I’ve represented thousands of family members in lawsuits against nursing homes. I’ve sued nursing homes in Lakeland, Winter Haven, Orlando, Tampa, even as far south as Miami. During the course of every first conversation I always ask the family how did you decide on that specific nursing home? Typically, the answer is they were referred by the Social Services person at the hospital. Did you know that same Social Services person is wined and dined by the Admissions Coordinators at those same nursing homes they are recommending? Things that make you go Hmmm!
It may surprise you but many of us who deal with nursing homes on a regular basis, the certified nursing assistants, nurses, therapists, the lawyers who sue them, are very familiar with those homes that should have been closed down a while ago and those that deserve their five star rating. We’ve learned through experience which nursing homes prioritize staffing and concern for their residents and which ones overwork their staff and jeopardize resident safety.
Years ago, I represented a family whose parent was blind and confined to a wheelchair. The nursing home typically held Sunday service in the facility. Due to the understaffing that Sunday morning a fellow confused resident was pushing their parent as fast they could down the hall. The hall was approximately 50 to 75 feet long. You can guess what happened next. The parent flew out of the wheelchair, fell and was later paralyzed. While not all falls and accidents are preventable, this one could have been if the facility had proper staffing requirements in place. So how do you find out which facilities are trying to do right, and which ones are valuing their bottom line over resident safety?
Here are Five Things you can do to choose a nursing home that has the right priorities:
- KNOW YOUR NURSING HOME REPORT CARD – Every Florida Nursing Home, whether in Tampa or Orlando or elsewhere, is inspected by the Agency for Health Care Administration (AHCA) on an annual basis and in response to individual complaints. Here is a link to when you can begin your search.
After you click the link it will take you to the general search page. From the Facility/Provider Type drop down menu choose Nursing Home. You can then either search by facility name, city or county. For example, if you choose Lakeland 11 nursing homes should show up. You could do the same for Orlando or Tampa. You can then click on any of the nursing homes. Once you click on any of the homes it will take you to a Provider Profile screen. On the bottom left you will see:
Watch List Information
By clicking on any of the above reports you will find how the nursing home did on their last exam. You should start with Inspection reports. Click Select next to any of the Inspection types and you have the nursing home’s last report card for general deficiencies or complaints.
- STAFF, STAFF, STAFF! Most families will tour a facility during the day. It’s not uncommon to feel comforted by the fact that the staff look attentive, responsive and engaged with their residents. Keep in mind visiting hours come to an end. So how does that same staff act when a post hip surgery resident presses the call light because he needs to go to the bathroom at 10 pm? What happens at 1:30 am when the bedridden resident needs a diaper change to prevent a pressure sore or urinary tract infection? Does the facility provide the same number of staff at night as it does during the day? Is the CNA to resident ratio the same during the 7 am to 3 pm shift as it is during the 3 pm to 11 pm shift? Just like class size is important to our children, so is staff ratios to our vulnerable, elderly population. How can you find out the facility’s staff ratios?
On Friday, October 28, 2005, the Centers for Medicare and Medicaid Services (CMS) released its final rule that requires skilled nursing facilities (SNFs) and nursing facilities (NFs) to post daily staffing information, including the total hours worked each day by nursing staff who are directly responsible for resident care. As a consumer you can easily access this information by simply asking the Director of Nurses of the Administrator where the information is posted within the facility.
- REPUTATION MATTERS. In many smaller communities like Lakeland, Winter Haven where we have offices, or even in Orlando where we handle too many bedsore cases, the community knows which facilities to avoid and which ones to trust. Instead of listening to the Social Services Director at the Hospital about which facility they recommend, ask the hospital nurses and CNAs. Remember they see the condition of residents who are admitted from these same nursing home facilities. They know which homes have the larger share of dehydrated and malnourished residents admitted for treatment. They know which patients left healthy and without bedsores but far too often return with bedsores. Next time do not read the google reviews, instead ask those folks in the best position to know, the hospital staff that will be entrusted to treat your loved one if the home neglects them.
- DO THEY EMPLOY THE PHANTOM NURSE? I represented a lovely family from Winter Haven, Florida. During the course of her parent’s stay at a facility they developed a routine issue that normally is resolved with over the counter medication. Rarely, but sometimes it may need an overnight stay at the hospital. As any concerned child would, she tried to keep informed on what was done treatment wise and the response to treatment. It didn’t matter when the family came in and who they spoke with the answer was always the same. “I don’t know I will have to ask the nurse from the last shift”. The family finally approached the Administrator and asked to meet the phantom nurse so they could get a real update on their parent’s care. Unfortunately for the family, by the time they sought answers the next morning their loved one needed emergency surgery. When choosing a nursing home, when you ask questions about your loved one’s care do you get answers or are you referred to the Phantom Nurse. A good nursing home is accountable to its residents and family. A bad nursing home employs phantom nurses.
- CAN THEY DO WHAT THEY SAY THEY DO. Some residents may need specialty care or specialty supplies for treatment. Whether it’s a tracheotomy or wound care ask to meet those care givers who the facility says possess the specialized training. Far too often a facility promises it can fulfill all the necessary care needed to treat a resident with unique needs. Alternatively, they claim to have staff who possess the knowledge to treat certain medical conditions. You can trust but always verify. Before you admit your loved one ask to speak to those responsible care providers directly and quiz them on their skills and recent training.