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- Where to Begin
- Facility
Visits: A Checklist
Like Their Patients, Every Nursing Home
is Unique
Making
the decision to enter a nursing home is never easy, and once it’s
made comes yet another difficult task – the task of choosing the
right facility. While the process of selecting a nursing home may
seem overwhelming at first, it helps to remember that all facilities
share the common goal of providing quality, round-the-clock patient
care in an environment as homelike as possible. Beyond that, every
nursing home has certain areas of expertise, offers certain special
services and may be better suited to a certain type of clientele. In
other words, specific factors, such as payment method, location and
availability of special care units, will make one nursing home
better suited to a patient than another.
For
instance, if the patient is eligible for Medicare or Medicaid, the
selected nursing home must participate in the program through which
the patient is receiving assistance. Most Tennessee nursing homes
accept Medicare patients, but, due to strict medical qualifications,
just 15 percent of nursing home patients receive Medicare coverage
to pay for their nursing home stays. Almost 90 percent of Tennessee
nursing facilities participate in the Medicaid program, and the
majority of Tennessee nursing home patients, approximately 68
percent, receive care that is paid for by Medicaid.
Location may be the most often-cited factor that influences facility
selection. Nursing home patients and their families often prefer a
facility that is close to the family’s home or hometown. Location
can be a key factor in a facility’s atmosphere, and the lifestyle of
the community in which the facility is located – urban, suburban or
rural – usually is reflected in the lifestyle of the facility.
Another
consideration is the special services or features of a facility. The
development of special care units to better treat certain
disabilities is a growing trend in nursing homes. Facilities may
have specialized units to care for patients with certain injuries or
illnesses, such as Alzheimer’s disease, or offer special therapy
programs or treatment not available at other facilities.
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Where to Begin
The
first step in the selection process is to seek referrals. Valuable
information can be gained by talking with long-term care
professionals, hospital discharge planners and social workers, your
family physician, and friends or acquaintances who may have
first-hand knowledge about choosing a facility. The information you
obtain from these sources will help clarify the issues and focus
your perspective.
And
remember, nursing home placement can be tremendously stressful for
both the person needing care and the family. Seek agreement by
involving the patient and family members in decision-making issues
of facility selection. This not only will help relieve immediate
concerns but also ease the transition into the chosen nursing home.
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Facility Visits: A
Checklist
The
best way to determine the appropriate match of nursing home services
and patient needs is through facility visits. Facilities may be
screened by calling and asking questions, thus saving time and
effort. However, it’s a good idea to plan personal visits to at
least three facilities, involving as many family members as
possible.
All
facilities offer tours to prospective patients and their families.
Some help visitors experience what the facility has to offer by
allowing them to sit in on activity programs or other events.
Ideally, you should visit each nursing home more than once to
observe activities throughout the day. At least one visit should
include a mealtime, which allows you to sample the food and see the
patients in a social setting.
Although the initial visit should be arranged with the administrator
so that you may ask specific questions of staff, management and
volunteers, follow up visits can be unscheduled. During each visit,
evaluate interaction between patients and their caregivers. If
possible, meet with the facility’s family council, or if no council
exists ask to speak with family members of other patients.
The
selection of a nursing facility is a crucial decision. All questions
should be answered and any doubts resolved before making a final
choice. Following is a checklist of suggested inquiries that can
help you conduct effective and successful facility visits.
