Seven Things to Expect from a Nursing Home

Attorney’s who work with the elderly are very familiar with the shortcomings of nursing home care.  Nursing homes perform an essential service and many take good care of their patients.  When a nursing home fails to do that, however, it can have disastrous consequences.   These consequences can range from physical injury, to financial harm.  Here are some things that you should expect from a high quality nursing home:

Clear About Cost and Terms

The terms and conditions of nursing home contracts are complicated.   The facility should fully explain the costs and terms of that contract.   You need to know if the facility accepts Medicaid if the resident runs out of money – many do not.   You should know if the monthly cost includes all expenses, or if some services are extra.   If a deposit is required, you should know under what circumstances it is refundable.  The facility should not pressure you to make a decision immediately.    Take your time, review the agreement and consider showing it to an attorney.   If the facility is not willing to let you do this, it should be a red flag.

Responsive to your Requests

Residents and family need to understand that the facility has many patients and that staff is very busy.    For that reason, you should always be polite and respectful.  Having said that, they should be available and willing to discuss your reasonable requests.  If a resident wants to sleep in on weekends, they should not be required to get up at 6:30 because that’s when the staff wants to make rounds.   If a resident isn’t getting out of the room much, they should be willing to assist them in taking walks.  Good communication is probably the most important element of providing good medical care.   A good venue for such communication is at the residents care plan meeting (discussed below).

Adequate Staffing

Most instances of nursing home neglect arise out of two things:  1) poor communication amongst staff, and 2) understaffing.  Ask how many people are on staff at various times, and their qualifications.   Is there an RN on shift every night?  How many CNAs are working?   If you suspect a staffing problem, visit the resident at night. This is the time the facility is most likely to be understaffed.  When a medical test is ordered – is the physician notified promptly?  If not, serious problems can follow.  Several web sites offer helpful information about nursing home staffing.

Prompt Disclosure of Problems

Problems will occur from time to time.  Residents have medical complications. Whether they are routine complications or results of a mistake by the nursing home, family members should be promptly notified.  A nursing home to worry about is one that doesn’t notice a problem, or tries to hide it.

Involving you in the Care Plan

A care plan meeting is a legally required meeting of the various members of the health care team.   They are required to take place quarterly for long term residents and more often for short term residents.  Family and residents have a right to be involved in the care planning process.  Go to the meetings, express your concerns, comment on the goals.  Your involvement will improve communications and improve care.  If it doesn’t – think about going elsewhere.

Excellent Treatment of the Resident’s Medical Condition

Just like hospitals have different areas of specialization, nursing homes also focus on certain conditions.  Not every facility is well equipped for treatment of dementia and Alzheimer’s.  Some facilities are known for wound care – others are not.  Whatever the condition, make sure that the nursing home has the experience and skills necessary to provide good care.  In the internet age, it is possible to learn a lot about available treatments.  Do some leg work and ask questions.  A quality facility should be comfortable discussing the treatments and options.

Respect for the Resident’s Rights

At the end of the day, the nursing home is not just a medical center.  It is the resident’s home.  For that reason, it is important for the facility to be respectful of their independence.   Illinois publishes a brochure listing resident’s rights and related information.  If you feel that you, or a family member’s, rights have been violated, you can contact your local nursing home ombudsman to make a report.

Getting good care often means learning to be a good advocate.  Most nursing homes want to provide good care and have happy residents and family.  By knowing what to expect and communicating it, you can ensure the best treatment.   Creative Case Management also offers a helpful guide on Rating Nursing Homes.   The State of Illinois also publishes a quarterly list of nursing home violations.

* This article was edited by Alix Burns

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