Using Reasoned Judgment to Choose the Right Nursing Home

Is there such a thing as the "right" nursing home? Not if you or I are going there. We will pitch a fit. But let's be realistic. Sometimes we have to choose the best option for ourselves or for a family member. When we have to, how will we make the hard but necessary decision?

In my last post, I gave some statistics that should make us think a lot about how to make the right decision. Recently, the Centers for Medicare and Medicaid Services gave one in five certified nursing homes only one star of five based on quality of care, staffing, and health inspections. For profit homes, contrary to our expectations, have the worst performance according to the Government Accountability Office. My research in cases that I've been asked to investigate show that reported deficiencies in nursing homes are only the tip of the iceberg and that substantial histories, documented in the medical records, show that untreated pressure sores, malnutrition, falls and other problems occur regularly. So what is one to do?

One source of information is attorneys in your neighborhood. We may have a useful perspective on who we are regularly asked to sue and who we are never asked to sue. That in itself may provide a lot of guidance for nursing home selection. When we investigate alleged nursing home malpractice cases, we look at common financial, administrative, medical and quality of life concerns that typically arise in nursing home settings. We closely examine inspection reports, medical records, and staff logs for evidence of failures in staffing, training, supervision, equipment, and oversight, but your problem is to look for red flags before you decide to sign the agreement to admit your family member there.

Here are some simple suggestions developed after a long time of looking at nursing homes that provide good care and those that don't. Consider the family member's special needs, for example, respiratory therapy. Make sure the facility offers that service and has a history of compliance with the necessary certification standards. Also, make sure the facility doesn't regularly reject appropriate patients simply for staffing convenience or cost control.

Check the records about the nursing home in places like Nursing Home Compare or similar sources. Those records should document the facility's record on key quality measures like infection control, pressure sores, weight loss, bladder control, use of restraints, daily living skills, and pain treatment. The records provide a good snapshot of each home in comparison to others.

Visiting the facility with a Medicare NH checklist available from government agencies and advocacy sources can be extremely useful. Take advantage of your local attorneys' knowledge of nursing homes. The free advice you can get may be invaluable to you in selecting the "right" nursing home.

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