Nursing Home

Checklist is Crucial When Comparing Homes
Glossary of Long-Term Care Terms
CMS Guide to Choosing a Nursing Home
How to Tour a Nursing Home
CMS - Nursing Home Compare
Nursing Home Report Card

CHECKLIST IS CRUCIAL WHEN COMPARING HOMES
When considering placement in a nursing home, it's a good idea to visit various homes. Most nursing homes will arrange for a guided tour.

Ideally, you should visit the home more than once, at different times of the day. Make an appointment to see the administrator or admissions director to explain the purpose of your visit. Mention that you'd like to watch the daily routine and observe as many resident activities as possible. During your visit, talk with residents and staff.

When you visit, bring along a checklist. Below is an abbreviated list of questions to ask. For a complete list of question, call the Advocacy Center for Long-Term Care at (612) 854-7360.

Before visiting a home

• What kind of care do I need and what is the lifestyle that I want to lead in a facility?
• Am I able to wait for a few weeks or even months if a facility has a waiting list?
• Would the home be close to family members and friends? Is it near other community contacts and resources I hope to continue to see and use?

Look at the daily life

• Do residents seem to enjoy being with staff?
• Does staff know the residents by name?
• Does staff respond quickly to resident calls for assistance?
• Are activities tailored to residents' individual needs and interests? Are residents involved in a variety of activities?
• Does the home consider personal food likes and dislikes in planning meals?
• Does the facility have contact with community groups such as pet therapy and scouts?
• Does it have a resident council or family council? If it does, does the council influence decisions about resident life?

Look at the care Do staff and professional experts participate in evaluating each resident's needs and interests?

• Does the resident or his or her family participate in developing the resident's care plan?
• Is a registered nurse available for staff?
• Does the home offer programs to restore lost physical functioning (for example, physical, occupational, speech and language therapy)?
• Does it have any special services that meet your needs? For example, special care units for residents with dementia or respiratory problems?
• Does it have a program restricting the use of physical restraints?
• Does the nursing home have an arrangement with a nearby hospital?
• Is the facility certified for Medicare and/or for Medical Assistance?

Look at the environment

• Are the inside and outside of the nursing home clean and in good repair?
• Are outdoor areas accessible to residents?
• Is it easy for residents in wheelchairs to move around the home?
• Are residents' bedrooms furnished in a pleasant manner and do they have some personal items as well as accessible storage space?

Source: Consumer Guide: Choosing a Nursing Home, Good Age Newspaper.

GLOSSARY OF LONG-TERM CARE TERMS
It's easier to make the right long-term care decisions when you understand the language that experts use to discuss the topic. Here's a glossary of terms commonly used by people in the nursing home and long-term care industries:

Admission Contract - A written, legal consumer contract that a resident or a resident's representative must sign when entering a nursing home or boarding care home. Residents should obtain a copy of the document ahead of time and read the document carefully before signing it. If you have questions or points you disagree with, be sure to have these answered or negotiated before signing.

Boarding Care Homes - These facilities are licensed to provide only personal or custodial care and related services such as meals, laundry, supervision of medication and activities. Unlike nursing homes, they provide minimal nursing care.

Care Conferences - Nursing homes are required to schedule a conference at least once every three months in which the resident's personal care plan is reviewed. A staff person from each discipline involved in the resident's care should attend. The resident, his representative or family members may also attend. Care conferences are a good opportunity for residents and family members to state suggestions, wishes and concerns and to ask questions.

Case Mix - Case mix is Minnesota's method for setting payment rates for nursing home and boarding home care. There are 11 case mix classification levels (A through K) and each corresponds to a different payment rate. Those who need the most care (level K) pay the highest rates and those who need the least care (Level A) pay the lowest rates. An assessment is completed for the resident upon entering the nursing home and periodically thereafter.

Equal Rates Law - Minnesota law requires that all residents in one home, regardless of payment sources, be charged the same rate for the same care. This means residents with the same case mix classification in the same home must be charged the same rate whether their bills are being paid privately, through insurance or by Medical Assistance.

Medical Assistance (MA) - MA, known nationally as the Medicaid program, helps pay the cost of medical care for those who have limited income and assets. About 75 percent of nursing home residents eventually receive Medical Assistance. Under state law, those residents receiving Medical Assistance may not be treated differently than private pay residents.

Preadmission Screening - Anyone applying to a certified nursing home or board and care home must receive a free preadmission screening (PAS). A public health or social service professional will schedule a visit or ask questions over the phone. The professional will then make recommendations about health care options that could meet the person's needs and explain ways to pay for that care. The professional can help the person access Medical Assistance or the Alternative Care program (helps pay for assistance received in the home) if the individual qualifies. A person being screened is not required to adhere to the professional's recommendations. But if the person chooses nursing home care and it was not recommended, Medical Assistance will not pay the cost of that care.

Resident Bill of Rights - Nursing home residents' rights are guaranteed protection by both federal and state laws because they depend on others to provide for their basic needs and are therefore more vulnerable to having the rights taken away or compromised. Resident rights include courteous treatment, information about medical situations an treatments, refusal of treatment, personal privacy and freedom from abuse. A copy of both the federal and state rights is available in all nursing homes. Ask for a copy when you visit.

Subacute Care - Nursing homes with subacute care units may offer a treatment program designed for people who, because of illness, injury or disease, require care that is more medical, high-tech or short-term rehabilitative in nature than regular nursing home care. Consumers should be aware that subacute care is not a recognized level of care by any government or regulatory agency. Therefore, find out from nursing home staff how services offered in their subacute unit differ from these in other units.

Similarly, terms such as transitional care and rehabilitative care are not licensed categories of care either but may refer to comprehensive, short-term care. Again, ask the staff to define these terms and the ways in which the services differ.

Source: Consumer Guide: Choosing a Nursing Home, Good Age Newspaper.

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