How to Choose a Safe Nursing Home

Choosing a safe, comfortable, and caring nursing home for your loved one is a significant and challenging task. It's an emotionally charged process that requires a balance between the individual’s healthcare needs, personal preferences, and legal safeguards. At The Law Offices of John M. McCabe in North Carolina, we understand these complexities and offer this guide to help you make an informed decision.

What is a Nursing Home?

A nursing home, also known as a skilled nursing facility or a long-term care facility, is a type of residential care establishment that provides around-the-clock healthcare services to individuals who are unable to manage independently in their homes. This includes people with chronic illness, those recovering from a hospital stay, or individuals with cognitive impairments like dementia.

Here's a more detailed look at the essential characteristics of a nursing home:

24-Hour Care

Nursing homes provide 24-hour supervision and medical care to their residents. This includes assistance with daily activities such as bathing, dressing, and eating, as well as medical care such as administering medications, wound care, physical therapy, and more.

Professional Staff

A variety of healthcare professionals staff nursing homes. This includes:

• registered nurses (RNs)
• licensed practical nurses (LPNs)
• certified nursing assistants (CNAs)
• and often occupational therapists, physical therapists, and speech therapists.

Many facilities also have a medical director, who is a doctor that oversees medical care.

Facility Services

Nursing homes typically provide meals, housekeeping, and laundry services. They also offer social and recreational activities to encourage socialization and improve the quality of life of their residents.

Rooms

Residents may have private or shared rooms, depending on the facility and the payment arrangement. Rooms usually have a bed, storage space for personal items, and often a private bathroom.

Medical Services

Nursing homes can provide a wide range of medical services. This includes regular care for chronic illnesses, rehabilitative services after surgeries or strokes, specialized care for conditions like dementia, and palliative and hospice care.

Regulations

In the United States, nursing homes are regulated at both the state and federal levels to ensure that they meet certain standards of care and safety. They are regularly inspected, and the results of these inspections are publicly available.

How to Choose a Safe Nursing Home

Choosing a nursing home for yourself or a loved one can be a daunting task. How do you ensure that the facility you choose is safe, reliable, and provides the best care possible? With so many options available, it's important to know what to look for and what mistakes to avoid.

Identify Your Needs

Each individual's needs are unique. Are you seeking a facility that offers physical rehabilitation, dementia care, or 24-hour nursing services? Understanding your loved one's specific needs can help you find a nursing home that provides those services.

Research Extensively

Start with an online search to find nursing homes in your preferred location. Websites like Medicare.gov provide detailed information and ratings on nursing homes across the United States. You can also seek recommendations from healthcare providers, friends, or support groups.

Visit Potential Nursing Homes

Once you have a list of potential nursing homes, visit each one. Take note of cleanliness, the interaction between staff and residents, and the overall atmosphere. Don't be afraid to ask questions about staff-to-resident ratios, turnover rates, and the qualifications of the staff. Your senses can be an excellent tool to gauge the environment - pay attention to unpleasant odors, noise levels, and how meals are served.

Check for Safety Measures

The safety of residents should be the utmost priority. Ensure the facility has clearly marked exits, handrails in corridors, functioning smoke detectors, and emergency evacuation plans. Inquire about their protocol for medical emergencies and their track record on falls and injuries.

Understand The Cost

Nursing homes can be expensive, and costs can vary widely. Find out what is included in the price and what additional services may require extra fees. Review your insurance coverage, any potential government assistance like Medicaid, and understand the terms and conditions of payment.

Assess the Quality of life

The quality of life in a nursing home extends beyond medical care. The facility should offer a range of activities to keep residents engaged. Check if the home allows for personal belongings and pets, or if they accommodate dietary preferences.

Read Reviews and Inspection Reports

Reading reviews and inspection reports can provide insights into a facility's operation. In the U.S., nursing homes are required to undergo annual inspections. These reports are publicly available and can provide crucial information about potential problems or concerns.

