Nursing Homes

Nursing homes provide an array of services, including 24-hour skilled nursing care for residents who require personal care, supervision and medical care. Nursing homes are appropriate for people who don’t need to be in a hospital but cannot be cared for at home.

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Teams of highly trained professionals provide nursing care on a short-term or long-term care basis. Nursing homes can provide rehabilitation and therapy to individuals who are discharged from a hospital and cannot return home immediately. People undergoing surgeries, such as hip or knee replacement, or those who have experienced a traumatic event, such as a stroke or bone fracture, often spend a few months in a nursing home before returning home.

A nursing facility may be a freestanding facility or may be a distinct part of a hospital. Most are certified to participate in the federal Medicare and state Medicaid programs.

Basic services include:

• 24-hour nursing care;

• individualized personal assistance with activities of daily living (dressing, eating, bathing,
  toileting);

• nutritional services and therapies;

• administration of medically prescribed medications and treatments;

• social and recreational program;

• physical therapy;

• speech therapy;

• occupational therapy;

• IV therapy;

• wound care;

• feeding tubes;

• housekeeping and laundry services;

• scheduling appointments for doctors, dentists, laboratories, x-rays, and pharmacists.


Specialized services that may be available include:

• dedicated units for people with Alzheimer’s disease and dementia;
• rehabilitation therapies that assist individuals to return home or regain a level of independence;

hospice and palliative care;
• respite care programs that relieve full-time caregivers of the duties they normally perform at home so the caregiver can have a short time to recover from an illness, have surgery, take a vacation or attend to personal needs.

Payment Options

Several options exist for payment of nursing home services. Options vary depending on several factors, such as your personal financial situation, the care you need, the length of time you will need care, whether the nursing home is certified to participate in the Medicare and/or Medicaid programs, and whether the nursing home of your choice contracts with certain government agencies, such as the Veteran’s Administration. Each nursing home is different. Options include:

• private funds;
• private health insurance;
Medicaid;
Medicare;
Public Employees Insurance Agency;
Veterans Administration;
TRICARE, formerly the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS).


Nursing Home Visit Checklist

Printable version

Things to Observe

_______ Is the facility free of overwhelming unpleasant odors? (Keep in mind that temporary odorsare sometimes unavoidable; they should dissipate within 10-15 minutes.)

_______ Is the facility well lighted?

_______ Is the facility clean and well maintained?

_______ Do chairs and other furniture seem sturdy and difficult to tip? Are they attractive and comfortable?

_______ Does each resident’s bed have a privacy curtain? Is it clean and free of rips or tears?

_______ Are activity schedules and menus posted for the week?

_______ Are handrails in hallways and grab bars in bathrooms?

_______ Are toilets convenient to bedrooms and easy for wheelchair-bound residents to use?

_______ Are call bells near each toilet and bed?

_______ Are the hallways wide enough to accommodate passing wheelchairs?

_______ Are the rooms large enough to allow a wheelchair to maneuver easily?

_______ Is the temperature comfortable? (Remember that many seniors prefer warmer
               environments.)

_______ Do all residents have closets or separate drawers for clothing?

_______ Do you see personal health information about residents posted?

_______ Is the atmosphere generally friendly and welcoming?

Staff and Residents

_______ Are staff actively using the privacy curtains to protect the dignity of residents receiving treatments?

_______ Are staff answering call lights promptly?

_______ Do staff appear happy and content in their jobs?

_______ How do staff members interact with residents? Are they courteous and friendly? Do they smile and address residents by their names?

_______ How do staff members interact with you? Are they friendly to family members and willing to interact and answer questions?

_______ Do residents appear well groomed?

Medical Services

_______ Is the facility licensed by the state of West Virginia? Does the nursing facility administrator have a current license from the state? If not, do not use the facility.

_______ If you have Medicare and/or Medicaid coverage, ask whether the home is certified to provide such care?

_______ Does the facility have an operating agreement with a nearby hospital for emergency services?

_______ Is a physician available in an emergency?

_______ Are personal physicians allowed?

_______ How often does a physician see a resident?

_______ How are residents and families involved in treatment planning?

_______ Are other medical services available (i.e., from dentists, podiatrists, optometrists)?

_______ What services does the facility provide for terminally ill residents and their families?

_______ Does the facility work with a local hospice?

_______ Does the facility have programs for residents with Alzheimer’s disease or dementia?

_______ How does the facility address pain management?

_______ Is a licensed nurse always available?

_______ Does a pharmacist review patient drug regimens?

_______ Is there a physical therapy program available under the direction of a qualified physical therapist?

_______ Are services available from an occupational therapist or speech pathologist?

_______ Is a social worker available to assist residents and families?

Dining and Food Service

_______ Do meals appear tasty and attractive? Ask to sample a meal. Does it taste good to you?

_______ Do posted menus feature a variety of foods throughout the week?

_______ Does the food being served match the description on the posted menu?

_______ Are residents who need help eating being given that assistance?

_______ Are snacks available?

_______ How are residents’ food preferences handled? Can residents substitute for foods they don’t like?

_______ Does a dietitian plan menus for patients on special diets?

Activities

_______ Are arrangements made for residents to worship or attend religious services?

_______ How are residents encouraged to participate in activities?

_______ How are residents’ activity preferences respected?

_______ Are group and individual activities available?

Admission and Financial Practices

_______ Are beds currently available? If not, is there a waiting list?

_______ Are all services covered in the basic daily charge?

_______ If not, does the facility provide a list of services not covered in the basic rate? (Some homes have schedules covering linens, personal laundry, beauty/barber services, pedicures, incontinence briefs, dental care, etc.)

_______ Will the facility directly bill insurance companies and other payers?

_______ Are advance payments returned if I leave the facility?

_______ If I am a private paying resident at the time of admission and later become eligible for Medicaid, will I be able to stay in the same bed and receive the same level of care?

Facility Policy/Procedures

_______ Does the facility conduct criminal background checks on all of its employees?

_______ What are the facility’s policies on the use of physical and chemical (drug) restraints?

_______ Does the facility regularly survey residents or family members to find out how satisfied they are with the quality of services the facility provides? If so, are they willing to share the results?

_______ How does the facility match roommates?

_______ Does the facility have a “visiting-hours” policy? Are family members welcome to visit at any time?

_______ How are disputes, problems or complaints with the quality of care resolved?

_______ Does the facility have a resident or family council?

_______ How does the facility protect medical health information?

Questions to Ask Yourself

_______ Do I feel comfortable at the facility. Does my family feel comfortable coming to the facility?

_______ Is the location of the facility convenient for frequent visits by my family and friends?

_______ Have I expressed my wishes regarding end-of-life care through a Living Will or Medical Power of Attorney?

_______ Have I appointed someone to handle my money through a Durable Power of Attorney?


Nursing Home Related Links

American Health Care Association

Apply for Medicaid in West Virginia

Medicare

Overview of Medicaid

West Virginia Health Care Association