Aging Well: Choosing a Nursing Home

Choosing the right nursing home is a very personal process. If you're helping someone else who is of sound mind, the final choice is up to that person.

If your loved one isn't mentally capable of making a decision, another person (maybe you) needs to be given the legal right to choose for him or her. By making your loved one as much a part of the process as possible, you can help him or her find the right place to live.

If this is the case, choosing a nursing home can be a delicate process. A nursing home that seems perfect to you might not seem that way to your loved one. He or she may be having a hard time leaving home. Your loved one may feel sad or frustrated at what feels like a loss of control over his or her life.

As you look at each nursing home, keep in mind that there are no federal requirements for how many employees a nursing home has to have. Ask questions to make sure that there are enough nurses and other staff to give you or your loved one the care you need.

Visiting a nursing home is the best way to find out if it's right for you or your loved one. People you know and trust may recommend nursing homes that they like. The best way to see if the nursing home, the residents, and the staff feel right to you is to go there in person.

If you can, visit the nursing homes on your list with your family. It may be helpful to keep written notes about each nursing home. You may want to visit each one more than once.

You may also want to try just dropping by the nursing home so you can see what it's like on a normal day. While you're there, ask for a copy of the most recent inspection report.

As you look at the choices before you or your loved one, pay special attention to the cost of each nursing home, how each one feels to you, where it's located, and the levels of nursing care it provides. Does the nursing home provide enough help with daily tasks? Is 24-hour nursing care available?

Answering the following questions can help you make the best possible decision:

• Does the nursing home feel right to you or your loved one?
  • Is the nursing home clean and odor-free? Are there smoke detectors and sprinklers? Are there handrails where you would need them?
  • Do the residents seem clean and comfortable? Is the staff responsive and friendly to them? How long does it take for a resident's call lights to be answered?
  • Are individual rooms available, or will you share with another resident? Can you bring your own furnishings? Will you have your own bathroom, or are these shared?
  • Do residents with special needs, such as dementia or Alzheimer's disease, live in separate areas?
  • Does the nursing home have a social director who plans events for the residents? Are religious services held? Is a hairdresser or barber available?
• Can the nursing home provide the kind of care you need?
  • Will your doctor be able to direct your care? If not, find out how often the nursing home's medical director personally visits each resident.
  • Can you see the state licenses for both the nursing home and the administrator? Both should be licensed in the state where the nursing home is located.
  • Can you see a copy of the nursing home's most recent state inspection report?
• Does the nursing home have adequate, qualified staff?
  • Does the nursing home staff have experience caring for people with your unique needs?
  • Is the nursing home able to retain qualified staff members? One good way to find out is to ask how much staff turnover there is.
  • What is the education level of the staff? Does the staff get regular educational training?
  • Does the nursing home screen potential employees to make sure that it doesn't hire people with a history of abusing others?
• How will you pay for your stay?
  • How much does the nursing home cost? Price can change depending on the nursing home and the type of care offered. Talk with your family, social workers, or eldercare agencies in your community about your payment options. If you have concerns about how you'll pay for a nursing home, talk to representatives from Medicare and/or Medicaid.
  • Think about your payment options:
    • Many people pay for nursing home services with their own money.
    • Some people have long-term care insurance that helps cover some costs.
    • Medicaid and Medicare offer resources for people who qualify.
  • Don't cancel your health insurance. You can use it to pay for hospital care, doctor services, or medical supplies in the nursing home.
• Is it the right location?
  • If you plan to have family and friends visit you, think about choosing a nursing home that's close by and easy for them to visit.

Visit the Medicare Nursing Home Compare website at www.medicare.gov/NHCompare/Home.asp to learn more about:

• How to choose a nursing home.
• Your payment options.
• Your rights as a nursing home resident.

For more information on Medicare and Medicaid benefits, visit www.cms.gov or call toll-free 1-800-633-4227.

To learn about alternatives to nursing homes, visit www.medicare.gov/nursing/alternatives.asp.

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