How to Evaluate a Nursing Home

A skilled nursing facility or nursing home cares for the elderly and others with disabilities who require 24-hour skilled nursing attention.

Instructions

Difficulty: Moderately Challenging

1. Understand that skilled nursing facilities are either stand-alone or part of a continuing care retirement community (CCRC).
2. Does the facility have specific services to match your needs? Services could include wound management for seniors who have bedsores or a specialized unit for those suffering from Alzheimer's disease and dementia.
3. Compare staff numbers with other skilled nursing facilities and look at the number on each shift for the weekend and weekdays. Also, a facility should monitor its staffing ratios daily, with the ability to increase staff should it receive patients who require special attention.
4. Ask if the facility does national criminal background checks on staff. Some do local or state background checks only. Also, what type of pre-employment drug screening does it do, and is drug screening ongoing?
5. See what type of initial and ongoing training a facility does with its staff. Ask to see staff training manuals.
6. Observe the upkeep and safety of the facility. Are there hand rails or grab rails in the bathing areas and hallways? Are the sprinkler systems and fire extinguishers easily accessible? Are there plenty of secured walking areas inside and out?
7. Find out how the facility handles people who can't feed themselves. Does the staff make every effort to feed seniors out of bed? Also, does the facility accommodate special dietary needs, such as preparing pureed foods?
8. Look at the range of activities. Does the facility offer on-site activities such as religious services, lectures, discussion groups, and arts and crafts classes?
9. Ask how the facility handles physical rehabilitation needs with patients who have memory impairment and cannot follow directions. Does the staff make an extra effort to work with these seniors?
10. Look at online directories of senior care (assisted living and nursing) facilities such as Senior Care Review, CareGuide(888-389-8839), New Lifestyles (800-820-3013) and Senior Alternatives(800-350-0770) for senior facilities.

Tips & Warnings

• Medicare may pay 100 percent of the first 20 days a person stays in a nursing home and then a portion of the next 80 days. After that the person must pay out of pocket for skilled nursing care.
• Medicaid (Medi-Cal in California) does cover skilled nursing facilities for those who are eligible. In some states it may also cover assisted living facilities.
• Make sure you check the Alzheimer's unit at a skilled nursing facility. Most will say they have an Alzheimer's unit, but when you go to evaluate the facility, you may find that the Alzheimer's patients are really housed with the other seniors.