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DATELINE: DEDHAM AND PLYMOUTH, MASS…The Commonwealth Advisory Group in Dedham, providing professional guidance to seniors and their families with regard to asset preservation and Medicaid regulations prior to nursing home admission, will hold a FREE seminar on Thursday, January 24, 2008 at 11 a.m. at Stafford Hill Assisted Living, 60 Stafford Street in Plymouth.

Protecting Assets and Qualifying for Medicaid

Attorney Philip Amaru and Executive Director Laureen Vaughn of Commonwealth Advisory Services will provide a one-hour presentation on the topic of how to protect assets from the high costs of nursing home care. Attorney Amaru will discuss the steps that may be taken in the case of an immediate need, as well as steps that ensure future assets are protected should the circumstance of nursing home admission ever arise.

Attendees will also learn about Medicaid regulations and how to qualify for Medicaid.

“Nursing home costs can be as high as $10,000 per month. During our seminar, in addition to asset preservation, we discuss how monthly nursing home costs can be reduced drastically and that ‘spending down assets’ is not necessary for benefit qualification. There are ways to preserve everything that you or your loved one has worked a lifetime for and that’s where we come in,” noted Amaru.

As professional speakers, Attorney Amaru and Ms. Vaughn speak to a variety of audiences about asset protection including Councils on Aging, nurses and other health professionals, Certified Professional Accountants, unions and elder service agencies. Recent speaking engagements include Milton Hospital; The Southeastern Area Department of Mental Health Committees and the Friends of Taunton State Hospital’s Caregiving for the Aging Mental Health Population.

For more information about this seminar, or to book a seminar, contact Laureen Vaughn at 800-705-1415.

Asset Preservation Planning

For 16 years, the Commonwealth Advisory Group has helped over 1,500 clients save their assets (which includes property, gifted assets, retirement accounts, insurance policies, investments and savings) prior to and during an admission to a nursing home. Unlike financial planners, Commonwealth Advisory Group specializes in asset preservation for elders and their families.

In addition to providing asset protection services to clients, Attorney Amaru and Executive Director Laureen Vaughn serve as educational speakers for hospitals, elder agencies and businesses throughout Southeastern Massachusetts. Commonwealth Advisory Group has appeared with Jordan Rich of WBZ News Radio 1030 in variety of seminars on the topic of Senior Asset Protection.

Attorney Amaru is a member of the National Academy of Elder Law Attorneys; the National Network of Estate Planning Attorneys; the Massachusetts Academy of Trial Attorneys; the Massachusetts Bar Association and the American Bar Association.

Commonwealth Advisory Group is located just off Route 128 at 3 Allied Drive, Ste. 125, Dedham, MA. For more information, contact 800-705-1415 or visit www.CommAdvise.com.

DATELINE: DEDHAM AND PLYMOUTH, MASS…The Commonwealth Advisory Group in Dedham, providing professional guidance to seniors and their families with regard to asset preservation and Medicaid regulations prior to nursing home admission, will hold a FREE seminar on February 26, 2008 at 11 a.m. at Stafford Hill Assisted Living, 60 Stafford Street in Plymouth.

Protecting Assets and Qualifying for Medicaid

Attorney Philip Amaru and Executive Director Laureen Vaughn of Commonwealth Advisory Services will provide a one-hour presentation on the topic of how to protect assets from the high costs of nursing home care. Attorney Amaru will discuss the steps that may be taken in the case of an immediate need, as well as steps that ensure future assets are protected should the circumstance of nursing home admission ever arise.

Attendees will also learn about Medicaid regulations and how to qualify for Medicaid.

“Nursing home costs can be as high as $10,000 per month. During our seminar, in addition to asset preservation, we discuss how monthly nursing home costs can be reduced drastically and that ‘spending down assets’ is not necessary for benefit qualification. There are ways to preserve everything that you or your loved one has worked a lifetime for and that’s where we come in,” noted Amaru.

Attorney Amaru and Ms. Vaughn speak to a variety of audiences about asset protection including Councils on Aging, nurses and other health professionals, Certified Professional Accountants, unions and elder service agencies. Recent speaking engagements include Milton Hospital; The Southeastern Area Department of Mental Health Committees and the Friends of Taunton State Hospital’s Caregiving for the Aging Mental Health Population.

