Choosing a nursing home for oneself or for a relative can be one of life’s most overwhelming tasks — right up there with picking a college or buying a house. In the selection process, there are certain obvious factors to consider, but perhaps even more important are some of the frequently overlooked details.
Most experts in the field agree on the basic steps involved in finding a nursing home that is suitable for an individual’s particular needs.
Yoel Lichstein, executive director of the Margaret Tietz Nursing & Rehabilitation Center in Jamaica Hills, is among those who stressed how important it is to “actually pay a visit to a facility.”
He suggested several questions one should ask oneself: “Is it a warm, friendly, pleasant environment? Do the residents appear cared for? If there is a particular specialty needed, is there a special unit? Does the staff have special training?”
If the resident is going to need rehabilitation, Lichstein suggested, “Get a tour. Is the gym bright and clean? Are they keeping up with the technology of the equipment and the latest treatment methods?” He also stressed it is important to “discuss the specific issues your person has.”
Sometimes it’s the smallest details that say the most. Lichstein pointed out a few to look for: “Are there any light bulbs that are out? Are the men shaved?”
According to Linda Spiegel, who works alongside Lichstein as the director of public affairs, Margaret Tietz is a 200-bed facility that was originally established for the care of Holocaust survivors, though today “we’re a cross section of the borough.”
She pointed out that, due to the mission of the facility, three-quarters of the residents have private rooms, a luxury she said is not available in many nursing homes.
Promotions for the facility suggest that “our goal is to get you back home as quickly as possible.” To this, Spiegel added, “We have a very good track record of getting people back into the community after rehabilitation.”
Another nursing and rehabilitation facility in the borough is the Elmhurst Care Center, a 240-bed facility that provides 24-hour comprehensive rehabilitative healthcare, offering individuals an opportunity to develop the skills essential to restore their independence.
Director of marketing Elizabeth Salisbury agreed with Lichstein when she said, “The best thing to do is call and take a tour. It’s seeing what it looks like.” A tour also provides an opportunity to experience “your general feeling,” she said.
It is important to “look at how the staff treats the residents,” said Salisbury, who suggested learning about the ratio of staff to patients, the number of nurses on site, and what is the nearest hospital to the facility.
Of Elmhurst’s prestigious five-star rating by U.S. News & World Report, Salisbury said, “That speaks for itself.”
It is an honor bestowed by the publication upon a facility based upon health inspections, nurse staffing and the quality of medical care being offered. For 2013, a total of 3,867 nursing homes earned the top rating, out of approximately 16,000 facilities nationwide. The website Best Nursing Homes allows a visitor to easily locate ratings on particular facilities.
Another local facility which earned the top rating by U.S. News is the Little Neck Nursing Home, where, according to promotional materials, “our residents are our passion.”
The home offers both long-term care and short-term rehabilitation, an integrated support system that provides physical and emotional needs, and round-the-clock care by nursing professionals.
Leslee Mavrovic, senior vice president for social work and resident life at Parker Jewish Institute for Health Care & Rehabilitation in New Hyde Park, suggested that “geographic location may or may not be a consideration” when choosing a nursing home.
She also pointed out that “insurance sometimes plays a role. It’s becoming more and more important.”
As for the facility itself, she said having good lighting, controlled temperatures year-round and an “appropriate noise level” are important.
Mavrovic recommended finding out if the facility allows smoking, if the staff members wear name tags, and if they knock on residents’ doors before entering.
“Privacy, dignity, courtesy and respect” are of utmost importance, she said.
According to Mavrovic, other details worth noting, particularly for long-term residents, include:
• Is there a window in the resident’s bedroom?
• Do the residents have access to a personal phone and television?
• Is there a choice of roommates?
• Are exits clearly marked?
• Are there handrails?
• Are there choices on the menu?
• Is there a common area for activities?
• Is an evacuation plan in place for emergencies?
• Can residents be seen by their own personal physicians?
• Does the facility offer preventative care, such as flu shots?
• What hospital would a resident be taken to when necessary?
• Is visiting permitted 24/7?
• Where are the results of the latest New York State Department of Health survey posted?
Mavrovic pointed out that “the results have to be posted and everyone has the opportunity to read the outcome and see if the deficiencies have been corrected.”
And, she said, one of the most important steps while on a tour of a facility is to “do a sniff test. Does it appear to be odor free?”
This was a point stressed by Christine Lipscomb, an 11-year veteran of the medical field who pointed out that if a facility has an unpleasant odor, “a lot of times that’s bed sores, rotting flesh,” the result of neglect.
Lipscomb pointed out that a tour should not just include the first floor, where “patients are most physically able.” Be sure to visit the facility’s other units, she said, which could be “overcrowded, with patients in wheelchairs.”
She indicated that “the dementia unit is one of the most important. Patients are 100 percent dependent on the nurses. That’s where you can see if they’re being taken care of. Did they come from the lunch room with food still on their clothes?”
Of great importance, she suggested, is finding out how many patients have fallen at the facility. “A fall is not supposed to happen,” she said.
How many times the facility has been cited for health code violations, such as failing to properly label patient doors, is also an important indicator, she said, as are statistics on choking victims and deaths due to possible neglect.
As suggested by many of the experts, one of the best sources of information on nursing homes comes from residents themselves and their families.
Holly Gendron of Hamilton Beach knows something about nursing homes, thanks to a 102-year-old grandmother who has been living at Queen of Peace Residence in Queens Village, a combination nursing care/independent living facility run by the Little Sisters of the Poor for more than two decades.
“My grandmother picked it out herself,” Gendron said, adding, “She was able to bring a lot of her own furniture from her house. It wasn’t a big transition. You want the residents to feel it’s their home. Our family could not be happier with the quality of care that she receives.”
Gendron said the residents appreciate “being treated like they’re special. It’s not run like a hospital. The cafeteria is decorated more like a restaurant.”
For Gendron’s family, it was important for grandma “to be in a facility that was run by a religious organization.” There is a chapel in the home where Mass is held every day, Gendron said.
Fresh Meadows resident Nora Cohen said her father had been at the Forest Hills Care Center for two weeks following a stroke. “It’s not huge, very individualized. Four or five patients at one time in rehab. At other places, they had a long line-up waiting. It’s nicely decorated. The rooms are nice. They have activities all day long.”
Of course, one of the most important factors to consider is the financial one. Medicare, Medicaid and other resources can help minimize the cost of long-term care, according to U.S. News.
“The cost can financially cripple a family,” the publication’s website suggests. “But there are steps to minimize the strain. Ideally, financial planning for long-term care should occur long before the need arises.”
A survey by MetLife found that in 2012, a private room in a nursing home cost an average of $248 per day, or over $90,000 annually.
According to U.S. News, the Veterans’ Administration can provide assistance, and, it points out, some nursing homes will negotiate long-term care costs. In extreme cases, it recommends relocating a patient to a city or state where nursing homes are less expensive, though it cautions not to do so if it leaves the patient far from any family.