October 12th, 2011 by Ken Coughlin

Choosing a nursing home for a family member can be one of the most difficult decisions anyone ever has to make. The fact that the family member needs to move to a nursing home means that he or she is in a vulnerable state and will be dependent on the care provided in the facility. Following are 44 questions (we counted them so you don’t have to!) that should help a family choose the best facility in an unfortunate situation:

• Is the facility certified by Medicare and Medicaid? How long has it been certified?
• Does the facility have an Alzheimer’s unit or other special care area restricted to patients with special care needs? Is the specialty unit separated from other areas of the facility?
• How convenient is the location to family members and friends? What are visiting hours? Location is important, because it can affect how often the patient is visited by family and friends. Frequent visits generally will improve the patient’s mental and emotional well being, as well as ensure that quality-of-care issues can be addressed as problems arise.
• Is the facility well lit, clean, safe, and welcoming? What diagnostic treatment facilities are available at the facility? What bathing facilities are available and how is bathing handled when the person needs assistance?
• What is the ratio of staff to residents during each shift?
• What kind of activities are planned each day for the residents? A good activities program should have regularly scheduled events, such as a weekly movie or musical event (even if it is just a “sing along” ), religious services, physical exercise activities (exercise classes or even dancing), bingo, educational classes, and other social events. Is there a library available for residents with large print and audio books? Is there a small for “store” for purchasing personal items, such as shaving cream, hair care products, and snacks? Is there a safe place for residents to enjoy outdoor areas, such as an enclosed garden? Are plants, pets, and other natural elements added to the residents’ environment? Are residents taken to special community events and cultural activities?
• Will the resident share a room and/or a bathroom with one or more other residents? How are roommates and rooms selected? If the resident is dissatisfied, can roommates be changed and how is that accomplished? Can the resident bring some of his or her own furniture?
• Individual care plans must be implemented with each resident. How often is the care plan reviewed and changed? What is the protocol for handling problems?
• How are employees selected? How are employees screened for drug use, criminal records, and other potential problems? What is the turnover rate for skilled employees? What is the turnover rate for employees who perform ancillary services, such as meal preparation and financial record keeping?
• If there is a physician that is used by the majority of residents, what are his or her qualifications? How often is the doctor on premises? What is his or her bedside manner with residents?
• Are meals served in a communal dining room or is each resident brought her meal in her room? If communal, how are tables assigned in the dining room? How long does it take for a meal to be delivered to a bedridden resident? How does the food taste and how is it presented to the resident? Is there a means of heating food that has become cold?
• What financial information will the facility require during the admissions process? Can the patient or his representative have copies in advance of all admissions documents and contracts for review? How long does the process take?
• What is included in the cost of care? How are “extra” items billed? Can laundry be taken off-premises and does this save the resident some costs? How are prescription drugs handled? What is the cost difference between a private room and a semi-private room?
• If required non-emergency medical services are not available on premises (such as dialysis), how is transportation arranged? What about transportation to other places, such as local stores and religious services?
• To compare nursing homes in your area, visit Medicare’s Nursing Home Compare site. For more help with the nursing home decision, click here