42 Questions to Ask a Skilled Nursing Facility

Here are the answers to the 42 Questions to Ask a Skilled Nursing Care Facility.  If you have any additional questions feel free to call or email.
Mary Coleman, Social Service Director 859 472-2217  Mary.Coleman@kyrvnh.com

42 Questions to Ask a Skilled Nursing Care Facility.

Are You Medicaid Certified?

The nursing facility may or may not be Medicaid Certified.

Does the nursing home smell and look clean?

Every nursing facility should look and smell clean.  Usually if there is a foul odor people will think it is because housekeeping is not doing their job properly.  The real reason however is more serious than that.  If the facility has an odor, it is a problem with the care-giving staff and not the housekeeping staff.  The nurses and assistants are not properly attending to the residents.

Do you have a rehabilitation dept on site?

With a rehabilitation department on site your loved one does not have to be transported out from the facility for rehab.  With an on-site rehab, it is convenient to the resident and the rehab staff can quickly attend to any changes in condition of the resident.

Do you have personable and individual treatment plans?

Every resident should have a file and a “game plan” that details their current health and future well being.  It is referred to as the Care Plan, every direct care-giver and responsible party should know the latest information about that resident.

Can the residents have their own personal items in the room?

Yes any items that residents would like to bring from home to make them feel more comfortable that do not interfere with the other residents should be permissible.  Also no items should be brought in that interfere with general safety guidelines.

Can family and friends visit at any time?

Family and friends should be able to visit at any time during normal visiting hours.  If they need to visit after hours then that should be arranged prior to the visitation with the staff at the nursing facility.  You want to have certain restrictions past normal hours to protect the peaceful environment that should exist at the facility.

Is the interaction between staff and patient warm and respectful?

Each staff person at any nursing facility needs to be a people person first and foremost.  If they truly enjoy being around people then literally every aspect of their job will fall into place.  The nursing facility should ask and investigate this with each and every new hire.  If the new hire is not a people person, regardless of their other qualifications they have no place being employed at a nursing facility.

Can residents make choices about their daily routine?

Your loved one had a routine prior to coming to the nursing facility.  Many of the nursing homes out there will say you now have to conform to our routine, but why?  Why not make it as comfortable as possible by learning the resident’s routine they had at their home most of their life and adopting that into the nursing home environment?

Do you have abuse prevention training?

Nursing facilities should have abuse prevention training.  If you have had children you know they can be very stressful with their requests at times.  The elderly can at times be in the same position.  With abuse prevention training the staff can fully understand how to deal with difficult situations and keep their cool and their demeanor at all times.

Do you have family and resident advocacy programs?

A strong advocacy program means that staff adopts residents and gets to know them better.  They pay particular attention to what the resident wants.  They are the resident’s voice, they are the resident’s support, they help them out as a personal attendant.

Is the home and current administrator licensed?

The nursing facility must be licensed and the administrator must be licensed.  Ask to see a copy of the latest inspection and see if that facility had any deficiencies.  Look at the deficiencies, how critical were they?  Did any of the deficiencies put residents at risk?

Do you have an on-site hair salon?

With an on-site hair salon residents do not have to leave the facility to attend to their grooming.  Having that personal attention in the facility helps to bolster their self confidence and well-being.

Are you Medicare Certified?

The nursing facility should be Medicare Certified and in good standing with local, state and national boards.

How many activities do you have per day?

This is a very important question.  Time ticks slowly for someone that has no stimulation or activities to be involved with.  Look for an average of three activities per 24 hour period every day.

Is your daily rate all inclusive?

Much like hospitals some nursing facilities will charge for literally every consumable.  There are some items that most will charge for such as medications, therapy, laundry services, incontinence products and hygiene products.

How often do the doctors visit?

Doctors visit nursing homes to check on their patients.  While one might assume that doctors visit regularly, this is sometimes just not the case at other facilities.  If the facility has a strong belief in being a place for people to come and live and not come and die, they will make sure doctors attend to their patients on a more regular basis.  It is a frame of mind.  Also look for strong working relationships between the nurses and the doctors, open lines of communication are vital.  Doctors should be local to the facility in both their residence and their offices.

How many average years experience do your top 8 managers have?

This will vary.  At River Valley our top 8 managers have over 177 years experience.

What is your ratio of staff to resident?

The National average is 3.2 hours per patient day.  At River Valley Nursing Home we run 4.0 hours per patient day.  So nearly one more hour per day is given to our residents verses the national average.

How many total staff do you have?

The answer should have a direct relation to the number of residents in that facility.  If the total number is higher, it doesn’t necessarily mean it is better.  It needs to be related to the residents care needs.  The next question is the best representation of how the residents are cared for.

Are residents clean, appropriately dressed and well groomed?

Residents should be attended to multiple times every day.  Proper grooming makes anyone feel better.  Residents should have their clothes changed every day with clean and laundered clothes.

Do you conduct background checks on all staff?

