THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, September 3, 1996 TAG: 9608310066
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: By DEBRA GORDON, STAFF WRITER
LENGTH: 139 lines
AFTER ALLEGEDLY putting some of its residents in danger, Manning Convalescent Home in Portsmouth now may be the safest nursing home around.
Regulators, mindful of the past problems, have put Manning under the microscope, requiring strict adherence to government rules.
But what about other nursing homes? With less government scrutiny of their facilities, how can residents and family members be sure conditions are safe, that problems like those that plagued Manning aren't quietly developing?
Here's some help:
Choosing a nursing home
Sometimes, if a patient is released from the hospital and can't return home, the hospital's discharge planners find an available bed in a nursing home. In that instance, the patient and his family may not have much choice about which home to choose.
But if you're able to choose the nursing home, here are some things to to take into account:
Consider if the nursing home is convenient for frequent visits by family members and for a personal physician (if personal physicians are allowed; some nursing homes contract with specific doctors to provide care for their residents) and if the nursing home is near a hospital where the physician practices.
Whenever possible, involve the patient in the selection decision. Go with him on admission day and stay several hours to get him settled.
Visit the nursing home at different times of the day and week. Check at night, during meals and on weekends.
Read the home's most recent state Health Department inspection report, which must be made available to you, and ask about each problem and why it occurred.
Nursing homes should not smell of urine or feces. If they do, a red flag should go up, because that means the home may not be active enough in dealing with incontinence problems. It also means the home might be understaffed in nursing or housekeeping. Do not be deceived by floral fragrances introduced in the air circulation systems; they may simply mask the problem.
Look for signs of restraints, such as cloth straps on the beds and on wheelchairs. Ask the home about its restraint policy - it should always be trying to use the least restrictive type of restraint, and should only use what is prescribed by the physician.
Ask residents:
How long they've been at the home.
Their likes and dislikes.
To rate the food.
If the nurses are responsive.
If the activity program is interesting.
If they are satisfied with the housekeeping.
How they would characterize the other residents.
If they could change two things, what they would be?
Check that residents are:
Out of bed and dressed appropriately for the weather in clean, neat clothes in good repair, and that they are clean with well-combed hair, clean and clipped fingernails and eyes free of crust or crumbs. They should also be participating in available activities.
Look for:
A well-maintained home with no chipped paint, broken equipment, torn mattresses, or leaking air conditioners, toilets or sinks.
At least one room available for patients with contagious illnesses.
Nurses and aides who are working with residents, not always busy at the nurses' station, and a friendly, respectful relationship between the staff and residents.
Obviously inappropriate roommate situations, such as an alert resident rooming with a noisy and confused person.
Interactions between staff and residents that are free of harassment, threats and humiliation.
Areas for residents to be alone or meet in private with friends and family.
Bedrooms that open onto the hall and have a window, with no more than four beds in each room, each with its own privacy curtain and call button. There should be enough space to store clothing, personal furniture and belongings and to maneuver a wheelchair. Check for fresh drinking water beside each bed.
Grab bars in all the corridors and bathrooms.
A clean, spacious dining room with assistance available to help residents eat. Residents' clothes should be protected against spills.
A clean kitchen, free of rust, drips or spillage on shelves or floors, with clean food preparation equipment.
Clean and working equipment in therapy rooms.
A dietitian who plans menus for patients on special diets, available snacks, food that is served warm.
Clearly marked and unobstructed exits. Written emergency evacuation plans posted with floor plans throughout the facility. Doorways to stairways that are kept closed.
After admission
Visit the home frequently, with an eye toward monitoring conditions. When problems arise:
Voice your concern to those directly involved, moving up the administrative line to staff supervisors and administrators if you aren't satisfied.
Go through the facility's grievance process, which the home is required to have.
Work with your resident or family council. Many nursing homes have resident councils or family councils that meet regularly to discuss projects, activities and concerns.
Contact the state's long-term care ombudsman in Richmond. The ombudsman is empowered to intervene on behalf of consumers having problems with nursing homes. Complaints can be kept confidential. But the program's powers are limited. (800) 552-3402
Contact the state Health Department, which also responds to complaints from consumers about poor nursing-home care. (804) 225-2271.
Talk with Health Department inspectors when they survey the facility. During each inspection, inspectors set aside time for private interviews with nursing-home residents and their families to discuss their views about the care. In Virginia, surveyors post a sign indicating that they are on-site in the facility. They usually spend three to five days in the facility, and must inspect every nine to 15 months. MEMO: Sources for this article include:
``Choosing a Nursing Home,'' by Seth B. Goldsmith.
``A Consumer's Guide to Long-term Care,'' published by the American
Health Care Association.
American Association of Retired Persons.
AVAILABLE RESOURCES
Here are some resources that may be useful to residents and family
members in dealing with nursing homes.
Federal agencies and national organizations:
National Institute on Aging, (800) 222-2225
U.S. Administration on Aging, (202) 619-0724.
American Association of Homes and Services for the Aging (an
association of not-for-profit nursing homes), (202) 783-2242.
American Health Care Association (an association of for-profit
nursing homes), (202) 842-4444.
National Citizen's Coalition for Nursing Home Reform, (202) 332-2275.
State agencies and organizations:
Virginia Department for the Aging, (804) 225-2801.
Virginia Health Department, Office of Health Facilities Regulations
(inspects nursing homes, investigates complaints), (804) 367-2100.
Virginia ombudsman program (responds to nursing-home complaints),
(800) 552-3402.
Virginia Health Care Association (a trade organization representing
nursing homes and homes for adults), (804) 353-9101. ILLUSTRATION: Photo by BILL TIERNAN, The Virginian-Pilot
After admission, visit the home frequently, with an eye toward
monitoring conditions. by CNB