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Selecting a Skilled Nursing Facility
 
There are many ways to select a skilled nursing facility (SNF).  This article will help you figure out what's important to you and your family.
  • Administration and Employee Longevity - Facilities that have employees who have worked for a long period of time have better outcomes. Policies and procedures are more standardized and care levels are higher with the stability of the administration. Facilities with lower turn-over rates have higher levels of care, better patient relationships and again, better outcomes.
  • Staffing Ratios - The staffing ratios are very important to patient quality of care. The more nurses (RNs) and certified nursing assistants (CNAs) in a facility the better. Some facilities have a ratio of 1 CNA to 16 patients and others have a ratio of 1 CNA to 8 patients. The response time decreases when you have a lower ratio of patients to CNAs. Imagine needing to go to the restroom, pulling the call cord alongside 16 others who pull the cord at the same time and then waiting for your turn. 
  • RN Coverage - The law states there must be 24-hour nursing coverage in all facilities. 
  • Concierge - Facilities have a receptionist and/or concierge to greet people when they arrive onsite. The doors usually are locked after 8:00 pm and do not open again until 8:00 am. When someone does visit, they must sign in to verify they are on the premises. They also must sign out. If there are people that are not allowed to see the patient, you must advise administration and they'll watch for people who don't belong.
  • Dining - Facilities have a communal dining room for socialization and meals.  Some people choose to stay in their rooms during meals which is allowed. This could be because of medical reasons or other reasons. It is healthy to be social and go to the dining room and preferred by most facilities. Some facilities provide options for meals, when they choose to eat and where they want to eat. Again, being social does help in the recovery process.
  • Care Plans - Facilities put together a care plan for each patient which is the strategy of how the staff will help the patient. The best care plans work to make a patient feel like his/her needs are being met and are consistent with the patient's goals and values. The care plan includes the following components: assessment, diagnosis, expected outcomes, interventions and evaluations. All care plans include continuity of care, safety, quality care and compliance aspects to safely care for patients. The care plan can be shared with the patient and their POA (Power of Attorney) for healthcare. 
  • Star Rating - Medicare.gov does rate SNFs on their quality of care, staffing ratios and health inspections. The overall star rating is between 1 and 5 stars with 5-stars being the best. Be careful choosing a SNF. The facilities with a 5-star ratio typically provide sub-acute rehabilitation services and not long term care. Those that do provide long term care usually don't get a 5-star rating, because they take care of the chronically ill, the difficult cases, Alzheimer's and dementia patients and have a more difficult time getting the very sick well again. You must tour the facilities to decide which one is best for your loved one and your loved ones needs.

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