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Factors to Consider in Selecting a Nursing Home

1. Facility certification and financial matters:

Is the facility certified by Medicare and Medicaid? How long has it been certified? Ask to see the two most recent Medicare and Medicaid surveys.

2. Specialty care available:

Does the facility have an Alzheimer’s unit or other area restricted to patients with special care needs? Is the specialty unit separated from other areas of the facility?

3. Location:

How convenient is the location to family members and friends? What are visiting hours? Location and accessibility are important because they can affect how often the patient is visited by family and friends.  Frequent visits generally will improve the patient’s mental and emotional well-being, as well as ensure that quality-of-care issues can be addressed as problems arise.

4. Physical considerations:

Is the facility well lit, clean, safe, and welcoming? What is the ratio of staff to residents during each shift? What diagnostic treatment facilities are available at the facility? What bathing facilities are available and how is bathing handled when a resident needs assistance?

5. Mental and emotional well-being of patients:

What kinds of activities are planned each day for the residents? A good activities program should include regularly scheduled events, such as a weekly movie, weekly or monthly musical events (even if it is just a sing-along), religious services, physical exercise activities (exercise classes or even dancing), bingo, educational classes, and other social events. Is there a library available for residents with large-print and audio books? Is there a small “store” that stocks personal items, such as shaving cream, hair care products, and snacks? Is there a safe place for residents to enjoy the outdoors, such as an enclosed garden? Are plants, pets, and other natural elements a part of the residents’ environment? Are residents taken to special community events and cultural activities?

6. Room sharing and furnishings:

Will the resident share a room or bathroom with one or more other residents? How are roommates and rooms selected? If the resident is dissatisfied with a roommate can the assignment be changed; how is this accomplished? Can the resident bring some of his or her own furniture?

7. The resident’s care plan:

Individual care plans should be implemented for each resident. How often is the care plan reviewed and changed? What is the protocol for handling problems? A resident of a nursing home must be under the care of a licensed physician who must evaluate the resident’s needs and prescribe a program of medical care including therapy, diet, restraints, and medications.

8. Employees:

How are employees selected? How are they screened for drug use, criminal records, and other potential problems? What is the turnover rate of CNAs (certified nursing assistants), RNs, and other patient caregivers?  What is the turnover rate for employees who perform ancillary services such as meal preparation and financial record keeping? Are these rates higher or lower than the local norm?

9. Physician:

If one particular physician is used by most residents what are her qualifications?  How often is the doctor on the premises? What is her bedside manner with residents?

10. Meals:

Are meals served in a communal dining room or is each resident served in her room? If communal, how are tables assigned in the dining room? How long does it take for a meal to be delivered to a bedridden resident?  How does the food taste and how is it presented to the resident? Is there a way, within a reasonable walking distance from the patient’s room, to heat food that has become cold?

11. Admissions requirements:

What financial information does the facility require during the admissions process? Can the patient or her representative have copies in advance of all admissions documents and contracts for review? How long does the admissions process take?

12. Cost of care:

What is included in the cost of care? How are “extra” items billed? Can laundry be taken off the premises and does this save the resident some costs? How are prescription drugs handled? What is the cost difference between a private room and a semiprivate room?

13. Transportation services:

If required non-emergency medical services (such as dialysis) are not available on the premises how is transportation arranged? What about transportation to other destinations such as local stores and religious services?

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