Evaluating Skilled Nursing Facilities

Skilled nursing facilities, better known as nursing homes, promote care to those individuals who can no longer care for themselves at home. A wide range of nursing, rehabilitative, social and medical services are delivered on a 24-hour basis. Skilled nursing facilities help people during a time when they cannot adequately care for themselves. These facilities provide necessary nursing and medical intervention while promoting the restoration of a person’s maximum independence. Evercare Connections

1. Know your rights. If a hospital informs you that your loved one must be discharged within 24 hours, remember that you have appeal rights under Medicare. This could allow you to extend your relative’s stay by two additional days and give you more time to research nursing homes. For details about appeal rights, ask the hospital for a copy of “An Important Message from Medicare,” or call 1-800-MEDICARE.

2. Turn to the Eldercare Locator for help. This resource will connect you with your local agency on aging, which can give you the names and locations of all nursing homes in a given area. Call the Eldercare Locator at (800) 677-1116.

3. Prepare to do lots of clicking. Consumer Reports recently completed an investigation of nursing homes across the country and made its findings available free of charge online. This will ultimately lead you to nursing homes in your state to consider and to avoid.

4. Tap into other resources. You also can check less complete surveys of nursing homes through the Nursing Home Compare database on the Web site of the Center for Medicare and Medicaid Services. Many state health agencies also track nursing homes in a similar way. To find such a resource, do a quick Internet search using the name of your state along with the words “health department.” Then visit that state Web site and find a phone number you can call. Ask the person who answers whether there’s a way for you to see nursing home surveys or ratings for your state.

5. Check state survey reports. When you visit a nursing home, ask for a copy of a report known as Form 2567, or the state inspection survey. This report will reveal the results of unannounced visits by state surveyors who spoke with residents and checked on sanitary conditions and care issues.

6. Contact your state’s long-term care ombudsman program. Another important resource for you can be the ombudsman who monitors nursing homes in your state or local area. You can do another quick Internet search using the name of your state and the word “ombudsman” to find the contact information you’ll need. You also can ask for this contact information when you call your state’s health department.

7. Make unannounced visits more than once. As you zero in on two or three nursing homes, visit them at different times of day. Are many residents still in bed at 10 a.m. or so? Do many eat dinner in their rooms rather than in the dining room? Both of these can be signs of an under-staffed facility that isn’t giving residents enough stimulation.

8. Stay alert for other telling details. Are toileting needs being met right away? Are safety precautions in place to prevent accidents? Are exercise and rehabilitation sessions scheduled regularly? How does the staff interact with residents? How does the food taste to you?

9. Sit down with the administrator. Ask about his or her views on long-term care, and find out if the nursing home has seen a lot of high-level turnover in recent years. If it has, that could be a sign of instability.

10. Inquire about Medicaid. If your relative lives in a nursing home for a long time, his or her financial resources most likely will be exhausted or “spent down,” and he or she will then be eligible for Medicaid. Get in writing the nursing home’s payment policy once private funds or Medicare reimbursements run out. Does the nursing home accept Medicaid payment eventually? If so, at what point?

Sources: Consumer Reports’ Nursing Home Guide, “Consumer Reports Complete Guide to Health Services for Seniors” by Trudy Lieberman and the Editors of Consumer Reports, U.S. Department of Health and Human Services © 2009 MSNBC Interactive. Reprints

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