Making a Nursing Home Decision

Because of the success the Janssen Law Firm had in litigation against nursing homes, people often ask us what they should look for in determining whether to put their loved one in such a home.   Starting January 1, 2011, it will be easier to make that determination.

As of that date, all California nursing homes will be required to post the ratings for that facility under the MEDICARE 5-STAR RATING SYSTEM.  That system looks at three different criteria to determine home’s rating: (1) health inspections; (2) staffing numbers; and (3) quality measures.

California is home to over 1,000 federally-rated nursing homes.  Of those, 195 got the lowest rating, one star, while 187 got five stars.   It is notable that an analysis of the government data by USA Today showed that 27% of the country’s 10,542 for-profit nursing homes are one-star, compared with 13% of the 4,182 not-for-profit nursing homes.  In other words, there is profit in not giving good care.

Not surprisingly, those nursing homes with low ratings have claimed that the system is unfair.  Consumer groups such as California Advocates for Nursing Home Reform (CANHR) and the National Senior Citizens Law Center do indicate that a five-star rating is not necessarily an indicator of good care, but no one seems to argue that one-star facilities should be considered high quality.

Even if a facility has a five-star rating, you should still take your time to assure that your loved one will get good care.  Among the obvious things to look for are:   (1) Does the nursing home smell clean?  That is at least some indication of whether or not the nursing home is providing appropriate bladder treatment;  (2) Are staff repositioning patients in a position in their wheelchairs and beds?  If not, this can be an indicator of potential bedsore problems; (3) What is the rate of staff turnover?  If staff turns over frequently, this is indicative that there is something fundamentally wrong with the way the nursing home is being managed.

Finally, try and visit the potential care home late at night on a weekend.  If the facility is going to crimp on staffing, that is the time when you’re most likely to find out.