You may have adequate time to choose a nursing home or it may be a last-minute decision as the result of a hospital transfer for nursing home rehabilitation after a senior has suffered a stroke or fall. Quality nursing home care requires efficient systems, adequate staffing and updated equipment and facilities. While every nursing home will experience difficult residents and staffing challenges, there are certain factors you can check to ascertain the quality of the care the nursing home will deliver. Based on industry experience, the following checklist will help you to evaluate a nursing home for its ability to deliver quality senior care. You may search for a nursing home in your area based on their rating (http://www.floridahealthfinder.gov/CompareCare/SelectLocationFacilities.aspx) and also review their daily costs (https://www.health.ny.gov/facilities/nursing/estimated_average_rates.htm)
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Nursing Home Checklist
Medicare only pays for post-hospital rehabilitation care and hospice care services in a nursing home for short periods of time. Medicare (medicare.gov) reimburses for some or all of the daily cost of care for these short stays. What are the daily fees after the Medicare coverage ends? If the senior were to run out of funds to pay for care privately, will the nursing home accept Medicaid (http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Institutional-Care/Nursing-Facilities-NF.html) as a form of payment? Find out Florida’s Medicaid eligibility (http://www.floridahealthfinder.gov/reports-guides/NursingHomesFL.aspx#FinRes) rules and how to apply.
Check the Florida nursing home state inspection report (http://www.skillednursingfacilities.org/directory/fl/). Remember that this report is based on an inspection once every 15 months. Many nursing homes have a “code” that goes out to the staff when the inspector enters the door, which means they are on their best behavior at that time. Also remember that state violations which often happen monthly, do not appear on the inspection report.
3. Certified Nursing Aide to Staff Ratio
Find out how many patients are assigned to each nursing aide. This one-on-one care is an important factor for a successful nursing home stay. If a nursing aide is assigned to 15 patients and one requires extra care, time may not allow for them to assist all patients with bathing and toileting during each shift. Caring for seniors with a variety of medical issues and memory loss presents many challenges but the number one success indicator will be adequate staff to assist the residents.
4. Staff Scheduling for Individual Care Needs
How does the nursing home schedule individual toileting needs for bladder and bowel movements and individual feedings for food and fluid intake? Are catheters being used for many residents? What about feeding tubes? Are they being used to compensate for inadequate staffing levels to toilet and feed residents adequately?
5. Staff Longevity
How long has the current administrator been at the nursing home? How long have the nursing aides been staffed and are they assigned to specific residents when they are on duty? Are any of the nursing aides from temporary staffing agencies? If so, why does the nursing home have a staffing challenge? Ask the aides.
What activities are available to residents? Does the nursing home offer additional meals and snacks? Do they have pets? Do they have a movie room? Do they have exercise classes? Will they involve the residents in the activities or will you need to have a family member or caregiver escort the resident to participate in activities? Is there a way for the resident to go out for fresh air when weather permits?
There should not be odors at the nursing home – a clean nursing home will not smell like urine when you walk in the door. How clean and organized are the hallways and nursing stations? Are the residents well groomed and appropriately dressed for the time of day?
8. Review Public Information
As of January, 2003, all Medicaid and Medicare certified nursing homes must publicly post the number of nursing staff they have on duty to care for residents on each daily shift. Licensed and unlicensed staff include Registered Nurses, Licensed Practical Nurses and Certified Nursing Aides. Nursing homes must also make readily available the name and contact information for all state client advocacy agencies, the state ombudsman program, the Medicaid fraud control unit along with the results of the most recent state or federal survey.
9. Talk to Residents
Talk to the residents and ask them about the staff, the meals, the activities. Consider what special care needs may be required, such as care for memory loss, and if the nursing home provides these specialized services.
10. Contact the Ombudsman
Contact the nursing home ombudsman to ask about any complaints or concerns at the nursing home you are considering.