Creepiest thing I’ve heard in a long time: An assisted living staff member was arresting for burying a resident behind the facility.
Assisted living operators sometimes have a checkered past. That’s why it’s always good to check with your local nursing home ombudsman or check your state’s assisted living complaints database.
This makes me sick: A broker in California used nursing home residents’ identities to scam investors.
For a long time now, I’ve written about how consumers can use Medicare.gov’s tool, Nursing Home Compare, to get ratings for skilled nursing facilities in their area. However, today I have decided that I can no longer endorse the use of Nursing Home Compare use as a tool for deciding between facilities.
There have been complaints about the accuracy of Nursing Home Compare’s ratings for a long time, but last week, several articles came out that make it impossible to ignore the problems. According to the New York Times:
Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.
The ratings also do not take into account entire sets of potentially negative information, including fines and other enforcement actions by state, rather than federal, authorities, as well as complaints filed by consumers with state agencies.
The remainder of the article goes into greater depth about how ratings are calculated and instances in which highly-rated nursing homes did not provide adequate patient care. (It’s a good article, and well worth the read if you have family members who need skilled nursing care.)
What should consumers do with this information? Well, a few things:
You can still use the site to find nursing homes in your area. It’s pretty straight-forward to type in your city, state, and ZIP code and narrow your search to a specific area. This is super helpful if you’re just getting started and need a quick, all-in-one place to find rating information.
You can still use the site to find basic information about a community. Nursing Home Compare still has a wealth of information: ownership, inspection reports, type of payments accepted, and location. So, feel free to use the site to help you learn more about potential skilled nursing facilities.
You can’t trust the site to provide accurate ratings. Unfortunately, you just can’t trust what you see on Nursing Home Compare. It’s too easy for nursing homes to game the system right now, and that means that the ratings just aren’t indicative of quality of care. Even using it to weed out seemingly poor-performing providers isn’t a good recipe for finding the best nursing home.
However, here are a few other ways of checking the quality of care at a senior housing community:
- Call your local ombudsman. Nursing home ombudsman are awesome resources that you can use free of charge. You can find your ombudsman by searching the National Consumer Voice website and clicking “Locate an Ombudsman.”
- Make multiple (sometimes unannounced) visits to the facility. I’ve heard of unscrupulous marketing agents who spray deodorizing spray in the skilled nursing wing of a retirement community prior to a scheduled tour. Of course, they do this because the nursing staff isn’t doing a good job of removing odor-causing soiled clothing, diapers, or wound dressings. But, because you only arrived for the “official tour,” then you won’t see (or, rather, smell) the truth. Another reason to make multiple visits is that, especially when you’re not accompanied by marketing agent, you have a higher chance of observing staff members revert to their “natural behavior.”
- Talk to other families in the parking lot or hallways. Now is not the time to be a wallflower. If you want to learn more about a skilled nursing facility, the best folks to ask are those who have been through the process with a loved one. To that end, feel free to strike up a conversation with other families that you see in the facility. They’re highly motivated to share “the gossip” with you and they don’t have any competing interests (unlike the marketing agent whose job is tied to filling beds). Note: Make sure you approach families in a respectful, discrete manner. It’s one thing to do your own due diligence. It’s another to infringe on a family who is going through a difficult time. Please do the right thing, and don’t be obnoxious or ask them overly personal questions.
I’m continually reminded of the fact that skilled nursing, assisted living, and dementia care are not easy jobs. The senior housing industry has a difficult problem: How can it make money, offer the highest possible level of care, and provide an affordable product? So far, no one has been able to provide a good solution to that equation, and it’s only served to harm seniors during a very vulnerable time in their lives.
Unfortunately, the odds are not in a consumer’s favor, and it’s very difficult to find a good, one-stop source for senior housing information. Especially after this week’s article, I can no longer recommend Nursing Home Compare as a viable option.
