The headlines in my home state of Florida post Hurricane Irma are horrific; the worst being the deaths of eight elderly patients in a licensed skilled nursing facility in Hollywood, Florida. The saddest news of all is that this was preventable and should never have happened. Yet it did. But why? And what can you do to make sure BEFORE you move your loved one to a nursing home that you have chosen a facility where this simply will not happen? Let’s face it, no one can promise that there won’t be some kind of natural disaster. What you want to know is this: how well prepared are they and what measures do they have in place. Most people simply don’t know what to ask when “shopping” facilities. When asked by a reporter why he chose the facility that his mother died in this week, he said “it was across the street from a hospital.” Clearly, his criteria were not enough to save his mother.
If anyone had looked a little deeper into the Rehabilitation Facility of Hollywood, owned by The Larkin group, they would have found that they paid $15.4 million in 2006 to settle federal and state civil claims for paying kickbacks to doctors in exchange for patient admissions. They would have found out how many times they were cited after being surveyed for numerous deficiencies in patient care including generator issues for cooling. But did the facility spend the money to address the concerns or add extra generators? No. Apparently, they would rather pay the penalty than take care of their patients. Simply criminal.
Federal law currently requires nursing homes to keep temperatures in a “safe and comfortable range,” (as if 100+ degrees was comfortable as was the case in Hollywood) but this rule only applies to skilled facilities certified AFTER Oct. 1990. Ironically, this law changes in November of 2017 and now clearly states that temperatures need to be between 71-81 degrees and the facility must have a backup power source. But will facilities comply?
Well, the good ones will. Below is a partial list of what to look for and why when looking for the best skilled nursing facility in your area.
- Number of total patients (or beds as they are referred to) in the facility
The larger the facility the harder to staff. Look for a smaller perhaps rural facility with
less than 60-70 beds.
- Staffing Ratio’s and Staff Turnover
Don’t settle for the pat answer “we meet state guidelines for staffing.” Ask for specific staffing ratio’s such as number of CNA (certified nursing assistants) per patient and the same for nurses. Is there at least one RN on every shift especially at night. Every facility keeps track of their turnover rate. Ask what theirs is for each category. Write it down and note who told you and keep your records. Make sure to meet the licensed Health Care Administrator and find our how long they have been on the job and the depth of their experience.
- Who is their Medical Director? Get the doctor’s name and meet him/her if you can. Do a background check. Have they been sued and for what? How long have they been employed? Do they have a financial interest in the facility? How many hours a week are they on site?
- What Corporation owns them and are they a division or is there a parent company?
Have they been sued? Settled claims of Medicare Fraud, patient death or neglect/ Is there a repeated pattern of deficiencies that have gone on over years?
- Is the facility spotless? Odor free?
Make sure to visit unannounced, especially on a weekend when you can chat with other visiting family members. Ask them lots of questions about the care their family member is receiving.
- Try the food:
What a facility spends on food is a good indicator of how much they are committed to a quality lifestyle. Look around the dining room and see if the patients are eating, how the staff is treating them, if they are talking or silent. Meal time is an indicator of the overall feel of a facility so pay attention, not just to the food!
- Ask to see their Emergency Plan
After Hurricane Irma they should be more than ready to comply. Any reluctance to share this information with you is a red flag. Ask LOTS of questions. What if they had to evacuate? Do they have an arrangement with another facility and where is it? Are they complying with the Nov. 2017 Federal law about a backup power source? Do they have generators now and are they large enough? Do they have food and water for 72 hours?
- Visit as frequently as possible.
Try to move your parent or loved one nearby. It will make a huge difference if the staff knows you are paying close attention. I’d love to say it does not make a difference, but it does.
- Look up ANY skilled nursing facility online to see how they are rated. Go to
www.medicare.gov/NursingHomeCompare/profile.html . Try to find a nursing home that has a even balance of both medicare AND medicaid patients. Homes that only accept medicaid tend to have more deficiencies and more staffing issues.
With 683 skilled nursing homes in Florida and 3,100 Assisted Living facilities with over 183,000 patients combined, guaranteeing excellent care is a serious challenge. But you can screen out the worst facilities with some homework and a little time online. Most importantly, you will have the peace of mind that you have done your best to find a skilled nursing home that will provide good quality care to someone you love.
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