For more information about this seminar, or to book a seminar, contact Laureen Vaughn at 800-705-1415.

Asset Preservation Planning

For 16 years, the Commonwealth Advisory Group has helped over 1,500 clients save their assets (which includes property, gifted assets, retirement accounts, insurance policies, investments and savings) prior to and during an admission to a nursing home. Unlike financial planners, Commonwealth Advisory Group specializes in asset preservation for elders and their families.

In addition to providing asset protection services to clients, Attorney Amaru and Executive Director Laureen Vaughn serve as educational speakers for hospitals, elder agencies and businesses throughout Southeastern Massachusetts. Commonwealth Advisory Group has appeared with Jordan Rich of WBZ News Radio 1030 in variety of seminars on the topic of Senior Asset Protection.

Attorney Amaru is a member of the National Academy of Elder Law Attorneys; the National Network of Estate Planning Attorneys; the Massachusetts Academy of Trial Attorneys; the Massachusetts Bar Association and the American Bar Association.

Commonwealth Advisory Group is located just off Route 128 at 3 Allied Drive, Ste. 125, Dedham, MA. For more information, contact 800-705-1415 or visit www.CommAdvise.com.

Help someone deal with emotions over moving

The decision to move — whether to an independent living community, assisted living community, or nursing home — is only the beginning of what can be a long and challenging journey. Helping someone through this important transition takes research and planning. Here’s a 10-step guide to smoothing her way to her new home and the next phase of her life.

1. Talk to her — and don’t forget to listen.

Even though moving will often improve her quality of life, it’s also likely to stir up all kinds of emotions, and even trigger what Nan Hayes, founder of Moveseniors.com, calls “transition trauma.” Many older adults are filled with anxiety about what a move will mean. They may see moving as a sign of defeat and a harbinger of increasing loss of control and independence.

The listening part should come first — find out as much as you can about her health, needs, fears, and hopes, so you can help her make the best choice possible.

After that, it’s your turn to talk. Help her understand that moving can be “just as freeing as going away to college,” Hayes says. The range of options has broadened tremendously since her parents’ day, and as the human lifespan gets longer and longer, a late-in-life move has come to be a rite of passage just as natural as buying a starter home. If you can help her see a move as a positive transition rather than a defeat, you’ll be off to a good start.

2. To reduce stress, hold off on selling the house if possible.

Moving is hard enough without asking her to live in a home that a realtor is showing to prospective buyers. If she has the assets to finance a move in the short run — or if you can lend her the deposit or entrance fee — move first, sell later is the way to go. If she’s moving to a community where she has to buy an apartment or condominium, a mortgage broker may be able to help her get a “bridge loan” to cover the down payment until she sells her home.

3. Plan on giving her extra support after the move.

A move may be the best thing for her, but it’s also going to be exhausting for her, physically and emotionally. A good assisted living community will offer plenty of support during the transition, but if you’re able to make time for extra visits in the days or weeks after the move, it will help reassure her that the most important things in her life — like family and friends — aren’t going to change.

4. Consider bringing in the pros.

A professional Geriatric Care Manager can assess the level of care an older adult needs, find senior communities in your area, navigate the application process, and prepare for a move. These services can be especially useful if you don’t live in the same state as the person who’s moving and can’t be there to manage the day-to-day aspects of her transition.

5. Help get her finances in order.

This is crucial in order to know what kind of care she can afford and how she plans to pay for it. Also, many continuing care retirement communities and other facilities will ask for thorough documentation of her income and assets in order to be sure she’ll be able to pay for her care over the long haul.

If she doesn’t have an accountant who can help you pull the paperwork together, the Society of Certified Senior Advisors can refer you to a financial planner who specializes in assisting older clients.

6. Get her home appraised.

If she’s planning to sell her home to finance a move, today’s topsy-turvy housing market makes a professional appraisal a must before assessing her financial position.

7. Talk to a doctor.

Deciding what kind of community is best for her is a medical decision as well as a personal one. Her family physician may be able to evaluate her and make a recommendation. If not, ask for a referral to a geriatrician who can do a full evaluation, or go to the American Medical Association’s Doctor Finder and search under “geriatrics” in your area.