Legal Considerations

Ensuring that the nursing home has a clear and legally sound contract is vital. Have a lawyer review the agreement to understand the terms and ensure your loved one's rights are protected.

Questions To Ask a Nursing Home Before Choosing To Live There

Deciding on the right nursing home for yourself or a loved one can be a daunting task. It involves not only evaluating the quality of care but also considering factors like the home's environment, services, cost, and how well it suits your personal needs or those of your loved one. Here are some crucial questions to ask a nursing home before making a decision:

About the Care:

• What types of care and services are provided?
• What is the staff-to-resident ratio during different shifts?
• What medical services are available on-site? Are there doctors and nurses available 24/7?
• How does the home handle medical emergencies or serious illnesses?
• What types of training does the staff have? Are they trained to handle specific conditions like dementia or Parkinson's?
• What is the process for assessing a resident's healthcare needs and updating care plans?

About the Facility:

• Can residents bring their own furniture or personalize their rooms?
• How clean and well-maintained are the facility and grounds?
• What safety measures are in place to prevent falls and accidents?
• What is the policy on visiting? Can visitors come at any time, and are there guest facilities?
• How does the facility handle resident's security, especially those with cognitive impairments?

About Daily Life:

• What activities and amenities are available for residents?
• Are there options for physical exercise or outdoor activities?
• How are meals prepared? Can the facility cater to special dietary needs?
• How does the facility accommodate the religious or cultural needs of the residents?

About the Cost:

• What are the costs for the different types of care and accommodation?
• What is included in the cost, and what services require additional fees?
• What are the payment policies, and what forms of payment are accepted?
• Is there financial assistance available? Does the facility accept Medicaid?

About the Track Record:

• What were the findings of the most recent state inspection?
• Are there any recent complaints or violations against the home?
• How does the nursing home compare to others in terms of quality metrics?

While this list is extensive, it is by no means exhaustive. It's crucial to ask any other questions you might have regarding the specific needs of the individual who will be living in the nursing home. Trust your intuition during visits and conversations, and keep the lines of communication open with the nursing home's administration. A transparent and forthcoming facility is generally indicative of good care.

Know The Signs of Nursing Home Abuse

Nursing home abuse is a serious issue that can have devastating effects on the well-being of elderly individuals. If you have a loved one in a nursing home, it's important to be aware of the signs of potential abuse. Here are some key signs that may suggest that abuse or neglect is occurring:

1. Physical Abuse

• Unexplained injuries such as bruises, cuts, burns, sprains, or fractures
• Injuries that are inconsistent with the explanation given
• Signs of restraint, like marks on wrists
• Frequent injuries, suggesting a pattern of abuse

2. Emotional Abuse

• Sudden changes in behavior or mood, such as increased agitation or withdrawal from social activities
• The resident seems fearful or nervous around certain staff members
• Frequent, unexplained crying
• Observable arguments or tension between the elderly person and their caregiver

3. Neglect

• Poor personal hygiene, such as unwashed hair or untrimmed nails
• Weight loss or signs of malnutrition
• Bedsores or other untreated health problems
• Lack of clean clothing or bedding
• Unsanitary living conditions

4. Sexual Abuse

• Unexplained sexually transmitted diseases or genital infections
• Unexplained bleeding or bruising in the genital area
• Torn or stained underwear

5. Financial Abuse

• Unusual changes in the person's financial situation, such as sudden withdrawals from bank accounts
• Changes in wills, power of attorney, titles, and policies
• Unexplained or unauthorized purchases
• Disappearance of funds, valuable possessions, or financial documents

6. Healthcare Fraud

• Overmedication or under-medication
• Lack of adequate care despite adequate payment
• Evidence of overbilling or billing for services not rendered

The most important thing you can do if you suspect abuse is to take immediate action. Contact the appropriate local authorities to report your concerns. In some cases, you may also need to consult with a nursing home abuse lawyer. At The Law Offices of John M. McCabe, we take allegations of nursing home abuse seriously and are ready to provide the legal support needed to protect your loved ones.

