When you hear about Medicare, you probably think of the federal program that helps pay for older adults’ health care. What you may not realize is that another of Medicare’s major responsibilities is to inspect health care facilities to make sure that patients receive safe and high-quality care. Among those facilities are the nation’s more than 15,000 nursing homes.
Nursing facilities that want to get reimbursed for treating Medicare patients must be certified as meeting certain health and safety requirements. The federal agency that oversees Medicare — the U.S. Centers for Medicare and Medicaid Services — works with the states to accomplish that.
Trained health professionals make regular unannounced visits to nursing homes to check whether the health and safety standards are being met and, if not, to ensure the problems are addressed. Additional inspections are often the result of a complaint lodged by a patient or family member.
Nursing homes that don’t promptly correct their shortcomings may be subject to fines. If the health and safety violations persist and pose a serious enough threat to patients, a facility may be terminated from the Medicare program and forbidden to bill the government for patient care.
Unless and until a nursing home loses its Medicare funding, this regulatory process often goes unnoticed by the public. But you can see how the nursing homes in your community have fared in recent health and safety inspections by visiting Medicare’s Nursing Home Compare website at medicare.gov/nhcompare.
Besides providing detailed information on inspections, the website reports on facilities’ staffing and such quality measures as whether residents are in pain or losing weight. The site uses a five-star rating system to help you understand the differences in the quality of care among nursing homes.
Often, families are searching for a nursing home for a spouse or parent at a moment’s notice after a crisis or emergency. With little time to spare, many turn to Nursing Home Compare to begin their research. The website receives more than 1 million visits every year. You can search for facilities by city, county, state or ZIP code.
Considering Your Options
As helpful as those online comparisons are, Nursing Home Compare isn’t meant to be the final word on the subject. It’s just one guide to use when looking for a nursing facility.
If you’re the one who’s been hospitalized, your physician, discharge planner or social worker can help identify an appropriate facility for your recovery.
If you’re the one assisting a spouse or parent about to enter a nursing facility, you also might:
— Ask for recommendations from friends, family or neighbors who have had a loved one in a nursing home.
— Call your state’s long-term care ombudsman to find out how many complaints have been filed against particular nursing homes, what kind of complaints they were and whether they were resolved. In Texas, the ombudsman’s number is 1-800-252-2412.
— Visit the nursing homes that interest you. Make an appointment and think of the questions that are important to you. Nursing Home Compare contains a checklist that covers everything from care and safety to activities and food.
When you or a family member become a patient in a nursing home, you have a right to expect the facility will comply with Medicare’s health and safety standards. The unannounced inspections done by federal and state surveyors are designed to hold rule-breakers accountable.
For more tips on selecting a nursing home, visit the Nursing Home Compare website at www.medicare.gov/nhcompare or call Medicare’s 24/7 customer service line at 1-800-633-4227. A free Medicare publication, a “Guide to Choosing a Nursing Home can also be downloaded from the website or requested by phone.
Original Article by Bob Moos