Tips to Find a Quality Nursing Home for Your Loved One (2024)

En español |If you’re looking for a high-quality nursing home, the advice from experts is loud and clear: Do your homework. They advise future residents and their families to dive into government records and conduct their own facility inspections.

They also recommend not rushing to choose a facility. Many people, however, are discharged directly from hospitals to one of the nation’smore than 15,000 nursing homes, leaving little time for research.

There’s no question that nursing homesface serious challenges. Many are short-staffed, a problem that hasworsened in the wake of COVID-19. And even before the pandemic, studies found that many facilities wereriddled with serious infections.

Those and other issues were underscored in anApril 2022 reportfrom the National Academies of Sciences, Engineering and Medicine.

“The way in which the United States finances, delivers and regulates care in nursing home settings is ineffective, inefficient, fragmented and unsustainable,” Betty Ferrell, director of the Division of Nursing Research and Education at City of Hope medical center near Los Angeles and the chair of the committee that compiled the report, said in announcing its release.

That makes it all the more important for older adults and their families to avoid last-minute searches by getting to know facilities in their area in advance, say government agencies, industry groups and advocates for the aging.

Narrow your search

Fortunately, the days are long gone of having to visit state regulatory offices to rifle through paper files. Much of that research can be done online, thanks to digital libraries of ratings and inspection reports.

Medicare provides an online tool to help usersfind and comparenursing homes, hospitals and other care facilities in their area. It uses a five-star rating system and includes information about each ranked nursing home’s staffing quality measures, vaccination rates and inspection reports.

Other useful digital resources includeNursing Home Inspect, a project of the nonprofit investigative news outlet ProPublica that compiles more than 80,000 nursing home inspection reports into a searchable database, andNursingHome411, run by the nonprofit Long Term Care Community Coalition, which offers state-by-state data on facilities’ staffing, citations and ratings.

If a loved one is going straight to a nursing home from the hospital and you don’t have much time to choose, Richard Mollot, the coalition’s executive director, recommends limiting the selection to facilities with four- or five-star Medicare rankings. But he notes that Medicare’s tool has strengths and weaknesses for assessing individual nursing homes.

For example, “the staffing measure is by far the most important and useful indicator of a facility’s quality,” Mollot says. But due tothe way Medicare calculates the ratings, a nursing home can rank low for staffing but still get four or five stars overall.

Conversely, “you may have a one-star home, where staffing is five stars,” says Roy Herzbach, regional ombudsman director at Legal Aid of West Virginia. “The numbers can be faulty.”

Studies have shown nursing homes should provide at least 4.1 hours of nursing care per resident per day, including at least 45 minutes of attention from a registered nurse, says Charlene Harrington,a professor emeritus ofsocial behavioral sciences at the School of Nursing at the University of California, San Francisco, who has written extensively on nursing home staffing and finances. But more than a third of five-star nursing homes don’t meet that standard, she says.

Visit in person, look for clues

No online search can replace visiting homes, talking to administrators and staff, and observing firsthand how residents are cared for, experts say.

Talk to staff at all levels

Speak to a range of employees, from administrators to culinary directors and activity managers, advises Howard Braxton, vice president of marketing and sales for the Kendal Corporation, a system of nonprofit long-term care and retirement communities with a dozen facilities in nine states.

Look at residents’ grooming

“Listen in the hallways. Look at the hair, clothing, teeth and fingernails of the residents,” says Tony Chicotel, staff attorney at the San Francisco-based patient advocacy group California Advocates for Nursing Home Reform.

Check the menu

“Try the food,” Braxton says. “Check out the menu. Ask about variety of food. Ask to sit in the dining room so that you can try the food and gauge how staff and the residents interact.”

Ask about activities

See what the home offers in the way of lectures, art classes and other ways residents can stay intellectually active and engage with each other, says Jodi Eyigor, director of nursing home quality and policy at LeadingAge, a national association of nonprofit nursing homes and other providers of aging services.

Observe response times

“How long does it take for call lights to be responded to? Are residents standing in hallways waiting for medication?” asks Shannon Gimbel, manager of the ombudsman program for the Denver region’s Area Agency on Aging and one of hundreds ofadvocates nationwidewho canoffer guidance on nursing homes.

