The Best Approach to Nursing Homes

Stephen Silverburg, an Elder Law attorney from New York, recently published the following blog regarding nursing home care and how to make sure your loved ones are being treated properly in these facilities. This article gives great advice and pointers on finding the best home and care for your loved ones.

Choosing the right nursing home for a loved one is never an easy task. Doing the legwork is time consuming, and making in-person visits and asking tough questions can be daunting.  But according to recent research reported in The New England Journal of Medicine (NEJM) and an insightful comment in a New York Times blog on the ineffectiveness of nursing home litigation and legal standards, carefully and thoroughly scrutinizing the facility and its employees is the best way to select the right nursing home.

The New York Times points out, “We tend to think of a lawsuit as a kind of slingshot allowing the little guy to take on a daunting Goliath – a large nursing home chain, say. If you can’t persuade a facility to provide proper care, if your elderly relative has suffered unnecessarily as a result, then you can sue.”

If this were true, researchers suggest that we ought to see lawsuits piling up against the worst institutions, and that the better ones would see significantly fewer lawsuits.

Unfortunately, the finding of the NEJM indicates that there no significant relationship between the quality of the nursing home (as determined by Medicare and Medicaid surveys) and the risk that one or more lawsuits will be claimed against that nursing home (as determined statistically from records.) “Good” nursing homes stand a 40 percent chance of being sued, while the worst institutions only stood only a slightly greater chance at 47 percent.

“It seems a fairly modest difference between the very best and the very worst facilities,” concluded Dr. David Stevenson, a health policy analyst at Harvard Medical School and an author of the analysis.

The NEJM goes on to conclude that “The results of this study raise questions about the capacity of tort litigation to provide incentives for improving the quality and safety of nursing home care. It is far from clear that superior performance will be rewarded with substantially lower risks of being sued.”
In other words, the laws and regulations now in place are not effective, and the threat of lawsuits has no impact on the quality of care.

The best solution to ensure that a loved one is placed in a safe environment is to research the facilities beforehand, and then, just as importantly, after the person has moved in.  Be present.  Visit often.   Be polite, but be on the look-out for quality of care issues.  Be persistent.  Ask questions of the nursing staff, talk to the team and supervisors assigned to your loved one’s care.   Lest this not be clear enough, we repeat: the best thing you can do to ensure the quality of care is to be present and make sure the staff knows this patient has a family member who cares.

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