Questions Answered

smiling older couple This is a list of our most commonly asked questions. Please contact us if you need more information or have questions. Please allow 48 hours for us to respond.

Why do problems happen in even the “best” nursing homes?

Even in the best nursing homes serious problems can occur. One way to find out about any problems, previous or ongoing, is to request and review a copy of the nursing home’s annual inspection report, which is required by federal law to operate in good standing. But these reports are infrequent, sample only a small number of resident’s and don’t tell you anything about what is happening to your loved one.

Virtually every nursing home in the United States has been cited for failing to meet some of the federal guidelines, which are in place to satisfy care and safety standards. Obviously, some violations are more serious than others, but when it comes to a loved one, one is too many. Even when a violation does not seriously threaten or injure a resident, it can significantly impact their quality of life.

Read Problems Even in Best Nursing Homes for additional reasons.
Learn How to Read a Survey (inspection report).


How do five star nursing homes “game the system”?

Top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors and others about conditions at the homes. The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify. Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value. The ratings also do not take into account entire sets of potentially negative information, including fines and other enforcement actions by state, rather than federal, authorities, as well as complaints filed by consumers with state agencies.

For more information, please read this article about how Medicare Star Ratings Allow Nursing Homes to Game the System on NYTimes.com. Read our 10/07/14 blog: Important Changes to Nursing Home Compare.
Also read our updated 2/25/15 blog: Sweeping Changes to Nursing Home Five Star Ratings.


I’m afraid I’m being pushy. Can they discharge my mom?

Absolutely NOT! Federal law is clear. 42 CFR, Part 483, Subpart B, § 483.12(a) 1. A nursing home resident cannot be sent to another nursing home or made to leave the nursing home, unless any of the following are true:

  • It’s necessary for the resident’s welfare and the resident’s needs cannot be met in the facility;
  • The resident’s health has improved to the point that nursing home care is no longer necessary;
  • The health or safety of individuals in the facility is endangered;
  • After appropriate notice the nursing home hasn’t been paid for services; or,
  • The nursing home closes.

What are the most common deficiencies in a Nursing Home?

A a report by ProPublica in 2012, analyzed government data and revealed the most common violations:

  • Facility was Not Free of Accident Hazards: 17,331
  • Facility Did Not Establish an Infection Control Program: 14,186
  • Facility Did Not Provide Necessary Care for Highest Practicable Well-Being: 13,401
  • Facility Did Not Store/Prepare/Distribute Food Under Sanitary Conditions: 11,746
  • Facility Did Not Develop Comprehensive Care Plans: 9,070
  • Services Provided Did Not Meet Professional Standards: 8,986
  • Clinical Records Did Not Meet Professional Standards: 7,962
  • Facility Employed Persons Guilty of Abuse: 7,288
  • Drug Regimen is Included Unnecessary Drugs: 7,040
  • Facility Did Not Protect Dignity: 6,605

See the article by ProPublica for full report.
If you’d like to know about a specific nursing home’s deficiencies, we can send you a copy of the most recent surveys (inspection reports).
For more information, read about How to Read a Survey.


Why is visiting my mother not enough?

We all know that the most important thing a family can do is to visit their loved one in a nursing home. Unfortunately visiting, even several times a week, simply isn’t enough to protect your mother, father or loved one from abuse or neglect. Why is that?

  • Family members aren’t trained to monitor nursing home care
  • Visiting can create a false sense of security
  • Nursing home residents have complex medical issues and it’s not enough to know that the correct orders have been entered by the physician.
  • Many of the preventable problems occur because of under staffing or poor communication
  • Nursing homes know how to manage a family
  • When family members are trying to monitor, they are not able to do their real job – provide love and emotional support

Please read Why Visiting is Not Enough.


Why are secret cameras not a good idea?

So called “granny cams” are sometimes in the news. At first glance they seem to provide a measure of protection but there are several problems. If their use is hidden, they will only catch and not prevent abuse. Their use without permission is also illegal in many states. They are only effective if the user is willing to watch or review all of the footage. In some States, there usage is permissible only if they are in plain view. Additionally, the use of a camera is inherently limited. The viewer is not a trained professional able to detect anything less than outright assault. Moreover, even a trained professional will not be able to determine much about the resident. Lastly, they do nothing to help monitor the actual care a resident receives since they do not consider the medical record.


Why are the current tools ineffective at preventing abuse, neglect or improper care?

There are several tools, services and resources available to help when bad things happen to your loved one in a nursing home. Unfortunately, there are no tools available to help PREVENT abuse, neglect or improper care from occurring in the first place.

Once you mother has fallen and broken her hip, you can contact the ombudsman, file a grievance with the home, even consult a lawyer to make sure she doesn’t fall again. But wouldn’t it be much better to help prevent the broken hip from happening in the first place?

As we discuss above, hidden cameras or visiting frequently may do a good job of identifying major problems AFTER they occur. The fact is, by the time the family becomes wise to the problem it is often far more difficult to fix it. And, even if the problem can be fixed, the quality of your mother or father’s life has already suffered.

At Nursing Home Guardians we strongly believe the focus must be on prevention and early detection and treatment. ‎Susan’s story is a great example of this. We believe the family should be able to monitor their loved one in an effective and affordable way. Please contact us for answers and to request more information.


If I sign up for your monitoring service, who will be visiting my loved one?

A Registered Nurse is sent for all visits. Although we do not provide any care, we think it is important to use RNs for several reasons. Nurses are educated in assessment and evaluation. A nurse also knows what is expected of a health care provider.


Why does your service work?

Our service works for two simple reasons:

  • Nursing homes provide better care when they know they are being monitored
  • Monitoring increases the chances of early detection and treatment of any problems

What does it cost?

Our typical monthly fee is $175. Of course, we can tailor our services to meet each client’s specific needs.


DISCLAIMER: This website is for general informational purposes only. Nothing in it should be used for diagnosis or treatment decisions. It is not medical, legal or other professional advice.   Read full Disclaimer.     Privacy Policy

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