8. Shop around.

In most areas of the country, there’s a wide range of options when it comes to eldercare communities. A good place to start is Caring.com’s local services directory, where you can search for nursing homes, continuing care communities, and assisted living facilities in your area. Your local Area Agency on Aging should be able to steer you to local communities. Your local Chamber of Commerce might also be able to help. Once you’ve narrowed down the list, tour several places — with the person in your care — and make sure to take time to talk to residents, eat a meal, and really get the feel of the place before making a decision.

9. Read the fine print.

Yes, those long contracts can be overwhelming, but don’t give in to the temptation to skim documents before signing (or asking her to do so). The contracts and agreements that come with moving into any kind of community may well spell out the parameters of the care she will — or won’t — receive for the rest of her life, so make sure you, and she, understand exactly what you’re agreeing to before putting pen to paper.

If you spot something worrisome or have questions the facility can’t answer to your satisfaction, the National Academy of Elder Law Attorneys can refer you to a lawyer who can go over the paperwork with you.

10. Plan the move logistics carefully.

Downsize and deal with belongings now to avoid moving day chaos. An estate liquidator can often help you with selling what she won’t need, and a senior move manager can help with all the logistics. Bring in a senior move manager who specializes in transition and relocation of older adults.

Myth #1: Nursing home facilities smell bad.

Reality: Most good nursing home facilities rarely smell bad, and when they do, chances are, it will be taken care of promptly. Not only are nursing home facilities inspected by each State on behalf of the Medicare administration every twelve to fifteen months, but they are also inspected by family members and other health professionals, albeit more informally, on a regular basis. So while you may encounter an unpleasant odor on one visit, it’s likely you may never experience it on subsequent visits. If you do, take it up with the administrator. Nursing home administrators are typically very sensitive to this issue and will take action quickly.

Myth #2: Nursing home facilities are like hospitals.
Reality: Nursing homes are residential facilities that provide medical care, but they are not like hospitals. The environment in nursing home facilities is much less clinical, for one thing. In addition, community living has a much different feel than a temporary stay in a hospital. Nursing homes offer activities to keep residents engaged in the community, and interacting with one another. And as neighbors, residents often form lasting friendships.
 
Myth #3: The people who live in nursing home facilities are all dying.

Reality: Nursing homes provide continuous medical care for people whose medical conditions require around-the-clock care or monitoring. While it is true that some elderly and terminally ill residents may be dying, at that point they are certified by their doctor to receive hospice (i.e., end-of-life) care, and that is certainly not the case for all residents. Many nursing home residents simply need a higher level of care than is available at an assisted living facility.

Myth #4: All nursing homes are the same.

Reality: This couldn’t be farther from the truth. It is important to carefully research the nursing homes you are considering, because despite stringent federal regulation, all nursing homes are different. This can be a wonderful thing-for example, when it creates a strong sense of community among residents-but it can also have a down side, especially when a facility does not address problems that affect residents’ quality of life and/or quality of care.

Myth #5: Caregivers can use restraints to control residents.

Reality: Restraints may only be used when it is medically necessary for a resident’s safety or the safety of others. It is unlawful for nursing homes to administer physical or chemical restraints for any other purpose.

Myth #6: Insurance will pay for my nursing home care.

Reality: It depends on the type of coverage you have. Many people are surprised to learn that Medicare only pays for 100 days of nursing home care per illness, and prior to that, you must meet a number of requirements before you are eligible for benefits. Also, only the first 20 days are covered in full; the rest requires a significant co-payment ($133.50 per day in 2009). After that point, you are responsible for paying for expenses out of pocket until you become eligible for Medicaid. Some long-term care insurance policies provide coverage in a nursing home facility, but not all. If you have a long-term care insurance policy that provides nursing home coverage, check your policy to determine your coverage limits and restrictions.

Myth #7: There is no privacy in a nursing home facility.

Reality: It’s true that there is typically less privacy in a nursing home facility than in other types of senior housing. Most rooms are shared by two residents, and caregivers may enter the room as needed-visitors, too, as desired. However, nursing homes are required to maintain a private area for visits with family, and most facilities try to respect residents’ privacy as much as is possible. Residents have the right to privacy, and to keep personal belongings and property as long as they don’t interfere with the rights, health or safety of others.

Myth #8: Nursing home residents have limited rights.

