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Ask the Experts

Careful checking is essential in selecting a nursing home

By KATHRYN HYER
Published December 20, 2005

EDITOR'S NOTE: Answers to the "Ask the Experts" column are written by a member of the University of South Florida's Collaborative on Aging, a group of faculty from throughout the university involved in research on aging, ranging from basic science to public policy analysis. Collaborative members have extensive experience providing care for older adults and their families or advising policymakers on improvements in care for older adults. To learn more about the Collaborative on Aging, visit http://aging.cas.usf.edu

Q. How do I go about choosing a good nursing home for a family member?

A. Choosing a nursing home for a parent or loved one is a difficult decision, especially because it is usually made during a health crisis. The decision can be easier if families discuss health and long-term care issues in advance, perhaps following the advice of professionals such as physicians, social workers, nurses, hospital discharge planners and elder law attorneys.

All facilities are inspected annually; inspection results, as well as cost of care, financial status and staffing ratios, are available from the state's Web site at http://ahcaxnet.fdhc.state.fl.us/nhcguide/

Another information site available through Medicare is www.medicare.gov/NHCompare/Home.asp. This site allows you to compare nursing homes in your area by entering your ZIP code. The National Citizens' Coalition for Nursing Home Reform has a booklet to help with nursing home choices. Visit http://nursinghomeaction.org or call 202 332-2275.

Be realistic about the goal of nursing home admission. Nursing home admissions are generally either rehabilitative, short-stay admissions (generally 23 days) or long-stay admissions.

All nursing homes permit a tour, but consider visiting more than once and at different times of the day, including meal times.

Other things to consider:

Is the facility clean and pleasant? How does the staff interact with residents? Do staff members know the residents' names? Are the rooms clean? Are residents encouraged to have personal mementos and family pictures on display? Are activities available that might interest your loved one? During meals, do residents receive assistance?

Nurses, therapists and paraprofessional staff provide most of the care. Fortunately, Florida has one of the highest staffing ratios in the country. Each resident should receive 156 minutes of paraprofessional care each day and 60 minutes of care from licensed or registered nurses.

Facilities vary in the way they train and use staff. Be sure to ask if the facility primarily uses temporary or permanent workers. Check staff turnover rates. Lower turnover is generally a better indication of quality and continuity of care.

Finally, if possible, select a nursing home close to where you live. That makes visiting easier, which can cut down on stress.

- Kathryn Hyer is an associate professor in the School of Aging Studies in the USF College of Arts and Sciences. She is also director of the Florida Training Academy on Aging within USF's Florida Policy Exchange Center on Aging and is active in local, state and national efforts to improve quality of care in nursing homes.

[Last modified December 19, 2005, 09:59:01]