Here are some tips for choosing the kinds of long-term care people most often use: home care (including home health care) and nursing homes.
In many States, home care agencies must be licensed. Check with your State health department to see if your State requires it. If so, be wary if an agency is not licensed.
Ask if the agency is certified by Medicare. Medicare inspects home health care agencies to assure they meet certain Federal health and safety requirements. Medicare will pay for services only if the agency is Medicare-approved and if the services are covered by Medicare.
If the home health care agency is certified by Medicare, you can review its survey report. Call the Medicare Hotline at 1-800-633-4227 and ask to be referred to the Home Health Hotline for your State. You can request a copy of the report from that hotline.
Find out if the agency has been accredited (awarded a "seal of approval") by a group such as the Joint Commission on Accreditation of Healthcare Organizations (630-792-5800); http://www.jcaho.org ) or the Community Health Accreditation Program (1-800-669-1656; http://www.chapinc.org ).
Contact your State or local consumer affairs office to see if any complaints have been filed against a home care agency. Also ask about the outcome of any complaint investigations.
Whether you work with an agency or hire someone yourself, carefully check the backgrounds of the people who will be coming into your home. Ask for references who have worked with the agency or person. Call them, and ask about their experiences. Would they use the agency or person again?
Does the home care worker have the necessary skills and training for your needs? Ask to see training certificates. Make sure the worker knows how to safely assist and care for patients.
Does the agency have supervisors who check on the quality of care its workers provide?
How does the agency follow up on and resolve complaints?
Nursing Home Care
All nursing homes that participate in Medicare or Medicaid are visited about once a year by a team of trained inspectors. They check the home and the care provided and prepare a survey report. You have a right to review the report, which must be posted in the nursing home. Speak to the nursing home administrator to learn more about any problems that appear on the report. Ask if the problems have been corrected.
Call your State or local Long-Term Care Ombudsman. Ombudsmen visit nursing homes on a regular basis and know about each nursing home in their area. You can ask about the latest survey report and about complaints that have been filed. You can also ask what to look for when visiting local nursing homes.
Some nursing homes have been accredited by a national group such as the Joint Commission on Accreditation of Healthcare Organizations (630-792-5800). It may be helpful to find out if the home participates in this voluntary process and to learn the results.
Location is very important. Is the nursing home close enough so that family and friends can visit? Close enough for the resident's personal doctor to visit?
The most important step is to visit-more than once-and look around. Go at different times of the day-for example, first thing in the morning and at mealtimes.
Do residents seem to enjoy meals? Is there help for those who cannot eat on their own? If possible, eat a meal at the facility.
Is the home clean and free of odors? Is it pleasant?
Are residents clean, well groomed, and dressed appropriately for the season and time of day? Are they involved in activities?
Are staff friendly, helpful, and respectful?
Talk to staff, residents, and families to find out what they think of the facility.
Ask to see the area where physical therapy and other rehabilitation services are provided.
Is the nursing home experienced with special needs-for example, problems with swallowing?