Care Compare website

Ed1937

I'm not sure just how reliable this will be, but it looks interesting.

You Can Now Compare Nursing Homes on Staff Turnover Rates and Weekend Help

•  January 13th, 2022

The Centers for Medicare and Medicaid Services (CMS) announced that it will add data on staff turnover rates and weekend staffing levels to its Care Compare website, giving consumers another tool when choosing a nursing home. 

The official Medicare website includes a nursing home rating system. Care Compare (previously called Nursing Home Compare) offers up to five-star ratings of nursing homes based on health inspections, staffing, and quality measures. Users can search for nursing homes by location and directly compare how they measure up. 

Ed1937

I just checked out the website, and there is a lot of information to compare facilities. You can search facilities by zip code or city/state. Not sure just how reliable the information is, but it might be worth taking a look at it.

harshedbuzz

It's certainly worth a look.

One thing I have noticed locally, is that a number of LTFs have changed names in the past 6 months. The one where dad lived was closed after the staff and residents were decimated by COVID in the early days of pandemic; it has since reopened under a new name. My mom's first choice for dad was also re-branded.

1934

Unfortunately, There is no information about Assisted Living facilities. Those that are not Nursing homes.

Jo C.

There is a big hole one can drive a truck through when using that site.  The data for the reports is SELF reported by the nursing homes themselves and no one, absolutely no one from oversight sources checks to ascertain how accurate the data is.   It is simply accepted as reported.  Some NHs are excellent, have good ethics and strive to provide good hands-on care to every patient resident and reports honestly and accurately. Then there are others.  

Other than that site, every two years, an onsight health department survey is done at NHs with experienced RN surveyors taking part in conducting the screening.   Believe me, the staffing goes WAY up on those days. The surveyors then produce a report of deficiencies which is given to the NH and the NH must provide a copy for family members to view upon request.

Sadly; in many states, for those whose LOs are in ALFs or Residential Care Homes, the oversight is not done by licensed nurses, but by a single social worker and then it is done only every FIVE years.

As for staffing, well; this is one of those things that can be fraught with manipulation and false reporting.   There can be a significant amount of false numbers from less ethical facilities.  As for licensed staff being present, either RN or LVN, facilities will often include in this, the licensed nurses who do absolutely no hands-on care such as the DON, Asst. DON if there is one, and others who fill part time or full time other functions unrelated to hands on patient care.   Yes; they may be licensed, but they will never be part of direct patient care. Such reporting gives a false picture of available daily care for a LO.  Be very careful about checking staffing and types of staffing on your LOs Care Unit on all three shifts.  Night shift is so short that patient problems are often not caught.  Usually, there will be only ONE licensed nurse, usually an LVN at night for the entire facility; even those that have 200 beds as I personally found out.  Ask and then check.  Talking to staff members can be very helpful; the aides are usually very clued in and talking with them can be helpful, especially when it comes to staffing and turn over as they are the ones who are flying Mach 2 with their hair on fire most of the time trying to care for their patients and they see it all. 

If a NH comes up with a deplorable rating, I would definitely not consider that one.  However; for me, even if there are good figures on the Compare site, when visiting a NH, I will request to see the report from their last onsite inspection.  This is not unusual; we are expected to ask for it, but most people do not know it exists for their viewing.  The law mandates it be available to family upon request.  NOTE:  Every single NH will have negative findings and receive "deficiencies;" this is true in all hospitals whether NH or acute care med centers.  It is a matter of how serious the problems are and how many and also, what the care center is doing to permanently fix the issue.

Talk a lot with the families who you see when making an onsite visit; see if the Ombudsman person for that area will talk a bit about quality care facilities.  While the Discharge Planner or Care Manager at a hospital will not professionally be able to recommend a specific  facility to you, one can ask, "Which facilities have the least family member or patient complaints and come in without serious issues such as frequent bedsores, etc.?"    If they are knowledgable and consciencious, they will often respond in a helpful manner.

If a facility is private pay and uber-fancy with crystal chandeliers and high quality furniture in the lobby and offices, check even more carefully.  It is also for me, good to see if they are on the stock exchange by company.  Such facilities organizations have an obligation to earn money for their investors and can be highly profit driven.  It is not unusual to see fancy for the family to give an initial sense of ooh-la-la; but for cost cutting to be done on staffing and other areas of patient use/need.  Not all of them will be "bad news," but it behooves us to check as historically there have been issues within that category. 

It takes a lot of research, inquiry and follow through. Try to make at least three visits; at least two unannounced for tour. Also try to be there at mealtimes to check and see the quality of the food, the process in the dining room - are patients who are unable to do so being fed by staff, and are patients sitting at tables with other like patients who are in their similar category for cognition - that is a big one. If a LO who is fairly high functioning is sat at a table with others who are acting out, drooling, taking food off  of others plates, etc., this will severely hamper the LO's own willingness to eat and also can contribute to depression.

Visitation helps the staff know someone cares and someone is watching.  I liked to visit not only on the day shift, but also on the p.m. shift and a couple of times ringing the buzzer to visit on the night shift.  Oversight is necessary and it will be noted and your LO will benefit from it in multiple ways. Right now, COVID is having an effect on all of this, but we can continue to try our best and see what we can work out.  Hopefully it will not be too long in the future when we can gain better access to all that works best.

There is a marvelous book regarding admitting a LO to a NH.  It is a highly detailed primer put together in Illinois and is applicable to all dynamics when admitting a LO to care.  Here is the link:

http://www.illinoiscares.org/book/chapter01 

Consumer Guides | FloridaHealthFinder.gov

https://www.kiplinger.com/article/retirement/T027-C000-S004-how-to-choose-a-memory-care-unit.html  

 

The larger the facility, the more screening and the more oversight visiting is needed so as not to have a LO get lost in the crowd as usually in such huge settings, there are often frequent changes.

This gives me a sense of even more need to screen far in advance of need for a, "Plan B," should an unexpected need arise that was unforeseen.  It saves having to run about under pressure and time constraints.  However; that is not  so easily done at this point in time thanks to COVID, so one gets on the computer, screens as best can, then speaks to those who may know a bit, and then hope to obtain screening visits by appointment.

How I wish this were easier and that all care would be superlative, that would be great.  I know the facility I would want for my LO and even for myself if something untoward came along. It has for years been a five star rated facility with wonderful feedback from patient's families; however, they have only 60 beds and those beds are usually filled.

Best of wishes being sent out for all of us for when the need arises  . . .

J.