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8 Choosing a Home

Moving Your Loved One to Safer Place

If your elderly loved one has been abused or neglected in a nursing home, one of your first steps should be to move him or her to a safer facility.

After going through such a jarring experience, it is understandable if you doubt your ability to choose the right place – or if you doubt whether any home could truly be safe enough.

However, by visiting the homes you are considering, going through the 21 items on our checklist below and researching facilities through online sources such as those offered by the Illinois Department of Public Health (IDPH) or the Center for Medicare & Medicaid Services, you should be in a much better position to make the best choice.

“If your elderly loved one has been abused or neglected in a nursing home, one of your first steps should be to move him or her to a safer facility”

Choosing a Nursing Home Checklist

The cost of a nursing home certainly will be a primary consideration for you. However, you should also ask yourself the following questions – based on suggestions from the Centers for Medicare & Medicaid Services – as you choose a new home for your mother, father or other elderly loved one:

Physical Considerations

1. Is the nursing home located close enough for friends and family to visit?

It is important to choose a conveniently located facility. After all, you will need to visit and make sure your loved one is receiving proper care and treatment. Go to the Illinois Council on Long-Term Care’s online nursing home directory to find nursing homes near you.

2. Are hallways and rooms well lit, comfortably heated, clean and maintained?

If a nursing home is well-maintained, it is a good sign that the owner, administrator and staff members care about their residents as well. On the other hand, a neglected facility may be just the surface of deeper problems.

3. Can all areas of the home be accessed by wheelchair?

Even though your loved one may not currently be in a wheelchair, one may be needed in the future. You should choose a facility that features common areas, rooms, bathrooms and doorways that accommodate wheelchairs.

Security Considerations

4. Does the nursing home have a security system?

A nursing home should feature locks on doors, alarms and surveillance equipment. A guard or staff members should be paying attention to who is going in and out of the building around the clock. This is especially important if your loved one suffers from Alzheimer’s disease or another form of dementia and is prone to wandering.

5. Does the facility have smoke detectors, sprinklers and emergency exits?

When you visit a home, look to see if it has smoke detectors, sprinklers and emergency exits. You should also ask about the home’s fire evacuation plan.

6. Does the nursing home have a system for protecting residents’ possessions?

Illinois law gives nursing home residents the right to have valuable possessions stored by the facility in a reasonably safe place. You should ask about steps the nursing home has taken to comply with this requirement.

Treatment Considerations

7. Are residents clean, well-groomed and appropriately dressed?

A nursing home may need to help residents to bathe, groom and dress themselves. The home may also need to frequently reposition residents in beds or wheelchairs. If you see that residents’ hygiene is being neglected, or if you learn that residents have bedsores, it very likely means that the facility neglects residents and cares little for their dignity.

8. Do residents have access to personal phones or the Internet?

A nursing home has a responsibility to give residents reasonable access to a phone, where they can hold conversations in private. The home should also make it convenient for a resident to use the Internet for research or entertainment purposes and, most importantly, to communicate with family and friends.

9. Are residents provided with exercise and recreational activities?

Nursing homes must have ongoing activities that are designed to meet each resident’s interests and enhance their physical and mental well-being. This is because regular exercise and activity plays a major role in an elderly person’s physical and mental health.

10. How does staff monitor residents when they go outside?

Ask the nursing home what it does to prevent residents – especially those with dementia – from wandering or eloping. Additionally, what is the condition of the outside of the facility? Are there nice places to sit, walk and enjoy exercise in the outdoors?

11. Does the nursing home provide for residents’ special dietary needs?

A nursing home is required to meet each resident’s nourishment needs. Ask the nursing home how it prepares meals: Are they staff-prepared or supplied by an outside vendor? Find out how the facility tailors meals to residents’ needs.

Staffing Considerations

12. Does the home conduct criminal background checks before hiring staff?

Checking the criminal background of potential staff members is not only common sense for a nursing home, it is also required under the Illinois Health Care Worker Background Check Act. The Act prohibits nursing homes from hiring any health care worker who has been convicted of committing or attempting to commit any one of several listed offenses.

13. Has there been any major or repeated turnover in administrators and staff?

A lack of stability in a nursing home is not a good sign. It may indicate that staff members face poor working conditions or lack support from the home’s owners and/or administrators. Disgruntled staff members may take out their frustration on residents.

14. Are staff members warm, polite and respectful to residents?

When you visit a facility, observe how staff members interact with residents. Are they warm, polite and friendly? Do residents seem anxious or fearful around any staff members (which is a sign of abuse)? Ask other residents about their experiences with the home’s staff members.

Medical Considerations

15. What is the nursing home’s staff member-to-resident ratio?

Under federal and state law, nursing homes must have enough staff to meet the needs of their residents. Since 2014, in Illinois, a nursing home has been required to have minimum staffing ratios of 3.8 hours of nursing and personal care each day per resident needing skilled care, and 2.5 hours of nursing and personal care each day per resident in need of intermediate care.

16. Are registered nurses (RNs) licensed practical nurses (LPNs) and/or certified nursing assistants (CNAs) available at the nursing home 24 hours per day?

If a medical emergency arises with your loved one, will there be nurses and staff members available to quickly respond? At a minimum, the law requires a nursing home to have at least one RN on site for a minimum of eight consecutive hours a day, seven days a week.

17. Does the nursing home have a policy for administering medication?

A medication error can cause serious, potentially fatal harm to a nursing home resident. Ask whether the home has strict controls in place for ordering, receiving and administering medications as they are prescribed. You should also know how powerful antipsychotic medications are controlled and administered at the home.

18. Are residents given routine preventative care and hearing and vision tests?

Preventative medicine can be essential to keeping an elderly nursing home resident healthy and active. Ask about the nursing home’s policy on flu shots, eye exams and hearing tests.

19. Does the nursing home help residents see their personal doctors?

A nursing home should protect and facilitate a resident’s right to see the doctor of his or her choice. Ask about transportation services or other arrangements that are available to help residents attend doctor appointments.

20. Is there an arrangement with a nearby hospital for emergencies?

If the home has ties with a nearby hospital or ambulance service provider, it should result in a faster, more-informed response to a medical emergency.

21. Does the nursing home have any reported deficiencies, and how were they corrected?

Every nursing home in Illinois is required to keep the most recent five years’ worth of annual surveys, complaint investigations, follow-up surveys, notices of fines and plans of correction. The home should make these materials available to anyone who asks to see them.

How to Use Ratings and Other Sources

In addition to visiting a nursing home, there are several sources of information available online that can help you to make an informed decision.

  • Nursing Home Compare – The most widely cited and comprehensive ratings system comes from the federal government. At Nursing Home Compare, provided by the Centers for Medicare & Medicaid Services, you can find nursing homes rated on a five-star scale (one being far below average, and five being far above average). The ratings are based on three factors:
    • Health inspections by state agencies
    • Staffing levels
    • Quality measures.
    You can search for nursing homes by city, zip code or by name. Pay close attention to whether the facility has a history of deficiencies, or violations of federal regulations. These deficiencies often are discovered during inspections that nursing homes must pass in order to receive federal funding. While it is actually common for a nursing home to have a few deficiencies on its record, a high number clearly are a red flag.
  • U.S. News & World Report – This media outlet publishes an annual list of the top nursing homes in the country on a state-by-state basis. You can search for homes located near where you live in Illinois, including homes that accept Medicare. The publication also features a five-star ratings system, with five stars representing the highest level of care provided.
  • Illinois Quarterly Violation Reports – The Illinois Department of Public Health (IDPH) will take action against a facility if it is found to be in violation of the state’s nursing home regulations. The IDPH also may recommend decertification to the Department of Health and Human Services for violations of federal standards relating to patient care. You can go to the IDPH website to see a list of all violations found by the IDPH since 2004.

Hopefully, these tools will be useful to you and help you to choose a home that is comfortable and safe, meets your loved one’s needs and satisfies any concerns you may have.

Sources / More Information

  • Your Guide to Choosing a Nursing Home or Other Long-Term Care, Center for Medicare & Medicaid Services
  • Illinois Nursing Home Directory, Illinois Council on Long-Term Care
  • Nursing Home Compare, Center for Medicare & Medicaid Services
  • Illinois Nursing Homes, U.S. News & World Report
  • Quarterly Reports of Nursing Home Violators, Illinois Department of Public Health
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A Family Guide to Safety in Illinois Nursing Homes