Families may let their diligence slip at a facility that treats their elderly relatives with respect, but standards of health and safety are still paramount. The federal Centers for Medicare and Medicaid Services rates nursing homes on health inspection results, nurse staffing, and quality of care. (The ratings are used to create the U.S. News America's Best Nursing Homes rankings.) Overall, nursing homes committed to culture change, like those that participate in the Pioneer Network, fare better than others do on average, particularly in overall ratings and nurse staffing (a reflection of the average time nursing staff spend with each resident), according to an analysis done by the group.
But better is far from perfect; a new culture doesn't eliminate human error. Evergreen, for instance, got a high overall rating (four out of five stars) in the latest CMS evaluation. But last October, an Evergreen nurse on her way to deliver medication first stopped in another resident's room to answer a call for assistance and set down the medication. The resident quickly swallowed the drug meant for a neighbor. A health inspection surveyor happened to witness the event. Though the resident was unharmed, Evergreen was still cited for a significant deficiency for failing to "make sure that residents are safe from serious medication errors." Evergreen's takeaway: "You learn from it," says Arneson soberly. Staff members were warned not to put drugs within reach of a resident for whom they are not intended when answering such calls.
Glitches aside, residents of homes like Evergreen, Abramson, and Garden Spot Village understand, and are grateful, that these are not typical places. "Compared with the nursing homes my mother and husband were in, this is heaven," Cecilia Nitzberg says of Abramson. "If I have to be in a nursing home, I couldn't do any better than this."
Corrected on 01/14/10: An earlier version of this article mischaracterized the waiting list status at Evergreen Retirement Community in Oshkosh, Wis. The nursing home facility does not have a waiting list.