The need for skilled nursing care is often unexpected. Your elderly dad takes a serious fall, mom has a stroke, or one of them is being discharged from the hospital after a stay but is not quite ready to go home alone. As their adult child, you have to make immediate skilled care placement decisions. You want your loved one to have the very best care, but how can you tell, especially when the situation is urgent?

Think about what you and your loved one need and expect, then ask probing questions.

A skilled nursing stay may be short-term, to give your loved one additional time to regain their strength and prepare them for a successful return to home. In this case, you’ll want to focus on how much therapy is available to ensure the speediest progress possible, and how to plan for going home. If returning home is not a viable option, your loved one’s stay will be long-term. So it’s important to consider if this community feels like home and a place they will want to live.

Even if your loved one lives in an area where there is only one skilled care option, it is still essential to ask questions and discuss your expectations with team members. Here are the five most critical questions families should ask when touring skilled nursing communities. 

1. WHAT ARE YOUR SPECIALIZED CARE CAPABILITIES?

All skilled nursing communities provide room and board and basic medical care, but beyond that the range of services can vary significantly. Is this one equipped to address your loved one’s care needs? For example, skilled nursing includes wound care, but if your loved one has an unusual or very deep wound, that could require specialized training or equipment. Also, most skilled care communities do not provide on-site dialysis, so if your loved one needs that they will have to be transported elsewhere. How will this work?

In other words, to what extent can your loved one’s needs be met on-site?

Know your loved one’s needs in detail, and also consider your needs as a family member. That way you can ask direct questions and be specific about your expectations. Can they be met? If there is a gap between your family’s needs and their capabilities, is there a way to bridge that gap and if so how? If they do not offer the relevant specialized services, for example transportation to dialysis, how do they accommodate?

If the services you need are not available, or there is little interest in making modifications to accommodate your care or communication expectations, this may not be the best place for your loved one.

2. WHAT ARE YOUR STAFFING RATIOS?

There is no “best” ratio of team members to residents because a simple number does not tell the whole story. You want to know if there are adequate staff on duty to attend to your loved one’s needs in a timely manner. Staffing ratios are typically higher where care is more complex, so what is appropriate for your loved one depends on the type of care the community offers and also on their specific care needs.

Ideally, more team members is better, but how consistent is the staffing? Excessive turnover often indicates internal deficiencies that can affect the nature and quality of care, so ask about staff longevity. Delivering skilled care is hard work. Employees who stay in spite of that do so because they love their job and the company they work for, and they love helping the individuals they care for.

3. HOW DOES THE THERAPY SCHEDULE WORK?

This is especially important when the goal of skilled care is to prepare your loved one to return home and remain as independent as possible. You want to ensure they will get an adequate amount of therapy, in the shortest timeframe feasible.

• Does this community offer all types of therapy (physical, speech, occupational)?
• Does the schedule include sessions on weekends?
• Are the sessions held within the residential building? If so, what equipment is available in their gym? Or will your loved one have to travel to an external location? In this case, who is responsible for providing transportation?
• How do the therapy and nursing teams communicate? Coordination of care is critical. Keep in mind that therapists may be contractors, not on staff, so smooth communication is crucial. It’s not unusual for a skilled nursing community to use contract therapists because they are highly trained professionals who provide personalized and effective support.

4. WHAT IS YOUR DISCHARGE PLANNING PROCESS?

If your loved one’s stay will be temporary, their first question will be, “When can I go home?” To ensure a successful transition, their discharge planning process should start on Day One.

•  How does the community prepare for this? How are family members included (in-person meetings, phone calls, other communication)?
• Do they have a checklist they use to ensure nothing is overlooked? Can you get a working copy of that?
•  Will your loved one need your (or someone’s) support once they return home? To what extent?

You should expect regular progress reports from the care team.

5. WHAT ARE YOUR FAMILY COMMUNICATION POLICIES?

Ask about communication with families of long-term residents. Phone calls? Email? Can you dictate your preference here? As a family member, you might prefer email because it gives you a written record of conversations and a point of reference to go back and re-read, if needed.

How often do they provide regular updates? How often do they anticipate meeting with you? The goal here is to learn how well this community’s practices match your expectations and whether they are willing to modify those practices to accommodate your wishes.

WE’RE TO HELP YOU DO WHAT’S BEST FOR YOUR LOVED ONE

Quality of care and the daily living environment directly affect your loved one’s progress and outlook. All communities managed by The Goodman Group, including skilled nursing, provide Platinum Service(R), which defines our approach to resident and patient care. By knowing your needs and expectations and asking the right questions, you will be able to make a confident decision even when time is short. With that peace of mind, you can relax a little and get ready to help your loved one pack for their stay in skilled care.