Locating Quality Care in a Skilled Nursing Facility
Locating a nursing home which provides the highest quality of care can be difficult for most families. To compound the problem the family is often required to make this decision on short notice often when the family member is scheduled for discharge from a hospital.
One of the first places to look is the Medicare website (www.medicare.gov/nhcompare). This website contains a newly implemented Five-Star Quality Rating System for nursing homes. The Five Star System provides nursing home ratings based upon three sources:
health inspections; staffing levels, and quality measures.
The system then provides a star rating for each category and a combined score in the form of an overall rating. This site allows anyone to research the highest rated nursing homes by state, county or city.
I advise “clicking” on “health inspections”, which gives a detail of areas cited for deficiencies. One cannot simply look at the number of citations, but look at the category that the weakness was in. for instance, clinical areas can include: accidents {falls}, pain management, pressure ulcers {acquired wounds}, nutrition, etc…. A deficiency citation regarding a medical record storage, or untimely activity, for example, does not imply any clinical nursing concerns. So one must read through the list of deficiencies carefully to make a judgement.
Families should then be encouraged to conduct their own in-person inspection of the nursing home. The Medicare website also provides a “Nursing Home Checklist” which can be printed out and used at the time of the in-person inspection. Families should talk with the nursing home staff about their Five Star Rating and ask what else they are doing to improve the care to their residents.
Many attorneys have discovered that skilled nursing homes are owned by “Shell Corporations” which have been set up by the real owners to avoid liability for negligent care of its residents. If a negligent case is proved in litigation, these nursing homes file for bankruptcy to avoid payment for damages. Families are not aware of the importance of researching the ownership of any facility that is being considered to care for a loved one.
My education and experience provide me with the skills to review the medical records from nursing homes for standards of nursing care. In addition, knowledge of state and federal regulations and accreditation standards enable me to determine if quality measures have been met in these cases.
Kathleen Martin, RN, MSN, MPA, LNHA, CPHQ, WCC