How to select a quality nursing home

Dec. 23--How can you find out if a nursing home in New York State is good or bad?

There are a number of ways.

There is a lot of information about New York's 619 nursing homes on the state Department of Health website and the U.S. Centers for Medicare and Medicaid Services'Nursing Home Compare website at medicare.gov/NursingHomeCompare.

Each website provides details on how nursing homes rank in delivering care, perform in annual health inspections, their staffing levels and the percentage of residents with bedsores.

Tony Szczygiel, a retired University at Buffalo Law School professor who specialized in elder law, recommended taking these additional steps:

--Most people go to nursing homes after being discharged from hospitals. Work with a hospital discharge planner so individuals and relatives have an active role in determining what nursing home is selected.

--If there is enough time, relatives should visit each of the nursing homes to conduct a "smell test." Szczygiel says that is a way of measuring staff attention to the basic needs of residents. During a visit, visual observation of what residents are doing -- such as if they are just sitting in wheelchairs without activities or staff interaction -- can be another indicator of how a home is operated.

--Consult with individuals who are more familiar with nursing home quality of care, such as officials with the Erie County Department of Senior Services or a geriatric care manager.

Under the best of circumstances, families should take these steps long before their loved one is in need of a nursing home in order to avoid a hurried and uninformed decision, according Roxanne Sorensen, the owner of Elder Care Solutions in Amherst.

Nursing homes, she pointed out, review a number of factors when deciding whether to admit a new resident:

--Does the individual have complex medical needs or suffer from dementia or mental illness?

--What types of medication is the person prescribed and how much do they cost? Facilities, Sorensen explained, often bear some of that expense.

--The age of the individual. A 62-year-old person on public-funded Medicaid could end up staying many years compared to an 85-year-old resident on Medicaid.

"A nursing home won't survive with 100 percent Medicaid residents due to the reimbursement rates," Sorensen said.

The average Medicaid rate for the 47 nursing homes in Erie and Niagara counties is about $229 per day, about $100 less than the average cost charged by nursing homes in the region.

Transparency in listing financial resources on an application is important, according to Sorensen. Some families attempt to hide assets and that could result in Medicaid sanctions.

Having savings can also work to an individual's advantage in gaining admission to a nursing home with a high ranking in the federal government's five-star rating system. A person with more than $50,000, Sorensen said, can use the savings to negotiate admission.

Those without assets also have the chance of being admitted to a highly rated nursing home, if their "Medicaid pending" application is in order, she added.

"There are a lot of buildings, many five stars, with open beds and if you can show that the Medicaid application will have no red flags and get approved, a person who is Medicaid pending can get in," she said.

[See how ratings for the 47 nursing homes in Erie and Niagara counties changed over the past nine years]

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