There are few decisions as difficult or important as deciding on a nursing home for your loved one. How can you know if you’re making the right choice? Will your loved one be well cared for and will the home be the most affordable option? If you ask around, you will most likely hear recommendations both for and against each of the nearby facilities. Other people’s opinions are very subjective, and because everyone’s situation is unique, these experiences may not be relevant to you at all. So, how can you determine which home is right for your loved one?
First, it’s important to know when it’s appropriate to be considering a skilled nursing home for your loved one. There are three reasons why a person needs to move to a nursing home for long-term care:
- Skilled nursing. Your loved one has a care need that requires skilled nursing services twenty-four hours per day. There are many options for people who need assistance or supervision around the clock, but only a nursing home can accommodate someone who truly needs a registered nurse at all times.
- Finances. Your loved one cannot afford the care required. While there are some Medicaid (known in Massachusetts as MassHealth) programs designed to help people stay at home for as long as possible, if someone needs more care than they can afford, they may qualify for MassHealth Standard. If qualified, the nursing home costs would be covered. For more information about this visit: https://www.mass.gov/masshealth-for-seniors-and-people-who-need-long-term-care-services.
- Personal preference. While there are options for care at home or in an assisted living community, some people feel safer in a more clinical setting with around-the-clock skilled nursing care.
Once you have determined that a nursing home is the right choice for your loved one, we recommend starting your search with Medicare’s Nursing Home Compare website: https://www.medicare.gov/nursinghomecompare/search.html. According to the website, the information on Nursing Home Compare can help you learn:
- How nursing homes have performed on health and fire safety inspections.
- How the nursing homes are staffed with nurses and other healthcare providers.
- How well nursing homes care for their residents.
When you pull up the website, first enter the zip code for the area you want to search. This will display all of the nursing homes within a 25-mile radius from the center of that zip code. You can evaluate each facility individually or up to three at a time using the “Compare 3” tool. You will see that these facilities are rated through the department of public health by a star rating system, ranked one through five. The overall star rating is a number is calculated through an average of their health inspection scores over the last three surveys, resident health quality indicators, RN staffing levels, and over all staffing levels.
While all of the information on this website is useful, it can be overwhelming. Our clients have found a few key areas that are most beneficial: health inspections, staffing, and quality of care.
Health Inspections: The “health inspections” tab includes information about a nursing home’s health inspections, complaints filed, and any resulting citations. Inspectors evaluate all nursing homes that are certified by Medicare and Medicaid annually. You will be able to see the total number of health citations for any given facility. As of April 2018, the average number of citations in Massachusetts is 5.6 and for the United States is 7.4. Find and click on the link that says: View all health inspection, complaint, and facility-reported issue details. Here, you will be able to see what deficiencies a facility has received. These deficiencies provide useful information for you to discuss when you meet with the administrator. You should be able to ask specifically about any deficiency and the corrective measures the facility has taken, providing you with information you can use to question the facility in order to get a sense of how well they have resolved the issues in question.
Staffing: This tab contains information on registered nurses (RN), licensed practical/vocational nurses (LPN/LVN), certified nursing assistants (CNA), and physical therapists (PT). Physical therapists are not included in the “staffing” star rating. We all want quality attention given to our loved ones, so while all of the staffing positions in a facility are very important, we suggest paying particular attention to the CNA hours per resident, per day. CNAs are primarily responsible for providing personal care. There can be quite a difference among facilities regarding the amount of time each resident receives personal care per day. As of April 2018, the average in Massachusetts is two hours and twenty minutes, but there are some offering only one hour and forty minutes while others provide three hours and twenty-two minutes.
Quality of Resident Care: This is a big concern for anyone seeking a first-rate nursing home. Open this tab and scroll down until you find the section for long-stay residents. Here you will find useful information such as:
- Percentage of long-stay residents experiencing one or more falls with major injury. The Massachusetts average is currently 4-percent.
- Percentage of long-stay, high-risk residents with pressure ulcers. The Massachusetts average is currently 5-percent.
- Percentage of long-stay residents who received an antipsychotic medication. The Massachusetts average is currently 0-percent.
We recommend spending some time on this website to create a short list of facilities worth investigating within your preferred location. Schedule a visit to meet with the admissions director who can give you a tour. Armed with the criteria from this website and your impressions of the facility from your visit, you can feel confident in making an informed decision, providing your loved one with the best and most caring environment for their needs.