Want to learn more? Here are a few other links that you might find helpful:
I spend a lot of time looking at Disclosure Statements for senior housing communities, and most people don’t know just how difficult it is to get one of these statements. Since some retirement communities view me as “an enemy,” they will not share any of their information with me. Instead, I often have to submit freedom of information requests with the states in which CCRCs are located. This is a costly and time-consuming process. It can take months to receive documents, and I have spent hundreds of dollars in copying and postage fees.
That’s where you come in.
As a senior or a family member, CCRCs should be giving you their Disclosure Statement as part of the marketing routine. They should also give you a full copy of their Resident Agreement.
If you’re so inclined, please send me a copy of the Disclosure Statement and/or Resident Agreement for CCRCs in your area. You can email it to me (firstname.lastname@example.org) or mail it to the address below. Anyone who sends me documents will get a free print copy of my book, “Continuing Care Retirement Communities: An Insider Tells All.” If you send me documents for 3, or more communities, I’ll send you all three of my books.
Your contribution will be included in my research and help future seniors and their families make a more informed decision regarding their move into a CCRC.
The address again:
Senior Housing Move.com
4447 N. Central Expressway
Suite 110 PMB 405
Dallas, TX 75205
Or email me at Questions@SeniorHousingMove.com
Thanks for your help!
I hope that no one ever has to use the information in this post. However, senior caregivers are in a unique position to either help people in their most vulnerable hour or inflict serious injury on them. While the industry has been working (somewhat unsuccessfully) to improve its safety record, there are a few things that you can do if you notice a facility isn’t properly caring for its residents:
First of all, if it’s an emergency, call 911. I sometimes forget to mention this because it seems really obvious, but not everyone thinks about it. If you see someone who is in serious danger, you can (and should) call the police. It may turn out to be something that is best handled by another agency, but, frankly, why not let the management sort that out? Your job is to keep your loved one safe.
Also, don’t hesitate to remove your loved one from the situation. There are probably other nursing homes in your area that meet your criteria and can provide good-quality care. If something “just doesn’t seem right,” then feel free to take your business (and your loved one) elsewhere.
If it’s not an emergency, but you suspect that there are problems or if you feel that your loved one is being unfairly treated, then you have a few things that you can do to help the situation:
1) Document everything. Whatever the situation, you will have a much stronger case if you keep a detailed record of your findings. Take pictures. Write down notes if you notice unusual behavior, bruising, marks, treatment, or other problems with dates, times, and other pertinent details. In some cases, police have even used hidden cameras to catch nursing home abuse. (Note: Check with authorities before placing hidden cameras or wires, since recording without someone’s consent can be a crime in some areas.)
2) Call the nursing home ombudsman in your area. You may not know it, but there is an individual (called an “ombudsman”) who is designated as a consumer advocate in your area. The nursing home ombudsman program is completely free for you to use, and the ombudsman in your area will be able to help you get your grievances resolved. Click here for information about locating an ombudsman in your area.
3) Call the state health department, aging, or human services. States regulate nursing home and assisted living facilities. Often, the state will handle certification and bed licensure, which means that a ding on the state’s database can prevent bad communities from having their licenses renewed. Formally submitting a claim can help open investigations into nursing home abuse and cement the case against operators. You should note two things about state oversight: 1) The department that regulates nursing homes differs from state to state, so you’ll have to do some research online to find the right person. 2) State regulatory oversight can be a slow and steady process, so you cannot count on the state to fix problems in a short time period. If your loved one is in danger, remove them from the facility immediately.
4) Call the county health department. Often times, the county will have some oversight in local nursing homes, especially when it comes to how the kitchen is handled. If you encounter a problem with sanitation, county health department employees may be able to help intervene to fix the problem.
Again, I hope that you never have to use the information in this post. Unfortunately, some residents of assisted living and nursing facilities experience abuse or neglect. It’s up to family members, friends, and concerned staff members to do something to prevent this type of treatment from continuing.
Want to learn more about senior housing? Check out some of these articles: