• Important Considerations Used to Select Facilities
  • June 20, 2014 | Author: Timothy K. Spencer
  • Law Firm: Weltman, Weinberg & Reis Co., L.P.A. - Brooklyn Heights Office
  • One of the more difficult healthcare decisions an individual and his or her family will make is choosing which nursing home the in-need individual will stay. The selection process is important, personal, and often, very sensitive. Because of this, health care facilities benefit immensely from focusing on and improving areas related to the most important considerations individuals and their families use when selecting a facility. While additional consideration to less important factors may help nudge a facility above competing locations, a facility that is unable to achieve excellence in the most basic of amenities will certainly suffer as a result. The following is an overview of what individuals and families seek out when selecting a nursing facility.

    Individual Needs
    Perhaps the most obvious consideration when selecting a nursing home is the specific needs of the individual. Although nearly every nursing facility provides certain basic health care services, some facilities serve special needs such as Alzheimer's patient care or having extensive experience caring for residents who have had strokes.1 A nursing facility that is able to demonstrate adequate capabilities for a variety of specialties will surely be amongst the top choices of potential nursing facilities.

    Staff, Ratios and Qualifications
    The composition, amount and qualifications of the staff are some of the premier considerations for an individual or family selecting a nursing facility. Because adequate staffing is critical to a safe and healthy environment, a lack in numbers or qualifications amongst the care staff could very well mean resident care suffers, and individuals and families are no strangers to this.2 Particularly concerning for individuals and families are the staff who will provide immediate care to the resident. The number of Certified Nursing Assistant (CNA) hours is an important consideration as CNAs often provide as much as 90% of the hands-on resident care.3 A facility with a low number of CNAs may not be able to provide the amount of attention that an individual or family demands. Individuals and family members are also keen on facilities having higher-skilled caretakers.

    The number of Registered Nurses staffed in a health care facility also speaks to the facility's commitment to quality care. Studies show that RN involvement in care is crucial for delivering quality health care services to residents, and a facility lacking an RN presence may be perceived as one unable to accommodate the demands of its residents.4 As such, a facility boasting a high presence of both CNAs and RNs is more likely to attract significant interest from potential residents.

    Nursing Home Numbers—Quality Measures
    Perhaps one of the most frequently-utilized tools for qualitatively analyzing a prospective nursing home is the Nursing Home Compare website found on Medicare’s website.[5] While not intended as a nursing home rating system, these quality measures are designed to provide comparison information among facilities. A nursing facility scoring well in these quality measures will likely attract prospective residents.

    Chief amongst the quality measure considerations relates to vaccination. According to the National Consumer Voice for Quality Long-Term Care, prospective residents and their families pay special attention to the percentage of residents who were given the Influenza vaccination and assessed and given pneumococcal vaccinations.[6] Because both Influenza and pneumonia can cause residents to become seriously ill, a nursing facility with a high percentage of vaccinations will be deemed safer and thus, more attractive to prospective residents.[7] Consequently, nursing facilities should aim to achieve high percentages in these areas. Additional consideration should focus on minimizing down time for each resident and encouraging activity.

    How frequently nursing facility staff interact with residents and encourage activity is an important measure of the quality of care provided. For instance, a nursing facility with a high percentage of residents who need help with activities of daily living (ADLs) may demonstrate to a prospective resident and their family that the nursing facility does not encourage autonomy and self-reliance amongst the nursing facility population.[8] Moreover, a facility with a high amount of residents restrained, in bed for long periods of time, given catheters and having bed sores could all individually—and much more so collectively—indicate the nursing facility is understaffed, unconcerned with its residents' independence, or both.[9] A nursing facility that strives to achieve low percentages in these areas will demonstrate a commitment to a healthy, active environment.

    Conclusion
    A nursing facility may very well benefit from focusing its efforts on a myriad of amenities. Efforts focused on offering nearly every amenity desirable by prospective residents may not be the best strategy, though, as budget limitations may not allow such lofty ambitions. At the very least, efforts focused on somewhat less important considerations may take the focus off of what truly matters to prospective residents and their families. Keeping the aforementioned considerations in mind and focusing the nursing facility's efforts on maximizing these core considerations will ensure that the nursing facility is at the forefront of options from which prospective residents will choose to best meet their needs.

    1 Joanna Saison M.A. et al., A Guide to Nursing Home: Skilled Nursing Facilities and Convalescent Homes, http://www.helpguide.org/elder/nursing&under;homes&under;skilled&under;nursing&under;facilities.htm (last updated June 2013)
    2 Kimberly Leonard, How to Choose a Nursing Home, U.S. NEWS, http://health.usnews.com/health-news/best-nursing-homes/articles/2013/02/26/how-to-choose-a-nursing-home (Feb. 26, 2013)
    3 THE NATIONAL CONSUMER VOICE FOR QUALITY LONG-TERM CARE, A CONSUMER GUIDE TO CHOOSING A NURSING HOME, https://www.theconsumervoice.org/sites/default/files/advocate/A-Consumer-Guide-To-Choosing-A-Nursing-Home.pdf (August 2009)
    4 Id
    5 www.medicare.gov/NHCompare/home.asp
    6 THE NATIONAL CONSUMER VOICE FOR QUALITY LONG-TERM CARE, A CONSUMER GUIDE TO CHOOSING A NURSING HOME, https://www.theconsumervoice.org/sites/default/files/advocate/A-Consumer-Guide-To-Choosing-A-Nursing-Home.pdf (August 2009)
    7 Id
    8 Id
    9 Id