long term care facility

Whether it is for ourselves, a parent, or another loved one, we would all rather avoid thinking about a long-term care facility. But all the health care experts will tell you: “Do your homework and do it before the need is urgent.” There is a lot to think about when choosing the right nursing home, but fortunately there are a lot of resources to help you, too. Here are some steps you can follow to make the process a bit easier.

Narrow the Search. According to the Centers for Disease Control and Prevention (CDC), there are about 15,600 nursing homes in the United States. Nebraska has 195 and Iowa has 431. That is a lot of facilities to review. Fortunately, you can winnow down the list by starting with online research. Medicare.gov can help you find and compare nursing homes in your area. According to Medicare its online tool allows you to “[p]ersonalize results by filtering the options that matter most to you”—including inspection results, location, number of beds, vaccination rates, staffing levels and more. It uses a five-star rating system. Some experts in the long-term care field recommend limiting your selections to only facilities with four- or five-star Medicare rankings, especially if circumstances dictate that you have to make a quick decision. AARP.com suggests another useful digital resource, Nursing Home Inspect, a project of the nonprofit investigative news outlet ProPublica.org that compiles more than 80,000 nursing home inspection reports into a searchable database.

Inspect Your Nursing Home Choices in Person. This, as you would expect, is the most important step. Talk to administrators, staff members at all levels, and especially residents for their opinions on the quality of care at the home. Medicare has a handy and detailed form to take with you to each facility you visit: The Nursing Home Checklist. You can download it at medicare.gov. (Use the search box for Nursing Home Checklist and you will find a link in the article Visit Potential Nursing Homes.) This is will be a big help after you have visited more than one facility and are trying to recall what you learned at each place.

Don’t be misled by what some call the “Chandelier Effect”. A dazzling décor in the home can mislead potential clients about the actual quality of the care for the residents. Don’t let the cost sway your decision, either. The most expensive homes are not necessarily the best. While you are touring a facility take careful note of the grooming of the residents—the condition of their hair, teeth, and clothing will tell you a lot about the care they are receiving. Check the menus and ask to try the food yourself. A good facility should be open to you eating in the dining room with the residents.

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”, suggests Jodi Eyigor, director of nursing home quality and policy at LeadingAge, a national association of nonprofit nursing homes and other providers of aging services.

Go to a resident or family group meeting. Medicare.gov suggests that “[w]hile you’re visiting the nursing home, we recommend that you ask if you can attend a resident or family group meeting. These groups are usually organized and managed by the residents or the residents’ families to address concerns and improve the quality of care and life for the resident. If you’re able to go to a meeting, ask a group member these questions:

  • What improvements were made to the quality of life for residents in the last year?
  • What are the plans for future improvements?
  • How has the nursing home responded to recommendations for improvement?
  • How are decisions made (for example, by voting, consensus, or one person makes them)?”

Learn how the nursing homes on your short list manage infection control and prevention. Since the COVID-19 pandemic we have all become more attuned to measures to prevent the spread of disease, but disease mitigation has always been a matter of concern to vulnerable populations in long-term care facilities. Under federal regulations, nursing homes must have an infection control and prevention program with, at a minimum, a part-time staff member trained in infection prevention, but it is even better if the nursing home has a full-time person dedicated to preventing the spread of disease in a facility.


Timothy J. Cuddigan
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Omaha Social Security and Veterans Disability Lawyer With Over 40 Years Experience
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