A nursing facility is a long-term care facility. Nursing facilities provide care for people with illnesses and disabilities that make it difficult for them to stay in their own homes. Nursing facilities are not hospitals. They provide a room; meals; help with daily activities such as eating, bathing, and dressing; and supervision. Nursing facilities are also called nursing homes or care centers. Because the facility is a home, people who live there are called residents.
The idea of living in a nursing facility does not appeal to most adults. It is a hard decision for them and their families to make. Nursing facilities can, however, be a good choice for both the resident and the family if they know what to expect.
People live in nursing facilities for many different reasons. Nursing facilities provide:
Nursing facilities offer several types of services:
Start by researching several facilities close to friends and family. You can get lists of nursing facilities from a hospital discharge planner, social worker, or the local Area Agency on Aging.
State or local ombudsmen are officials who work on behalf of nursing facility residents. They may be able to steer you toward good facilities and away from bad ones. The Area Agency on Aging or your state's department of aging can help you find the ombudsmen in your area.
Call each nursing facility you are considering. Ask about waiting lists and admission requirements. Then visit each facility even if some do not have a bed currently available. There is no substitute for on-site visits. Pay attention to how the facility treats your request for a visit and how much they allow you to see. This will tell you a lot about their attitude toward residents and their families.
Try to check out 3 or 4 nursing facilities. If possible, the family should visit each facility with the person who may live there.
Visit the facilities at different times of the day without calling first. Be there during meals and activities. Consider the size of residents' rooms and privacy. Look at the kitchen and laundry facilities, the recreation area, therapy rooms, and all other areas of the facility. Talk to other residents and their families to learn how satisfied they are with their care. Notice if the facility seems cheerful or depressing. Look at how staff members interact with residents. Ask the staff if they like working there, and if so, why.
A good nursing facility should:
When you visit a nursing facility, answer for yourself the following questions about the facility, staff, and services.
Staff and services
It may be quicker and easier for the staff to do things for the residents. However, most adults are happier and healthier if allowed to do as much for themselves as possible. Notice whether the staff encourages residents who want to walk, dress, and feed themselves.
It is also a good idea to find out how the facility deals with residents who have problems with bladder and bowel control. Do they encourage frequent trips to the bathroom and the use of adult diapers only when necessary? Do they often use urinary catheters?
The family and future resident should meet with the administrator of the nursing facility. This gives you a chance to get answers to questions about activities, care, and services offered to residents and families.
Ask to have all rates and charges fully explained. Ask for a written list of the services and supplies that are included in the basic rate and what costs extra.
Ask for a copy of the admission contract. Ask them to explain anything that you do not fully understand. A private attorney or one from legal services at the Area Agency on Aging can provide advice if there are terms you do not understand or that seem unreasonable. It should be possible to change the contract.
Ask for a copy of the most recent state inspection report (also called the state survey) on the facility. According to federal guidelines, nursing facilities are required to provide their latest inspection report to residents and the public. The family is entitled to take a copy home. There may be a small charge for the copy. This report may also be available on the Internet. If you cannot get a copy of the report, there may be a problem in the way the facility operates.
Most inspections identify some problems. Many of these are minor and may not affect the quality of care. You should be concerned if any major problems are cited. Find out if the problems have been corrected and what is being done to keep them from happening again.
You must feel confident that the nursing facility administrator is qualified, competent, and responsive to residents, their families, and staff. This individual is responsible for everything that happens in the facility and is the person to contact when there are problems.
Nursing facility care can be paid for with personal funds, long-term care insurance, Medicaid, or Medicare. Sometimes several of these payment methods are used.
Living in a nursing facility is expensive. Nursing facility care costs $30,000 to $75,000 a year. The amount you pay depends on where you live and the type of room. Some nursing facilities will accept only residents who are paying with personal funds. Most people cannot afford these costs for very long. When they have spent all their money, many need government help to pay for nursing facility costs. The Medicaid program pays for most of the nursing facility costs in the US.