Things You'll Need:
- Patience
- Time
- writing tab
- pen
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Step 1
Locate the nursing facilities within your comfort zone for visiting purposes. You will be there often.
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Step 2
Visit each Facility at least twice various times. The busiest times are during the meal periods, am care (7 am to about 11 am), pm care( 6:30 pm to about 9:30 pm), during the change of shift (most change at 7 am, 3 pm and 11 pm)and on weekends.
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Step 3
Questions to ask:
How will Dental exams be handled?
How will Opthalmology exams handled?
How will Hearing exams handled?
How will transportation to appointments handled? and will there be an escort if "you" or another family member can not go along? Escort meaning a driver an a Nursing assistance if your loved are unable to ambulate.
Keep in mind that only direct care staff may take patients to the bathroom ie nursing assistance, LPN or RN. That does NOT include dietary worker, Social Service, unlicensed management, custodial service and activities. Physical, Occupational and Speech Therapist can tend to your loved ones. -
Step 4
Check the past survey results. Posted and available for anyone to view. (They just don't tell you) It is usually kept in the lobby in a binder.
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Step 5
Now here comes the hard part find out what is the direct care staffing. Meaning, how many nurses per patients and how many nursing assistants per patients on each floor and on each shift.
A respectable staffing ratio are:
Nurse not more the 20-25 patient day and evening shift.
Nursing assistant not more then 8-10 during the day shift and 10-16 on the evening shift.
For example a ward of 50 patients on day shift should have 3 LPN/RN and a Charge RN. Also, should have 5-6 Certified Nursing assistance on the floor (not on trips). -
Step 6
Next check the environment.
There should not be any more then 2 patients to a room.
How far is the room from the nursing station? Will someone notice/hear your loved one calling for help if they can't get to the call bell?
Are there enough room for a bed, chair, W/C, bedside commode (if needed) and over the bed table to prevent clutter thus preventing falls
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Are there enough electrical sockets to accommodate the bed, oxygen, IV Pump and a nebulizer if needed without using surge protectors or extension cords (these are against safety regulations).
Is there enough space for clothing and personal effects.
How is laundry handled? If you are going to do the laundry for your loved ones, is there room for the hamper? Who marks the clothes?
Is there a phone in the room? Patients are suppose to be able to make a phone call in private. If there is no phone then where? It's a little hard to make a private call at the Nurse's Station. -
Step 7
All nursing facilities are not allowed to use restraints. No side rails on the bed! Yes, I know, I don't agree with not having side rails. So you need to check/ask how they will protect your loved ones from falling out of bed or at least minimize injuries from falls.
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Step 8
Now within a month the nursing facility should have assessment and care plan written out and "Team Meeting" held with "YOU"! The Care plan should have the problem stated, what they are going to do about the problem and who is responsible. The important things about this, is that you should have a "Team Meeting" within a month and every three months thereafter. Government regulation states annually and quarterly team meeting are to be held.
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Step 9
Also, nursing homes are to keep you informed of any changes your loved ones care. Nurses should be calling for any injuries, accidents, abnormal labs and any change in medication.
Comments
handiedan said
on 7/31/2009 As a retired RN who spent 30 years in ER and supervised nursing homes for 5 years, I appreciate your article.