Reality: Nursing home residents retain all of their legal rights once they move in. In addition, Medicare has established a Nursing Home Residents’ Bill of Rights that clearly defines residents’ rights pertaining to: respect; services and fees; money; privacy; and medical care.

Myth #9: A move to a nursing home facility is a permanent move.

Reality: Most nursing homes have wings for both long-term care and short-term care. The long-term care wing is for residents, while the short-term care wing houses people who are recovering from an illness, injury or surgery and require rehabilitation. So while a move to a nursing home facility may be permanent for some people, many others return home once they have sufficiently recovered.

Myth #10: Nursing home residents are always on caregivers’ schedules.

Reality: It’s true that a structured schedule can enable caregivers to do their jobs in the most efficient manner possible. However, more and more rest homes are recognizing the need to address residents’ needs in a more holistic manner, and in a way that honors their dignity and preferences. This includes empowering residents with more options and autonomy in setting their own schedules.

Why are there so many people who want to become home health care nurses ? By 2020, the world will need almost one million nurses, as more and more population will be getting old or sick for various reasons. This will make it easier and more desirable to land a job in this field someday. Moreover, the nursing profession is perhaps one of the highest-paid professions these days. A registered nurse, for example, can earn an average of $50,000 annually.

The Difference between Regular Nurses and Home Health Care Nurses

In truth, there’s not a stark difference between home health care nurses and regular ones, except that you can find nurses mainly in hospitals while home health care nurses can mainly be found in hospices, nursing homes, and in patient homes. Normally, their patients are elderly, who may need some assistance from professionals. It’s also one of the reasons too why a travel nurse also specializes in home health care. Rather than allowing the patient to suffer or be inconvenienced by commuting, they offer their services at the comfort of their patient’s home.

How to Become a Home Health Care Nurse

A home health care nurse needs to have the following:

1. The proper degree. You can never be a home health care nurse unless you have a proper educational background, which includes a nursing degree. Almost all universities and colleges all over the world offer some type nursing programs, so it shouldn’t be too hard for you to search for schools.

2. Certification. Home health care nurses need to be certified, or licensed, before they can practice their profession. Certifications can vary widely from state to state and country to country. A certified home health care nurse will want to be sure to be licensed properly to avoid legal issues. Anyone who wishes to become a home health care nurse should be aware of the rules and requirements in the area they wish to practice in beforehand.

3. Experience. Novice home health care nurses can still land a job; however, the more experience you have in this field, the higher your chances of getting better opportunities. While you can earn a sizeable income working for a home health care company, you will have more income potential if you are hired for private home health care nursing.

4. Patient bill of rights. A home health care nurse is required to provide a patient bill of rights to the patient or to the family or a representative of the patient just in case he doesn’t have the capacity to read or understand his rights. This means that nurses should be very knowledgeable in his or her duties and the rights of the patients under his or her care. 

5. Close coordination with doctors. Nurses should have excellent communication and analytical skills so that medical situations can be described properly. Home health care nurses may need to coordinate with other health practitioners and doctors at times when  the ailment is severe, requiring immediate help, or unusual, requiring a specialist.

FIRST-CARE OF NEW YORK Inc. is a New York State Home Care service agency licensed by the New York State Department of Health.  We provide services to: Westchester, Bronx, Brooklyn, Queens, Manhattan and Staten Island.

We pride ourselves on our ability to provide customized home care services for all of our patients.  Careful attention is given to identify each patient’s needs; thereby providing effective and affordable services to our patients every step of the way.

Our Areas of Service Include:

Nursing Care
Certified Home Health Aides
Certified Personal Care Workers
Homemakers
Live-In Care

First-Care of New York Advantage:

First Care of New York is licensed by the NYS DOH and accredited by the Joint Commission to provide home care services.

We are contracted with various:

Managed Long Term Care Programs
Long Term Home Health Care Programs
Hospice program
Certified Home Health Agency

Serving :- Manhattan, Bronx, Brooklyn, Queen, Staten Island and Westchester County.

Advantages :-

Depending on the patient’s needs, if they require assistance with activities of daily living, rehabilitation or skill nursing (pre pour medication, wound care, etc…).  First-Care can facilitate and ensure that proper and immediate care is in place.

Physician: Do not have to fill out M11Q’s and submit them to CASA for approval of home care services and wait months before service begins for the patient.  Instead, submit to First Care a referral form and First Care will arrange for services to begin within a week or 2 and deal with the entire process.