Beware the ‘chandelier effect’

Some people may be tempted to choose a nursing home because of fancy décor or because the price is higher than other facilities nearby.

“I don’t think you can trust the cost to decide if the care’s going to be better or worse,” says Alexa Schoeman, Texas deputy state ombudsman for long-term care.

Stay close to home if you can …

Focus on facilities located close to relatives and friends, as long as they are highly rated, experts say. That makes it more likely a resident will have frequent visitors — and employees will know those visitors are scrutinizing the care they’re providing.

… but widen the search if you must

The nursing home industry has lost 15 percent of its workforce since March 2020, according to federal figures. Many facilities have limited resident populations to maintain the quality of their care, says Holly Harmon, senior vice president at the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), a joint organization that represents nursing homes and assisted living facilities.

“This means that family members should be prepared to possibly expand their search to find a facility that is able to accept their loved ones, depending on their area,” Harmon says.

AARP,MedicareandAHCA/NCALoffer detailed checklists of questions to ask prospective nursing homes.

Pandemic priorities

COVID-19, which has devastated nursing home populations, introduced a new set of concerns and considerations for families seeking placements for loved ones. Here are some things to ask, and know, about what facilities are doing to reduce the spread of infection and disease.

Air quality:Check if your candidate facilities have invested in portable room cleaners equipped with high-efficiency particulate air (HEPA) filters. These have become popular as a proven way to reduce the spread of COVID-19 particles.

Infection control:Federal regulations mandate that nursing homes have an infection control and prevention program with written standards for issues such as how to identify infections and prevent spread to other residents or staff. The facility must have, at minimum, a part-time staffer trained in infection prevention; ask if there is anyone dedicated full-time to the issue.

Hygiene and mitigation:“Core practices” such as hand hygiene and use of personal protective equipment (PPE) are required, according to the AHCA/NCAL. Nursing homes may customize other infection control procedures based on local factors, such as COVID-19 spread in the surrounding community.

On your visit, look for how employees observe protective and preventive measures such as PPE use, and ask questions like:

  • Does the facility have a staff member dedicated full-time to infection control?
  • Does it regularly test staff and residents?
  • Are visitors required to take a test, or show proof of a recent negative test, to enter?
  • What happens when residents test positive? Are they moved into a dedicated COVID-19 unit or quarantined in their room?
  • How are residents and families notified when there’s a case on-site? Are their changes in activities, communal dining or visitor polices when that happens?

Infection control isn’t just a COVID concern. Well before the pandemic,nursing homes struggled with infection problems. Fully 82 percent of facilities surveyed by the Centers for Medicare & Medicaid Services (CMS) between 2013 and 2017 were cited for infection-control deficiencies, the U.S. General Accounting Office reported in 2020.

Influenza can spread rapidly within nursing homes, and more than 1 in 11 people older than 65 who contracted a health care–associatedinfection calledClostridioides difficiledied within a month of diagnosis, according to the U.S. Centers for Disease Control and Prevention (CDC).C. diffspreads by tiny spores left on bedside tables and other surfaces, making thorough cleaning essential.

Understand your payment options

Private-pay rates at nursing homes are typically expensive, and so are the amenities. The 2021 national median for monthly nursing home costs was $7,908 for a shared room and $9,034 for a private room, according to the2021 Cost of Care Surveyby insurance company Genworth.

Prices for care vary widely by state and region. For instance, a private room costs a monthly median of $12,775 in New York state, more than twice the median rate in Oklahoma.

Long-term care insurancemay pay some costs for nursing home residency, as does Medicaid,if you qualify.

Medicare, however, does not cover long-term residency in a nursing home. It mightpay some costsof short-term stays under specific, limited circumstances.

For example, a doctor might send your loved one to a skilled nursing facility for specialized care and rehabilitation after a hospital stay. If the patient had a stroke or serious injury, recovery could continue there.

In such instances, original Medicare can pay a portion of the cost for up to 100 days in a skilled nursing facility. But there are strict rules:

The patient must have received at least three consecutive days of inpatient hospital treatment. He or she must be admitted to the skilled nursing facility within 30 days of leaving the hospital. The skilled nursing care must be for the same illness or injury, or for a condition related to it.

