Many families struggle with the heart wrenching decision of placing a loved one in a skilled nursing facility. Once the decision has been made, here are some important factors to consider before selecting a RI nursing home:
What Are Your Loved One’s Medical Issues?
By state and federal law, upon admittance nursing facilities must conduct an initial assessment of your loved one’s medical needs, including their functioning as to activities of daily living (“ADLs”). Before this occurs, you should understand your loved one’s medical needs. Speak with your loved one’s doctors and observe everything (some of my clients even keep a journal). Once you understand the exact medical issues, you can better evaluate and interview potential nursing homes. For example, dementia and Alzheimer’s patients have special needs that not every RI nursing home can adequately address. Knowing your loved one’s medical needs will help you become an active advocate for your loved one. When nursing homes may mistakes, this may help you minimize the effects of such mistakes or even prevent injury.
What should you learn about potential nursing facilities?
First and foremost, who owns and operates the facility? Many nursing homes are now owned by large corporate conglomerates that are not based in Rhode Island. Most experts urge consumers to seriously be wary of such nursing facilities, because they may overemphasize corporate profit over quality care. The RI Secretary of State provides ownership information here. Next, from my perspective as an RI personal injury lawyer including RI nursing home lawyer -- understaffing is a major concern. Some important questions to ask are: How many staff to patients are there (“staff-patient ratio”) on a given shift? How many Resident Nurses (as opposed to Certified Nurse Assistants) are on duty each shift? Finally, access the public records and ask specific questions about past deficiencies. There are minimum standards set forth in state and federal regulations. The RI Department of Health maintains information here. This agency also conducts inspections and any deficiencies cited are public record. This is important because I have handled cases as an RI nursing home lawyer where falls and elopement (wandering from the facility) were substantially caused by understaffing and/or there was a pattern of neglect.
What Is The Facility’s Cost And Fine Print?
Although outside my realm as an RI personal injury lawyer, it is a good idea to consult with a Rhode Island attorney who advises on Medicaid/Medicare issues and financing a loved one’s stay at a nursing home. That same lawyer should also be able to review the nursing home’s contract before you sign. You may be surprised at the sources of funding available ... and of the terms in the contractual fine print.
Govstench
5:39 pm on Thursday, April 19, 2012
Mr. Botarro
This is a good blog to start - it does give the care givers a chance to “vent”.
The nursing home situation in this state is a disaster for care givers. For those who get involved with it for the first time, you will quickly learn the game that is played. Any personal items of value or importance will quickly disappear by other patients. They will steal from one another.
The greatest fraud is the “bed hold”. Most of these facilities don’t have doctors on board and when a loved one gets into trouble, and needs to be transported to the hospital for a shot or seek attention from a doctor, the nursing home will make the bed available for another patient. Your loved one will not be allowed to return to that facility. To hold the bed, the cost is almost $750 a day. That is extortion!
Dementia patients need to go through a “certification” process before they can go to nursing care. I stint at Butler Hospital is ordered and then the hospital will place the patient in a nursing facility for you - you have no control over that.
Patient/staffing ratios are around 9 to 1. You also run into more nursing assistance or CNA versus RN as these homes refuse to pay for that expert care. Grossly insufficient for adequate care. (Perhaps that was what contributed to the Pawtuxet Nursing Home closure in Warwick)
Govstench
5:39 pm on Thursday, April 19, 2012
Couple that with the pending Medicare cuts and a dysfunctional RI Health Department with their regulations and you are taking a real chance with your loved ones. Nursing home care is horrible and it will pain anyone to see a loved one subjected to it. Rhode Island may be in a "race to the top" with its education programs, it is however, in a race to the bottom with its healthcare!
Mike Bottaro
1:08 pm on Friday, April 20, 2012
For those interested, here is information about the Warwick nursing home closure that you mention: http://personal-injury-ri.tumblr.com/post/19450417491/ri-nursing-home-lawyer-news-warwick-nursing-facility
Govstench
9:25 am on Saturday, April 21, 2012
Mike, the DOH needs to start getting more aggressive with this nursing homes. The Coventry Rehab facility on Rt. 3 is owned by an out of state corporation and went into bankruptcy. That facility was going day to day with its operations and the care was getting very questionable. I moved my loved one out of there (where she was placed by Butler Hospital) to another facility in South Kingstown. Much better, but you still have to keep an eye on them.