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What to look for in a nursing home?

Realize there are good and bad nursing homes. It will take some time and effort on your part to discover the better facilities.

Remember to involve the patient as much as possible in this process!

Pre-visit Investigation / Preparation

  • Make a list of nursing homes that are close enough for family and friends to conveniently visit the patient.
  • If your loved one will need assistance from Medicaid and/or Medicare in paying for their stay, list only those nursing homes that participate in the Medicare and Medicaid programs.
  • Learn as much as possible about each nursing home by talking with:
    • People that have loved ones in nursing homes
    • Ministers
    • Health Professionals such as, Doctors, Social Workers, Nurses
    • Long Term Care Ombudsman
    • Nursing home employees
  • Review state survey inspection reports for each facility

Visit and Evaluate Each Nursing Home

Look

  • Do patients appear happy and well taken care of?
  • Is the building clean and well maintained?
  • Are wheelchairs and other equipment in clean working order?
  • Are activity calendars posted with a variety and sufficient number of activities for patients to choose from each day?
  • Are patients involved in activities or just sitting around bored with nothing to do?
  • Does the food look appetizing and are patients eating most of their meal?
  • Does the dining room and kitchen look clean and are cooks wearing hairnets?
  • Do the patients look well fed?
  • Are the rooms neatly arranged and individually decorated with personal possessions of patients?
  • Do staff members interact cheerfully with patients and each other?
  • Are patient call lights responded to quickly?
  • Does the facility overuse physical restraints (devices that tie patients to chairs or beds)?
  • Are staff members responsive to patient or family member needs and requests?
  • Are staff members visible?
  • Are patients treated with dignity and respect?
  • Does the linen look clean and not old and thin?
  • Is there an outdoors patio for patient and family use?
  • Is patient privacy protected during patient care and treatment (are room doors and privacy curtains used)?
  • Do staff members stop and knock on room doors prior to entering patient rooms?
  • Is the facility well lighted?

Listen 

  • Are call lights sounding for a long time before being answered?
  • Are patients calling out for help?
  • Is patient care and information being discussed within hearing range of others?
  • Is there an excess amount of noise in the facility caused by staff, intercom, etc.?

Smell 

  • Do patients smell clean?
  • Are there any strong odors in the facility?
  • Are rooms well ventilated and kept at a comfortable temperature?

Taste 

  • Ask to eat a meal and evaluate the quality and taste of the food.

Ask Staff 

  • What special services are available or provided by facility (transportation, beauty shop, store, etc.)?
  • Is there an active patient council? When and how often do they meet?
  • Is there an active family council? When and how often do they meet?
  • Do you like your work?
  • What do you like best about working here?
  • What do you like least about working here?
  • If you could improve or change one thing about this nursing home what would that be?
  • When do you use restraints?
  • How many patients do you directly care for?
  • Do you ever work short of staff?
  • Do you like to eat here?
  • How often are patients checked on in their rooms?
  • What happens when someone has a complaint or problem? Has is it handled?
  • Are snacks available if wanted by patients?

Ask Patients and Family Members 

  • What is the best thing about this nursing home?
  • What is the worst thing about this nursing home?
  • Are you glad you choose this nursing home?
  • Is the staff helpful and caring?
  • Does the staff meet your needs?
  • What happens when you voice a complaint or concern?
  • Do you attend patient / family council meetings?
  • Were you involved in choosing your own room and roommate?
  • Is the food good and do you get enough to eat?
  • Have you ever had missing possessions?
  • Does each shift have enough help?
  • Does the staff treat you with respect and dignity?
  • How often do they check on you when you’re in your room?
  • Does the staff provide needed assistance with toileting, bathing, dressing, and eating?
  • Do you attend and enjoy the activities provided in the nursing home?
  • Are you invited to care plan meetings?
  • Does the staff close the door and pull the privacy curtains when they provide care?

Do all of the above twice at different times in each nursing home. Try to go one time in the evening or on weekends.