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How to Select a Nursing Home

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A Guide to the Right Choice

The most important consideration in any choice is the individual's specific situation. The elderly resident often has different needs than the young resident. Each individual has different needs, preferences and desires that need to be considered in the selection of an appropriate facility. Although the emphasis you place on any question is up to you, keep in mind that you cannot change the resident to fit the home. You must select the home that meets the needs of the resident. The following checklist is intended as a convenient guide for use when visiting Nursing Homes.

Licensure

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Does the home have a current license from the state?

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Does the administrator have a current license from the state?

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If the answer to either of these questions is "no," do not use the home.

Certification And Quality Review

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If Medicare and/or Medicaid coverage is needed, is the home certified to provide it?

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Is the latest state survey available for review?

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Does the home have a formal quality assurance program?

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Does the facility belong to New Hampshire Health Care Association?

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Does the staff regularly attend educational programs to maintain or enhance their skills?

Location

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Is the facility pleasing to the resident?

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Is the facility convenient for frequent visits of family and friends?

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Is the facility near a cooperating hospital?

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Is the facility convenient for the resident's personal physician?

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Is the facility near a hospital where your personal physician practices?

Lobby

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Is the atmosphere welcoming?

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Is the furniture attractive and comfortable?

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Are certificates and licenses on display?

Cleanliness

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Is the facility as clean as you set your personal standards?

Hallways

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Are halls large enough for two-way traffic to pass easily?

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Do halls have hand grip railings?

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Are halls well lighted?

Bedrooms

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Ask to visit a typical room. Does the living space suit the needs of the resident?

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Do bedrooms open onto the hall?

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Does each resident room have a window?

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What is the policy for decorating rooms with personal items?

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What is the policy for residents having a private telephone?

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Are rooms limited to four beds or less?

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Is there privacy for each bed?

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Is there a nurse call bell by each bed?

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Is there at least one comfortable chair per resident?

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Is there a clothes closet or separate set of drawers for each resident?

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Is there room for a wheelchair to maneuver?

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Is care used in selecting roommates?

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Is there easy access to each bed?

Toilet Facilities

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Are toilets convenient to bedrooms?

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Are they easy to use for a resident with physical challenges?

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Is there a sink conveniently available to each bathroom or bedroom?

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Are nurse call bells and handgrips near toilets?

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Do bathtubs and showers have non-slip surfaces and handgrips?

Dining Room And Meals

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Observe mealtime at the facility. Is the menu managed weekly? Monthly? Ask to have the dining procedures explained to you.

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Is the dining area attractive and inviting?

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Are tables convenient for those with physical challenges?

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Are personal food likes and dislikes taken into consideration?

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Does a dietitian review and approve menus for residents on special diets?

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Are there reasonable choices of dining times?

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Are private dining areas available when family and friends are visiting?

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Is food tasty and attractively served?

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Is plenty of time allowed for each meal?

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Are snacks available?

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Is food delivered to residents unable or unwilling to eat in the dining room?

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Are those needing help receiving it?

Special Purpose Rooms

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Are rooms set aside for physical examinations or therapy?

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Are rooms available for private visits with family and friends?

Isolation Room

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Does the home have the ability to provide private accommodations for residents with a contagious illness?

Grounds

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Is there easy access for the handicapped?

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Is outdoor furniture available for residents and visitors?

Kitchen

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Is the food preparation area separate from the dishwashing and garbage areas?

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Is food needing refrigeration not standing on counters?

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Does kitchen help observe sanitation rules?

Activity Rooms

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Are rooms available for resident activities?

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Is equipment (such as hobby supplies, easels, yarn, etc.) available?

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Are residents using equipment?

Care Planning

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Are residents and families involved in developing their care plan?

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Does the home provide services for the terminally ill residents and their families?

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Does the home have an Alzheimer's disease program?

Medical

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Is a physician available in an emergency?

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Are personal physicians allowed?

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Is regular medical attention assured?

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Are medical records and plans of care kept?

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Are residents involved in plans for treatment?

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Is confidentiality of medical records assured?

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Are other medical services (dentists, podiatrists, optometrists) available?

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Will the resident's personal physician be notified in an emergency?

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Does the facility report periodically to the resident's personal physician?

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Will a bed be available after hospitalization?

Pharmacy

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Are routine and emergency drugs available?

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Does a pharmacist review resident drug regiments?

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Is a pharmacist available for staff and resident consultation?

Hospitalization

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Does the home have a transfer arrangement with a nearby hospital?

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Is emergency transportation readily available?

Nursing Services

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Is a registered nurse responsible for the nursing staff?

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Are licensed nurses on duty around the clock?

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Are registered nurse assistants on duty in homes providing nursing care?

Therapy Program

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Is there a physical therapy program available under the direction of a qualified physical therapist?

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Is therapy available to meet special needs?

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Are services of an occupational therapist or speech pathologist available?

Social Services

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Are social services available to assist residents and families?

Grooming

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Is assistance in bathing and grooming available?

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Are barbers and beauticians available?

Religious Observances

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Are arrangements made for residents to worship as they please? 

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Are religious services held on the premises?

Activities Program

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Ask to see the activity calendar for the week/month.

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Are activities planned around each resident's individual preferences and life pattern?

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Are group and individual activities available?

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Are residents encouraged to participate?

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Are outside trips planned?

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Do volunteers work with residents?

Staff Attitudes

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Does staff show interest in and respect for individual residents?

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Is staff courteous?

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Is the administrator available to answer questions, hear complaints, or discuss problems?

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Does staff respond quickly to resident calls for assistance?

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Does staff know residents by name?

Resident Rights/Autonomy

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Does the facility have a written description of resident rights and responsibilities?

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Is staff trained to protect resident dignity and privacy?

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When are restraining devices recommended and why?

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Does the facility have a resident council?

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Does the facility have a family council in which you can participate?

Costs

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Are all services covered in the basic daily charge?

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If not, is a list of specific services not covered in the basic rate available?

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Are advanced payments returned if the resident leaves the home?

Your Part

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If you are selecting a facility for someone else, are you:

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Involving this person in the choice?

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Prepared to ease the resident's transition to the home by being with them on admission day and staying a few hours to get them settled? 

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Ready to visit the resident frequently and to make sure that friends make similar visits?

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Willing to provide the resident with the same amount of love in the facility that you would if they were at home?

Waiting For Placement

After you have identified an appropriate facility, you may find there is no vacancy. Put your name on the waiting list. In the meantime, check alternatives such as day care, night care, home health agencies and other community resources that might help meet immediate needs. 

Finally, nursing facilities should try to be like a community - where residents can feel comfortable, find familiar faces and build relationships just like they enjoyed in their own homes. By planning ahead, you can ensure that your loved one will be provided with the highest quality of care and quality of life.

 

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