Deborah Schoch is an independent journalist who spent 18 years at theLos Angeles Timesand helped found the Center for Health Reporting at USC. She is a board member with the Association of Health Care Journalists.

Learn More About Caregiving

  • How to handle nursing home problems and complaints as a caregiver
  • Medicaid coverage for nursing homes: Don't ‘spend down’ without a plan
  • Home health aides: When your loved one needs help with personal care
Tips to Find a Quality Nursing Home for Your Loved One (2024)

FAQs

Tips to Find a Quality Nursing Home for Your Loved One? ›

A great home offers a variety of activities, including music, entertainment, and faith-based services. Excellent Nutritious Food –Dining with friends in a pleasant atmosphere is an important social experience. The food should be high-quality, nutritious, freshly prepared, and customized for specialized diets.

What factors distinguish a good nursing home from a bad one? ›

To distinguish a good nursing home facility from bad one, there are many things you can review before selecting a place.
  • Background Checks. ...
  • Safety Alert Systems. ...
  • Caring For Residents Suffering From Alzheimer's Disease. ...
  • Administering Medicine. ...
  • Infection Prevention & Control. ...
  • Renovations & Floor Plans to Prevent Falls.
Aug 13, 2018

What questions to ask when touring a nursing home? ›

12 Questions to Ask a Nursing Home
  • What is the staff-to-resident ratio? ...
  • Is there a pattern of staff turnover? ...
  • How many hours a day do staff members spend with residents? ...
  • Are there any previous cases of elder abuse or neglect by nursing staff? ...
  • How do staff members interact with residents?

What makes a successful nursing home? ›

A great home offers a variety of activities, including music, entertainment, and faith-based services. Excellent Nutritious Food –Dining with friends in a pleasant atmosphere is an important social experience. The food should be high-quality, nutritious, freshly prepared, and customized for specialized diets.

When should someone go into a care home? ›

A care home may be the best option if you or someone you know:
  1. is struggling to live alone – even with help from friends, family or paid carers.
  2. had a needs assessment that suggested a care home is the best choice.
  3. has a complex medical condition that needs specialist attention during the day and night.

Who is most likely to need a nursing home? ›

Skilled nursing homes provide medical, health, and personal care, as well as supervision to people who need it. Nursing home residents generally have severe illness, disability, or cognitive impairment (problems with thinking, learning, or memory).

What are 5 disadvantages to living in a nursing home? ›

Here are some of the disadvantages of nursing homes for seniors.
  • Nursing homes are expensive. ...
  • Nursing homes can be depressing. ...
  • Loss of freedom and independence. ...
  • Proximity to family. ...
  • Potential for sub-quality care.
Jun 28, 2017

What are threats of a nursing home? ›

With the right security systems, long-term care facilities can provide occupants with the support they deserve and appropriately mitigate security threats.
  • Violence. Resident aggression is a serious concern. ...
  • Theft. Theft is the most common crime reported in nursing homes and assisted living centers. ...
  • Patient elopement.

Which of the following are common problems in nursing home patients? ›

14 Common Nursing Home Problems
  • Increased Costs. Nursing homes generally cost more than in-home care or assisted living facilities. ...
  • Smaller Living Arrangements. ...
  • Living Among Other Residents. ...
  • Fewer Chances to Go Out. ...
  • Boredom and Isolation. ...
  • Disregarding Preferences. ...
  • Less Say in the Care Plan. ...
  • Restricted Visiting Hours.
Jan 17, 2022

What do you talk about in a nursing home? ›

For example, you can ask about your loved one's favorite food, their most memorable vacation, what their hobbies are, their favorite season, their favorite movies and TV shows or what makes them happy. Asking an open-ended question can help to break the ice and start a conversation.

What does a nurse assess during a home visit? ›

Medical Conditions & Allergies: Understanding chronic or acute conditions, as well as recent hospital or skilled nursing facility stays, is important for our team to identify. We also assess hearing, speech, vision, and swallowing. Known allergies are also included in our assessment.

What should I ask in a care plan meeting? ›

Questions to Ask at a Senior Rehab Patient Care Conference
  • What types of therapy does my parent need?
  • What are your COVID-19 Protocols?
  • What is their rehab schedule going to look like?
  • What will they be doing when they aren't in therapy?
  • How are medications handled?
May 24, 2023

Who pays for most nursing home care? ›

Who pays for nursing home care? The most common payment methods for nursing homes include government health care programs like Medicare and Medicaid, private pay options such as savings and retirement funds, and individual insurance plans.

