As published in the Houston Chronicle, 50 Plus Section, on October 25, 2002

Selecting a Nursing Home

By Wesley E. Wright and Molly Dear Abshire

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Although most people have no desire to be admitted into a nursing facility, there sometimes comes a time when there seems to be no other choice.  Once other lifestyle options have been used or vetoed, such as independent living, assisted living and retirement communities, then a nursing facility may be the answer.  Selecting an appropriate facility is a task which is very important.  The following suggestions may help you arrive at the desired home for your family member.

How will the nursing facility get paid?  The answer will factor into the decision.  There are basically only three ways of paying a nursing facility;  paying privately, using long-term care insurance, or obtaining Medicaid benefits.  If the person will eventually require Medicaid assistance, it is worthwhile considering a facility that accepts Medicaid early on.  The reason is due to the fact that it is hard on elderly folks to be moved.  Think about how disruptive it is for you to move if you are healthy.  It is much more traumatic when you are old and frail.  Although most nursing homes take Medicaid, some do not.  There are various periodicals available with lists of nursing homes in your area.  One periodical which provides such a list in most areas of Texas is called New Lifestyles.  If you definitely want a facility that accepts Medicaid, you can obtain a list from our office which lists all of Medicaid nursing homes in Harris and surrounding counties.

Location should be high on your selection priority list as you will want a nursing facility which is close to the homes of family members who will be visiting often.  If the family does not live in the same geographic region, the location issue may be more connected to the airport or highway you might use to travel to the facility.

Reputation of the facility is another factor.  Keep in mind that facilities change hands which means that what may have been a good facility before, may not be today, and likewise, that which may have been bad before may now be good.  There are internet sources which provide analyses of data which may help compare nursing facilities in a given area.  These can be located by searching www.medicare.gov on the web.  You can also see information regarding complaints made against a certain facility.  The facility is required by law to post a state survey regarding such information in the facility in open view.

Once you have narrowed your search and are beginning to look at specific facilities, try and meet some other family members at the home who may be able to give you worthwhile information about care from their experience at the home.  Visiting the home on multiple occasions will also better help you assess the caregivers there and the general environment.  Visiting once or twice unannounced, at different times of the day, should provide information which can be helpful in evaluating the home.  Schedule a formal tour as well and ask questions regarding care, personnel ratios per patient, activities and food.  Ask permission to attend a resident family counsel meeting to get an idea of issues which are being discussed by other family members who have loved ones residing there.  A nursing home checklist is also available at the web site mentioned above. 

That particular checklist is important.  It can be a useful tool in collecting information about the facilities in a thorough and organized manner.  It will also guide you in testing the facility standards in areas such as quality of care, quality of life, policies, menus and food, services and fees, security, living spaces, resident rooms and resident appearance.  Hopefully, once you have made it through the questions suggested above, you will be in a position to make a final decision regarding a nursing facility placement for your family member.

Wesley E. Wright and Molly Dear Abshire are attorneys with the firm of Wright Abshire in Bellaire.  Wright is board certified by the Texas Board of Legal Specialization in Estate Planning and Probate Law and is certified as an Elder Law Attorney by the National Elder Law Foundation.  Abshire is certified as an Elder Law Attorney by the National Elder Law Foundation.  Nothing contained in this publication should be considered as the rendering of legal advice to any personís specific case, but should be considered general information.