If a member switches from a Medicaid HMO program to a Managed Long Term Care Program.  (Takes approximately 4 weeks)

Clinics:

PCP can bill Medicaid their clinic rate, not a deep discounted rate paid by the Medicaid HMO, which is capped.  (a lot more capital for the clinics)

Members

PCP remains the same
Member can receive long term care (FREE)
Member can receive skilled nursing, if applicable  (FREE)
Transportation to MD Appointments (FREE)
As well as many other benefits (FREE)

What are some examples of nursing home abuse?

When a nursing home fails to provide sufficient care, basic human needs, and protection of a resident’s health and safety, it may be negligent. Examples of nursing home negligence include failure to provide:

Food and water or failure to prevent malnutrition/dehydration
Sufficient medical care or the proper distribution of medications
Assistance with personal hygiene
Proper treatment to promote healing
A safe and clean and living condition
Adequate treatment and services for incontinent residents
Appropriate supervision and assistance to prevent accidents

Why is abuse present in nursing homes?

Sadly, many nursing homes are insufficiently staffed, and under-trained employees are responsible for the care of elderly residents. The result can be a painful and unfair living environment for residents, who may be deprived of life’s basic essentials and proper medical care. The tragic truth is that the nursing home industry and it often acts like one—housing your loved ones for the lowest cost possible. Other factors that can lead to nursing home abuse include minimum staff qualifications, low wages and a high turnover rate. Each certified nursing home assistant is responsible for 15 to 20 residents per day on average, meaning each resident gets only a half-hour of attention during the employee’s eight-hour shift.

How prevalent are incidents of nursing home abuse?

About 1.5 million elderly residents reside the 17,000-plus nursing homes throughout the United States. In a congressional report prepared by aides to Rep. Henry Waxman (D-Ca.), state inspectors cited almost 5,300 of these facilies in a two-year period. In more than 1,600 of these nursing homes the violations were deemed “serious enough to cause actual harm to residents or to place the residents in immediate jeopardy of death or serious personal injury.” The number one violation was failure to “properly investigate,” the report states. Additionally, statistics reveal that the percentage of nursing home abuse incidents has doubled since 1996.

If I suspect my loved one is being abused, what should I do?

Visit the home frequently and begin gaterhing facts. Collect all the material that you need so that paperwork cannot be later changed in court. You should also contact the administrator or director of the nursing home and file a complaint so that you have it on record. Finally, contact a http://www.cochranfirm.com/index.html nursing home abuse attorney who can inform you about your rights and the steps for pursuing legal action against the neglectful home.

How soon should I file my claim against the nursing home?

Begin the claims process as soon as possible. Each state implements a different statute of limitations. There could also be deadlines you must meet, as certain claims against governmental entities can require a sooner deadline. Also keep in mind that a medical and legal analysis must be conducted prior to filing a claim, so be sure to speak with a qualified lawyer as soon as possible.

What are some common signs of nursing home abuse?

Here are some telltale signs of abuse among elderly residents:

Unexplained bruises, cuts, burns, sprains, or fractures in various stages of healing
Bedsores
Mysterious venereal disease or genital infections
Vaginal or anal bleeding and stained or blooding undergarments
Abrupt behavioral changes
Staff who refuses to allow visitors or delays during visitation
Staff who do not allow you to be alone with your loved one
Residents who are kept constantly over-medicated

Home health care can often be better for seniors that need one on one assistance and care. Skilled and certified nurses operate within most of these businesses to verify high levels of professional service. You and your parents are the absolute decision maker on who you want to use for therapy and nursing services through home health care. While you need to utilize a Medicare certified agency to have Medicare pay for services, you and your parents have the right to use any home health agency that you desire. Home health care services are offered all around the country, which means that there is one close to your loved ones. Elderly home care consists of many services, however, Freedom Home Health offers:

•    Home Health Aides
•    Physical Therapy
•    Occupational Therapy
•    Speech Therapy
•    Nursing

Nursing homes are more about companionship for the elderly. If you are looking to make sure your parents always have a close eye kept on them as well as their health, an assisted living facility is necessary. These services are available in most nursing home facilities:

•    Wellness Program
•    Activities and Entertainment
•    Assisted living
•    Meals   

Take the time to analyze which option will best suit your parents necessities. A free home health assessment can be taken at Freedom Home Health to help you understand the needs of your loved ones.