Licensure
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Does the facility hold a current license from the state? |
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Does
the administrator hold a current license from the state? |
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If the answer to either of these is "no," find
another nursing home. The nursing home you are dealing with
could be some other type of facility falsely claiming to be a
nursing home. |
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Ask the administrator to describe the facility’s most recent
survey (state/federal inspection). |
Location
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Is
the patient happy with the location? |
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Will
family and friends be able to make frequent visits? |
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Does
the patient’s personal physician make visits to the
facility? |
Facility
Appearance and Design
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Is
the entire facility clean enough to satisfy your personal
standards? |
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Is
it free of unpleasant odors? |
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Are
hallways and rooms free from hazardous objects? |
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Does
the facility meet the safety standards required for nursing
homes? |
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Do
you feel welcome when you enter the nursing home? |
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Does
everything appear organized and well-maintained? |
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Are
the grounds neat and well-kept? |
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Is
the view pleasant? |
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Is
there outdoor furniture for the patients to use? |
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Are
there areas where patients can enjoy being outside? Are they
encouraged to do so? |
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Have
certain rooms been designated for physical examinations or
therapy? |
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Is
there a room for private visits with family and friends? |
Staff
Attitudes
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Is
the facility’s general atmosphere warm and pleasant? |
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Do
staff members show interest in and affection for individual
patients? |
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Are
staff members courteous and respectful? |
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Do
staff members know patients by name and take time to deal with
them personally? |
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Do
staff members and the administrator take time to answer all
questions, hear complaints and discuss problems? |
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Do
staff members respond quickly to patient calls for assistance? |
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Are
visiting hours convenient for patients and visitors? |
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Does
the staff encourage family visits? |
Bedrooms and
Bathrooms
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Is
there a
window in every bedroom? |
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Does
each bed have a privacy curtain? |
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Does
each bed have a nurse call button or bell? |
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Is
fresh drinking water at each bed? |
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Does
every patient have a comfortable chair in the room? |
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Are
there reading lights? |
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Do
patients have their own clothes closet and drawers for
personal items? |
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Are
personal items throughout the room and on the walls? |
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Is
the furniture spaced so that a wheelchair can maneuver easily? |
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Is
each bed easily accessible? |
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Are
the bathrooms convenient to the bedrooms? |
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Are
bathrooms easy for wheelchair patients to use? |
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Does
each bathroom have a nurse call button or bell? |
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Are
hand grips on or near the toilets? |
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In
shower areas, do showers and tubs have non-slip surfaces and
hand grips? |
Dining
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Is
the dining room attractive and inviting? |
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Are
the tables and chairs comfortable and safe? |
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Is
it easy to move around, even for those in wheelchairs? |
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Is
the food fresh,tasty and attractively served? |
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Does
it appear that the food served is among that preferred by
patients? |
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Is
there a pleasant variety from meal to meal? |
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Are
patients given enough time to eat? |
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Are
they served at normal meal times? |
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Do
patients receive help eating if they need it? |
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Is
food delivered to the rooms of patients unable to eat in the
dining room? |
Activities
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Is
there adequate room for patients’ activities? |
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Are
activities planned? |
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Are
all patients able to get involved in some activity? |
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Is
equipment available to use for activities (i.e., games, craft
supplies, books)? |
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Are
patients using the equipment? |
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Are
patients’ preferences of activities observed? |
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Are
outside trips planned for patients able to enjoy them? |
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Do
volunteers work with patients? |
Patient
Care Services
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Does
the nursing home have an arrangement with a nearby hospital
for transfer if necessary? |
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Is
emergency transportation readily available? |
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Is a
physical therapy program available under the direction of a
qualified therapist? |
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Is
therapy available to meet patients’ particular needs? |
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Is
occupational and/or speech therapy available? |
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Is a
social service worker available to assist patients and
family? |
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Is a
registered nurse available for nursing staff? |
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Are
barbers and beauticians available for patients? |
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Do
staff members encourage patients to maintain a neat
appearance? Do they help if needed? |
Patient
Rights
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Does
the facility have a written description of patient rights and
responsibilities? |
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Is
the description readily available for patients and families to
review? |
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Are
staff members trained to protect dignity and privacy and
respect the patients’ rights? |
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Does
the facility have a patient council? |
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Have
arrangements been made for patients to worship as they please? |
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Have
arrangements been made to accommodate patients who celebrate
religious holidays? |
Costs
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Are
most services covered in the basic daily rate? |
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If
not, is a list available of specific services not covered in
the basic rate? |
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Does
the facility accept Medicaid payments? |
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Does
the facility accept Medicare payments? |
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What
is the facility’s policy on returning advance payments? |
Your
Part: Family Involvement
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Does
the facility have a family council? |
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Are
you prepared to ease the patient’s transition to the nursing
home by being with him or her for several hours on admission
day? |
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Are
you ready to visit the patient frequently and ask his friends
to also visit regularly? |
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Are
you willing to provide the patient with the same amount of
love in the nursing home as you would if he were at
home? |
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