Skilled nursing facilities, often referred to as nursing homes, provide long-term, medically necessary treatment to residents of all ages. The majority of nursing home residents are seniors who need a higher level of care than they can receive at home, but do not need acute care in a hospital setting. Others are people of all ages who are rehabilitating from a major illness or injury.
[1]Americans over the age of 65 have a 70% chance of needing some type of long-term care in their remaining years, and about 25% of them will require care in a skilled nursing facility. The real numbers behind those projections are increasing exponentially as our population ages. In California, the 65+ population increased 34% between 2012 and 2022. That means more of us will need a nursing home or be responsible for arranging care at a nursing home for a loved one.
Finding a nursing home is emotionally and financially stressful—and not many know where to start. A methodical approach can break the complexity down into less overwhelming steps. Here are five tips that may help.
1. Consult agencies that measure and report on quality.
There are multiple agencies that measure and rate key indicators of quality and safety in nursing facilities. A reputable option is the Centers for Medicare and Medicaid Service’s [3] (CMS) five-star quality rating. It’s intended to help consumers, families, and caregivers compare nursing homes more easily and identify good questions to ask when evaluating whether a nursing home is the right fit for you or your loved one.
2. More expensive is not better.
Long-term skilled nursing care is prohibitively expensive for most people. That’s one reason that Medicaid is the primary payer [4] for over 60% of residents in nursing facilities. A common but inaccurate assumption is that private, for-profit facilities are better. In fact, for-profit nursing homes have a lower CMS star rating than most nonprofit nursing homes, on average. Here in Alameda, there are two public safety-net skilled nursing facilities operated by Alameda Health System that both have five-star CMS ratings, the highest possible score.
3. Assess medical care.
If your loved one has specific medical needs such as dementia, mobility issues, or chronic illnesses, it’s crucial to ensure that the facility can accommodate these requirements. Ask about specialized programs and services, such as memory care units, physical therapy, or rehabilitation services. Inquire about the qualifications and training of the staff, particularly those responsible for direct patient care. Understanding the staff-to-resident ratio and the presence of licensed nurses can provide insight into the level of attention your loved one will receive.
4. Use your senses.
Tour the facility and observe. Richard Espinoza, chief administrative officer of post-acute services at Alameda Health System, suggests the following considerations: “How are the residents and families treated and acknowledged? Are staff engaged with visitors, one another, and residents? What do you hear? Is it quiet, joyful, or do you hear people calling out for help? Is it clean, organized, and is there a smell? A clean environment does not smell.”
Cleanliness not only smells good, it also suggests that the facility is sufficiently staffed and that protocols, including those to prevent the spread of germs and disease, are in place. An organized environment also allows clear corridors for residents to move about with ease in the event of an emergency.
5. Social and emotional wellbeing is paramount.
Quality of life extends beyond medical care. Social and emotional well-being is directly related to health. Inquire about the facility’s recreational activities, social programs, and opportunities for resident engagement. A vibrant social environment can enhance your loved one’s emotional and psychological well-being. Observe how staff interact with residents and whether they foster a sense of community and belonging.
Healthy Alameda is a healthcare column provided by Alameda Health System (AHS), the public safety-net health system that serves all in Alameda County. AHS operates five facilities in the City of Alameda, including Alameda Hospital, Creedon Advanced Wound Care Center, Park Bridge Rehabilitation and Wellness, South Shore Rehabilitation and Wellness, and Marina Wellness and Surgical Associates.