Questions to Ask When Choosing Nursing Homes

When it comes time to choose a nursing home for you or a loved one, it can be difficult to know where to start. The sheer number of options available can be overwhelming and the process of narrowing them down can seem daunting. But with the right questions in hand, you can make an informed decision that is best for your or your loved one's particular needs.

What should you ask when choosing a nursing home? Here are 15 key questions to get you started:

1. Is There a Doctor to Serve the Facility?

Finding out if there is a doctor on staff or available to serve the facility should be near the top of your list when choosing a nursing home. Not only does this ensure that your loved one will receive appropriate medical care when needed, but also guarantee that any medications they may need are dispensed properly by someone who knows their history and current health condition.

2. What Are Your Care Plan Options?

It is important to know what kinds of care plans^[1] are offered by the nursing home. Do they provide short-term options for elders who may need some rehabilitation or recovery services before returning home, or are they only capable of providing long-term care plans? Knowing this ahead of time can help you plan and budget accordingly.

The nursing home staff understands that every patient is different and will work with you to develop a care plan tailored specifically for your needs. If you are unable, your family or someone acting on your behalf have the right to be part of the decision-making process when it comes to your care plan.

Depending on what you need, your care plan may include the following:

• The type of personal or health care services you need
• The category of staff or personnel who will provide assistance
• Frequency requirement for the services you need
• Accessories and equipment you might need like a wheelchair or feeding tube
• Your diet if special attention is needed and your food preferences in general
• How your care plan will guide you in accomplishing your goals
• Information about whether you're returning to the community and a plan to help you with that goal

The federal government requires nursing homes to submit their residents' care plans as this information affects quality measures, nursing home payment, and state inspections.

3. Average Staffing Ratios

It's important to know if the facility is staffed by enough people to provide each resident with quality care. Ask the nursing home what their average staffing ratios are, and how often they have additional staff on hand during holidays or special events. This could also be a good opportunity to find out more about the qualifications and experience of the staff, too.

4. Staff Turnover Rate

To get a better sense of how well the staff works together, ask the nursing home about their staff turnover rate, as it is an important indicator of quality. A high turnover rate may indicate that there are issues with management or the atmosphere at the facility.

5. What Are the Recent Inspection Results of Your Nursing Home?

Inspections are an important part of the nursing home evaluation process. Ask for copies of any recent inspection results so that you can get a better sense of how the facility is run and managed. The findings from inspections by state agencies^[2] give you an indication of how well the facility is abiding by certain regulations and standards.

Nursing homes are federally mandated to have regular inspections, the findings of which are available to the public. Request to see these reports and take note of any infection control issues present. This is always a significant concern in nursing homes, but especially during the Covid pandemic. If it appears that infection control is not up to par, you should look elsewhere for care.

6. Staff Training

Find out what kind of training programs the nursing home provides to its staff, and how often they have refresher courses or other ongoing education. Knowing that the staff are regularly trained in best practices can help put you at ease. It also helps to make sure that each resident is getting adequate and appropriate care on a consistent basis.

7. How Many Hours a Day Do the Staff Spend Time with Residents?

. Ask about the staff's daily schedule and find out how many hours a day are spent caring for each resident. How often are residents unsupervised for long periods; and how frequently do staff members check up on them?

This can give you an indication of the quality of care that you or your loved one will receive. It's also important to make sure there is enough supervision during meal times, to ensure that residents are not eating alone or without assistance.

8. Is There Ever a Case of Elder Abuse?

You should never be afraid to ask about elder abuse. It's important to know that the nursing home staff is taking all precautions to protect residents from any kind of abuse or neglect. Ask if there have ever been any reported cases of elder abuse, and how they were handled. The nursing home should have a strict policy in place to prevent such occurrences.

9. Specialized Services, Resources, and Equipment Available

When considering a nursing home for your loved one, you should make sure that the staff will be able to provide care tailored to your specific health needs. Examples of such services include preventative care, physical rehabilitation, dementia-specific treatment, counseling sessions, and more.

