Choosing a nursing home requires vigilant research – published August 6, 2012
Rita Watson
The decision to entrust a spouse or relative to nursing home care is fraught with anxiety. Referrals from friends and visits to facilities are helpful. Yet, gleaning facts from state websites or www.Medicare.gov can be difficult because of incomplete or misleading information. As Iris C. Freeman, associate director of the Center for Elder Justice & Policy at the William Mitchell College in Minnesota, said: “The notion of comparative shopping with nursing homes, as one does with consumer goods, is to some extent an illusion.”
Unhelpful Discharge Planners
Oftentimes, the nursing home choice is made during a crisis. A family member is hospitalized, needs rehabilitation and then suddenly long-term care is required. In the hospital-discharge planning process, people rely on hospital social workers who may earnestly wish to help a family. However, a patient is often released sooner than expected, leaving little time to investigate options. And discharge planners may not always disclose whether a home they are recommending has failed any nursing or safety inspections.
California Advocates for Nursing Home Reform
Patricia L. McGinnis, executive director of California Advocates for Nursing Home Reform, said: “Contradictory to their role — appropriate placement — discharge planners are often pressured to get patients out of the hospital because of billing issues.”
A fact sheet, “Challenging Hospital Discharge Decisions” is at www.canhr.org. McGinnis also expressed concern over protecting residents from the abuse and the misuse of psychotropic drugs.
While nursing home directors say that facilities are as heavily regulated as the nuclear industry, quality ranges from caring and safe to shameful.
Ombudsman problem
Despite touting patient rights and ombudsmen (to whom patients and families are often fearful of speaking with honestly), Patricia McCormick, managing attorney for the Elder, Health & Disability Unit at Greater Boston Legal Services, pointed out: “In theory all nursing homes should have ombudsmen, but the challenge takes place when they become so intertwined with management that they don’t always advocate effectively for residents.”
Determining nursing home rating
Determining a nursing home’s inspection rating takes digging. One neighboring state site may indicate a satisfactory rating despite “isolated/actual harm.” Does this mean one incident? Actually, one state media office said “it depends on the circumstances, especially the sample size, how many records were looked at, and facility size. Two in a 300-bed facility, for example, would not be the same as two in a 20-bed facility.”
The most user-friendly source is the National Nursing Home Watch List at www.memberofthefamily.net, which was spearheaded by a physician who was concerned about discrepancies in his medication orders. Unlike many sites, reporting is for three years.
Learning to Breathe by Priscilla Warner
Even if you do the homework and have the money to pay for the best care, there are still no guarantees. One must call, visit often and be concerned about nursing changes and staff training in an industry with high turnover. Priscilla Warner, author of “Learning to Breathe,” said that she changed her mother’s nursing home three times “until I was comfortable.” Warner’s book received high praise on the Today Show by Meredith Vieira.
NOTE: To read the column “As elder abuse grows, causes and solutions sought,” please go to Pamela Reinsel Cotter’s professional Facebook page: facebook.com/pamelareinselcotter.