What to look for in Nursing Homes
Nursing Homes
Nursing homes are required to have medical directors and physicians who supervise the medical care provided in the facility. Nursing homes can administer medication but the medications can only be administered by a medication aide, licensed vocational nurse (LVN) or registered nurse (RN).
Review medication with staff. Medication errors occur frequently and can be extremely dangerous. Make sure that the medication aide has a photograph of your loved one on his/her medication chart. It is a huge problem when medications are dispensed to the wrong resident and a photograph can sometimes be a lifesaver. If the physician orders a change in your loved ones medication, be sure to check that the change is noted and the proper medication is being given.
Video Monitoring
Many states have passed laws specifically providing families the right to have video monitoring of their loved one. Ask the facility whether you can place a video monitoring system in your loved one’s room. Some cameras can be set up to be attached to a computer at your location so you can monitor your loved one at any time (like those systems used to monitor children in daycare centers). If you are told that placing a video camera in the room is a violation of the resident’s rights, make sure to check the laws in your state for specifically how they can be set up. Videotaping may lead to an improved quality of care, but it is not without significant legal ramifications which will have to be resolved.
The most difficult problem that confronts families and the largest single cause of abuse and neglect of residents is the lack of sufficient staffing. Federal law requires all nursing homes to provide enough staff to adequately care for residents. However, there is no current federal standard for the best nursing home staffing levels.
The nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. CNAs provide the daily care to nursing home residents twenty four hours per day, seven days a week.
The Centers for Medicare Services (CMS) monitors staffing in nursing homes. The following types of staff are included in the information collected and reported by CMS:
- RN’s
- LVN’s or LPN’s
- CNA’s
- Physical Therapists
Each nursing home is required to report the staffing hours to the state agency for the two weeks prior to the survery. The data can be found on CMS’s nursing home compare website: http://www.medicare.gov/NursingHomeCompare/search.aspx