How to Select a Nursing Home
Selecting a nursing home is an important, personal, and often difficult decision. Sometimes the selection is the result of deliberate planning, but often the decision happens during a crisis situation. A nursing home selection involves many people including the resident, the resident's family, and many health care professionals. This part of the guide is designed to assist potential residents and their families through the process of selecting a nursing home. It is addressed to the resident who is actively looking for a long-term nursing home placement. However, others who must place a family member in a nursing home can use this same process.
Step 1: Evaluate Your Needs
The medical needs of nursing home residents vary greatly between individuals. Likewise, the nursing care services available vary greatly between facilities. Although every nursing home provides certain basic health care services, some facilities serve special needs. One special need would be caring for someone with Alzheimer's disease. Some facilities have specialized equipment on site, such as dialysis machines. You should ask your physician to list any specific health services that you will need and make sure the nursing home can accommodate these needs.
Besides providing health care services, you should think of the nursing home as your home. This is important if you are planning to stay for a long period of time. Many factors need to be considered, such as location, proximity to family and friends, distance from busy streets, special amenities, room sizes, noise, odors, and compatibility with other residents.
Talking with others will give you information and support. You should discuss your needs with health care professionals. Get insight and advice from family, friends, and neighbors who have been through a similar situation. Government agencies are another good source of information (see the Important Telephone Numbers section).
Based on your discussions, you will find it useful to create two lists. On one, list the most important characteristics that you are looking for in a nursing home (i.e. location, special services, etc.). On the other, list the nursing homes that have these characteristics. These lists will help guide you through the process of selecting a nursing home.
Step 2: Use the Tables Available at http://ahca.myflorida.com/
This website will help you to gather contact and location information for the nursing homes in your area. Make a list of the possibilities.
If you have too many facilities on your list to visit each one, you could trim your list down by calling the nursing homes. Call each facility on your list during standard business hours, when you will be more likely to speak with someone who can answer your questions. Ask for the administrator, admissions coordinator, or social service director. Discuss your nursing home needs, including payment sources. Find out if there are beds available or if there is a waiting list. Pay close attention to details during the telephone call. Is the staff responsive to your call? Are they friendly? Does this sound like a place where you would like to live? Note whether you wish to consider the facility further. By making these telephone calls, you can save time and effort in your search for the best nursing home for you.
After your telephone calls, you should have a list of specific nursing homes to visit. From your list of specific important characteristics, you should have a list of specific things to ask about or look for during your visits.
Step 3: Visit the Nursing Homes
There is no substitute for a visit. Even if your telephone inquiries have left you with only one nursing home, you should go for a visit. If possible, make two visits - one announced and the other unannounced. During both visits, observe the residents, the nursing home personnel, and the general condition of the facility.
The First Visit
On your first visit, make an appointment to meet the administrator, the director of nursing, the dietitian, the activity director and any specialists. Decide in advance what questions to ask. During the visit, be observant and write down your observations as well as answers to your questions.
Here are a few things that you should look for during your visit:
- Do the residents appear happy, comfortable, and at home?
- Is the facility clean, odor-free, and well staffed?
- Are residents being taken care of in a timely manner?
- Are the rooms decorated with personal furnishings and belongings?
- Do the residents have adequate privacy?
Interview the Staff
By making an appointment, several key personnel should be available to meet with you. The administrator should be able to answer most of your questions about the facility concerning costs and policies or direct you to someone who can. The director of nursing will be able to answer specific questions about resident care. The director of social services and/or the activity director will tell you about the social environment of the home and the activities available to residents. For special dietary needs, talk to the facility's dietitian or food service supervisor.
Ask Questions
Here are some sample questions to ask the staff professionals. Not all of these questions will be applicable to you. Do not limit yourself to just these questions.
- When was the facility last inspected?
- What deficiencies were cited, if any? Ask to see the last inspection report.
- How many residents does a nurse care for during a day, evening, or night shift?
- How many residents does a nurse's aide care for during a day, evening, or night shift?
- What arrangement does the facility have for medical services such as doctor visits and specialized equipment and therapies?
- What transportation arrangements does the facility have for the residents?
- What special training does the staff have?
- What are the policies for deposits, refunds, and bed holds?
- How does the nursing home safeguard against loss of residents' personal belongings?
- How much advance notice does the facility provide before increasing charges for regular or additional services?
- What types of activities are included in the facility's social program? Ask to see the activity calendar.
- Does the nursing home have a program to limit the use of physical restraints?
- What are the designated visiting hours? Can exceptions be made for special needs?
Participate
Ask to attend a few nursing home sponsored activities. Ask to have lunch in the dining room. This way, you can sample the food. Talk to the residents, family members, and other visitors. Ask their opinions of the home.
The Second Visit
If the first visit goes well, make a second unannounced trip. Visit on the weekend, in the evening or at a different time of day than the first visit. The purpose of this visit is to observe the nursing home during a more normal working situation than a scheduled appointment. Staffing might be quite different during the evenings and on the weekends. Making observations is the main purpose of the second visit.
Step 4: Select a Nursing Home
After you have visited all of the nursing homes that you are considering, use your comparison worksheet to select a nursing home. Talk about your selection with family, friends, and your doctor. You should have all of the information that you need to make the decision. If you feel you need more information, call the facility or one of the resources listed in the Important Telephone Numbers section.