Every nursing facility should do background checks on every person hired to come into the facility.  The reason is simple, we must hire upstanding people that will take care of and not jeopardize the safety of your loved one.

Do you have any awards that have been presented to the nursing home?

Skilled nursing facilities are judged and evaluated multiple times a year.  Facilities that actively participate in contests and judging have EXPOSED themselves to greater scrutiny.  Why would they do this?  When you are judged by your peers you naturally want to make a good impression on them.  When you choose to be judged you raise the bar, you make the standards higher for the staff at the facility.  Everyone gets on board and works harder to make that facility the best it can be for the residents.

Can residents keep medications in their room?

The department managers have to determine if the medication can be safely kept in the resident’s room.  The medication would have to be in a lock box so that no other person would have access to it.  It is rare that a resident would have the need to keep medication in the room.  The staff of the facility should be readily available to administer medication at the time the resident needs it.

Does every resident room have a window?

Every resident room must have a window.  Exceptions would be made at the family’s request for residents in a severely declining health situation.

Are bathrooms located in the resident’s room or do they have community bathrooms?

Look for facilities that have bathrooms in each of the resident’s rooms.  This is much more convenient for both residents and staff.

How often do residents get bathed?

Personal Hygiene is important to making anyone and everyone feel better.  Residents should be bathed daily.

Do you provide wheelchairs and or other assistive devices like walkers, splints, canes, etc?

Facilities should provide these assistive devices and have them readily available as conditions and situations change with residents.

Can you identify the staff with uniforms and name tags?

YES.  The answer must be yes.  The staff has chosen to be in a professional career.  Professionals dress accordingly.  Uniforms and name tags must be worn at all times.

How many staff do you see actively working when you visit the facility?

Well it is one thing to have staff and quite another to have staff engaged in working.  If staff is sitting around idle then it is a management issue.  Are the residents being attended to?  If the answer is yes then the facility is overstaffed.  If the answer is no then management needs to focus on directing and training everyone to attend to the residents.

Does the staff meet and greet you when you enter the facility?

The staff at a Skilled Nursing Facility needs to be AWARE.  Aware of the surroundings, aware of the residents and aware of everyone’s needs.  When you walk into a facility the staff should recognize you immediately and greet you with a warm friendly smile.  If you are not getting a warm friendly smile, your loved one will not be getting it either.

Do you have a security system?

A security system and auto-locking doors are a must.  When a resident has a tendency to try and unsafely roam outside the building, auto-locking doors will keep them at the attention of the staff.

Do the residents have the same care givers on a daily basis?

Naturally there are different shifts at any business.  There are also weekday and weekend differences.  It is important for a facility to not move staff around continuously so the residents can get familiar with their care givers.  Facilities should keep staff on the same wing or floor each time they work, they can better familiarize themselves with the residents and be in better touch with them.

Do you provide personal hygiene products?

The facility should provide everything the resident needs and make sure the products are being used.

Do you have an outdoor area for resident use and do you help the resident get outdoors?

Residents need to go outdoors as often as possible.  Having a garden area or even an actual garden the residents can raise flowers and vegetables in is a wonderful activity for them.  Also residents can take field trips to other destinations.

Do you have volunteer organizations that come to the facility?

Any town will have volunteers that are begging to help the elderly.  Make sure the facility actively pursues volunteers and gets them plugged in to the activities of the home.  These volunteers in many cases can help by just sitting and talking with the residents.  Again!  It is important that the facility has a good working relationship with the community it is located in.  If the facility is seen as a bright spot or a positive part of the community it serves, volunteers will want to be a part of it.

Is the nursing home and the dining room generally quiet?

The environment your loved one lives in should be controlled to allow for a peaceful experience.  This happens from different sources.  The staff needs to understand they need to keep the chatter and kitchen noise down to keep it quiet and peaceful.  The visitors must realize their level of volume while they are in the facility.

Are the meals prepared on-site or off-site?

On-site meal preparation just means the food tastes better!  Also on-site meal preparation means that individuals can make choices in their eating habits and the meals can be catered to the resident’s likes and dislikes.

Do you have a therapeutic whirlpool bath?

A therapeutic whirlpool bath helps to alleviate muscle soreness and promote better circulation throughout the body.  Critical to residents that are susceptible to circulation problems.

Do you have nursing care available 24 hours a day 7 days a week?

Nursing care must be available all of the time.

Do you have facility transportation available for outings and events?

Some of the residents just “Gotta Get Out!”  The facility should have quality transportation available to take residents to special outings or events.  They shouldn’t be limited because of their disabilities.

Do you have pharmacy, lab and X-ray services available?

With additional services available on-site critical changes in health can be attended to quickly, possibly even saving one’s life.  At the very least, resident discomfort can be addressed in a timely manner.

Is there enough staff at nights and on the weekends?

If you ask that question, obviously a person is going to say “yes”.  Visit the facility on nights and weekends and see if residents are being attended to properly.  See how available the staff is and that will answer your question.