Five Tips for Choosing a Nursing Home

Five Tips for Choosing a Nursing Home

Few decisions in life are as stressful and as personal as selecting a nursing home for a family member.

Not only are there more options than ever before in history— you’ll also get different opinions on what your priorities should be from everyone in your circle. I’ve been in the long-term care and post-acute care business for more than 20 years and, having worked with countless nursing homes in my time at The Joint Commission, I can offer some detail on how to separate those truly providing quality care from those with fancy marketing collateral.

Here’s what I’d tell my friends to consider when finding a nursing home fit for a family member:

1. Review the federal Center for Medicare & Medicaid Services (CMS) Nursing Home Compare Star Ratings: In particular, look at the quality star rating score, which is a rating of 11 different physical and clinical measures including the use of antipsychotic medications. In the last year, CMS actually re-vamped its Nursing Home Compare model in response to concerns about the high volume of facilities receiving four or five star ratings, as The Joint Commission’s Gina Zimmermann discussed in another blog post. As a result, today’s CMS nursing home ratings reflect an even greater quality representation.
2. Voluntary accreditation: Is the facility willing to hold itself to a higher standard than a state survey by seeking and maintaining accreditation? Rather than just document errors, The Joint Commission surveyors need confirmation that there’s a process for making and sustaining any necessary improvements. We’ll also collaborate and share best practices with facilities that aren’t meeting a standard so they can improve. Any nursing home willing to undergo the extensive commitment to a voluntary accreditation survey is over par.
3. Specialization in high-acuity care: As more people seek higher, more complex care from nursing facilities (not hospitals), many facilities specialize in pulmonary, cardiac, neurology and orthopedic care, to name a few. Some questions to ask are:

Does the facility offer therapies such as speech, swallowing and physical therapies?
Are physicians board-certified in their respective specialization?
What unique programing is offered to meet your family member’s specific medical needs?
4. Rates for readmission to the hospital and discharge to the community. If you are seeking a transitional short-stay in a nursing facility, compare the facilities’ scores in these measures and benchmark them with others in your market. The Centers for Medicare & Medicaid publishes an updated record of nursing home readmission and discharges rates online.
5. Clinical Care Practitioners: Start a conversation to find out exactly who will manage your care in the nursing facility. Ask if it will be the:

Medical Director
Nurse Practitioner
Skilled Nursing Facility Practitioner.
It’s important to know how often this person comes to the facility to see patients or if the clinician is full-time staffed at the facility. Depending on your needs, accessibility to this individual and their ability to help coordinate care can be key. If the care manager isn’t permanently on-site, get a read on whether there’s a strong working relationship with the staff and nursing facility. It’s been documented that far too many medical errors occur in transition—when an individual is transitioned from the hospital to the nursing home or even between different multi-disciplinary care teams. A team that’s truly collaborative really could improve outcomes.

Lastly, trust your intuition. Nobody knows your family’s medical and social needs better than you do. If it doesn’t feel right, it’s probably not the best fit. Luckily, there are plenty of quality options out there.