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TECHNOLOGY AND A GOOD CHECKLIST MAKE CHOOSING A NURSING HOME EASIER

Placing a loved one in a nursing home can be a difficult task.  Families struggle to make the best possible choice despite anxiety, doubts and lack of information. And while nothing may take away those natural apprehensions, good information can make the process easier.

“When the decision to choose a nursing home becomes necessary, knowing ways to compare nursing homes is the key to peace of mind,” said Catherine West, Director of the Maryland Quality Improvement Program, Delmarva Foundation.  “Now it’s easier to learn what steps to take and what questions to ask as you go through the process.”

Delmarva Foundation, a non-profit corporation contracted by the Centers for Medicare & Medicaid Services (CMS), a federal agency of the U.S. Department of Health and Human Services, helps improve the quality of nursing home care for Maryland beneficiaries.

The first step in choosing a nursing home is to ensure that the prospective resident’s medical condition has been thoroughly evaluated, Catherine West said.  Knowing the person’s physical limitations and what treatments are needed will help determine what level of services is required.

If a physician believes a nursing home is necessary, family caregivers should do some preliminary research before visiting any facilities.  Some quality issues are subject to personal preferences, while others are critical to any resident’s health and well being.  Common concerns include bed availability, quality of care, affordability and location.

Experts urge caregivers to seek the opinions of nursing home residents, their families, citizen advocacy groups and the patient’s physician.  They also suggest taking along a checklist or set of questions when visiting potential facilities.

A set of federal nursing home quality measures now available on-line is a good way to start.  By visiting www.medicare.gov and clicking on “Nursing Home Compare,” caregivers can create side-by-side comparisons of local nursing homes based on a range of specific quality measures.  The site includes 17,000 nursing homes nationwide.  CMS first made the quality measures available late last year, and updates the information regularly as part of a national initiative to improve the quality of care in nursing homes.

Caregivers can check state nursing home inspection reports, staffing descriptions and affordability information, and compare the newly released quality measures, which include nursing homes’ prevalence of bedsores, pain, physical restraints and infections among their resident population.

A comprehensive, easy-to-use checklist is also available on the Web site with the suggestion to print it for use during informational visits.  The checklist gives caregivers a step-by-step question guide on basic information.  It also encourages caregivers to ask about residents’ appearance, nursing home living spaces, the nursing home staff, residents’ private rooms and public access rooms, menus and food, activities, safety and care.

Consumers who do not have Internet access can call 1-800-MEDICARE (1-800-633-4227) to obtain the information.

“Caregivers should consider a variety of issues when evaluating nursing home choices.  Each facility will have unique strengths and weaknesses.  It’s important to use as many sources of information as possible to determine the best home for a loved one,” said Catherine West.

Maryland long-term care ombudsmen can provide assistance at no charge to residents. Ombudsmen address concerns about care in nursing homes and other long-term care facilities and services, including rights and regulations protecting nursing home residents. The ombudsmen also investigate complaints and are familiar with nursing homes throughout the state. The state office of long term care ombudsmen can be reached at 410.767.1091 or at 1-800-AGE DIAL ext. 1091.

Because many nursing home residents are unable to pay for the full term of their stay, caregivers should consider selecting a facility that is certified by Medicare and accepts Medicaid payments.  This will enable the patient to maintain a stable residence rather than be forced to move because of future cost concerns.

Advocates suggest that caregivers and, if possible, the prospective resident, visit as many nursing homes as they can. Taking time to sit and observe how a facility’s staff interacts with residents can reveal a great deal about a nursing home.  Families should use the Medicare checklist for reference, and pay attention to cleanliness, courtesy, staff knowledge and concern, and available medical services.

Also, it is important to visit nursing homes a second and third time during the evenings and on weekends.  These are times when many nursing homes reduce their staff and services.

Finally, once a family or caregiver has chosen a facility for a loved one, experts say it is equally important to continue to provide love, support and a watchful eye.  A caregiver’s involvement can be the key to getting and maintaining good care for a loved one.

Caregivers should voice concerns, be informed about the staff and be willing to share important details about the resident’s likes, dislikes and daily routines.  Caregivers should also follow up on care plans and document any changes or problems that occur.  The state ombudsmen can also help when caregivers or family members experience any difficulty resolving problems or communicating with the nursing home staff.

Experts recommend that families who are faced with the decision of placing a loved one in a nursing home visit www.medicare.gov to obtain “Nursing Home Compare” information.  The Web site includes nursing home quality measure information on individual nursing care facilities throughout the country.
 

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About Delmarva Foundation

Delmarva Foundation, a national non-profit health information organization, creates clarity in a complex healthcare delivery system through data-driven decision-making, front-line collaboration and innovative analysis of information.  Delmarva provides valuable, creative and cost-effective approaches to positively impact the quality, safety and integrity of health and human services.  Since 1973, Delmarva has assisted with quality assessment and improvement in a variety of healthcare settings including hospitals, physician offices, nursing homes, home health agencies and managed care plans.  In over twenty states, Delmarva provides an essential link between government agencies, healthcare providers and consumers to ensure the highest quality of care.  Delmarva conducts work ranging from quality improvement, quality assurance, utilization review, and external quality review.  The company's corporate headquarters are located in Easton, Maryland with other offices in Baltimore, Maryland; Washington, DC; Charleston, West Virginia;  Essex Junction, Vermont; Columbus, Ohio; Sacramento, California; Tampa, Florida; and Tallahassee, Florida.  For more information, please visit DFMC on the web at www.dfmc.org.