How to Choose a Nursing Home in Rhode Island

Choosing a nursing home for an elderly family member is not a task that should be taken lightly. Careful consideration must go into selecting a facility capable of providing your loved one with a safe, comfortable environment, as well as the level of attention and care that is needed. Your loved one’s health condition, the location of the nursing home and how well it is maintained are only a few of the factors to consider.

Be thorough in your search. Visit as many nursing homes throughout Rhode Island as you can before you make a final decision. Ask a lot of questions and be sure to look around, paying close attention to the condition of the building and the interaction between the residents and nursing home staff.

The Rhode Island nursing home you select should be a place where your loved one’s rights will be respected. It needs to be a place where your loved one will not feel abandoned or neglected. You do not want your elderly loved one to be put at risk of nursing home neglect or abuse. Keep these points in mind while you research the nursing homes in your area.

What Are Your Loved One’s Needs?

Not all nursing homes provide equal levels of care. If a nursing home does not have the proper facilities, is inadequately staffed, or its staff lacks the necessary qualifications and training, it is your loved one who may suffer.

When choosing a nursing home, you need to consider:

• Medical condition
  Is your loved one in poor or failing health? If so, it is important for you to find a nursing home that has on-site physicians capable of properly evaluating, diagnosing and treating your loved one.
• Nursing care
  While most nursing homes around the country are able to provide residents with nursing care from either a licensed practical nurse (LPN) or a certified nursing assistant (CNA), Rhode Island is one of only a handful of states that require nursing homes to have a registered nurse (RN) on duty 24/7.
• Personal care and attention
  If your loved one requires assistance tending to day-to-day personal grooming and basic activities, make sure the nursing home has a sufficient staff-to-resident ratio.
• Residential care
  Your loved one will have more of a chance of staying active, alert and engaged if the nursing home has in-house activities designed to meet residents’ physical, mental, social and spiritual needs.
• Special care
  Does your loved one have special needs that go beyond the general scope of care many nursing homes can provide? Discuss those needs with the staff to find out if they are able to provide the necessary care. If not, find a nursing home that offers these special care services.

Some nursing homes provide hospital-like care, while others are more like an apartment setting with personnel to assist. Many people are more comfortable in their own space with their own possessions, while others need to be in a medically supervised setting.

How to Research Rhode Island Nursing Homes

Researching nursing homes in Rhode Island may appear to be a daunting task. Where do you start? How do you go about finding the information you need to decide if a particular nursing home is capable of providing the care and attention your loved one requires?

A factor that may weigh heavily on your decision is whether Medicare, Medicaid or long-term care insurance will cover the costs of nursing home care – or whether you or your loved one will pay for it out-of-pocket.

Medicare.gov has a simple, 5-star Nursing Home Quality Rating System that can be used to compare nursing homes and see how each ranks on issues like health inspections, staffing, quality measures and overall rating. The Rhode Island Department of Health has its own Nursing Home Summary Report that details capacity, certification, staffing, health inspection results, resident satisfaction levels, family satisfaction and other information that may be pertinent to your research.

The Rhode Island Division of Elderly Affairs also provides important information about Medicaid and has wide variety of resources that can be used to find out more about nursing homes in the state.

Before you make any final decisions, it is advised you speak with family and friends to find out any personal experiences they have had with the nursing homes you are considering. This first-hand information can often be more valuable than many statistical reports you find online.

A Checklist for Visiting Potential Nursing Homes

Once you have determined which nursing homes you want to visit and inspect, you should take the time to figure out what to look for and the questions you want to ask. The following checklist can help you ask the right questions during your visit.

Basic Questions

• Is the facility Medicare and Medicaid certified?
• Has the facility’s license ever been revoked? If so, why?
• Are new patients or residents being accepted?
• Is there a waiting period before being admitted?
• Are background checks conducted on all staff?
• How many LPNs, CNAs and RNs are on duty each shift?
• Is at least one RN on duty 24 hours a day, 7 days a week?
• What is the resident-to-staff ratio?
• What is the resident-to-nurse ratio?
• What is the nursing home’s visiting policy?
• What is its discharge policy?
• Are nursing home residents seen by doctors on a regular basis?
• Is transportation provided for appointments with a resident’s personal physician?
• Are eye doctors, dentists and other medical specialists available to see patients regularly?
• How are medical emergencies handled? Are arrangements in place with nearby hospitals?

Safety Questions

• Are hallways, walkways and stairways well-lit?
• Are exits clearly and properly marked?
• Do hallways, stairs and elevators have handrails?
• Are rooms and bathrooms equipped with grab bars and emergency call buttons?
• Do doors and windows have safety locks?
• Does the facility have properly functioning security and fire safety systems?
• Are visitors required to check in before entering and leaving the facility?
• Does the facility have an emergency generator or alternate source of power?
• Is the floorplan easy to navigate?
• How does the facility handle reports of neglect, abuse or mistreatment?

