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Assessing Nursing Home Facilities It is important to take the necessary time to properly research and investigate a nursing home before allowing a family member to take up residency at any given care facility. Be careful not to focus on properties relating to physical appearance when evaluating a potential nursing home. An attractive tour that showcases expensive furniture and a pleasant staff does not necessarily reflect the reality of the environment in which your loved one will be spending their days. Visiting With Residents Establishing a relationship with at least one existing resident in a prospective nursing home will help you to evaluate a facility from the inside. Whereas a guided tour may be misleading, visitations with pre-existing nursing home residents will provide accurate information regarding the conditions of a given care facility. Use visitation time to explore the physical surroundings of the facility. Making conversation with bedridden and wheelchair-bound residents will allow you to investigate the cleanliness of the facility as well as the hygiene of the residents. Take time to notice the physical appearance of residents, including hair, nails, and teeth. Evaluate the emotional and mental disposition of the residents, taking time to notice any visible signs of depression or unhappiness. If the majority of the residents you come in contact with appear out of touch or unable to maintain a regular conversation, be cautious about the nursing home in question. Avoid Restricted Access Facilities Avoid nursing homes where visitor access is restricted. If a facility only allows visitation with specific clients who are willing to socialize, this should be seen as cause for concern. Although every care facility will have certain areas that are inaccessible to visitors and the general public, be cautious of nursing homes that only allow selective access to common areas or those that impose restrictions regarding visitation, or only allow visitation with a select group of willing residents Notice Odors Take notice of any odors surrounding the physical elements of a facility as well as the residents themselves. Noticeable odors of urine or feces surrounding the common areas, rooms, or residents of a facility could be an indication of improper treatment. Health hazards related to lack of proper care (changing of clothing) can include such potentially life-threatening illnesses as urinary tract infections and decubitus or pressure ulcers (bedsores). Time Your Visits Plan your visits so that they occur at various times throughout the day. Visiting a facility during the day may provide a much different picture than what is seen at night. Often, a nursing home may appear to be more adequately staffed during daytime than during the evening or on weekends. Be sure to evaluate the conditions of a prospective care facility at various times and on different days. Visit During Meal Times Visiting during meal times allows you to observe how the residents are being fed, and if they are being fed properly. Take notice of the amount of time each staff member spends with each resident, how much food is being eaten by the residents, and the visible physical health of the residents that are eating. Compare the general physical stature and size of the residents in the dining room to that of those senior citizens you see outside of nursing homes. If residents appear to be too thin, this should be cause for concern. Take time to notice the eating habits and conditions of those residents who are fed in their beds. If the residents are unable to properly access their food, if the food appears cold, or if required aide assistance appears to be unavailable or scattered, be reluctant of the nursing home in question. If it is possible to eat a meal yourself, take advantage of the opportunity to judge the quality of the food based on taste, freshness, and temperature. Check for Water Every room should include a pitcher of fresh ice water, easily accessible to the resident. Staff should be providing water to those residents unable to obtain it themselves, and clean cups should be available in each room. Evaluate the Staff Inquire about the amount of available staff working at a care facility during various shifts, morning, afternoon, and evening. Request information regarding the number of available nurses and aides on duty, as well as the amount of certified nursing assistants (CNAs) present at any given time. Compare the ratio of staff to residents. Take note of the number of wheelchair-bound or bedridden residents, as these clients require additional care related to daily activities, such as showering, drinking, eating, toileting, and grooming. If there is a large population of those residents in need of additional attention or special care, there should be an adequate number of CNAs on staff. With a greater population of bedridden or wheelchair-bound clients, the ratio of CNAs to residents should be smaller. Specific state licensure rules and regulations are available (INSERT URL LINK) and should be double-checked when evaluating the staff-to-resident ratio of a care facility. Check the State Survey As required by Medicare regulations, the most recent state survey of a residential care facility should be readily available onsite. Take the time to read through the state survey carefully, taking notice of any concerns relating to fundamental nursing and medical care. Medicare's guidelines for nursing home facilities, an invaluable tool in the selection of a nursing home care facility, is located at http://www.medicare.gov/NHCompare/home.asp. This website provides up-to-date federal survey results, residential population statistics, and information regarding management and ownership of specific nursing homes. Talk with Family Members Introduce yourself to the relatives of existing clients in prospective nursing homes. Take the time to discuss the nursing home in which their loved one resides, and make note of any potential concerns or issues that you may have. If friends and family members of an existing client in a prospective nursing home have experienced difficulties with the care facility, it is likely that your loved one will experience similar problems. Other Tips In addition to the previously mentioned suggestions regarding assessment, there are several other useful steps that can be used in evaluating the suitability of a prospective home. You can help to ensure the safety and happiness of your loved one if you consider taking the following steps:
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