Questions to Ask Yourself

Although this website and this category in particular are designed for persons considering nursing home care, readers should first remember that a nursing home is not the only alternative for a person who finds himself needing assistance in his daily life. Other alternatives which could meet the person's needs in a more desirable way may exist, such as Meals on Wheels or nutrition services, homemaker services, home health care services, adult day care centers, assisted living retirement communities, etc. To find out what alternative paid or volunteer resources or services exist in your area, you may wish to contact your parish Council on Aging. 

If, however, a person does decide to enter a nursing home, the question becomes which facility would best meet his needs. Because the facility chosen will become the person's home, and because the quality of nursing homes vary widely, the decision is one that should be made carefully after much deliberation. 

Gathering Information 
The first task in choosing a nursing home is discovering what options are available. Perhaps the best way to accomplish this is to obtain a list of area nursing homes from the local Council on Aging or the nursing home ombudsman program in your parish. For more information on the ombudsman program in your area, you may contact the Off ice of the State Ombudsman, Post Off ice Box 80374, Baton Rouge, Louisiana 70898-0374 (telephone: 504-925-3990 in Baton Rouge or 1-800-259-4990 statewide). 

Once you have determined which nursing homes interest you, you may wish to know if any complaints have been filed against the facilities and what the State found upon investigating these complaints. To learn this information, you can contact the following State agency: 

Visiting the Nursing Homes 
Perhaps the most important step in selecting a nursing home is to visit the facilities which interest you. It is best to visit the facilities more than once and at different times of the day. For example, you may wish to visit in the morning to see if residents are properly assisted in getting out of bed and dressing, at meal times to see if meals are pleasantly presented and the dining room atmosphere is to your liking, and in the evening or on the weekends to see if staffing appears adequate at these "off -times." 

On your first visit to the nursing home, you should ask to see a copy of the latest survey results regarding the facility. The State inspects each nursing home each year and the facility is required to make the results of the inspection available for examination. If the nursing home is reluctant to let you examine this report, this should be a warning sign that perhaps the facility is hiding problems from you. 

During your first visit, you should also make an appointment to meet with the administrator or admissions director to make sure that the nursing home meets your needs. You should request answers to your questions, such as:

• Is the facility certified for Medicare and Medicaid?

• Does the facility assist residents in applying for these benefits? 

• What costs are included in the basic fee and what services are provided at extra cost? 

• Are there nurses on duty around the clock? 

• Is the facility able to meet special needs, such as rehabilitation therapy, special diets, or respiratory care? 

• What programs does the facility have in place to assure that residents do not decline physically (such as by losing mobility, becoming incontinent, etc.)? 

• What is the facility's policy on the use of restraints? 

• How does the facility respond to a medical emergency? 

• Does the facility honor residents'wishes regarding advance directives, such as living wills? 

• Will the facility provide you with references? 

• Will the facility provide you with a copy of its rules and regulations?

During your visits, also take time to speak privately with the residents. Many nursing home residents love seeing visitors and will be more than willing to share their thoughts and experiences with you. Ask them questions such as:

• Would you recommend this nursing home to me as a place to live? 

• What do you like and dislike about the facility? 

• Are the staff responsive and courteous? Do they respond quickly when called? Do they consider your complaints seriously and try to correct the problems? 

• Does the facility keep your room clean and free from pests? 

• Are you allowed to wake up and go to sleep at times you prefer?

• Are the meals tasty and varied? Are snacks available when desired?  

• Are the activities fun and interesting? Is there a variety of activities or simply the same ones (such as bingo) over and over? Do outside groups (such as Scouts, church groups, school groups, etc.) visit the nursing home often? 

• Are religious services held in the facility?

• Is transportation available for outside services? 

• Is there a television available for residents to watch? Who decides what channel the television is on? 

• Does the facility respond quickly (such as by calling a doctor) when you have a medical complaint? 

• Have you ever been restrained against your will? Does the nursing home often restrain or over-medicate other residents to keep them under control? 

• If you have funds on deposit with the nursing home, is it easy to get your money when you need it? 

• Are you allowed to smoke or have an alcoholic drink if you desire? Are there too many restrictions on these rights? 

• Are you allowed to go outside when you wish? 

• Have you or other residents ever had anything stolen here? How did the facility respond? 

• Is your mail given to you promptly and unopened? 

• Do you have access to a suitable telephone for private conversations? If you need a private area for a personal visit, is this provided?

In addition to asking questions, be observant. Notice the following:

• Does the facility appear clean? 

• Are the grounds well-kept and accessible to residents? 

• Do staff members seem to be polite, busy, attentive, and responsive?

• Do residents appear to be clean and appropriately dressed? 

• Are residents restrained or do they appear over-medicated? 

• Are residents who need assistance (such as with eating) given the necessary help? 

• Do the residents seem interested or stimulated by the activities taking place? Are bed-bound residents also provided with alternative activities? 

• Are there handrails in the hallways and bathrooms? 

• Is the noise level acceptable? 

• Do residents have sufficient light for reading or activities? 

• Is there a persistent unpleasant odor? 

Know Your Rights Regarding Admission 
Finally, it also important that you know your rights regarding admission to a nursing home. For example, the nursing home may not take any of the following actions: 

• Require you to give up your rights under Medicare or Medicaid 

• Require oral or written assurances that you are not eligible for, or will not apply for, Medicare or Medicaid benefits 

• Require that someone else personally guarantee payment in order for you to be admitted, to be admitted more quickly, or to continue to be allowed to stay in the facility 

• If you are eligible for Medicaid, the nursing home may not charge, solicit, accept, or receive any gift, money, donation, or other consideration as a precondition for admission, expedited admission, or continued stay in the facility