CHOOSING A NURSING HOME FOR A LOVED ONE: QUESTIONS TO ASK, ISSUES TO CONSIDER

By: BENJAMIN D. ECKMAN, ESQ.
Elder Law Attorney

For many families there comes a time when they realize that a father, mother or other loved one will be best off in a nursing home, where the specialized needs of old age can be best met. The process of finding a nursing home is not only difficult for you, but also for your loved one. In many cases, their lives will be dramatically altered. This article is intended to help people make the best possible decision when selecting a long term care facility.

A loved one is a special individual with specific interests and needs, all of which should be reflected in the nursing home you and your family select. Options must be well researched with every family member having a voice. Once the decision is made for a nursing home, ask your doctor, hospital discharge planner or social worker to provide you with a list of qualified nursing homes. Most nursing facilities offer more than one level of care, specifically a “skilled” care section and an “intermediate” care section. Before choosing a nursing home, you should try to visit at least three potential facilities. During each visit, the family members should tour the facility with a staff member and feel free to ask questions. It is a good idea to take notes during this exchange so you can later compare your impressions of each site. If you are faced with constraints or if you do not live in the area, speaking with the admissions director of several facilities may be useful in deciding where the best option exists.

THE COST

When looking for a nursing home, compare room rates and additional costs among several facilities. Always ask what is included in the cost of the room. A low per-day rate may increase significantly when you add costs for such things as medications, administration and personal care. The harsh reality is that sometimes the decision will be based on what you can afford. Therefore it is important to know up front what the total cost of care will be and what help is available through Medicare, Medicaid or Veteran’s benefits. It is appropriate to discuss your initial financial concerns during your visit. When comparing prices, be aware that most but not all facilities are obligated to accept patients who qualify for Medicaid. However the number of Medicaid beds in each facility may be limited and names of potential residents may be placed on a waiting list.

PHYSICAL SETTING

Location is major factor to consider when choosing a nursing facility, as distance may affect how frequently family members and friends are able to visit. Also important is the overall physical setting. Does the center offer gracious living in a home-like atmosphere with quality color-coordinated furnishings and surroundings? Is the environment clean, odor-free and have well groomed, attractive lawns and grounds? Does the facility meet your personal standards for cleanliness and neatness? Does the facility meet or exceed local, state and federal fire safety requirements? Are there lounges for family visits and socialization? Is the resident’s room adequately lit? Can the resident provide his or her own decorations, furniture, telephones and televisions?

MEALTIME

Mealtime is usually a highlight of each day in the facility. Most nursing home will be glad to show their menus for the month and talk about the time allotted for each meal, arrangements for special diets, and assistance that is available to residents who can’t feed themselves. Ask the facility to tour the kitchen to determine whether it is clean and whether the cooks and servers are wearing gloves and hair nets. Make sure that the food is prepared in a way that your loved one would enjoy, and served in a pleasant atmosphere. Ask the facility representative whether meals are delivered to residents who are unable to eat in the dining room.

MEDICAL CARE

Medical care is an essential component of nursing home care and you should not hesitate to ask questions about it. Who comprises the treatment team, and how involved are residents in their care? Are there licensed physicians and nurses on duty around the clock or are they only available by phone? Are sick patient treated on the premises or are they quickly transferred to a hospital? How close is the nearest hospital? Are other medical services like dentistry, podiatry, speech therapy, physical therapy or occupational therapy available? If so, what is the frequency of these sessions? Are personal physicians granted privileges in the facility? How experienced is the staff in regard to treating patients suffering from stroke, Alzheimer’s diseases, joint replacements, bone fractures, and related illnesses.

SECURITY, ACCREDITATION & QUALITY

Every nursing facility you consider for your loved one must have a current license from the state and have an internal assurance program in place. Facilities certified by Medicare and Medicaid should be able to produce a copy of the state certification survey, conducted yearly. It is important to note the level of security, specifically whether visitors are required to sign in before they enter the premises. Is solicitation allowed within the facility? Are the residents notified if there is a visitor to see them? Are there security guards and/or cameras at the front desk? Is there a guard on duty around the clock? To better ensure the safety of your loved one, it is important to ask questions about the employees of the facility, specifically the screening process in hiring an employee. Far too often, these questions are not asked because they may seem insulting. Please remember that the safety of your loved one is at stake.

SUMMARY

Choosing a nursing home is in no way an easy decision. In fact, it may be one of the most difficult decisions you ever make. The selection of a nursing home is best made by visiting the facility and by asking questions and then more questions. Do not accept advice blindly. A lack of planning and preparation could lead to a rash decision and toward grave consequences. It is critical that you contact my office and consult with Benjamin Eckman, Esq. an experienced Elder Law attorney who has guided many others down this road before. I sincerely hope that this article eases some of the burden of choosing a nursing home for your loved one.

Benjamin D. Eckman, Esq. concentrates his practice on Elder Law & Estate Planning. Elder law is intended to broadly assist “extended living”. An elder law practitioner provides the legal information necessary for persons whose lives will extend or have already extended beyond the time when all children are usually out of the house and when regular employment ceases. After the elder law attorney and client complete their work, legal documents have been drafted, tax considerations have been analyzed, and a plan to protect the elder’s estate has been implemented.

Benjamin D. Eckman’s practice focuses on Estate Planning & Elder Law – legal issues facing senior citizens. Benjamin D. Eckman received his Bachelor’s Degree in Business/Accounting from Touro College and his law degree from Seton Hall University School of Law. He is a member of the New York State Bar Association, the New Jersey State Bar Association, the National Academy of Elder Law Attorneys, the Elder Law Section and Real Property, Probate and Trust Section of the New Jersey State Bar Association, the Union County Bar Association, Passaic County Bar Association and the Bergen County Bar Association. He can be reached at (973) 709-0909, (908) 206-1000 or (201) 263-9161.