How To Find a Good Nursing Home

Poor-quality nursing home care is still too common in the United Stats, but there are ways to avoid it, says Consumer Reports.

The magazine's September issue includes Consumer Reports' analysis of 16,000 U.S. nursing homes.

"We ended up classifying 4% of the homes in the country as homes to consider, and 3% of homes in the country as homes to avoid," says Charles Phillips, PhD, MPH.

Phillips directs the Health Services Research Program at Texas A&M Health Science Center. He worked with Consumer Reports on the nursing home project.

"Our data is really a starting point for families when they begin to look for a nursing home," says Trudy Lieberman, who wrote the magazine article.

Lieberman directs the Center for Consumer Health Choices at Consumers Union, which publishes Consumer Reports.

Lieberman and Phillips discussed the article in a media teleconference.

Tips For Finding Good Nursing Home Care

Consumer Reports suggests these steps for people looking for a nursing home:

  • Get the names of local facilities Call Eldercare Locator (800-677-1116) to find your local agency on aging.
  • Check Consumer Reports Nursing Home Quality Monitor which has state-by-state findings, at www.consumerreports.org/nursinghomes.
  • Check on ownership Independent nonprofit facilities may be better than for-profit chains, according to Consumer Reports.
  • Check with your local long-term care ombudsman This government official can be found through your local agency on aging. He or she should know about local nursing homes.
  • Don't rely on the federal Web site Nursing home information at www.medicare.gov may be "incomplete and possibly misleading," says Consumer Reports.
  • Visit homes several times
  • Read each home's Form 2567 That's the facility's state inspection survey.
  • Check on the staff Talk to the home's administrator and ask about top-level staff turnover.

    Nursing Home Visits

    Consumer Reports has specific suggestions for nursing home visits.

    First, make unannounced visits. Go at different times of day.

    If you go in the morning — say, around 9:30 a.m. or 10 a.m. — see how many people are still in bed. "Homes with too few staff members don't get people out of bed until late in the day, if at all," says the magazine.

    If you go around dinnertime, check out the dining hall.

  • "If 75% of the residents are eating in their rooms, that's not a good sign," says Consumer Reports. "Most people prefer to be out of bed and to eat in the dining room."

    Those aren't hard-and-fast rules. But visiting before committing may give you a better sense of what life is like in that nursing home.

    Already Made Your Choice?

    Do you already have a loved one in a nursing home? Consumer Reports' Web site offers these tips for ensuring good care:

  • Follow up on the care plan Federal law requires nursing homes to gauge new residents' physical, mental, and social abilities and make a care plan for them.
  • If possible, attend the first care plan meeting with the resident That way, you'll know what's in the plan.
  • Try to attend monthly care plan meetings "Speak up when you feel your relative needs change," says the magazine.
  • Visit frequently You'll see how the home is working out for your loved one.
  • Get involvedIf the home has a family council or residents' council, take part.
  • Troubleshoot Raise unsolved issues with your local long-term care ombudsman or community watchdog group.

    Not All Bad

    The vast majority of nursing homes in the study — 93% — weren't rated either as a home to consider or one to avoid.

    But 12 have been on Consumer Reports' poor-performance list since the magazine started the list in 2000.

    "I don't want to leave the impression that all nursing homes in this country are bad. There are many nursing homes that are doing a good job of trying to provide care," Lieberman says.

    Nursing home leadership can change quickly, so some poor performers may improve while others may decline, Lieberman adds.

    Poor-quality nursing homes are a "chronic, tough issue," Bruce Yarwood, president and CEO of the American Health Care Association, says in the Consumer Reports article.

    But "for every bad story, there are probably 50 good ones," Yarwood adds.

    SOURCES:: Consumer Reports, "Nursing Homes, Business as Usual," September 2006; Vol. 71: pp. 38-41. Charles Phillips, Ph.D., MPH, director, Health Services Research Program, Texas A&M Health Science Center. Trudy Lieberman, director, Center for Consumer Health Choices, Consumers Union. Consumer Reports, "How You Can Find Good Nursing Home Care," September 2006; Vol 71: pp. 41-42. ConsumerReports.org: "Ensuring Good Care." ConsumerReports.org: "How the Nursing Home Quality Monitor was Created."
    By Miranda Hitti
    Reviewed by Louise Chang, M.D.
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