Find out if the nursing home has access to specialized medical equipment and resources such as physical therapy machines, oxygen tanks, or any other necessary services. This is especially important if your loved one has specific health needs that require special attention. If the nursing home does not offer the services you require, it may be best to look elsewhere.

10. Are There Recreational or Social Services Available?

It's important for nursing home residents to have access to recreational and social activities. Find out what kind of services the nursing home provides in terms of physical, emotional, and mental activities that can help keep you or your loved one healthy and stimulated. Ask about any volunteer programs or visits from family members that are available at the facility, as well as any trips or outings.

Recreational activities that are common in nursing homes include:

• Exercise classes
• Art or music therapy
• Movie nights
• Field trips and outings

Social activities such as discussion groups, card games, and group outings can help your loved one stay socially connected with other residents at the facility. This can be a great way to maintain mental stimulation and combat loneliness.

11. Is the Facility Accredited?

The Joint Commission^[3], formerly known as the Joint Commission on Accreditation of Hospitals (JCOAH) is an independent organization that accredits hospitals, nursing homes, and other healthcare facilities. The Joint Commission strives to improve safety and quality in healthcare by supporting outside organizations that wish to do the same. They hope to empower these groups and help them enact change within the healthcare industry as a whole.

To be accredited, your organization must successfully pass an on-site survey. The survey is conducted by a team of trained surveyors from The Joint Commission who will evaluate compliance with their standards.

To assess compliance, surveyors speak with randomly selected patients, doctors, nurses, and staff, observe interactions between staff and patients and review medical records. All regular Joint Commission accreditation surveys are unannounced and accreditation is generally given for three years at a time.

12. What Is the Visitation Policy?

Nursing homes usually have a set policy for visits, whether it's before or after admission. If visiting hours are limited or not an option, you can ask to video chat instead. Be sure to ask about the facility's rules for visitors and if there are any restrictions. Some nursing homes may allow visitors at any time, while others may have designated times or days when visitors can come in.

If you'll be given a chance to visit the facility before admission, take note of the following things:

• The cleanliness of the facility and its grounds.
• The attitude of the staff towards visitors and residents.
• Whether there is enough space for all the residents in the nursing home.
• If any amenities, such as a library or salon, are available to residents.
• If you notice a strong odor of urine, this may mean that the staff is not tending to a resident's incontinence properly.
• Request to see the rehabilitation room; this will give you an idea of how well patients are being cared for.
• Inquire about the activities schedule; if there are few activities scheduled, it could be an indication of poor care.

13. How Are Complaints Being Handled?

Nursing homes should have a system in place to handle any complaints that come up. Before admitting your loved one, ask about their grievance procedure and what steps are taken when a complaint is made. Find out if the facility has an advocate to help with any issues that may arise.

It's important to ensure that there are clear channels of communication between the administrator and staff, as well as the residents and their families. You should also ask if there have been any complaints made in the past, and how they were resolved. An effective grievance system is vital to ensure that all issues are quickly addressed and solved to the satisfaction of both residents and their families.

14. What Is the Facility's Security Like?

The safety and security of nursing home residents should also be a top priority. Ask about the facility's measures for ensuring the security of its residents, such as door locks, alarms, and cameras if applicable. Find out if there are any particular protocols in place for visitors entering the premises - such as the need for a visitor's pass or other forms of identification.

If your loved one will require any additional security measures, discuss these with the staff beforehand so that you can be sure they are met. Anything from medical alerts to bed alarms should be discussed prior to admission. The facility should also have a robust emergency response plan in place, so make sure to ask for details about this as well.

15. What Are the Privacy Policies?

Finally, your loved one's right to privacy should be respected at all times, regardless of the facility they are in. Ask about the confidentiality and privacy policies that the nursing home has in place to protect residents' information. This includes information such as medical records, financial details, and contact information. Find out if the facility adheres to HIPAA (Health Insurance Portability and Accountability Act)^[4] regulations, and ask how they handle data security enforcement.