Now You Can See More Data Before Choosing a Nursing Home

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Entrusted Legacy Law

Posted on

Feb 17, 2023

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Pennsylvania - Greater Pittsburgh Area

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For families seeking nursing home care for a loved one, getting information on what a nursing home is truly like or who owns it is easier said than done. Many rely on word of mouth, referrals, or recommendations. Others must depend on their gut instincts and site visits as part of their decision-making process. 

Family members often find themselves playing detective or hoping for the best. Much of this is because little information has been made available to the public. However, recent events show this is changing. 

New Efforts to Increase Transparency

State and federal governments recognize the lack of transparency or data available to ordinary people regarding nursing homes. Some are taking action to try to change this. In September 2022, the Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services will provide a way for users to search for data regarding who owns a nursing home. 

Similarly, Medicare provides an online tool that allows you to find nursing homes in your area and compare them against others. States such as New York have also set up sites for visitors to compare the quality of care, quality of life, safety, preventative care practices, and inspection and complaint information of nursing home facilities. 

There are limits to the data available. For example, the data on the Centers for Medicare & Medicaid Services regarding ownership is self-reported. This means data on hundreds, if not thousands, of nursing homes is unavailable. In addition, untangling all this information and determining whether a nursing home is a good fit is not easy and may feel like a guessing game to some. 

However, there is a consensus that more information must be made available to the public, and a proactive effort is underway. As the data banks grow, researchers will be able to identify facilities owned by companies with a history of poor performance within other facilities or that may have other troubles. 

For example, in 2022, the Department of Justice charged the owner of the nursing home chain known as Skyline with failing to pay employment and unemployment taxes for more than 15,000 employees at 95 facilities in 11 states to the tune of a bill for $29.5 million owed to the IRS. The fallout was terrible for nursing home residents all over the U.S. who had to find new homes as staff were told there was no more money to pay them.

Hopefully, the search tools, once further developed, will allow viewers to see whether the nursing home they are considering is affiliated with troubled facilities they may have heard about.

What You Can Do Now

So, what can you do in the meantime? Checking out the above resources is an excellent first step. Another option is to look up your state’s portal for nursing home complaints. Many of these are online and have links to comparison tools and other resources. 

Several public projects have also created a database of nursing home deficiencies cited by regulators and incidents of penalties, such as ProPublica’s Nursing Home Inspect.

Finally, consider seeing if the nursing home you have in mind is active in your local courts. They may frequently try to sue residents or guarantors for bills or be subject to elder abuse and malpractice complaints. Some court systems have online search systems that allow you to view the details of all filed cases online, while others may require a trip to the clerk’s office. This can be invaluable in giving you an idea of what the nursing home environment is like behind closed doors after all the paperwork is signed.

The best position to be in is to have as much information as possible. Whether it be through online searches or in-person visits, do as much research as possible. Find more answers to your nursing home questions on ElderLawAnswers.com.

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One study shows that 1 in 10 deaths from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene (Sjogren et al., 2008). Unfortunately, proper oral care and monitoring of meals is often overlooked in the health care setting.  Perhaps the greatest reason for this is the challenge that almost every health facility faces today: adequate staffing. When I started working in acute care as an RN over 20 years ago, nursing assistants (these are the staff generally responsible for proving oral care in an acute care setting) were typically responsible for 5-7 patients. Nurses had 3-5 patients (this was on a step down cardiac unit). Between the nurse and the assistant, we were able to provide oral care at every meal and offer one-on-one assistance to any patient that was at risk for aspiration. 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I hired a companion for my father when he was in a skilled nursing facility. He was not getting his teeth brushed or flossed regularly, and I was seeing a decline in his dentition. Having this extra support provided him with much needed assistance and the care companion had the added benefit of encouraging him to eat more at every meal, something that was a bonus as he was not meeting his nutrient needs. Touching base with staff to request that oral care and meal monitoring be done can also be helpful. Having an advocate to ensure necessary care is getting done can also be very effective in the health care setting.  What is proper oral care and effective meal monitoring?  Proper oral care includes brushing the teeth for at least 1 minute after every meal. It also includes using a soft bristle brush, fluoride toothpaste, flossing daily. A final component of oral care that is often not discussed is denture care. Dentures should be cleaned at least once per day and removed at bedtime. Removing them prior to sleeping can greatly reduce the risk of pneumonia (Iinuma et al. 2014). Effective meal monitoring includes adequate supervision during mealtime for those at risk of aspiration. Such supervision includes ensuring the individual is properly positioned for a meal (head of bed as high as can be tolerated and supine position), takes small bites, eats slowly, swallows a couple times in between each bite, and intermittently takes a sip of liquid to clear the mouth of food particles. The use of straws is generally not recommended for an individual at risk for aspiration as it propels the food to the back of the throat and hence can increase risk. I recall when I was working as a Registered Nurse (RN) in acute care that I was constantly removing straws from the bedside of at risk individuals and often reminding them to eat slowly and swallow at least twice between each bite to ensure food clearance. Individuals at risk for aspiration often require a modified texture diet as it can further prevent the aspiration of food and liquids.   This is a brief summary of the attention to detail needed in addressing oral hygiene and meal monitoring amongst the aging population. Both measures can play a significant role in reducing aspiration pneumonia.  If you would like more information on understanding proper oral care or any other questions that you may have regarding aging life care, please feel free to reach out to me.    Sources:1.      Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. 2008. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 56:21242130. 2.      Iinuma T, Arai Y, Abe Y, Takayama M, Fukumoto M, Fukui Y, et al. 2014. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J Dent Res. doi: 10.1177/0022034514552493 3.      F Muller, 2015. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541086/#   

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Entrusted Legacy Law

Elder Law 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086

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