Choosing the right long term care organization is a challenging task. Whether it will be for yourself, a family member or a friend, it is important to know what questions to ask when you visit long term care facilities.
Long term care organizations:
― known as nursing homes, skilled nursing facilities, or extended care services ― provide 24-hour nursing or rehabilitative care to both young and old. The goal of care in a nursing facility is to help individuals meet their daily physical, social, medical, and psychological needs and to return home whenever possible.
When you are faced with making a nursing home decision, ask your doctor, hospital discharge planner or community social service agency to recommend several nursing homes in the area of your choice. Then, visit each one and talk with the manager or other staff members about the organization’s services, policies, history and staff credentials. The following questions can be a guide to gathering the information to find the best match for your needs.
About the organization:
• Does the organization have a written description of its services and fees? What resources will the organization provide to help you find financial assistance if it is needed? Will Medicare and Medicaid provide payment for eligible residents?
• How is the organization staffed during evenings and weekends? How many nurses are on duty?
What is the ratio of nursing assistants to residents? How are medical situations handled that are beyond the organization’s capabilities?
• Is the community involved in the organization? Does the organization have volunteers who work in the resident care areas? If so, what is the nature of interaction with residents?
• Do the medical and nursing programs offer restorative physical, occupational and other therapies? If offered, does the organization’s dementia special care unit provide a physical environment that is designed for the safety of the residents and the common behaviors associated with dementia?
• Do you know the organization’s philosophy about end-of-life decisions? Are residents or their families involved in decisions that will prolong life with artificial means?
Individual and family concerns:
• Does the organization provide the services you or your loved one needs? Does a qualified staff member conduct a preliminary evaluation of the resident’s needs? Can you be involved in this evaluation or assessment?
• Does the organization create a plan of care for each new resident? The plan of care should include details about the care to be provided, the frequency of this care and the period of time over which the care will be provided. The plan of care should be updated as the resident’s needs change. Will you be involved in establishing the plan of care?
• Are the resident’s individual psychosocial needs attended to? Is the environment comforting? Are there activity programs? Are there opportunities to attend religious services?
• Does the facility explain the resident’s rights and responsibilities? Ask to see a copy of the organization’s resident rights and responsibilities information.
• Does the organization have a resident and family council? These councils meet regularly to talk about the care and services provided by the nursing home and ways to improve them. How often are the meetings? How does management deal with suggestions from the councils, families and residents?
• Is attention given to individual food preferences? Can substitutions be made to the menu? Can food be brought in from outside? Is there an opportunity to meet with a registered dietitian?
• Is there a newsletter, website or other regular communication that is available to residents and their families? Ask to see a sample.
Questions about quality:
• Does the organization accept payment from Medicare and Medicaid? For eligible residents, Medicare and Medicaid will provide payment for designated services offered by a certified agency. Medicare certification means the organization has met the minimum health and safety requirements established by the federal government.
• Does the organization have a quality improvement program? Does the organization monitor itself or does it rely only on state oversight?
• Does the organization have an emergency plan in case of a power failure or a natural disaster? In an emergency, can the organization provide care or make arrangements for care to be provided?
• What is the procedure for receiving and resolving resident complaints?
• Is the organization accredited by a nationally recognized accrediting body such as The Joint Commission? Joint Commission accreditation means that the organization voluntarily sought accreditation and met national health and safety standards.
To find out if the long term care organization you are considering is accredited by The Joint Commission, see Quality Check at www.qualitycheck.org.