Best Nursing Homes: the U.S. News Honor Roll

How To Ensure Your Loved One Gets Good, Safe Care

I've been an RN for almost 30 yrs. I've been charge nurse, supervisor & Director of Nursing. I'll you in 2 words what makes the biggest difference in patient care. I'll also tell you what's the biggest danger facing residents in 37 states.

Two Words: Family Involvement

That's it. When families show up & are visible care improves. Why? Simple economics. There are only so many staff a facility can afford to care for all the residents. Each year Congress cuts Medicare reimbursements & profit margins are slim. Baths, feeds, dressing, etc must be done, but when families are present these are done first, done right & never skipped.

When my dad had to be in a home after his stroke I came in on day 1 to find his food sitting there ice cold. No one had fed him. I raised hell. I said if it happened again I'd file a complaint with the state. They made sure his care was A-1 - and not because I was a nurse, either. It was because I was there... at random times & at night, too.

The Biggest Danger to Residents

Before choosing a home be aware of a SERIOUS danger to your loved one: in 2001 the gov't changed the rules & said (nursing home lobbyists paid a fortune for this change) NON-NURSES MAY PASS MEDS. Believe it or not their stated rationale was by letting aides pass meds it would "increase their self esteem & improve job satisfaction." The result? The death/injury rate in nursing homes from med errors soared. By 2006 there were 800,000 med errors WITH harm & 55,000 deaths ANNUALLY. More residents die in 1 year from med errors because of non-nurses passing highly dangerous drugs than died in all 10 yrs of Vietnam!!! It's a high price for 'self-esteem'.

Nurses learn in detail about body systems, basic life support, what to do if a patient has a bad reaction, drug interactions & much more. Make a med error & a nurse loses more than her job. Our license can be yanked along w/stiff penalties. Aides? The worst that happens is they're not allowed to pass meds anymore. Whoopee.

DO NOT take the home's assurance that "our aides are trained". That's NOT true. Med Techs get 9 mos training(CA). Aides in Ohio get just 10 DAYS! Appallingly, most states train aides less than a month, leading to horrible mistakes. Aides not only can't read a drug manual (no nurse would ever pass drugs without one handy) they have no way to intervene if a drug reaction occurs. Believe it or not, in Ohio & other states a home doesn't even need to have a nurse in-house while meds are being given!

Med errors lead to expensive avoidable emergency room visits, hospital stays, permanent disability & death. If a facility says 'We only use nurses' don't take their word. CHECK! Ask the staff, ask the residents & check the medication administration record (MAR) signatures. If every signature doesn't have LPN or RN after it the facility's letting non-nurses pass meds. If nurses aren't passing meds, leave! NO AIDE CAN EVER SAFELY PASS MEDS. PERIOD.