Choosing a Skilled Nursing Facility

How to Choose the Best Skilled Nursing Facility for Your Loved One

The satirical website “The Onion” recently posted an article titled “Nursing Home CEO Afraid He’ll End Up in One of Those Places He Owns.” And while this article is obviously fiction, it illuminates some very important points about nursing homes and what you need to know before choosing one for your loved one. Choosing a skilled nursing facility can be a very stressful event and here we’re going to provide a list of things to consider before making that critical decision.

No one expects their loved ones to ever need nursing home care, but it’s inevitable for 70% of us. Statistics show that 7 of 10 people will need some form of nursing home care in their life. Whether it be for rehabbing an injury or long-term care, it’s very likely for most of us. We may not like this statistic, but we should all be prepared when that time comes.

Skilled Nursing Facilities vs. Assisted Living Facilities

First let’s distinguish between a personal care home, an assisted living facility, and a skilled nursing facility. A personal care home is a home care facility that provides housing, food, and one or more services for two adults who are not related to the owner or someone in an administrative role. An assisted living facility is similar to a personal care home, but with more emphasis on independence, providing medication reminders, and check-ins.

A nursing home is a skilled nursing facility that provides a wider range of services and higher level of health and personal care. This usually includes 24-hour supervision, meals, assistance with activities of daily living, and rehab services. Usually the rehab services are only for someone there for a temporary stay. If you’re recovering from a fall, hip surgery, knee surgery, heart attack, or stroke, your stay would be for a short time after being discharged from the hospital. This time frame is usually 60 to 90 days depending on the severity of your situation.

If you have ongoing physical or mental conditions that require constant care and supervision, you are more likely to be a permanent nursing home resident. Examples of this would include individuals with Parkinson’s, dementia, or Alzheimers. This would also include those who aren’t able to ambulate or who require a feeding tube.

Choosing a Skilled Nursing Facility

If your loved one requires permanent residence in a skilled nursing facility, how do you ensure that you choose the right facility for them? This is a difficult decision. You should first consider what you want and what’s important to you. From my perspective as someone who deals with skilled nursing facilities on a daily basis, I mainly look at staffing levels and nursing care. I look at what physical therapy facilities they have and if they have a special care unit. Think about what’s important to you and your loved one and make an educated decision based on what facility has those features.

Secondly, talk to friends and family about the places they would suggest. I am quite sure that someone you know has had an experience with one or more of the skilled nursing facilities in your area. Also check with the doctors that your loved one sees on a regular basis. Ask them which nursing homes in the area provide the best care. Always do your own research and do it thoroughly.

The internet can be a blessing and a curse at the same time, but in this situation it’s a blessing because it provides ratings and comparisons for skilled nursing facilities. You can research complaints and violations for all the nursing homes in your area. You can go to the Georgia Department of Community Health website, the Medicare website, or the CMS website to find plenty of information comparing local skilled nursing facilities.

Thirdly, make phone calls and visits to the skilled nursing facilities in your area. Ask them how many residents they have, the cost per resident, and what is their staff turnover. The latter is very important because frequent staff turnover is usually an indication of a poorly-run skilled nursing facility. If the nursing home is always bringing in new staff and having to train them, your loved one is probably not going to receive a high level of care.

Make plans to visit with the executive director and nursing director at these skilled nursing facilities. Visit at different times of the day and use your nose when you visit. Does the facility smell dirty or clean? Look at the residents to see if they look like they’re receiving exceptional care. Are the residents confined to their room or are they allowed to go into the hallway or activities room? Notice what the staff is doing when you visit. Are they actively taking care of the patients or are they busy on their phones? Visit at mealtime to see if the food looks appetizing. Is it something you’d want your loved one eating?

Ask the directors how long they have been at that facility. We have several facilities in our area and it’s really difficult for us to keep track of the directors because they change so often. I don’t really understand why there is such a high turnover with the skilled nursing facility directors, but it seems like they change frequently. Ask the directors if they have an activities person to help the residents with activities. Be as thorough as possible and ask lots of detailed questions.

Skilled Nursing Facility Contracts

Once you’ve chosen a skilled nursing facility for your loved one, they’re going to give you a contract. They’ll have you complete a bunch of forms and tell you where to sign. Be sure to read the contact carefully. Question the director or assistant director about anything in the contract that you don’t understand. Better yet, find someone like myself or another elder law attorney that’s familiar with these skilled nursing facility contracts. We can help make sure you understand all the fine print so that there are no surprises.

I always caution my clients about the arbitration clause that many of these skilled nursing facilities will have. I always advise opting out of the arbitration clause. This will prevent you or your loved one from becoming pigeon-holed into something that you don’t necessarily deserve if something happens to you or your loved one in the facility and you have to take legal action. Also, be sure to check the latest inspection for that skilled nursing facility. Make sure they have a recent inspection on file before signing any contract. If they don’t, call the State inspection agency to see when their next inspection is scheduled.

Contact Us So We Can Help!

This is obviously a very tough subject for most people. No one wants to be in a nursing home, but sometimes it’s the only option for your loved one. If your relative needs a skilled nursing facility, hopefully it will just be temporary stay and they will go home after 60-90 days. But if it’s permanent, we hope these tips were helpful so that you can make the best decision for your loved one.

If you have any questions regarding finding a skilled nursing facility or want us to look over a contract before you sign it, don’t hesitate to contact us. You can complete this form or give us a call at (229) 226-8183. You can also send us an email to dearnursinghomeguy@gmail.com.

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