A quick test for choosing a skilled nursing facility
What is the first thought that comes to mind when you hear the phrase, “nursing home?” I am often taken aback by some of the responses I receive when I ask this question during presentations: Bingo, awful food, urine smell, institution, old people and the place where old people die. Some of these impressions are substantiated. For example, bingo is and always will be a favorite in nursing homes throughout the United States. But the stereotypical “nursing home” stigma still haunts skilled nursing facilities to this day.
A skilled nursing facility (SNF) provides 24-hour skilled nursing services to individuals who require long-term care or short-term rehabilitation. Long-term care residents require stable 24-hour care for their activities of daily living (ADLs), and short-term rehabilitation patients require post-acute care due to a temporary decreased ability to perform ADLs.
SNFs specialize in either long-term care, short-term rehabilitation, or both. As the American population ages, the demand for skilled nursing services are growing substantially. The United States Administration on Aging reports that by 2030, the U.S. population of people 65 and older is projected to be 72.1 million, which is more than double the population in 2000 and is three times the population in 1980.
When demand is knocking, a surplus of providers usually follows, meaning consumers will be faced with many options. Where do you begin in selecting a quality facility?
Regulatory agencies, health-care administration consultants and consumer review sites offer a wide array of comprehensive checklists for prospective consumers seeking these services. Although these checklists are well-researched and developed, over the past three years, I have encountered only one consumer who toured a facility with a checklist in hand. When advising prospective skilled nursing consumers on where to receive their skilled nursing services, rather than handing them a four-page checklist, I keep it simple.
I have been in and out of several skilled nursing facilities throughout the United States — as a consumer, employee and employer — some shocking me with their lackadaisical attitude. I have gone from secret shopping a skilled nursing facility for a “family member” of mine where I witnessed residents using oxygen smoking in a nondesignated area with no staff members around, to entering a facility through the main entrance, walking past the receptionist and wandering around talking to residents and answering call lights for over an hour, without a single staff member saying a word to or engaging me. I have also walked into facilities after hours and being thrilled by a team of caregivers greeting me, asking me who I was, who I was there to see and how they could help me. Drawing from my experience in the industry, here are my top five guidelines for selecting the quality skilled nursing facility that is right for you or your loved one.
The 60-second experience: When you pull into the parking lot and enter the facility, how does it look, feel and taste? Are there cigarette butts and trash in the parking lot? Are the lobby and entryway tidy? Does the facility feel warm? Does somebody greet you? What taste is left in your mouth after 60 seconds of being in the building? Do you feel at ease or uneasy?
Staff engagement: Do staff members acknowledge your presence? Is management staff around? Do staff members acknowledge the other residents or patients? Are they communicating with one another and working together? Do staff members walk past call lights or respond to them promptly?
Resident or patient engagement: Do residents or patients make eye contact with staff? Are they withdrawn? Are their clothes dirty? Are residents and patients engaged in activities or are they sitting around staring into space?
Facility cleanliness: Does the facility appear cluttered? Are there beds, chairs, hygiene products, medications or dirty laundry lying out in the open? Are trash bins overflowing? Go to the restroom even if you don’t have to use it — is it clean? Is the dining room cleaned up or are their remnants of the last meal still sitting around?
Facility smell: Is the facility masking smells? Are there pleasant smells mixed with foul odors? Are there cleaning products lying around? Peruse the halls — what do you smell as you pass residents’ rooms?
As you may have noticed, there is a common theme among these areas. They are all experiential. It will take a consumer less than five minutes to review these guidelines and decide whether the prospective skilled nursing facility is acceptable or not — all without meeting the administrator. If a skilled nursing facility can get these five areas right within the first five minutes of your initial visit, it will more than likely be a quality facility that can offer you peace of mind. If a minor setback occurs in you or a loved one’s life and the need for skilled nursing services arises, I hope that this information will aid you choosing the right care setting. The next time you hear the words, “nursing home,” what thoughts will come to your mind?
Robert Baker is executive director of Heritage Park Care Center in Carbondale.
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