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In many cases, when a loved one begins to need more care than the family is able to provide, the family's only option is to place that person in a facility. To choose a facility that is appropriate for your loved one, you must consider a number of factors, such as:
- the type of facility that best meets the loved one's care needs
- the facility's record for following regulations about care, including minimum staffing
- the location of the facility
Then take these steps for each facility you are considering ...
If you can, time your visits so you can observe mealtimes and meal service. Also try to visit in the evening or on a weekend so you can observe whether the facility has enough staff at those times.
2) Talk to families
Ask whether the facility has a family council. If so, speak with representatives of the council. Be sure to ask
- How available is the administrator to residents' families?
- Is the facility adequately staffed?
- Is the quality of the meals acceptable?
- Is the nursing care of good quality?
- Do staff members respond promptly to call lights and calls for help from residents?
- How does the administration respond to complaints?
- What is the facility's occupancy rate? (Are there a lot of vacancies in the building?)
3) Get information from CMS
Use the Nursing Home Compare website of the Centers for Medicare and Medicaid Services (CMS) to check the facility's staffing levels, results of past surveys, and other regulatory information.
CMS has developed quality measures to make it possible to compare the performance of nursing homes. Information about these measures is available on the CMS website. The Nursing Home Compare site uses quality measures to help you choose the best facility for your loved one.
Some of these measures are:
- incidence of restraints
- incidence of pressure sores
- weight loss
- pain management
- declines in activities
- use of antipsychotic drugs
- management of delirium
- post-acute pain management
- improvement in walking
4) Get information from OLTC
The Office of Long Term Care surveys each facility every 9 to 15 months (for a statewide average of once every 12 months). The survey is a "snapshot" evaluation of the care provided in the facility. Our survey teams always include at least one registered nurse and other professional staff. We also investigate complaints made by the public.
Ask OLTC for copies of:
- survey reports
- complaint history
- records of enforcements that followed surveys, if any
- records of denial of payment for new admissions, if any
- records of civil money penalties, if any
- records of termination of the Medicare/Medicaid provider agreement, if any
5) Check what is posted
Facilities are required to post the results of the most recent OLTC survey and the OLTC Complaint Hotline number, which is (800) 582-4887. They also must post on each hallway a list of staff available.
6) Stay involved
Like all organizations, facilities change over time. After your loved one is placed, visit often, keep asking questions, and stay involved.