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WHEN LOOKING FOR A NURSING HOME FIRST: Ask for a tour of the entire home. Are the rooms and hallways clean, neat and free of foul odors? Is there a nurse call light by each bed? Is there fresh drinking water within reach of residents? Do residents have their own belongings in their rooms? Do some areas of the facility appear more desirable than others?
Ask to see the actual room where the person will be. Are there curtains, bed stands, and individual closets? If possible, visit during a meal. Does the food look appetizing? Do residents eat together and talk with each other? Are aids helping people who cannot eat by themselves? Are the inspection reports and license posted in a public place? Are they current (within the last year)?
SECOND: Observe the residents and how the staff treats them. Do the nurses and aides seem to treat residents with respect? Is the staff attentive to the residents’ needs? Are residents properly dressed, clean and active? Is there an atmosphere of warmth and friendliness? If possible, speak to some of the residents and get their impressions.
THIRD: Ask what services the home provides. What social/recreational services are offered? How often do they occur? Is there a resident council? How are residents’ dental, eye and hearing needs met? Are there physical, occupational and speech therapy? How does a resident qualify to receive these services? Is there a program for the prevention and treatment of incontinence? How does the home provide for mental health needs of residents? What is the physician’s name and phone number? How often does the physician see the residents? Is the physician available in emergencies? Request a copy of the nursing home’s rules and policies.
FOURTH: Ask the administrator about the nursing staff. Nurse aids proved most direct care in nursing homes. They are also called CENA’s which is an for Competency Evaluated Nursing Assistant. Fine out what kind of training and orientation are given to the CENA’s and how often is training updated and by whom. How long have most CENA’s worked there? A home with a high employee turnover has difficulty giving good quality care. Ask about qualifications of nurses to give adequate supervision and help to the CENA’s.
FIFTH: Finances and admission contract. If the person considering admission will have their bill covered by Medicare or Medicaid, either on a admission or in the future, you need to find out if the home is certified to participate in these programs. Expenses will not be covered if the home is not certified. If the source of payment is or will be Medicaid, ask what the policy is concerning keeping residents who switch from private pay to Medicaid. When you enter a nursing home, you must sign an admissions agreement. This is a contract which describes your legal relationship with the facility. The agreements you make in this contract are very important. They describe the services you receive, your rights and responsibilities, and the charges for your care. Michigan law requires that nursing homes establish a written contract with all residents before admission, again when a contact expires, and when the source of payment changes. A copy must be given to the resident or the resident’s representative upon admission. The contract must include: Length of the contract Services to be provided, along with itemized charges Any additional services which may be required and the charges Who is responsible for payment The amount of deposit required The rights, duties and obligations of the resident It SHOULD also include: Daily room rate and what services that covers A list of optional services and charges for them If you are considering admission to a nursing home, get a copy of the admission contract as soon as possible. Most are long and contain legal terms. The more time you and your representative or attorney has to review and admission contract, the better. Some contracts contain legal requirements. Some of these requirements may be legal but not acceptable to you. You may negotiate agreements to make changes to the contract. Under federal law, Medicare and Medicaid approved nursing home cannot require anyone other than the resident to guarantee payment. Federal law also prohibits charging deposits or pre-admission fees to anyone whose nursing home care will be covered by Medicare or Medicaid.
ADMISSION CONTRACT CHECKLIST Items to be included in the contract: __ Services included in daily rate __ Services for which there is an extra charge __ Source of payment __ Cost to resident __ Terms of security deposit __ Resident’s Rights and Grievance Procedure __ Additional provisions agreed to by both parties __ Designation of patient representative, if desired by resident At the signing, make sure you receive;
A copy if the signed contract and all attached forms. Make sure your copy includes all changes and that they have been initialed by you or your representative and the nursing home’s representative. Make sure the nursing home attaches to the contract:
Under federal law, Medicare and Medicaid approved nursing homes cannot require anyone other than the resident to guarantee payment. Federal law also prohibits deposits or pre-admission fees to anyone whose nursing home care will be covered by Medicare or Medicaid. IF YOU ARE ASKED TO SIGN THE CONTRACT AND ARE ONLY AGREEING TO PAY FROM THE RESIDENT’S FUNDS, MAKE SURE THE NURSING HOME INITIALS THE CHANGE. FOR HELP FROM YOUR LOCAL OMBUDSMAN, CALL 1-800-833-9548
Rev: 02/04
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Site last updated 06/26/04