How to Ensure Quality Nursing Home Care

Texas Health and Human Services

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Quality of care in nursing facilities remains a major problem for which there are no simple solutions. However, there is no shortage of proposed initiatives to improve care.

These options for reform include strengthening the regulatory process, improving information systems for quality monitoring, strengthening the caregiving workforce, providing consumers with more information, making consumer advocacy stronger, changing Medicare and Medicaid reimbursement, developing and implementing practice guidelines, and changing the culture of nursing homes.

The quality of nursing home care remains a critical challenge. Here are some steps you can take to ensure your elderly loved one is receiving quality nursing home care, and if they’re not, what you can do and who you can contact about it:

1. Get involved and be informed. Call your Long-Term care (LTC) ombudsmen (the state agent who oversees elder care in your area) to obtain a copy of the rules and regulations governing nursing homes. Know residents’ rights. The Capital Area Ombudsman may be reached at 1-888-622-9111.

2. Make unscheduled visits. Pop in to see how your loved one is being treated when they don’t know you’re coming. Carefully check your loved one’s condition by looking at the sheets. Make sure the call and light buttons are within reach.

3. Read the charts. Don’t assume the facility is properly caring for your loved one. If you don’t understand what you read, ask questions. If you suspect improper treatment, ask for copies of the records and take them to an independent source for review.

4. If you have concerns, document them. Keep meticulous records of any problems you encounter, including dates, times and parties involved. Send a letter of concern to management with a copy to your ombudsman.

5. Create a resident advocate group of family members. Meet with family members of other residents on a regular basis to discuss concerns. Document the discussions and copy your ombudsman.

6. If you suspect abuse…start documenting your concerns both in writing and with photographs and videotape, the sooner, the better. Ask questions and write down what you are told.

Potential Signs of Abuse or Neglect

1. Rapid weight loss
2. Development of bed sores
3. Broken bones
4. Injury resulting from use of restraint or lack of restraint
5. Heavy medication and sedation use in place of supervision
6. Caretaker cannot adequately explain condition
7. The occurrence of nursing home resident-on-resident violence
8. The resident is suddenly and unexpectedly emotionally upset or agitated, withdrawn or non-communicative
9. Resident known to be incontinent is left in his or her urine or feces
10. Unexplained falls
11. Unexplained or unexpected death

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