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Tips for Choosing the Right Nursing Home

Caregiver

There are several key factors to consider when you are contemplating a nursing home for yourself or a loved one.
 

Covid Considerations

The COVID pandemic has made it more challenging to judge a home—most nursing homes won’t allow walk-throughs and staff shortages are an unfortunate reality nationwide. But it is possible to do some preliminary research to learn whether a nursing home might be a good fit for you or your loved one.

If you are concerned about the COVID vaccination rate in nursing homes, statistics show that roughly 85% of nursing home residents in Michigan had two shots, but only 26% had the booster as of late November. About 62% of nursing home staff had two shots, but only 10% had the booster. During the four weeks ending on November 21, nearly 75% of nursing homes confirmed staff cases of COVID. The numbers come from AARP’s Public Policy Institute, which is tracking COVID data.

A recent survey by the John A. Hartford Foundation and the University of Chicago found that most Americans 50 and up are not willing to live in a nursing home. Not surprisingly, most say the COVID pandemic has affected their attitudes, and an overwhelming number say nursing homes need significant changes.
 

Long-term Ombudsman Program Can Be a Resource

We spoke with Mary Katsarelas and Louise Verbeke, who are part of the state’s Long Term Care Ombudsmen Program. Their job is to advocate for residents in licensed long-term care facilities like nursing homes, adult foster care homes and homes for the aged.

The two ombudsmen, who work out of the Area Agency on Aging 1-B (AAA 1-B) with their colleague, Elaine Hearns, offered their expertise in choosing the right nursing home.
 

Location—Close to Home Often Works Best

If you’re going to be visiting, choose a home that is close to where you live.

“If something happens and you need to get there, such as your loved one gets sick or hurt, the quicker you can get to them, the better,” says Verbeke. “You want to know what’s going on; you don’t want second- or third-hand information.”

Rush hour traffic and bad weather are realities to consider, too, says Katsarelas. You want to be close enough to the nursing home so that they don’t seriously impact your ability to get there.

If you live in a more rural area, you may have better luck. Nursing homes in smaller towns tend to hire locals, and often they are known to nursing home residents.
 

Size of Facility

If you or your loved one is mobile and active, a larger facility – 100 beds or more—might be more suitable because it will offer more activities and social opportunities. Introverted people and those with memory issues may fare better in a smaller facility, one with under 50 beds. There are more opportunities for one-on-one attention.

“The smaller ones are more adaptable to dementia residents,” says Katsarelas.

Younger people who use a wheelchair because of a medical condition like MS or who have a developmental disorder may opt for a nursing home that offers more activities like shopping and going out for lunch, says Verbeke.
 

Environment

Is the place clean? Does the food look good? If you are hit with a bad odor when you walk through the front door, turn around and leave.
 

Staffing

Most nursing homes are suffering from a staff shortage, so judging them based on the number of staff they have may be unfair.

Many of them are using staffing agencies to find help, and turnover is high, says Verbeke.

But, the more staff a nursing home has, the better, says Katsarelas.
 

Staff-Resident Interaction

When you have a chance to tour a nursing home, take note of how staff and residents talk to each other and how staff responds to residents’ needs.  Are staff helping residents eat? Are residents getting regular showers?

“Look at staff attitudes, their interactions with residents,” says Katsarelas. “All of those interactions are really important.”
 

Activities

What sort of activities are available for residents who have dementia? Do residents seem to be stimulated?
 

Responsiveness

If you call and don’t get a call back, or it takes a lot of time to hear from the home, that is a good indication of a lack of responsiveness. Move on.
 

Nursing Home Compare/Inspection Reports

The state inspects nursing homes and posts results of inspections online. You can view reports and compare nursing home scores at Medicare.gov or by clicking here.

“Look at what they’ve been cited for in recent surveys,” says Katsarelas. When comparing nursing homes, scroll all the way to the bottom of the page.
 

The Upshot

COVID has upended nursing homes, and while the pandemic continues, they are all facing the same realities with staffing and COVID closures when someone is exposed to the disease.
 

The Long-term Ombudsman Program Is Here to Help

If you aren’t sure about a nursing home, call the Long Term Care Ombudsmen Program. Advocates like Katsarelas, Hearns and Verbeke can’t make direct recommendations, but they can help point you to surveys to make a more informed decision. They can also advise you against a nursing home if they know the home to be problematic.

If you have a complaint about a nursing home, you may call the Michigan Long Term Care Ombudsman Program at (866) 485-9393 or file a complaint online at LARA (Michigan Department of Licensing & Regulatory Affairs).  You can also call the Complaint Hotline at (800) 882-6006.

You may also call individual LTC ombudsmen, who cover certain territories in the 6-county service region of the Area Agency on Aging 1-B:

  • Elaine Hearns (Macomb and St. Clair): (248) 515-3199
  • Mary Katsarelas (most of Oakland County): (586) 295-0367
  • Louise Verbeke (Livingston, Monroe, Washtenaw and parts of Oakland County, including South Lyon, Troy, Rochester Hills, Royal Oak, Ferndale, Beverley Hills, Clawson, Madison Heights and Lake Orion): (586) 980-9303

To file a complaint against an Adult Foster Care home or a Home for the Aged, call (866) 856-0126.

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