Who makes the most money in a nursing home? ›

While each nursing home has a unique leadership structure, the director or chief executive of nursing is usually the person ultimately responsible for everything that goes on inside a nursing home. In the majority of cases, the director of nursing is the highest-paid position in nursing homes.

How do nurses make money from home? ›

Today, there are many ways nurses can work from home.
  • Telehealth Nurse. Telehealth is becoming much more popular today and can easily be a full-time career. ...
  • Medical Surveys. ...
  • Nurse Blogger or Health Writer. ...
  • Medical Transcription. ...
  • CPR Instructor. ...
  • First Aid Instructor. ...
  • Teach or Tutor Nursing Students Online. ...
  • Health Coach.
Mar 20, 2023

How do you know when it's time for long term care? ›

People often need long-term care when they have a serious, ongoing health condition or disability. The need for long-term care can arise suddenly, such as after a heart attack or stroke. Most often, however, it develops gradually, as people get older and frailer or as an illness or disability gets worse.

What is the average life expectancy in a care home? ›

Main points. Life expectancy for care home residents between 2021 and 2022 ranged from 7.0 years at age group 65 to 69 years, to 2.9 years at age 90 years and over for females, and from 6.3 years at age group 65 to 69 years, to 2.2 years at age 90 years and over for males.

Is it better for someone with dementia to be in a home? ›

For seniors diagnosed with Alzheimer's, living at home is often ideal because it provides them with benefits, like: Comfortability with their surroundings. Higher level of trust in caregivers.

How long do most people live in a nursing home? ›

Once in a nursing home, about half of residents stay for at least a year, while 21 percent live there for almost five years, according to the Health in Aging Foundation.

What age do most people go to nursing home? ›

Resident age groups by percentage

According to their national study of long-term care providers: 38.6% of nursing home residents are older than 85. 26.7% of residents are between 75 and 84. 18.2% of residents are between 65 and 74.

What are the odds of ending up in a nursing home? ›

Misconception No. 1: Very few people end up using long-term care. This study by researchers from the National Bureau of Economic Research estimates that a 50-year-old has a 53 to 59% chance of entering a nursing home during his or her lifetime.

Why should seniors live in nursing homes? ›

Advantages of Nursing Homes for the Elderly

Loved ones can get assistance with daily tasks, including things like dressing, bathing, eating, housekeeping, meal service, and so forth. Nursing homes can also provide around-the-clock attention for those who need a chronic condition monitored.

What are the disadvantages of home care for the elderly? ›

Cons of Home Care

Increased Stress – Although many seniors feel most comfortable at home, the outside influences can be straining. They may feel as though they are losing their independence. Less Structure – While home care allows for patients to remain independent, it does not have the structure of a facility.

What is the advantages of a long term care facility? ›

Trained, medical professionals will tend to minor injuries, major injuries, and assist with the administration of prescriptions. Most importantly, long term care facilities offer emergency medical services–some even have 24-hour monitoring services so you or your loved-one will never be stranded in need.

What is an example of a conflict in a nursing home? ›

Examples include taking or touching a resident's belongings or food, or unwanted entries into their bedroom or bathroom. The most prevalent triggering event was someone being too close to a resident's body.

What is patient exploitation? ›

• Definition: taking advantage of a resident for personal gain through the use of. manipulation, intimidation, threats, or coercion.

What factors contribute to unsafe conditions for patients in the nursing home setting? ›

Unsafe Environmental Conditions

Environmental nursing home risks such as poor lighting, wet floors, improperly maintained or fitted wheelchairs, and incorrect bed height may contribute to falls.

What is the biggest complaint in nursing homes? ›

The most common complaint in most nursing homes is the unresponsiveness of staff members. Whether staff take an unreasonably long time to respond or fail to respond at all, many residents feel that their calls for help or assistance are not prioritized.

What factors would indicate poor quality of care? ›

Here are what he and other experts consider especially serious red flags:
  • Marked emotional or physical changes. ...
  • Unanswered or deflected questions. ...
  • Frantic, discordant, or inadequate staff. ...
  • High staff turnover.
Feb 26, 2013

What are the five nursing problems? ›

The five stages of the nursing process are assessment, diagnosing, planning, implementation, and evaluation. All steps in the nursing process require critical thinking by the nurse.