Do not hesitate to ask questions when searching for local home health care or nursing home services. This is a decision that requires a lot of research to ensure you are making the proper decision for your family member.

All residents in nursing homes are entitled to receive quality care and live in an environment that improves or maintains the quality of their physical and mental health. This entitlement includes freedom from neglect and abuse.

WHAT CONSTITUTES NEGLECT AND ABUSE?
Neglect: Neglect is the failure to care for a person in a manner, which would avoid harm and pain, or the failure to react to a situation which may be harmful. Neglect may or may not be intentional. For example, a caring aide who is poorly trained may not know how to provide proper care. Examples include:

Incorrect body positioning — which leads to limb contractures and skin breakdown;

Lack of toileting or changing of disposable briefs — which causes incontinence and results in residents sitting in urine and feces, increased falls and agitation, indignity and skin breakdown;

Lack of assistance eating and drinking — which leads to malnutrition and dehydration;

Lack of assistance with walking — which leads to lack of mobility;

Lack of bathing — which leads to indignity, and poor hygiene;

Poor handwashing techniques — which leads to infection;

Lack of assistance with participating in activities of interest — which leads to withdrawal and isolation;

Ignoring call bells or cries for help.

Abuse: Abuse means causing intentional pain or harm. This includes physical, mental, verbal, psychological, and sexual abuse, and intimidation. Examples include:
Physical abuse from a staff member, another resident, or visitor from outside the facility — including hitting, pinching, shoving, force-feeding, scratching, slapping, and spitting;

Psychological or emotional abuse — including berating, ignoring, ridiculing, or cursing a resident, threats of punishment or deprivation;

Sexual abuse — including improper touching or coercion to perform sexual acts;

Substandard care which often results in one or more of the following conditions — immobilization, incontinence, dehydration, pressure sores, and depression;

Rough handling during care giving, medicine administration or moving a resident.

REPORTING NEGLECT AND ABUSE

It is a violation of State and Federal law for any person, including facility staff, volunteers, visitors, family members or guardians, or another resident, to neglect or abuse a resident.
Anyone can and should report neglect and abuse. If you suspect neglect or abuse, or if a resident tells you they are experiencing this problem, it is important to believe the resident and REPORT THE ALLEGATION IMMEDIATELY. This will help prevent further suffering by any resident.

Many states have laws that require the reporting of abuse and neglect. Find out what your state requires.

Put your report in writing, date it, and keep a copy. Convey as much information as you can about the situation. Remember to include:

WHO The name of the victim, including age and address; the name of the facility and the people responsible for the victim’s care; the identity of the person who you believe abused or neglected the resident;
WHAT The nature and extent of harm and any physical signs of abuse or neglect; any previous incidents; what happened;
WHERE and WHEN the place where the incident happened and time and date of the incident.
Make Your Report To:
The nursing home’s administrator, director of nursing, and social worker

The state or local Ombudsman

The local police or State law enforcement

Adult Protective Services agency – which is part of the Department of Social Services

The state survey agency that licenses and certifies nursing homes (often in the Health Department)

A citizen advocacy group or other church or community group that visits regularly.

Keep trying until you get the assistance you need.

AFTER THE REPORT:
Follow up with the resident and facility to make sure the neglect or abuse has stopped.

Follow up with the person or agency conducting the investigation. Ask for written copies of investigative reports.

If the perpetrator is charged with abuse or neglect, the charge will be referred to the state licensing authority. If the guilty person is a nurse aide, the charge will be reported to the state nurse aide registry. This registry is used by nursing homes to prevent abusive aides from working with the elderly. Nursing homes are required to check the registry before hiring a person.

If all the safety options fail, you may have to contact the local media, the U.S. Justice Department, or seek private legal assistance.

