Nursing Home Checklist

One of the scariest moments for a daughter, son, brother, sister, niece, nephew, spouse, aunt, neighbor, best friend without family, etc. is the decision to have to put a loved one and/or a relative into a long-term care facility. As a past Director of Nursing for a large, skilled nursing facility, I have learned that it is of the utmost importance one seek the necessary information to keep their precious one safe, healthy and happy! In fact, it does not hurt to be guided by a simple checklist that will bring great piece of mind choosing the right location. My biggest complaint as the Director of a nursing home years ago was the staffing issue.

I remember one winter season when almost all of the staff had the seasonal flu at the very same time. To my disappointment, they would not allow us to use a pool of nurses or CNAs for no other reason than the cost of that pool. I hated the fact that greed was apparent and this is a real concern when checking out nursing homes. Our bed sores skyrocketed, meals were not timely, bathing became an issue, activities were lacking, etc. I pitched right in on the floor duties, but felt as though one person could not get the proper job competed in a timely fashion. Furthermore, my expertise was in nursing, not cooking, social activities, administration, housekeeping, maintenance, or any of the above.

Here are some of the most important things I can think of to ask in regards to long-term care facilities:

oWas the last State inspection positive? What did it reveal? How many "tags" did they have, and what were they?
oWhich safety measures does the facility have in place?
oWhat is the staffing ratio for registered nurses (RN), licensed practical nurses (LPN) and certified nursing assistants (CNA) to residents?
oIs the facility Medicare and Medicaid certified?
oWho owns the facility?
oIs the long-term home a non-profit organization or for profit?
oHow do they deal with call-ins and short-staff, i.e. what back-up measures are in place - do they use pool nurses and CNAs for help?
oAre there any pending lawsuits?
oWhat is the ratio of urinary tract infections, pneumonia, dehydration, bed sores and/or malnutrition?
oHave there ever been abuse issues, and if so, how long ago? What is the protocol for these incidents?
oWhat special therapies and activities do you have and how often? How leads these activities?
oDo you have a registered dietitian that plans the meals?

In addition to these very important questions, look around at the facility. Be sure it is clean and don't be afraid to talk with other family members and to the residents. Speak with the Administrator, the Director of Nursing, the social worker, the activities coordinator and to the dietitian to address any special needs that may be an issue, i.e. diabetes, hypertension, macular degeneration, poor skin turgor, weight gain or loss.

The decision is not an easy one, and it is certainly in your best interest and the patient's best interest to get all of your ducks in a row before moving forward. Make certain to inquire with other families that have gone through similar situations. Also, check the state records for the facility - they can be obtained via Internet quite easily and are a matter of public record.

Lastly, don't hurry or be in a rush when checking all of your options. Remember how important it is to keep your family member, or other special human being, in the best possible place. Don't forget to consult your checklist. Rule of thumb - how would you want to be treated in a like situation? I literally shutter to think what I could go through with my own loved ones, let alone what my children may have to face one day. Bottom line, keeping your very special one in a well respected nursing home that is run by experts can, indeed, give you peace of mind!