Choosing a nursing home for a loved one can be daunting and time-consuming. Experts say you should break it down, starting with deciding if a retirement home is the right option or if it’s the right time. Seniors may be better off with home or community care, housekeeping or meal services, or adult day programs, for example.
Housing for people aged 55 and over could provide the framework an older person may need to live independently without too much extra care. Assisted living facilities with meals or à la carte health services can also provide sufficient care for a person in need of assistance.
Once health conditions require full nursing care, the length of stay will help determine where to start your search, said Vince Mor, a professor at the Brown University School of Public Health.
“If you’re looking for rehabilitation or post-acute care for a stroke or a broken hip after a hospital stay, you’ll be looking at a different set of criteria than a long-term stay,” Mor said.
Families looking for top-notch facilities for this post-acute care should first visit the Centers for Medicare and Medicaid Services’ Care Compare website to review Medicare vs. Medicaid funding volume for the home. Those who receive more health insurance are likely to specialize in rehabilitation, with more therapists. The family may also be more interested in reviewing facility readmission rates for so-called resident rehab stays.
Long-term stay decisions should be based on a broad analysis of all quantitative data available online, combined with qualitative information in person.
“Once you get to the point where you can’t get out of bed, cook, dress, or go to the bathroom on your own, you’re likely to need more care on an ongoing basis,” Mor said. “The same facility that does a great job of rehab with Medicare patients might not be the best place to stay.”
Because nursing homes are federally regulated, they are subject to greater scrutiny, producing reports to the federal government that feed into the Care Compare site. Some of this information is self-reported, while some is taken from algorithms that rank key metrics. Some go through in-person inspections by auditors.
Experts named Care Compare as the first stop for key metrics like staffing levels and infection control. New data points have been added during the pandemic to help consumers, including resident and staff immunization status and death data during outbreaks. USA TODAY released a new tool here that uses federal data and a government formula to rank nursing home performance during the height of the pandemic last year.
Other independent news organizations like ProPublica provide search tools on their websites that may be helpful, said Bob Stephen, vice president of health and care at AARP. Her agency hosts a care home guide and a “10 questions to ask” feature on its website.
Local aging agencies also often provide resources. Some state health departments collect data on skilled nursing facilities and publish it online. Ombudsman in each state serve as a liaison between residents and settlements and often offer resources on choosing homes.
Stephen warned that people should be careful when looking for sites and services that include a limited view of homes based on whether an establishment is a member of a specific organization, and be wary of those who receive a commission for the landing of residents.
“I would be a bit wary of the authenticity of online reviews and cautious about giving out your information as you will be solicited – and with organizations having financial ties to ranking sites, you can imagine there has a conflict,” Stephen said.
The American Health Care Association, the nation’s leading industry group of for-profit nursing providers, hosts a site, OurSeniorCare.org, with resources from its member facilities and a checklist of questions to ask operators.
Families should seek qualitative advice on their nursing home decision, said Toby Edelman, senior policy attorney at the Center for Medicare Advocacy.
“Look at your network and who you know, consider asking your church or someone you know who has had actual experience at these facilities,” Edelman said.
Edelman said statistics and reports offered online for a nursing home may also be outdated. Conditions could change quickly with new administrators, new owners or different personnel. She recommended researching patterns over time and then consulting with people with first-hand installation experience.
Similarly, Edelman said star ratings and inspection citations from the Centers for Medicare and Medicaid Services often don’t reflect the maximum penalty for serious problems and routinely describe problems as “harmless” when the reality is more. complex.
Data filings, homework and counseling should always be accompanied by in-person visits, said Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, a group that advocates for long-term care consumers.
Full in-person visits have been limited for much of the coronavirus pandemic, but are slowly coming back. During a visit, the family must use all their senses.
“What do you see and hear? The locals are calling? Are you hearing the appropriate music? Are staffing levels posted? And what are the interactions of the staff with the residents? Smetanka said.
Experts warn that you shouldn’t be distracted by the “gloss effect” of fancy furniture that doesn’t always translate to quality care. The family can pay attention to the small details: Are the residents well cared for and engaged, or do they seem comfortable? Do staff members refer to residents by name?
Smetanka said the visits help answer not only questions about physical needs, but also support the emotional well-being of residents.
“You can ask questions like: What kinds of activities do you have here? How do you organize outings and if people want to go out in the community? Smetanka said. “Is there an expectation that the family can visit at any time? It would be a red flag for me if they restricted visitors to certain times at this point.
And after gathering as much information about the facility as possible, Smetanka said, the cost will inevitably have to be factored in. The median cost in 2021 of a private room in a nursing home was $9,034 per month, according to the Genworth Cost of Care Survey.
Generally, Medicare pays for up to 100 days of rehabilitation in nursing homes. Then Medicaid can be used, but it has complex eligibility requirements and seniors may need to tap into private funds.
Nick Penzenstadler is a reporter with USA TODAY’s investigative team. Reach him at npenz@usatoday.com or @npenzenstadler, or on Signal at (720) 507-5273.
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