Health Care Reform:

What Caregivers Should Know About Nursing Home Care

Nursing Home Checklist

• Does the nursing home provide the level of care needed?
• Does the nursing home meet local and/or state licensing requirements?
• Does the nursing home's administrator have an up-to-date license?
• Does the nursing home meet state fire regulations (including a sprinkler system, fire-resistant doors, and a plan for evacuating residents)?
• What are the visiting hours?
• What is the policy on insurance and personal property?
• What is the procedure for responding to a medical emergency?

Admission

• Is there a waiting period for admittance?
• What are the admission requirements?

Fees and financing

• Are fees competitive?
• Have fees increased significantly in the past few years?
• Is the fee structure easy to understand?
• What are the billing, payment, and credit policies?
• Are there different costs for various levels or categories of services?
• Are the billing and accounting procedures understandable?
• Does the nursing home reveal what services are covered in the quoted fee and what services are extra?
• What governmental financing options are accepted (such as Medicare, Medicaid, Medicare Supplemental Insurance, Supplemental Security Income, and others)?
• When may a contract be terminated? What is the refund policy?

Needs assessment

• Is there a written plan for the care of each resident?
• What is the procedure for assessing a potential resident's need for services? Are those needs reassessed periodically?

Professional staff

• Do the nurses, social workers, and administrators have geriatric experience and/or education?
• Are staff members available to meet scheduled and unscheduled needs?
• Do staff members seem to genuinely enjoy working with the residents?
• Do staff members treat residents as individuals?
• Is staff available to assist residents who experience memory, orientation, or judgment losses?
• Does a doctor or nurse visit the resident regularly to provide medical checkups? 
• Do residents appear happy and comfortable?
• Do residents, other visitors, and volunteers speak favorably about the nursing home?
• Are residents clean and adequately dressed?
• Are the rights of residents clearly posted?

Facility design

• Do you like the appearance of the building and its surroundings?
• Is the decor attractive and home-like?
• Is the floor plan easy to follow?
• Do doorways, hallways, and rooms accommodate wheelchairs and walkers?
• Are elevators available?
• Are handrails available?
• Are shelves easy to reach?
• Are carpets secured and floors made of a non-skid material?
• Is there good natural and artificial lighting?
• Is the residence clean, odor free, and appropriately heated/cooled?

Medication and health care

• What is the policy regarding storage of medication and assistance with medication?
• Is self-administration of medication allowed?
• Who coordinates visits from a physical, occupational, or speech therapist if needed?

Services

• Is staff available to provide 24-hour assistance with activities of daily living, if needed? Daily activities include:
• Dressing
• Eating
• Mobility
• Hygiene and grooming
• Bathing, toileting, and incontinence
• Using the telephone

Room features

• Are rooms for single and double occupancy available?
• Is a 24-hour emergency response system accessible from the room?
• Are bathrooms private? Do they accommodate wheelchairs and walkers?
• Can residents bring their own furnishings? What may they bring?
• Do all rooms have a telephone? How is billing handled for long-distance calls?