Increasingly one of life’s landmarks is when the time comes to choose a nursing home.
It should be a carefully thought out process, but typically the decision is made when a loved one is about to be discharged from a hospital, often with 48 hours or less notice.
Even on that tight deadline it’s possible to make a good choice.
Lee Bowman, medical reporter for Scripps Howard News Service, talked to many of the nation’s top experts on nursing homes to come up with some guidance.
They recommend starting with the U.S. Centers for Medicaid and Medicare Services’ Nursing Home Compare, a database that ranks 15,700 nursing facilities on a star system, from one star — “much below average” — to five stars — “much above average.”
Around 12 to 13 percent of nursing homes have the top rating; slightly more than 20 percent the lowest.
But the star system can be slightly misleading.
In a study of the CMS database, Scripps Howard came up with a few general principles to help read between the ratings:
n Homes run by nonprofits, about two-thirds of all facilities, generally score better than those run by for-profits and tend to have more nursing staff per patient.
n Homes with more than 100 beds tend to get lower scores in all categories, including the health of their residents and the level of nursing care.
Experts recommend finding a nursing home close to the patient’s home for the simple reason that it’s easier for family and friends to visit.
He also recommends meeting the home administrator and making several visits to the facility at different times of the day to talk to the staff and inspect the home’s public areas for upkeep and cleanliness.
Look for longevity among the key caregivers.
If more than 25 percent of the staff are recent hires, that can be a worrisome sign of turnover and employee dissatisfaction.
The best recommendation is perhaps the hardest — plan early. It’s human nature for a family to avoid discussing what happens when a loved one can no longer be looked after at home.
Choosing a nursing home is a difficult decision but knowing in advance the patient’s preferences and priorities removes much of the stress from the process and greatly improves the chances that the ultimate decision will be the right one.