Choosing a Nursing Home: What to consider

If you’re looking for a nursing home in Iowa or just want to monitor the level of care now being provided in a home, here are some tips:

Don’t put off a search for a nursing home until a health crisis forces an unplanned move from a hospital to a nursing home. If you do, your options will be limited to homes with openings at that time.

Check out the federal government’s Web site that provides consumers with 10 quality indicators on almost every nursing home in America. The indicators provide such information as the percentage of residents with bedsores and the percentages of residents with infections. The data are based on information that is largely self-reported and unverified by the government. Still, for Iowans with loved ones in homes located in other states, the site is worth periodic checks. It is located at http://www.medicare.gov/NHCompare/home.asp

Make a personal, unannounced visit to homes you’re considering. While there, ask the nurse aides how long they have worked there. Homes with high turnover rates and lots of temporary help hired through agencies tend to provide lesser-quality care.

Ask the staff how many licensed practical nurses and registered nurses work at the home and ask how many hours they typically work each week. Be sure to check on staffing levels for evening and overnight shifts as well.

Talk to the residents. Ask how long it takes for call lights to be answered. Ask about the quality of food and activities offered at the home.

Look for facilities that offer full continuum of care. Homes that offer both assisted-living services for healthier seniors and skilled nursing care for those with greater needs are ideal for couples whose care needs are different. Find out whether the home offers dementia-specific care for people who may develop Alzheimer’s disease as they age.

Ask how long the administrator and director of nursing have had their jobs. Long-term employment at the management level is often a good sign. Check to see whether an administrator splits his or her time at another facility owned by the same company. You should also ask whether the home’s corporate owners live in the community and visit the facility.

Look for the latest state inspection report, even if you’ve read it online. It should be posted where residents, relatives and visitors can read it without having to ask for permission. Check to see that it’s complete and is, in fact, the most recent report.

Visit a home at different times of day and on weekends. Ask whether you can buy a meal and eat in the dining room with residents. Does the meal itself match what’s listed on the posted menu? Are the residents who require eating assistance getting the help they need?

Get a feel for whether there’s a homelike atmosphere. Are the rooms adequately maintained? Are there areas where residents can sit outside? If you have a loved one who is prone to wandering, you’ll want to check the home’s security system and consider the facility’s proximity to busy streets.

Talk to the overnight-shift workers about the time of day residents are awakened for breakfast. Homes that are short-staffed sometimes wake residents long before dawn, lining them in hallways hours before breakfast.

Call the Iowa Department of Elder Affairs at (515) 242-3302 and ask for the names and phone numbers of people who serve on the home’s Resident Advocate Committee. Talk to the committee members about past problems and the administration’s willingness to address those issues.

Ask whether the administration schedules regular meetings with residents to hear their concerns. If such meetings are held, look at the minutes so you can get a sense of the issues residents have.

If you have a loved one entering a home on a private-pay basis, talk to the administrator about what happens when residents’ money is depleted and Medicaid begins paying for their care.

-Clark Kauffman