Dear Baxter,
My husband and I are evaluating nursing homes for his mother. We set up several tours. We are wondering if you could suggest questions to ask at these meetings? Thanks for your help!
Wanda Fine-Darytwan
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Dear Wanda,
When you visit a nursing home to check it out, it’s important to be prepared. It is a good idea to conduct tours of at least three separate facilities. Here are some basic questions to ask during the tour:
Problems or special needs:
•How would your home deal with my father’s [dementia, weight loss, disability following stroke, or ____________________ ].
Toileting
•How do you handle incontinence?
•How often do staff members help incontinent residents use the restroom?
•How many residents are in diapers?
•How many residents have indwelling catheters?
•Do you utilize condom catheters for male residents with urinary incontinence?
Nutrition
•How flexible is your menu—can residents make choices, or are all Monday meals the same, for instance?
•How do you identify residents who are losing weight?
•What do you do to make sure residents are eating, especially those who have lost interest in food?
•Can residents eat meals whenever they want, or are meals only at scheduled times?
•Are healthy snacks available?
•Does your home honor religious or cultural dietary restrictions? Could you show me a sample menu of a [gluten-free, dairy-free, Kosher, low salt, or ______________] diet?
•How do you ensure that your meals meet high nutritional standards?
Falls
•What do you do to prevent falls?
•How often do residents fall?
•What do you do when there’s a fall?
Health inspections
•Please show me your last three survey inspection reports.
•How has your home fixed any problems that were identified?
•How quickly were the problems addressed?
Medical care
•How often is a doctor on site?
•Are dental services available?
•How do you keep track of residents’ medical records?
•If you have computerized health records, have you ever had any problems with the system?
•Do residents receive preventive care such as annual flu and pneumonia shots?
•Does your home arrange for regular hearing or vision screening?
•If Mom has a medical need, who contacts the doctor?
•If Mom needs to see her doctor, who arranges for transportation?
•What hospital arrangements do you have for emergencies?
Staffing
•What is annual rate of your nurse and nurse aide turnover?
•What do you do to try to improve turnover?
•How often do you use agency temp nurses?
•What proportion of families would you say hire private nursing aides or sitters to supplement your staff?
•How often do nurses and aides update doctors on residents’ health status?
•What kinds of background checks do you perform prior to hiring?
•Do you have volunteer programs?
•Do you have a relationship with local schools or houses of worship?
Safety
•Do you have an emergency evacuation plan?
•Do you hold regular fire drills?
•Who helps residents with bathing?
•Do you do nightly bed checks?
•How often does the staff check on residents during the day?
Overall direction
•What improvements have you put in place in the past year?
•What other improvements are planned?
•Do you often have to put residents on a waiting list?
•Where would we direct our questions and concerns if we were to enroll our dad here?
Feel free to tailor these questions to your situation. And for an even more complete list of questions, please see our website at
http://farrlawfirm.wpengine.com/wp-content/uploads/2014/06/NURSING-HOME-EVALUATION-TOOL.pdf
Hope this is helpful and that you find the right place for your loved one!
Sincerely,
Baxter
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