When choosing a nursing home, below are are nine essential questions to ask when making a decision:
- What is your staff-to-resident ratio, and how is staffing managed?
Staffing and quality of care are directly related. Low staffing frequently results in neglect and/or shoddy care, which increases the risk for injury. Ask about staffing coverage during days, nights, and weekends. Don’t be contented with answers about state-mandated staff-to-patient ratios; these minimum staffing requirements can and often do fall short of meeting residents’ needs, which federal regulations require.
- What is your staff turnover rate?
High turnover can be a red flag, signaling either poor management or unhappy employees. An environment of low morale where employees are feeling resentment can directly impact quality of care, resulting in neglect and even abuse; moreover, a revolving door of unfamiliar caregivers is far from ideal. Look for stable staffing where reliable, attentive care is possible.
- What measures do you take to prevent bedsores?
Bedsores (aka pressure ulcers) are a top warning sign of nursing home neglect. Nursing homes should perform skin assessments of new residents. If a resident is determined to be at risk for pressure injuries, pressure-reducing methods like frequent turning and repositioning should be implemented immediately. The home also needs to develop a care plan for at-risk residents. This care plan might include interventions like pressure-reducing mattresses and cushions, skin ointments, and other measures.
- What methods do you use to prevent falls?
Falls are a leading cause of nursing home injuries. Like with bedsores, a nursing home should use an assessment/care plan approach to safeguard at-risk residents from falling. Proper staff training should be included as part of a home’s fall prevention policy. Fall-detection systems and other modern technology may also be implemented.
- What infection control protocols do you have in place?
Like bedsores and falls, infections are a top indicator of neglect. A quality nursing home should have clear-cut infection prevention protocols in place and have adequate numbers of trained staff in order to detect and immediately address any signs or symptoms of infections.
- What safety and security measures are in place for residents?
Security means more than locks and alarms. Ensure that the nursing home monitors for safety by using surveillance systems and by adhering to specific visitor policies. The nursing home should outline what guidelines it follows to prevent nursing home abuse and neglect (such as refusing to hire employees with any history of abuse or neglect), as well as procedures for reporting poor care, endangered resident safety, abuse, and neglect.
- Can I review your most recent state inspection reports?
State inspection reports show how well a facility performs; it will reveal any health and safety violations or care deficiencies. Any reputable nursing home will openly share these reports and offer explanations about what they’ve done to correct any deficiencies or issues.
- How do you ensure dignity and respect for your residents?
Residents have a right to be treated with dignity and respect. Learn what kind of training in compassionate care staff receives for upholding the self-esteem, individuality, and rights of its residents.
Residents should feel comfortable voicing concerns. Ask how the nursing home responds to complaints and whether or not it provides highly visible contact information for persons or groups that help with problems, including the state Long-Term Care Ombudsman and the Medicaid Fraud Control Unit.
- What do you do to provide for residents’ emotional security?
Nursing home care goes beyond physical care. For residents to be comfortable, they must feel emotionally secure. Learn what steps a nursing home takes to provide structured routines in familiar settings, and what opportunities the facility provides to keep residents socially and emotionally engaged. Ask whether residents have a voice in their day-to-day routines, including activities and food preferences. Ensure the home encourages family involvement to help residents feel secure in their new home.
