Entering a loved one into a nursing home can be an overwhelming and emotional process, though it is often an unfortunate necessity for people who need consistent nursing care. Choosing the right nursing home is crucial as the quality of care provided at these facilities can vary dramatically, and moving someone to a new nursing home can be just as difficult as getting them into one the first time.
If it is feasible, you should visit a nursing home before you enter your loved one into it. Once your loved one has been admitted, it remains important to continue visiting them to monitor their care, and the nursing home itself, throughout their stay.
Many innocuous things that may seem commonplace at a medical facility are signs that the building is understaffed, or is undergoing other issues.
Constant Ring of Call bells
Call bells are a necessary tool in a nursing home for the residents to request assistance from the nursing staff, and it is normal to hear them ring while in a nursing home. What is not normal is hearing the same call bell go unanswered for 15 minutes, or even hearing multiple call bells going off for extended periods of time. Nursing homes strive to have staff respond to call bells as quickly as possible, so if call bells are going off without being answered, that may mean that there is not enough staff to assist all of the residents of the nursing home. Be sure to listen for call bells going off consistently when you visit a nursing home.
Missing Basic Care
Nursing home residents often require a great deal of care that they cannot provide for themselves, which is why they were admitted to the nursing home in the first place. This care includes the resident’s specific medication and treatment, but also includes grooming and cleaning. For family members without medical training, it can be difficult to know for sure if a resident received each day’s therapy or medication, but it is noticeable when their loved one isn’t being cleaned or groomed regularly. This is even more obvious when a resident is left to sit in soiled sheets for extended periods of time. If residents of a nursing home are not regularly groomed, bathed, or changed out of soiled sheets, this can mean the nursing home does not have enough nursing staff to provide these services they deem as “less important,” even though these are still very important to a resident’s health. Make sure to learn what your loved one’s grooming/bathing schedule is so you can be sure the nursing home keeps up with it.
Only Seeing New Staff Members Each Visit
It takes a great deal of staff members to keep nursing homes up and running, so seeing the occasional new face should not be surprising. However, when you only see new staff members each time you visit, that could be a sign that the nursing home is having trouble keeping employees consistently. When the same staff provide continuous care for residents, this ensures that the staff members are familiar with the residents’ conditions and issues, and also keeps the residents calmer as they become familiar with their care providers as well. When there is high staff turnover at a nursing home, the residents are left with strangers to them who are also unfamiliar their medical conditions. Take note of what staff members care for your loved one so you can tell if they’re constantly changing.
Keeping the Family in the Dark
Nursing homes are required to update a resident’s physician and family with certain changes in condition, such as if they need to be sent to the hospital. However, families are not always immediately notified when their loved one is transferred out of the nursing home. Sometimes staff do not have enough time to call the family, or they may simply forget this requirement. Either way, this can indicate larger issues with both staff levels and training at the nursing home. It is important to check in with your loved one occasionally to be sure you are aware of any updates, and to make sure the nursing home has your contact information for when you need to be notified regarding your loved one’s care.
Similarly, if the nursing home is constantly rushing you during your visit, trying to get you to leave, or preventing you from taking pictures with your loved one, this could be a sign that something deeper is wrong. Nursing homes know that when family members visit, they might pick up on the other red flags discussed here, so if there are issues such as understaffing they might try to get the families in and out as quickly as possible to prevent them from noticing. Be sure to visit your loved one when you are able and to get the visitation policy in writing so staff are not able to bully you out of seeing your loved one.
CMS Ratings of Nursing Homes
Prior to entering a nursing home, and for those who are unable to visit, there are other ways to evaluate a specific care facility. Be sure to check the Centers for Medicare and Medicare Services (CMS) website to see what the nursing home’s ratings are. These ratings are broken down into “overall,” health inspection, staffing, and quality measures. These ratings are directly from the government inspectors and are more reliable than the reviews on Google, Yelp, or any other similar online service. Checking the nursing home’s website will not provide much insight as to the actual quality of care at the nursing home, but it can still be useful to see what services they promise for their residents.
Visiting your Loved One
Once your loved one is in a nursing home, family members should sometimes make “surprise” visits to the nursing home. When staff know a family is coming, they clean a resident up so it seems like the resident has been taken care of the whole time, when in reality they could have been sitting in soiled sheets for days before being cleaned up for the visit. When a family does a “surprise” visit, they can see the nursing home how it really is- and staff may make a better effort keeping their loved one clean when they think the family could drop in at any time.
Many nursing homes now also have “virtual” visits, where loved ones can have a video telephone call with their loved one in the nursing home. These are often shorter visits since it takes a staff member to operate, but can provide some much needed support for those whose families live further away. Ask about virtual visits when considering what nursing home to enter your loved one into.
When Things Go Wrong
Unfortunately, things may still go wrong at your loved one’s nursing home. If you notice an issue, whether it was described above or not, it is important to make your complaints in writing to the Director of Nursing or Nursing Home Administrator. Simply reporting it to the nurse on staff can lead to your complaint being lost. Similarly, it may be appropriate to make a complaint directly to CMS or the Department of Health, who have the ability to investigate further.
Some red flags at nursing homes are clear, but others are harder to can be harder to notice without the right experience. At Anapol Weiss, our attorneys have many tools at our exposal and routinely help residents who have been injured in nursing homes. If you or a loved one has suffered injuries at a care facility, please contact us today at (215) 929-8822 or here for a free consultation. Our attorneys have extensive experience in nursing home, assisted living facility, and personal care facility litigation.
