It is SO important at this juncture to research, research, research.
First find out what is the per diem on your mother or father's long-term care insurance. Different plans pay different amounts per day.
Every facility has a per diem, and any difference between what your insurance provides and what the actual cost of the nursing home facility is would come out of you or your parent's pocket.
A long-term policy might pay $114 a day, but the best nursing home facilities may charge $250 or more. (This is also important to think about in your 40s when you start looking at purchasing long-term care insurance.)
So, have your insurance paramaters straight before you journey out into the unknown nursing home world.
The first thing you want to notice as you walk into a nursing home facility, is does it smell? If it does, walk out. Bad smelling facilities are poorly run. It means that the patients are not being changed and cleaned routinely. It also means the staff and director are willing to tolerate that -- which raises concerns about what other poor care they are willing to tolerate.
I would ask to meet with the Director of Nursing (DON), not just the Admissions Director or Assistant, who are basically the sales people. If the DON is not willing to make an appointment to meet with you, I would go elsewhere. It is unusual for the request to be made, most people don't know to ask. But he or she is the person who runs the facility, if it is skilled nursing, so it is very important to interview them.
Ask the DON what the staff turnover rate is, what is their proportion of CNAs, LVNs (who give medicine) and RNs per patient. How many charge nurses are on duty (those who sit at the desk) during each shift. This should also be posted somewhere on a wall in the entry way by law in most states.
In Part 2 we'll focus on the difficulties many nursing home facilities have in training and keeping good staff, and how to give your Mom or Dad the best chance to get into the best nursing facility.
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