THCA

Tennessee Health Care Association


Home
About THCA
Consumer Information
Friends and Families
Finding The Right Care at the Right Time
What is a Nursing Home?
How to Select a Nursing Home
What to Expect at Admission
Paying for Nursing Home Care
What Families Are Saying About Tennessee Nursing Homes
Locate a Nursing Home In Your Area
Volunteer Opportunities
Success Stories
Long-Term Care Glossary
Who's Who In Tennessee Nursing Homes
Government Resources
Education Foundation
Get Involved
Member Facilities Only
Career Opportunities
Contact Us
Site Map
 

How to Select a Nursing Home

- 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.

back to top

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.

back to top

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

bullet Does the facility hold a current license from the state?
bullet Does the administrator hold a current license from the state?
  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.
bullet Ask the administrator to describe the facility’s most recent survey (state/federal inspection).

Location

bullet Is the patient happy with the location?
bullet Will family and friends be able to make frequent visits?
bullet Does the patient’s personal physician make visits to the facility?

Facility Appearance and Design

bullet Is the entire facility clean enough to satisfy your personal standards?
bullet Is it free of unpleasant odors?
bullet Are hallways and rooms free from hazardous objects?
bullet Does the facility meet the safety standards required for nursing homes?
bullet Do you feel welcome when you enter the nursing home?
bullet Does everything appear organized and well-maintained?
bullet Are the grounds neat and well-kept?
bullet Is the view pleasant?
bullet Is there outdoor furniture for the patients to use?
bullet Are there areas where patients can enjoy being outside? Are they encouraged to do so?
bullet Have certain rooms been designated for physical examinations or therapy?
bullet Is there a room for private visits with family and friends?

Staff Attitudes

bullet Is the facility’s general atmosphere warm and pleasant?
bullet Do staff members show interest in and affection for individual patients?
bullet Are staff members courteous and respectful?
bullet Do staff members know patients by name and take time to deal with them personally?
bullet Do staff members and the administrator take time to answer all questions, hear complaints and discuss problems?
bullet Do staff members respond quickly to patient calls for assistance?
bullet Are visiting hours convenient for patients and visitors?
bullet Does the staff encourage family visits?

Bedrooms and Bathrooms

bullet Is there a window in every bedroom?
bullet Does each bed have a privacy curtain?
bullet Does each bed have a nurse call button or bell?
bullet Is fresh drinking water at each bed?
bullet Does every patient have a comfortable chair in the room?
bullet Are there reading lights?
bullet Do patients have their own clothes closet and drawers for personal items?
bullet Are personal items throughout the room and on the walls?
bullet Is the furniture spaced so that a wheelchair can maneuver easily?
bullet Is each bed easily accessible?
bullet Are the bathrooms convenient to the bedrooms?
bullet Are bathrooms easy for wheelchair patients to use?
bullet Does each bathroom have a nurse call button or bell?
bullet Are hand grips on or near the toilets?
bullet In shower areas, do showers and tubs have non-slip surfaces and hand grips?

Dining

bullet Is the dining room attractive and inviting?
bullet Are the tables and chairs comfortable and safe?
bullet Is it easy to move around, even for those in wheelchairs?
bullet Is the food fresh,tasty and attractively served?
bullet Does it appear that the food served is among that preferred by patients?
bullet Is there a pleasant variety from meal to meal?
bullet Are patients given enough time to eat?
bullet Are they served at normal meal times?
bullet Do patients receive help eating if they need it?
bullet Is food delivered to the rooms of patients unable to eat in the dining room?

Activities

bullet Is there adequate room for patients’ activities?
bullet Are activities planned?
bullet Are all patients able to get involved in some activity?
bullet Is equipment available to use for activities (i.e., games, craft supplies, books)?
bullet Are patients using the equipment?
bullet Are patients’ preferences of activities observed?
bullet Are outside trips planned for patients able to enjoy them?
bullet Do volunteers work with patients?

Patient Care Services

bullet Does the nursing home have an arrangement with a nearby hospital for transfer if necessary?
bullet Is emergency transportation readily available?
bullet Is a physical therapy program available under the direction of a qualified therapist?
bullet Is therapy available to meet patients’ particular needs?
bullet Is occupational and/or speech therapy available?
bullet Is a social service worker available to assist patients and family?
bullet Is a registered nurse available for nursing staff?
bullet Are barbers and beauticians available for patients?
bullet Do staff members encourage patients to maintain a neat appearance? Do they help if needed?

Patient Rights

bullet Does the facility have a written description of patient rights and responsibilities?
bullet Is the description readily available for patients and families to review?
bullet Are staff members trained to protect dignity and privacy and respect the patients’ rights?
bullet Does the facility have a patient council?
bullet Have arrangements been made for patients to worship as they please?
bullet Have arrangements been made to accommodate patients who celebrate religious holidays?

Costs

bullet Are most services covered in the basic daily rate?
bullet If not, is a list available of specific services not covered in the basic rate?
bullet Does the facility accept Medicaid payments?
bullet Does the facility accept Medicare payments?
bullet What is the facility’s policy on returning advance payments?

Your Part: Family Involvement

bullet Does the facility have a family council?
bullet 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?
bullet Are you ready to visit the patient frequently and ask his friends to also visit regularly?
bullet 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?

back to top

Home | About THCA | Consumer Information | Government Resources | Education Foundation
Get Involved | Member Facilities Only | Career Opportunities | Contact Us | Site Map

© 2001 Tennessee Health Care Association