The decision to place a loved one in a nursing home is one of the most difficult tasks a family member ever faces. Prospective residents and their families should have the best information possible to make this decision. The purpose of this article is to help guide you in making an informed choice.
CONDUCT YOUR OWN INVESTIGATION

Once it is certain that nursing home care is necessary, determine which qualities of a nursing home are most important for meeting the needs and expectations of the resident. Each nursing home in your area will have unique strengths and weaknesses. Some issues to consider when evaluating your choices include quality of care, bed availability, provision of services that the resident will need, cost, quality, and location in an area where friends and family of the resident can visit often. It is critically important that you visit any facility on your list. Speak with other residents and families. Take a look at staffing levels on weekends or evenings – all of these first-hand observations are critically important. We have attached to this article a rating guide or checklist for your use as you survey each nursing home facility.
Look to the Experts:

Long Term Care Ombudsmen and Citizen Advocacy Groups

A state or local Ombudsman and/or citizen advocacy group can assist you in piecing together the different sources of information to make an informed decision about nursing home care. To find your Long-Term Care Ombudsman, go to the National Citizens Coalition for Nursing Home Reform (NCCNHR) website at www.nursinghomeaction.org and click on the button labeled “Ombudsmen.”

An Ombudsman:

Educates consumers and long term care providers about residents’ rights and good care practices
Provides information to the public on nursing homes and other long term care facilities and services, residents’ rights, and legislative and policy issues
Investigates complaints and advocates for residents’ rights and quality care in nursing homes, personal care, residential care and other long term care facilities
Will be familiar with the homes in your area and often with the staff and residents who reside in them.
The Ombudsman can help you find and interpret information from state inspection reports (discussed below) and the resident characteristics or quality measures.
Many states and/or communities have active Citizen Advocacy Groups that are knowledgeable about nursing homes and can be very helpful in evaluating advice and information you receive. To find a local citizen advocacy group go to the NCCNHR website at www.nursinghomeaction.org and click on the button labeled “Citizen Groups.”
Nursing Home Compare Website

Nursing home data is provided by the federal government through the Nursing Home Compare web site found at: www.medicare.gov/NHCompare/home.asp. On this site, you can search for nursing homes by state, county, city, or zip code. Once you have selected the nursing facility or facilities, you are given the option of viewing several different types of information including facility inspection, staffing level, and quality measure information. Below are consumer tips on how – and how not – to use each of these sources of information.
Staffing Information

The Nursing Home Compare web site also provides information about the hours of nursing care provided at each facility. Staffing levels are a critically important factor to consider in evaluating the quality of care given at a facility. The information provided on nurse staffing levels includes national and state staffing averages, and the daily average for individual nursing homes.
Tips:
Pay attention to the number of Certified Nursing Assistant (CNA) staffing hours. CNAs provide 90% of the hands-on resident care.
Visit the facility and ask staff and families about the actual numbers of staff available to directly care for residents on each shift.
State Nursing Home Inspection Reports

Every state has an agency responsible for the regular inspection of its nursing homes. State inspection or “survey” reports contain information about any deficiencies found when inspectors complete their annual inspection of the facility. Inspections take place at least every 9 to 15 months. You can also obtain state inspection reports from the state survey agency, the facility itself, or the long-term care ombudsman. Each facility is required by law to make the latest state inspection report available for examination in a place readily accessible to residents. To look at a summary of state inspection information on ‘Nursing Home Compare’, click on the tab labeled “Inspections.” You may obtain a copy of the inspection reports in Virginia by contacting the Center for Quality Health Care Services and Consumer Protection, 3600 West Broad Street, Suite 216, Richmond, VA 23230-4920.
Cautions:
Beware of choosing a facility with a very high number of deficiencies compared to other facilities in the area and the state average.
Don’t assume that a “deficiency free” rating necessarily means that there are no problems with care at a particular facility.
Family Involvement

Once your loved one is living in a facility, your continued care, support, love, and involvement in his or her life are absolutely key to getting good care there. Make sure you:
Visit frequently and encourage others to visit;
Speak up to raise concerns and compliments;
Participate in family council meetings if a family council exists, or seek out other family members to organize one;
Attend quarterly care plan conferences and advocate for individualized care;
Get to know the staff and help them get to know the resident. Share details about the resident’s likes, dislikes, and daily routines;
Follow up on the agreed upon care plan. Make sure the resident’s doctor knows what is in the plan. Notice if the plan is not being followed and request another meeting if necessary;
Make contact with your community’s long term care ombudsman, any local citizen advocacy groups and become familiar with the state and federal laws and regulations that apply to nursing homes and;
Document (date, time, persons involved) any problems you might observe so that managers, the ombudsman, or state survey agency can investigate.