Care Questions

• Is the facility clean and adequately maintained?
• Does it have a fresh smell?
• Do residents appear to be clean and well groomed?
• Do staff interact well and often with residents?
• Does the facility offer resident activities and exercise?
• Are resident caregivers the same day-to-day?
• What is the staff response time to calls for help?
• Does each room have fresh water available?
• How is the appearance and smell of the food? Is it nutritious and tasty?
• Are residents given a choice of options at mealtimes? Can special dietary needs be met?
• Is assistance available to residents who need help eating or drinking?
• Are snacks available and easily accessible to residents?
• Do residents have access to physical therapy?
• Are any staffers specifically trained to handle patients with Alzheimer’s or dementia?
• Does the facility have separate programs or services for residents requiring special care?

Quality-of-Life Questions

• Are residents’ rights posted in plain sight?
• Does the staff respect resident privacy and knock before entering a resident’s room?
• Are doors shut when residents are being bathed or dressed?
• Does the facility have daily visiting hours?
• Is it easy for family and friends to visit a resident?
• Are residents’ cultural, religious and language needs met?
• Does the facility have outdoor areas accessible to residents?
• Are residents who want to spend time outside monitored and provided care when needed?
• Can residents or their families make decisions about daily schedules and routines?
• Are residents permitted to have personal belongings and furniture in their rooms?
• Are residents treated with the care and respect they deserve?
• Does the nursing home have a safe, friendly, home-like environment?

Making Your Selection

Once you have visited and revisited a number of nursing homes, met the administrative staff, talked to residents, observed the interaction between patients and nursing staff, and compared quality ratings, the next step will be making a choice.

After your selection has been made, contact the administration staff so you can begin the admissions process. You should also schedule to meet with the nursing home administrator and the staff who will be responsible for your loved one’s care to discuss any specific concerns you have, care needs you want to be sure are addressed and personal preferences.

Make sure to let the staff know you would like to be included in any care-planning decisions regarding your loved one.

Now that your loved one is enrolled and settled, continue to be involved. Make sure you visit often. Play an active role in his or her ongoing care.

Rhode Island Laws and Regulations for Nursing Homes

Rhode Island General Laws, Title 23 Health and Safety, Chapter 23–17 Licensing of Health Care Facilities details the requirements nursing homes must meet to become and stay licensed. Section 23–17.2 covers the accountability of services to patients and residents of nursing or personal care homes, which includes the duty to report violations and how to handle those who fail to comply with state laws.

One of the most important nursing home laws, the 1987 Nursing Home Reform Law, requires that resident’s rights be fully protected. Under this law, residents are afforded the right to:

• A guaranteed quality of life.
• Be fully informed.
• Participate in decisions pertaining to their own care and treatment.
• Refuse treatment.
• Be free from abuse.
• Choose their own physician.
• Privacy and confidentiality.
• Dignity, respect and freedom.
• Voice complaints or grievances without fear of retaliation.
• Have relatives, friends and other visitors of choice.
• Keep and use their own personal possessions.
• Share a room with their spouse.
• Administer their own financial affairs.

In Rhode Island, the Office of Facilities Regulation (OFR) is the agency responsible for making sure nursing homes adhere to each of the laws and regulations regarding the quality of care, quality of life and overall service residents receive. This is done through unannounced yearly inspections and on-site investigations. As the majority of nursing home funding comes from Medicare and Medicaid programs, and the OFR certifies nursing homes meet federal standards, nursing homes are often quick to respond to instances of non-compliance or customer complaints.

Legal Help for Victims of Nursing Home Abuse

At Marasco & Nesselbush, our experienced attorneys are dedicated to holding negligent nursing homes and staff accountable for the wrongs they have committed against the elders in their care. We are committed to providing every client with the personal attention and skilled legal representation they deserve.

To learn more about how we can protect your loved ones, please fill out our free case evaluation form or call us today for a free consultation.

Sources:

• The New York Times: Where Are the Nurses?
• Medicare.gov: Nursing home results: Rhode Island
• Rhode Island Department of Health: Healthcare Quality Reporting Program: Nursing Home Summary Report
• Rhode Island Division of Elderly Affairs: Nursing Homes/Long Term Care
• AARP: Comparing Nursing Homes
• Rhode Island Department of Health: Nursing Homes
• National Long Term Care Ombudsman Resource Center: Residents’ Rights
• Rhode Island General Laws: Chapter 23-17 Licensing of Health Care Facilities