How do I tell my mom it's time for a nursing home? ›

Express the concerns you have about being able to provide good care, reminding your parent that you want him or her to be as safe, comfortable, and happy as possible. Use any falls or accidents as examples of the need for added care. Talk about the challenges you and your siblings face.

How do I move my mother to assisted living against her will? ›

The only way you can legally force your aging dad or mom to move to assisted living against their will is to obtain guardianship (sometimes called conservatorship). By obtaining legal guardianship, you can place your loved one in an assisted living community even if it's not their personal will to do so.

What is one to one communication in a nursing home? ›

One to one communication are simple interactions between only two people, it can either be someone you know well or someone who you don't particularly know. If it is someone that you don't particularly know it is important to create a positive atmosphere before you deliver information.

What is bag technique? ›

Definition. Bag technique-a tool making use of public health bag through which the nurse, during his/her home visit, can perform nursing procedures with ease and deftness, saving time and effort with the end in view of rendering effective nursing care.

What is the first step in a home visit? ›

Greet the patient and introduce yourself. Observe the patient and determine the health needs. Put the bag in a convenient place and then proceed to perform the bag technique. Perform the nursing care needed and give health teachings.

What is the most crucial aspect of the first visit to a new client? ›

The first impression can be the most important, but especially when meeting a prospective client for the first time. People tend to form their opinions about others based on all sorts of non-verbal cues.

What does a good care plan look like? ›

Every care plan should include:

A discussion around health and well being goals and aspirations. A discussion about information needs. A discussion about self care and support for self care. Any relevant medical information such as test results, summary of diagnosis, medication details and clinical notes.

What questions to ask when considering a nursing home? ›

Six Questions You Should Ask Before Choosing a Nursing Home
  • What is the turnover rate for nurse's aides? ...
  • Does the patient's doctor serve the facility? ...
  • What is the status of the facility's recreation and social services? ...
  • What is the reputation of the nursing staff? ...
  • Is the facility accredited? ...
  • How is the environment?
Jul 5, 2022

Can patients choose their nurse? ›

Patients don't have a legal right to select their nurse. However, they do have a right under a "Patient's Bill of Rights," often posted by a facility or health plan, to safe care; to be treated without consideration of race, gender, sexual orientation, and religion; and to have their complaints addressed promptly.

What is in nursing? ›

Nursing is a well-respected medical profession that includes several duties and specialties. In general, nurses provide patient care and triage or specialize in certain areas of medicine. Nursing includes health promotion, illness prevention and the care of ill, disabled and dying people.

What is the nurse golden rule? ›

Our day-to-day routines as nurses at the hospital can be scary, significant, life-changing events for patients. We need to remember and implement the Golden Rule-treat each patient as we would like to be treated-by taking a moment to ask, "How are you feeling?" and then listen well.

What is considered an unsafe nursing assignment? ›

Some of the more common examples of unsafe assignments can involve (1) not receiving any type of orientation to the unit; (2) a discrepancy between the patient's needs and the nurse's skill set; (3) an inappropriate number of patients assigned to one nurse, with respect to patient acuity; and/or (4) a critical lack of ...

Can a nurse sleep with a patient? ›

Given the nature of the nurse practitioner-patient relationship, crossing professional boundaries can lead to some sticky interpersonal, not to mention legal, situations. Taking a relationship with a patient outside of the professional realm can be considered sexual misconduct and carry some serious consequences.

What are the 4 A's in nursing? ›

As a systematic process for change, this article offers the AACN's Model to Rise Above Moral Distress, describing four A's: ask, affirm, assess, and act. To help critical care nurses working to address moral distress, the article identifies 11 action steps they can take to develop an ethical practice environment.

Which type of nursing is best? ›

The top 4 highest paying nursing jobs
  • Legal nurse consultant. ...
  • Forensic nurse consultant. ...
  • Public health nurse. ...
  • Occupational nurse. ...
  • Medical writer. ...
  • Physical therapist. ...
  • Psychiatric nurse practitioner. ...
  • Medical or pharmaceutical sales.

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