What To Do If You Suspect Nursing Home Abuse

Suspecting nursing home abuse is a deeply unsettling situation. The welfare of your loved ones is paramount and it's crucial to take immediate action if you believe abuse or neglect is occurring. Here are steps you should follow:

Document the Evidence

Begin by documenting any signs of abuse or neglect. This could include taking photos of injuries or unhygienic conditions, keeping a journal of behavioral changes or unusual incidents, and noting any concerning interactions with staff.

Communicate with Your Loved One

Talk to your loved one about your concerns. Ask them about their experiences, bearing in mind that they may be reluctant or fearful to disclose abuse. Ensure them that they are not alone and that you are there to support them.

Confront the Administration

Discuss your concerns with the nursing home administration. They should be responsive to your worries, and take immediate steps to address the situation. Document these conversations as part of your record.

Report the Abuse

If you suspect that your loved one is in immediate danger, call 911. Otherwise, report the situation to your local Adult Protective Services (APS) and the Long-Term Care Ombudsman in your state. In North Carolina, you can contact the Division of Health Service Regulation to report the abuse.

Consult with a Nursing Home Abuse Lawyer Near Me

If the situation doesn't improve or if your loved one has suffered significant harm, it may be time to consult with a nursing home abuse attorney. An experienced elder law attorney or personal injury attorney can guide you through the legal process, help gather evidence, and ensure your loved one's rights are protected.

Consider Relocation

Depending on the severity of the situation, it may be best to relocate your loved one to a safer environment as quickly as possible. This can be another nursing home, an assisted living facility, or a home with a caregiver.

Contact The Law Offices of John M. McCabe

Choosing a nursing home and ensuring the safety and well-being of a loved one is a complex and emotionally charged task. However, armed with the right knowledge and questions, you can make a confident and informed decision. Remember, it's essential to advocate for your loved ones, maintain open communication with the facility, and act quickly if you suspect any abuse or neglect. At The Law Offices of John M. McCabe, we stand ready to assist you through every step of this journey. Whether you need advice in selecting a nursing home, dealing with suspected abuse, or navigating complex legal matters, we are here to offer our expertise. Your loved one's safety, dignity, and quality of life are our top priority. Please feel free to reach out to us at any time.

Nursing Home FAQs

Q: What is the difference between a nursing home and assisted living?

A: Assisted living facilities are designed for individuals who are generally able to care for themselves but may need some assistance with daily activities such as cooking, cleaning, or medication management. On the other hand, nursing homes provide round-the-clock care and medical supervision for individuals who have more significant health care needs and cannot live independently.

Q: Who regulates nursing homes?

A: In the United States, nursing homes are regulated at both the state and federal levels. The Centers for Medicare & Medicaid Services (CMS) sets federal regulations, while each state has its own additional regulations. Regular inspections are conducted to ensure compliance with these rules.

Q: What is the average cost of a nursing home?

A: The cost of nursing homes varies significantly depending on the location, level of care, and the specific services provided. As of my knowledge cutoff in September 2021, the national average cost for a semi-private room in a nursing home was about $7,500 per month.

Q: How do I pay for nursing home care?

A: Nursing home care can be funded in several ways, including private pay, long-term care insurance, Medicaid, and in some cases, Medicare. It's essential to speak with a financial advisor or elder law attorney to understand the best options for your situation.

Q: Can a nursing home evict a resident?

A: Under certain circumstances, a nursing home can legally discharge or evict a resident, such as if the resident's health has improved to the point they no longer require the facility's services, or if the resident poses a danger to the health and safety of others. However, there are strict regulations and procedures that must be followed in these cases, including providing sufficient notice and planning for the resident's transition.

Q: How can I ensure that my loved one is well cared for in a nursing home?

A: Regular visits can help you monitor your loved one's care. During these visits, observe the cleanliness of the facility, the behavior of the staff, and any changes in your loved one's health or behavior. Communicate regularly with the nursing home staff and don't hesitate to ask questions or raise concerns.