How To Find Good Nursing Home Care

Dear Savvy Senior,

Can you give me some tips on finding a good nursing home for my 86-year-old mother? She had a stroke a few months ago and has been receiving care at home but it's become too much.

Leery of Nursing Homes

Dear Leery:

Finding a well-run nursing home that provides quality care is an important decision that requires some homework. Here's what you should know.

Finding Good Care

The decision to move a loved one into a nursing home can be a difficult one. In most cases, the decision is forced by a sudden decline in health or mental ability, or by a gradual realization that the person can no longer receive the care they need at home. Whatever the circumstance, here are some steps that can help you find a good nursing home and avoid a bad one:

+ Make a list: Contact your area agency on aging for a list of local nursing home facilities. Ideally, the facilities should be close to family members and friends who can visit often. Residents with frequent visitors usually get better care. The national Eldercare Locator (800-677- 1116, or www.eldercare.gov) can direct you to your local agency for the aging.

+ Online help: The Internet is a great resource to help find and research nursing homes. Medicare's Nursing Home Compare resource at www.medicare.gov/nhcompare/home.asp lists every nursing home that accepts Medicare and Medicaid by state, city, and ZIP code. Also, see the Consumer Reports Nursing Home Quality Monitor at www.consumerreports.org/nursinghomes. This free resource identifies nursing homes that are likely to provide betterquality care and those you need to avoid. You can also purchase detailed nursing home reports through companies like www.healthgrades.com and www.carescout.com.

+ Ombudsman help: An ombudsman is a government official, who in this case investigates nursing home complaints and advocates for residents and their families. Find the one in your area and be sure to give him or her a call. They can tell you about the nursing homes in your area as well as which ones have had complaints or other problems. To find your local ombudsman, call your area agency on aging or see www.ltcombudsman.org.

+ Check the ownership: According to a recent study by Consumer Reports, independent, not-for-profit homes generally provide better care than for-profits owned by chains. Call the nursing homes you're interested in and ask if they have recently changed owners, or are about to. A facility that's for sale might have problems, just as one with a new owner might be getting better.

+ Facility visits: Once you've narrowed your search, visit each facility so you can evaluate it firsthand. Be sure to find out if they're capable of providing the kind of care your loved one needs, what they charge and if they accept Medicaid. While you're there, talk with the staff and residents and their family members, if possible. Taste the food, check the cleanliness of the facility and notice if the staff is responsive and kind to the residents. Ask the nurses' aides how many residents they each care for (the smaller the number, the better). It's also a smart idea to make an unannounced visit in the evening or on a weekend when staffing problems are most evident.

+ Staff turnover: Ask the nursing home administrator about top-level turnover. If the administrator and the director of nursing have worked at a facility for several years, that's usually a positive sign. Frequent changes in those positions indicate instability, which could translate into poor care.

+ Inspect the inspection: Read the nursing home's state inspection survey, known as Form 2567. It should be readily accessible. If it's not and you have difficulty obtaining it, consider that difficulty a warning that the facility may be hiding problems or violations.

+ Compare facilities: Medicare has a checklist at www.medicare.gov/nursing/checklist.asp that can help you evaluate and compare the nursing homes you're considering.

Savvy Tip: If you find yourself in a situation where an elder loved one has been hospitalized because of a medical condition or injury and the hospital wants to discharge them before you've had time to investigate any nursing homes, you can appeal to Medicare to extend the hospital stay for two days. That will buy you some time to locate a good facility.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the "NBC Today Show" and author of The Savvy Senior books.