Comparing Nursing Homes
Q: Is there a new way to evaluate nursing homes?
A: Yes. The federal government recently unveiled a new database, called "Nursing Home Compare," which compares 17,000 nursing homes across America according to ten quality measures. The purpose of the new database is "to help families make informed decisions about placement in nursing homes." The idea is that consumers will study these quality measures and learn more about which facility is right for their loved ones. But it's not quite as simple as advertised.
This database is found at http://www.medicare.gov/Nhcompare/Home.asp. You first select a state, then a county, and then choose from a list of nursing homes you want to review. "Nursing Home Compare" than displays some background on each nursing home: how many beds it has, its occupancy level, whether it's for-profit or non-profit, owned by a chain, etc. It then lists ten quality measures including: the percentage of residents unable to perform basic daily tasks; the percentage of residents with pressure sores; the percentage of residents with pain; the percentage of residents in physical restraints; the percentage with infections; the percentage of short stay residents with delirium; the percent of short stay residents with pain; the percentage of residents who walk. Understanding these measures is like learning a foreign language. Read the definition of what each quality measurement means. You can also take the list of deficiencies for each facility with you to the nursing home and discuss the survey findings with the nursing home administrator.
Caution: this database alone is not enough to make a clear decision about whether a nursing home is providing quality care that is right for your loved one. In fact, the U.S. General Accounting Office warns that the data can be contradictory, and nursing homes with high ratings can still have serious health care quality problems.
Some advocates say they have a better quality indicator: their nose. They recommend going to a nursing home to see if the resident areas smell of urine. Nothing substitutes for a visit to the facility. Go unannounced. Make a visit in the evening to observe the staffing level at night. Ask to sample a meal. You can also call 1-800-AGE-INFO to be connected to your local nursing home ombudsman. Ask the ombudsman which facilities in your area have a good quality reputation.
Before you visit nursing homes, first explore your options in the community. Some people enter a nursing home as a private pay resident and never learn their community choices. Call 1-800-AGE-INFO and press "3" to speak with a Care Options Consultant about community services in your area. No one should enter a nursing home without first exploring what's possible in the community.