Questions to Ask AFTER Touring a Nursing Home

Questions to Ask AFTER Touring a Nursing Home

No doubt, you’ll have questions to ask the admissions director after you’re done touring a nursing home. If a few questions come to mind over the course of the tour, don’t hesitate to ask them right then and there. In an earlier blog, I advised focusing on your direct observations and sense impressions while taking a nursing home tour and waiting until it’s done to ask questions. Often admissions directors will reserve time for questions after the completion of a tour. This is a perfect time to ask a couple questions based on first impressions. But don’t worry if you need a little time to reflect and formulate specific questions. It’s typical for an admissions director to give you her business card and encourage you to reach out at a later point.  

Below are suggested questions to ask after touring a nursing home. Several of these, or only a few, may be relevant to you. Underneath certain questions, in parenthesis, are my thoughts for why it may be an important question to ask.  

Nursing Staff Ratios and Other Characteristics

How many residents are assigned to each certified nursing assistant (CNA)?

How many residents does each nurse care for?

What is the ratio of LPN to RN?

Is the nursing supervisor free-floating or assigned to a specific unit?

(On occasion, the RN supervisor will be the charge nurse on a unit.  This can happen because of a last-minute call out.  However, if this situation is routine, then you have an indicator that- at least- the licensed (RN and LPN) nurse staffing is tight.)

 

Is the Director of Nursing (DON) on-call 24hr/day- 7/days week?

(Granted, this is one of the toughest parts of the DON role.  It’s a job with a huge amount of responsibility.  But the answer to the question is YES in all cases.  If you get an “I’m not sure” or “I don’t really know” then you’ve come across a yellow, if not red flag.)

 

How are call-outs handled?  

Does the regular nursing staff have a weekend rotation OR is there a different group that only works weekends?

Is the staff multi-lingual?

Staff Turnover

How long has the Administrator/ Director of Nursing worked here?

(The administrator and director of nurses are the licensed directors of any nursing home.  High amounts of turnover in these top positions have a direct effect on patient care. If there’s turnover in these roles every year or every few months, then that’s a significant red flag.)

 

How many years have you (i.e. admissions director) worked here?

Does this nursing home use “temporary” agency/pool staff?

What is the biggest category of staff turnover?  What does management/ ownership do to address this situation?

Training and Development

Does the staff receive special training on dementia?

How much orientation and training do new hires receive?

Medical Care

Who should I speak with when I have questions about my loved one’s care?

(The first person to speak with is the Charge Nurse assigned to that nursing unit. You may have questions about care at any time of day and any day of the week so these nurses, covering 24hrs/day- 7 days/week, are your primary point of contact. In an upcoming blog, I’ll outline “who’s who” on the interdisciplinary team, all of whom you will get to know over time.)

 

When are newly admitted residents seen by a physician?  What is the frequency thereafter?

Will my loved one have a choice of attending physician while at the facility?

Who is the Medical Director and how long has she been with the facility?

What additional medical services do you offer?  Laboratory?  Radiology? IV Therapies?

Is there a specialized memory care (dementia) unit?

Daily Care

How will the CNAs know when my loved one needs help?

Will my loved one have the same caregivers throughout the week?  

How often will the nurse assess my parent?

If a resident is offered a shower, but declines at that time, will she be offered it again later that day?

(Residents of nursing homes have the right to refuse or decline care at any time. You want to get a sense of how this common occurrence is handled by the nursing home staff.)

 

Is laundry done onsite?

How frequently are resident rooms cleaned?

Skilled Therapy 

My loved one is coming to the nursing home for long term care, not a short-term stay.  Will she be eligible to receive physical therapy? 

What are the criteria used to evaluate that eligibility?

Does the facility offer Respiratory therapy? 

Recreation Activities

Are there group activities organized throughout the week or only Monday thru Friday?My loved one is not able to get to recreation programs on her own.  Will someone take her?

Are there organized events for residents to attend outside of the nursing home?  Museums, movies, shopping?

What is the hairdresser schedule and charges?

My loved one never socialized much and probably won’t attend many group activities.  Are there opportunities for her to have visits from recreation staff 1:1?

Dining and Dietary Preferences

What if a resident doesn’t care for any of the meals on the daily menu?  Is there an “always available” alternative menu?

What are the mealtimes?

My loved one is a late riser.  Will she still be given breakfast even if it’s past that mealtime?

Is there food available at all hours?

Are snacks between meals offered to residents?

Can I bring in prepared food? Is there a refrigerator accessible and available for resident use only?

Do you have a dietician on staff?

Family Involvement

Are there any restrictions on family visitation?

Are visiting hours flexible?

Can we take my loved one out of the facility for dinner or for an overnight stay at our house?

Does the facility have an organized Family Council?

Are family pets welcome to visit?

Billing and Payment

What insurances do you take?

Do you accept out of state Medicaid?

If/when it’s time to apply for Medicaid, is there someone on staff who can guide us?

What are the Business Office hours?

Can residents set up personal banking accounts onsite?

What services are included in the “daily rate?”

IN CONCLUSION

Selecting a nursing home is a process that involves researching, touring, and asking plenty of questions. In this article, I’ve offered a selection of questions that may be helpful for you to ask after taking a tour and when you’re ready to learn more. Think about it this way… If you don’t like the overall feeling you got when touring a facility, you might not want to waste your time asking a bunch of follow-up questions. Just move on. In choosing a nursing home, first impressions count!