis, to find a suitable facility…[y]ou’re forced into an impulsive decision that you’re not likely to be happy with unless you’re really very lucky.”

Ms. Leefer offers a number of tips for vetting your nursing home options:

Start with the cost.

• “When paid for privately, the average ranges from $10,000 to $15,000 a month. Medicare does not pay for long-term nursing home care, only temporary skilled care, usually in the rehabilitation section of the home.”
• “If the patient qualifies for Medicaid, and the nursing home accepts it, most of the cost is generally covered.” To qualify for Medicaid, the beneficiary must be a United States citizen, age 65 or older, and disabled, and can have no more than a certain amount of assets determined by the state in which he or she resides.

Choose a location that is convenient for everyone who is likely to visit your loved one on a frequent basis.

• Once you have your list of possible homes in the chosen area, you can check out the government’s report card at www.medicare.gov/nursinghomecompare.
• “Every home that receives federal funding must be evaluated and rated on a scale of 1 to 5 (5 being best).” Fair warning though, the “star ratings often don’t correspond to how patients feel about their nursing homes.” Even so, Ms. Leefer suggests only considering homes with a rating of 3 or higher.

Examine each nursing home’s characteristics.

• What specialized services will your loved one need and does the facility offer them? (e.g., a dementia program, mobility practice, hospice, etc.)
• Are there medical specialists on call?
• Is the nursing home affiliated with a quality hospital nearby?
• Does your loved one’s primary care physician have privileges at the nursing home?
• If your loved one is not fluent in English, are there staff members who speak his or her language?
• Are there activities offered at the home that your loved one enjoys? Will he or she be permitted to go outside?
• Are there private rooms? What are the visiting hours?
• Are there strict meal times and set menus?

Don’t rely on the brochures and marketing materials.

• Take multiple tours at all different times of the day, including mealtimes. Does the place look and smell clean during each tour? “An odor of urine is a clue to neglect.” Are the rooms welcoming? Can your loved one bring personal items?

During your visit observe how patients are treated.

• Are they respectful of a patient’s privacy?
• Are the patients’ needs therein promptly taken care of? If possible, try to talk with a few residents and their family members.
• Ms. Leefer points out that admission to a nursing home is not guaranteed and that some wait lists can be longer than a year. “It is best to submit applications to chosen homes well in advance of a needed admission.”

Remember that your job does not end once you have your loved one admitted to the nursing home; monitoring their care provided therein is equally as important to their health.

With our aging population, nursing home and long-term care facilities are increasingly more important. All the more reason to make your decisions wisely!