Few of us want to think about the quality of nursing homes until it’s time to help a parent or relative or maybe use one yourself for rehab. But a recent story in the New York Times (NYT) by Katie Thomas found the Medicare watchdog system doesn’t always work. That’s why it’s important to take care when you choose a nursing home.
I found this out the hard way with my cousin Marilyn. Before she moved into assisted living, she’d call an ambulance every time she had a back ache. Each hospital stay resulted in some kind of infection and when she was ready for release, they’d send her to a nursing home. For a year or two she bounced between her Queens apartment in New York City, where she lived alone, the hospital and two nursing homes.
Both nursing homes were imperfect. They seemed to warehouse their patients and, in Marilyn’s case, to give her little care. One nursing home embarked on a dusty construction project while she was there. The other just seemed grimy, and I had to ask for cleaning solution and rags to wipe out the set of drawers before I put her things in them. I couldn’t wait to get her out of there and into an assisted living facility where she finally agreed to move.
But the nursing home had Medicare’s seal of approval with a five-star rating, and my complaints did little to improve anything for Marilyn or anyone else.
The NYT story found that across the nation, the Medicare five-star rating system doesn’t ensure five-star treatment. Although more than 15,000 nursing homes earned Medicare’s top rating, many may have potentially dangerous problems like inadequate staffing.
That’s what we found at the Queens facilities where Marilyn stayed. Medicare relies on nursing homes to self-report about staffing levels and other things and apparently some nursing homes figure out how to work the system. In addition, the NYT’s Thomas reported that the Medicare ratings don’t include negative information that states compile.
The last time Marilyn was in the hospital, I wanted her to go to a good rehab facility so that she could return to her assisted living apartment. By this time, I was a pro. I asked the social worker for a recommendation for a good nursing home. She refused to endorse one. But when I named a facility she said, “We don’t send anyone there.”
That was a good enough for me. I could strike a place from my list and ask about others. The social worker urged me to visit several nursing homes before I selected one. Honestly, I dreaded the visits and the time that it would take. But this was great advice.
There’s a lot to consider if the nursing home will be a long-term residence, and we’ll cover those concerns in a separate post. But here are some suggestions for choosing a temporary nursing home.
10 Tips to Choose a Temporary Nursing Home
1. Ask medical professionals or a social worker for suggestions of nursing homes that are close to where you live or work so that you can visit often.
2. Consult the Medicare list of nursing homes in your area even though it may be imperfect: Medicare.gov/nursinghomecompare/search.html. And again, try to find a facility that’s close to where you live or work so that you can drop in at your convenience.
3. If the “professional” you ask for a referral won’t give you a straight answer, use the back door approach and ask where they don’t send people.
4. Visit more than one nursing home so that you can make your own comparison. This is time-consuming, but worth it.
5. Check to see if the rooms and bathrooms are clean and free of foul odors. I’m smell-sensitive and this was really important to me. Check to see if drawers and closets for personal possessions are clean.
7. Look at the other patients. Are they cared for? Are they dressed appropriately? Are they free of restraints?
8. Find out about staffing and how much attention each person gets from the nursing staff.
9. If it’s a rehab facility, visit the rehab area and see how the therapists and patients work together. Ask how much time is given to rehab and ask patients and family members if they are satisfied.
10. Ask about the food. This is really important. Ask other residents, or family members if they can eat the food.
Always try to find a nursing home resident or a visiting family member who can tell you about their experience. It’s true that some people are always unhappy, but you are bound to find some who will talk honestly and share their knowledge with you.