how to select a nursing home?

Many people simply choose the closest facility. Before making this decision, you should do a little shopping. Some facilities are better than others. Unfortunately, there are facilities that consistently violate state standards and subject their residents to poor care. You should start by asking friends with relatives in nursing homes for their recommendations. Ask your physician and nursing staff if there are places close to you that stand out as very good or very bad.

Pick three or four facilities close to home and prepare to visit. When you first walk into a nursing home, take a deep breath. How does it smell? As you walk down the halls, take another deep breath. How does it smell? Look at the floors. Are the floors clean? These simple observations will alert you to conditions that residents live with daily. A facility that does not keep residents clean will smell bad. A facility that allows floors to stay dirty does not put a high priority on cleanliness.

Ask to see the most recent survey report. Every year, the State Government inspects each nursing home and prepares a survey report. This report cites deficiencies found by state surveyors during recent inspections of the facilities. It describes violations in detail and describes the efforts by the facility to correct problems.

If the documented problems show poor care of residents, incompetent staff, a callous attitude by management, or if a facility took too long to correct problems, you probably do not want your loved one there. Sometimes, poor care creates new problems. For example, unanswered call lights can lead to urinary incontinence when a person needs help going to the bathroom.

By law, nursing homes must make this and other compliance reports available to you. The facility must also post a notice informing you that these documents are available. If the facility fails to meet any of these requirements during your visit, notify the Department of Human Services in your state. Remember, facilities are often at their best when the state government inspects them.

In fact, most facilities have some violations, but this does not necessarily mean the facility provides poor care. You will be more concerned about some violations than others. Standards exist for several areas, including nursing care, quality of life, dietary services, physician services, rehabilitative services, infection control, pharmacy services, facility management, and observation of resident rights. Violations of these standards are labeled by "tags" on the survey report.

Following is a brief summary of the violations to look for in a facility's survey reports:

-- physical, verbal, sexual, and mental abuse, and involuntary seclusion and misappropriation of resident property.

-- residents' dignity and individuality have not been respected.

-- residents' needs and individual preferences have not been accommodated.

-- housekeeping and maintenance for a sanitary, comfortable, orderly environment has not been maintained.

-- beds and bath linens are not clean and in bad condition.

-- residents do not receive help to maintain good nutrition, hygiene, and grooming.

-- residents do not receive help with exercise in order to prevent the decline of their ability to move.

-- residents with mental or social problems do not receive help in order to help them adjust to living in a nursing home.

-- the facility does not provide adequate help to prevent accidents and minimize accident hazards.

-- adequate diet, proper medical assistance, and hydration have not been provided to each resident.

-- the facility does not have an infection control program to prevent development and spread of disease.