How to select a nursing home (Suburban Journals)
April 23, 2009
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How to select a nursing home
Tips from the industry
In recent months, the Journal has published a series of stories about nursing homes and the rating system used to measure nursing homes against state and federal regulations.
A common thread throughout many of the stories has been the admission by many - including those who are both happy and dismayed with the care a loved one receives in a nursing home - an expression of consternation when the time came to select a nursing home for a family member.
Eric Setzer, information coordinator with the Long Term Care Ombudsman Program of St. Louis, said many people immediately assume an older family member needs assisted living or skilled nursing help. However, that may not always be the case, Setzer said.
"We want to talk about what a person is capable of doing on their own and what kind of things they need assistance with," Setzer said.
Take into consideration an individual's ability to go shopping, bathe, do laundry and perform other daily activities.
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"What I'm trying to determine is whether we are even needed to talk about long-term caregivers," Setzer said of the questions he immediately asks when a person consults the ombudsman program about services for an elderly or disabled loved one.
It is also important, he said, to make sure that if an individual needs long-term care, the choice of facility is made with thought toward the individual's future needs. In other words, Setzer said he tries to steer families away from selecting a facility that works immediately, but is no longer suitable six months or a year down the road.
One should make certain a facility has what Setzer called a "pathway to safety" - a route an individual can take to safety in the event of an emergency. The pathway to safety should not take longer than five minutes.
It also is important facilities conduct regular assessments of a resident's care plan, Setzer said.
Setzer suggested thoroughly evaluating a site. That includes looking at state and federal inspection reports (www.dhss.mo.gov/showmelongtermcare/), the 5-star rating system from Medicaid (www.medicare.gov/NHCompare/) and, most importantly, visiting the facility.
Setzer also warns against visiting more than three or four facilities a day, so as not to get them confused.
Senior care service experts agree the site visit is the most important part of selecting a nursing home.
Julie Eckstein, the former director of the Missouri Department of Health and Senior Services, said it is essential families research facilities before placing a loved one in a nursing home.
"It's sad that in many cases we'll do more research for a car or television rather than health caregivers," said Eckstein, who now runs the Missouri office of the Center for Health Transformation.
Talk to family members, ask facility workers to address violations in reports, talk to the facility director, and take a friend who is likely to address the issue without the emotional connection to your family member. If a facility director seems to dodge your questions about violations, Setzer said a red light should go off in your head.
"I would feel much more comfortable if the response started like this: 'We realize there have been some medication errors in our facility and we are taking the following steps,' with a time, place and those attending," he said.
Setzer recommended people start looking at facilities as their parents age, so they're not caught hurrying if and when the time comes to place their parents in a nursing home.
Also, if financing is a worry, the ombudsman program advises families to ensure loved ones are being cared for by a registered nurse, skilled nurse or occupational therapist. Medicare requires that skilled professionals administer care in order to cover expenses.
Quick guide
1. Determine what level of care is needed. An individual that is relatively independent may not need a nursing home, but other service, such as an in-home assistant.
2. Research state and federal inspection reports and Medicare 5-star ratings for facilities you are considering.
3. Visit multiple homes. Be sure to speak with family members of residents, the director of nursing, and have the director of nursing address violations of regulations cited in inspection reports.
4. Take a friend or someone else who is not emotionally attached to the individual who needs assistance. He or she may provide a different perspective on each nursing home you visit.
Resources:
www.dhss.mo.gov
http://www.ltcop-stl.org/
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