Families are often faced with the need to find a care facility for a loved one on very short notice after a hospital stay or an unexpected health problem. This is a difficult decision required at a very stressful time. The hospital may be saying that Medicare will not pay for any more days in the hospital and an immediate transfer is necessary. Home care may not be an option and the family is faced with finding an appropriate placement.
Q: Will hospitals arrange for a patient to be transferred to a nursing facility?
A: If the patient is being transferred from a hospital, the hospital social service worker usually makes a recommendation and may actually arrange for admission to a facility. However, patients and families may not like and do not have to accept the social worker’s choice. Patients and family members should tell the social worker about any preferences they may have.
Q: What should I look for when choosing a nursing facility?
A: Whether you are considering a hospital-recommended facility or looking for one on your own, there are some guidelines you should follow and data you can access. First and foremost, visit the facility. Go at meal time, if possible, so you can learn about the quality of the food and the dining experience for residents, and so you can observe the facility staff at a busy time. In most nursing homes, not everyone is bedbound, and you should see a number of residents who are up and dressed. If possible, visit the facility more than once and at different times. Also notice the facility’s appearance. Is it clean? What odors are noticeable?
Q: Who should I go to with my questions?
A: Administrators, directors of nursing and other management staff of facilities can answer most questions, but talk with residents and their families as well. Focus on quality of care, life at the residence, activities, food, number of staff, resident rights, resident relationships with staff and other issues of concern.
Q: Is there anything else I can do to find out about a facility?
A: Yes. You can find resources that list facilities and report on their performance. For example, the Ohio Department of Aging offers a Web-based consumer guide (http://www.ltcohio.org/consumer/index.asp) lets you search for facilities geographically, by name or affiliation or by types of services needed. The site also provides links to the state inspection reports and family satisfaction surveys. These reports tell you where the state found deficiencies in facility operations. Once you’ve gathered data about the facility you are considering, compare it with the data from other facilities in the area to determine whether the findings posted on the site are significant or serious. For Medicaid- and Medicare-certified homes, the state inspectors must “rank” any deficiencies according to the severity and scope of the deficiency – the seriousness of the violation and how many residents it affects. Often the facilities contest state findings and, upon reconsideration, the state will withdraw or change a finding; however, that information will not necessarily be posted. Ask the facility administrator about anything in a report that concerns you.
Q: Is there other information that might help?
A: Yes. The U.S. Department of Health and Human Services Web site also includes the National Clearinghouse for Long-Term Care Information (www.longtermcare.gov/LTC/Main_Site/index.aspx).
Q: Assuming none of the facilities in my area is perfect, what are the most important qualities I should look for?
A: While some facilities achieve “perfect” inspections from time to time (a very difficult thing to do), most facilities show some deficiencies. The real concern is whether they affect the quality of care provided and whether the facility promptly addresses them. A good facility staffed with caring people who communicate with the resident and family can make a significant difference in the resident’s quality of life.
Law You Can Use is a weekly consumer legal information column provided by the Ohio State Bar Association. This article was prepared by Martha Sweterlitsch, an attorney with the Columbus firm of Benesch Friedlander Coplan & Aronoff.