What Should You Consider When Choosing a Nursing Home?

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By Robert F. Daley

Making the decision to put yourself, or a spouse, or a parent, or even an incapacitated adult child into a nursing or personal care home can be a tremendously difficult ordeal on its own. But once you’ve made that decision, another difficult one looms: choosing the nursing home itself.

Understand your options
The first step in selecting the proper care for your loved one is understanding your options. We often find that many people do not know the differences between various care models, making the selection process even more overwhelming. Educating yourself on these differences can make your decision much easier.

  • Skilled Nursing Care: Depending on the situation, skilled nursing care can be utilized on a short-term or a long-term basis. For instance, short-term care may be required for recovery from an illness, injury or surgery, while long-term care is typically required for those with chronic medical conditions, severe pain or those with permanent disabilities. In general, skilled nursing care, whether it’s short or long term, is for those individuals requiring round-the-clock care. Skilled nursing facilities are highly regulated, licensed and inspected by state and federal agencies.
  • Personal Care: Personal care homes are designed for residents who can maintain a high level of independence, but need some level of help with daily tasks. Assistance with bathing, dressing, walking, medication administration, personal hygiene, housekeeping, laundry and arranging and transporting to physician appointments are some of the day-to-day tasks offered by a personal care home. However, personal care homes do not provide the type of care found in skilled nursing facilities. These facilities are also regulated by state and federal agencies and inspected on an annual basis.
  • Assisted Living: For many years in Pennsylvania, there wasn’t a clear difference between personal care and assisted living. After legislation was passed in 2007 defining clear differences between the two, however, the Pennsylvania Office of Long-Term Living began to license assisted living residences separately from personal care homes. This change was initially enacted to bridge the gap in care between personal care homes and skilled nursing homes, with an alternative solution offered at a lower cost.

According to the Office of Long-Term Living, assisted living residences are different from personal care homes in three ways: concept, construction and level of care. From a “concept” perspective, assisted living residents can “age in place” for a longer period before being transferred to a skilled nursing facility. “Construction” refers to core building requirements, including creating a model that allows for more privacy and independence. Assisted living residences are also required to have larger units, private bathrooms and kitchen facilities. Regarding “level of care,” assisted living residences are required to provide more assistance for a resident whose needs become too great for a personal care home, allowing them to stay in the facility longer.

Do your research
To narrow down your options, talking to people is key, especially at the beginning of your search. Ask friends, co-workers or business associates for recommendations or for the names of people they know have been through this process before. Online research is also a good way to gather information and get a general sense of what a particular nursing home or care facility is like. You may also be able to access basic information about certain facilities via government web sites. 

After narrowing your choices based on the information you’ve gathered and factors such as geographic location and affordability, visit the nursing homes on your list at least once during both visiting and non-visiting hours.

During these visits, take time to observe the general mood of the residents you see. Do they seem happy? In pain? Worried? Also, take note of how well the facility is maintained. Are the hallways and common areas clean and well-lit? Are the residents outside their rooms and engaged in daily activities? These questions are important when determining the best fit for your loved one.

You should also ask to view the most recent state survey of the facility. A copy of that report should be readily available for review at the nursing home’s front desk. You can also ask for the contact information of the facility’s ombudsman. The ombudsman will answer any direct questions you have regarding complaints involving specific facilities.

Create a pro/con list
Once your initial research and visits are complete, take time to thoroughly review your options before making a decision. It may also be helpful to list out the pros and cons of each facility. Creating a document to house your thoughts will make it easier to point out clear discrepancies between each facility and narrow down your choices.

Regardless of the care model or facility, the most important thing to remember when selecting a new home for your loved one is to make sure your values align with the organization. Only you know what’s best for you and your family. Be vocal with your needs, and choose an environment that’s well-suited for your situation.

– Robert F. Daley, Robert Peirce & Associates, bdaley@peircelaw.com